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Maternal Nursing > Pediatric COPD > Flashcards

Pediatric COPD Flashcards

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1
Q

What is asthma characterized by?

A

Chronic inflammation and exacerbation of irritation from an allergen, bacteria, virus, exercise, or stress.

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2
Q

What is cystic fibrosis?

A

A genetic disease characterized by an exocrine gland dysfunction causing excessive mucus production.

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3
Q

What happens during an asthma exacerbation?

A

Irritants cause bronchioles to become hypersensitive, bronchospasms occur and mucus production leads to air trapping, respiratory failure occurs/

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4
Q

What are the four classifications of asthma?

A

Intermittent, mild persistant, moderate persistent, severe persistent

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5
Q

What are characteristics of an intermittent exacerbation of asthma and what is the treatment?

A

Symptoms are less than 2 days a week, ADLs not effected, use rescue inhaler.

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6
Q

What are characteristics of a mildly persistent exacerbation of asthma and the treatment?

A

Symptoms more than 2 days a week, mild effect on ADLs, use rescue inhaler and inhaled corticosteroid.

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7
Q

What are characteristics of moderately persistent asthma and the treatment?

A

Symptoms are daily with ADL interference, use daily inhaled meds including a long acting bronchodilator and corticosteroid.

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8
Q

What are characteristics of a severely persistent asthma episode and the treatment?

A

Continual symptoms, limits ADL, use high dose corticosteroid, oral steroid, and long acting bronchodilator.

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9
Q

What are some extrinsic triggers to exacerbations?

A

allergens, foods, irritants, colds

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10
Q

What are some intrinsic triggers to exacerbations?

A

Emotions, exercise, GERD, hormones

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11
Q

What are clinical manifestations of asthma?

A

Inspiratory and expiratory wheeze, cough, SOB, accessory muscle use, hyperresonance, tripoding.

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12
Q

How do you diagnose asthma?

A

History, manifestations, physical exam, lab tests- PEFR

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13
Q

What is the treatment of asthma?

A

Allergen control- clean dust, pets, smoking. Drug therapy of rescue inhalers, long term therapy, and acute exacerbation.

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14
Q

What are rescue medications used for and some examples?

A

Quick relief of symptoms- beta adrenergic agnoists for bronchodilation. Albuterol.

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15
Q

What are corticosteroids used for and examples?

A

Long term relief and antiinflamatory. Flovent

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16
Q

What are some long term drug therapies for asthma?

A

Non steroidal antiinflammatory inhalters, leukotriene modifiers, long acting beta agnonists, and combo-drugs.

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17
Q

What is an example of a non-steroidal antiinflammatory inhaler?

A

Cromolyn sodium (intal)

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18
Q

What are leukotriene modifiers used for and an example?

A

to block inflammatory and bronchospasm effects- oral. Singular

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19
Q

What are long acting beta agnoists used for an an example?

A

Anti-inflammatory and are not for acute symptoms. Serevent.

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20
Q

What are combination drugs and an example?

A

Usually a beta adrenergic agonist and steroid- advair inhaler.

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21
Q

What drugs should be used for acute exacerbations?

A

Anticholinergics, Methlxanthines.

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22
Q

What to anticholenergics do?

A

Bronchodilate and decrease mucous- atropine.

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23
Q

What to methlxanthines do?

A

Relax muscles- theophylline.

24
Q

What are some nursing considerations for beta adrenergic agonists?

A

Assess heart rate before and after the treatment

25
Q

What are some considerations for corticosteroid inhaler uses?

A

use a spacer and rinse the mouth

26
Q

What are some considerations for leukotriene modifiers?

A

Give 1 hour before meals or 2 hours after, asess for jaundice and use precautions with coumadin

27
Q

What are some considerations for bronchodilators?

A

contraindicated with rapid heart rate and know pt’s therapeutic range.

28
Q

How is exercise induced asthma prevented?

A

Premedicate 20 minutes prior to the exercise

29
Q

What causes an asthma exacerbation?

