Pediatric - EET, Respiratory

Question 1

Strabismus

Answer 1

Squint or crossed eyes. Treated with corrective lenses or patching or surgery to realign weak muscles. Usually performed before age 2.

Question 2

Otis Media

Answer 2

Inflammatory disorder caused by an infection of the middle ear resulting in a blocked gustation tube.

Question 3

Interventions for Otis Media

Answer 3

1. Encourage fluids
2. Antipyretics
3. Analgesia
4. Antiemetics (for use in children 6+ months - CAREFULLY)
5. Myringotomy

Question 4

Myringotomy

Answer 4

Surgical incision into the tympanic membrane to provide drainage of purulent fluid. Tubes may be inserted to allow drainage to continue and equalize pressure and allow ventilation.

Question 5

Tonsilitis and Adenoniditis

Answer 5

Inflammation and infection of the tonsils and adenoids (pharyngeal tonsils)

Question 6

Epiglottitis

Answer 6

Inflammation of the epiglottis. Considered an emergency as it can progress to sever respiratory distress.

Question 7

Symptoms of epiglotitis

Answer 7

1. Fever
2. Inflamed throat
3. Inspiratory stridor
4. Tripod positioning
5. Tachycardia
6. Tachypnea

Question 8

Interventions for epiglotitis

Answer 8

1. Maintain airway
2. Take lateral neck x-rays
3. IV - fluids, antibiotics, meds

Question 9

Laryngotracheobronchitis

Answer 9

Inflammation of the larynx, trachea and bronchi. Can be viral or bacterial.

Question 10

Bronchiolitis

Answer 10

Inflammation of the bronchioles that cause production of a thick mucus that occludes bronchiole tubes and small bronchi.

Question 11

Respiratory Syncytial Virus (RSV)

Answer 11

Acute viral infection affecting the respiratory tract which is transferred by direct contact and is highly contagious. It can lead to bronchiolitis and pneumonia.

Question 12

Interventions for bronchiolitis and RSV

Answer 12

1. Cool, humidified air
2. RSV - isolate the child or cohort them
3. Position supine with 30-40 degree angle with neck slightly extended.
4. Administer ribavirin via inhalation.

Question 13

Pneumonia

Answer 13

Inflammation of the pulmonary parenchyma or alveoli or both. Caused by a virus, bacteria, or aspiration of foreign substances.

Question 14

Interventions for Pneumonia

Answer 14

1. Treat the symptoms
2. Antibiotic if cause is bacterial
3. Promote bedrest
4. If unilateral, place child on affected side to reduce discomfort by pleural rubbing
5. Encourage fluids
6. May require a chest drain or thoracentesis

Question 15

Thoracentesis

Answer 15

Removal of fluid from the pleural cavity via a syringe or catheter.

Question 16

Asthma interventions

Answer 16

1. bronchodilator (short/long acting)
2. steroid (reduce inflammation)
3. Anti-inflammatory
4. Med to prevent bronchospasm
5. Teach breathing exercises
6. Nebulizer

Question 17

Cystic Fibrosis

Answer 17

A chronic, multi-system disorder characterized by endocrine disfunction. Mucous produced is abnormally thick causing obstruction of small airways in the lungs. It is progressive and incurable.

Symptoms are produced due to the stagnation of mucous in the airway leading to bacterial colonization and destruction of lung tissue. Emphysema and atelactis develop.

Question 18

Cystic Fibrosis and the GI

Answer 18

Intestinal obstruction caused by thick mucous.

Question 19

Cystic Fibrosis and the skin

Answer 19

Causes dehydration and electrolyte imbalance.

Question 20

Tuberculosis

Answer 20

Contagious bacterial infection transmitted by droplets affecting the respiratory system. Tuberculin skin test determines whether a person has been exposed to TB. If they have they will always test positive even if the disease is not active.

Question 21

Interventions for Tuberculosis

Answer 21

1. Isoniazid (9-12 month course) if the disease is not latently active.
2. Isoniazid + Rifadin + PZA daily if disease is active.

Question 22

Risk factors for otitis media

Answer 22

1. Bottle feeding.
2. Smoking
3. Exposure to children with infections
4. Congenital conditions such as Down Syndrome and cleft palate.

Question 23

Positive result for tuberculin skin test

Answer 23

10mm in children over 4 years. 5mm in children at high risk.

Question 24

Diet for children with Cystic Fibrosis should be….

Answer 24

High in calories and high protein.

Pancreatic enzyme replacement therapy and water-soluble vitamin supplements (A, D, E, and K) are administered. If nutritional problems are severe, supplemental tube feedings or parenteral nutrition is administered. Fats are not restricted unless steatorrhea cannot be controlled by administration of increased pancreatic enzymes.

Question 25

Croup

Answer 25

A viral infection of the upper airway, which obstructs breathing and causes a characteristic barking cough.

Question 26

Treatment for Croup

Answer 26

1. Provide soothing environment to prevent crying & coughing which will irritate airways
2. Steroids like dexamethasone and epinephrine may also be used in severe cases to reduce airway inflammation.

Question 27

Symptoms of Croup

Answer 27

1. Begins like a cold
2. Barking cough develops
3. Fever
4. Hoarse voice
5. Labored breathing