A

When a patient comes in contact with a trigger

30
Q

What is status asthmaticus?

A

An emergency- respiratory distress.

31
Q

What are some nursing responsibilities for a hospitalized child with asthma??

A

IV therapy- D5 1/2 NSS with K to keep ions balanced. NPO, Bedrest, nebulizer, O2, chest physiotherapy, monitor pulse, HR, Ox, ABGs

32
Q

What are some things to educate the patient and family on related to asthma?

A

Recognize symptoms, keep meds on hand, peak flow meter use, treat URIs, predose for exercise induced asthma, determine triggers

33
Q

What is cystic fibrosis?

A

An exocrine gland dysfunction that increases mucous production and viscosity that causes multi-system involvement

34
Q

What kind of gene is cystic fibrosis?

A

Autosomal Recessive

35
Q

What is the protein that causes cystic fibrosis?

A

Cystic Fibrosis Transmembrane Regulator (CFTR Protein)

36
Q

What is the pathophysiology of cystic fibrosis?

A

the CFTR protein is a transporter for Cl and HCO3 and affects the activiy of the other plasma membrane channels. It causes electrolyte imbalances and mechanical obstruction which causes tubules to become blocked.

37
Q

What are respiratory clinical manifestations of CF?

A

Viscous mucus, cough, dyspnea, wheeze, atelectasis, clubbing, barrel chest, cyanosis.

38
Q

What are GI clinical manifestations of CF?

A

Steatorhea (fatty stool), prolapsed rectum, weight loss, malabsorption of fat soluable vitamins, abdominal distention, meconium ileus

39
Q

What is steatorhea?

A

Fat in the stool

40
Q

What are integument clinical manifestations in CF?

A

Increased sodium- salty skin.

41
Q

What are reproductive clinical manifestations in CF?

A

Females have mucous plugs in cervix and delayed puberty, males have a 95% sterility rate.

42
Q

How do you diagnose CF?

A

History, physical exam, sweat chloride test, chest xray, fecal fat test, lung function test, immunoreactive trypsinogen test.

43
Q

What is the screening for CF?

A

Immunoreactive trypsinogen test, newborn screening, CFTR gene mutation

44
Q

What are the therapeutic goals of CF?

A

Prevent/minimize pulmonary complications, ensure nutrition for growth, physical activity, reasonable quality of life.

45
Q

What is the treatment for cystic fibrosis?

A

Chest PT, forced expirations, bronchodilators, mucolytics, corticosteroids, IV antibiotics, oxygen, lung transplants

46
Q

What is chest PT?

A

Chest physiotherapy- manual and mechanical. Cupped hand tapping on back to try to move mucous out of the lungs.

47
Q

What are contraindications to chest PT?

A

After eating, pulmonary hemorrhage, PE, increased ICP, osteogenisis imperfecta, cardiac complications, ESRD

48
Q

What are drug therapies for CF?

A

Neubulized bronchodilators, mucolytics, antibiotics, kalydeco

49
Q

What are some nebulized bronchodilators?

A

with hypertonic saline, before chest PT, Albuterol and Intal

50
Q

What is a mucolytic used for CF?

A

Pulmozyme by nebulizer

51
Q

What is an antibiotic used for CF?

A

Tobramycin by nebulizer

52
Q

What are some respiratory complications associated with CF?

A

Infection- P. aeruginosa and B. cepacia, E. Coli, H. influenza, MRSA, pneumothorax, epistaxis

53
Q

What is the nutrition for a CF patient?

A

High protein, high calorie, need pancreatic enzymes, salt, and frequent meals.

54
Q

What should you teach the patient and family on for CF?

A

Med management, oxygen, peak flow meter, infection control, skin care, immunizations, high calorie diet, limit fat intake, stool softener, independence, support

55
Q

What is the prognosis for CF patients?

A

Live to 37-38 years, complications increase with age.

Maternal Nursing (22 decks)

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