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Maternal Nursing > Pediatric Pulmonary > Flashcards

Pediatric Pulmonary Flashcards

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1
Q

What are characteristics of airway cartilage in infants?

A

Soft and compressible

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2
Q

How do infants breath and why can this be problematic?

A

Through their nose and their nares are small

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3
Q

Why can infection spread quicker in infants anatomically?

A

Everything is smaller and closer together.

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4
Q

An infant’s metabolism is faster so they require….

A

More oxygen

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5
Q

What is the diaphragm made out of in infants?

A

Muscle fibers

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6
Q

Since infants have a lower number of alveoli, they need to…

A

breathe faster to get the oxygen.

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7
Q

What do you observe during a respiratory assessment?

A

Affect, color, respiratory rate, accessory muscle use, retractions.

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8
Q

Where are the different retraction sites?

A

Suprasternal, Substernal, Clavicular, Intercostal, Subcostal

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9
Q

What kind of accessory muscles do infants use?

A

Abdominal

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10
Q

What change should you look for during feeding and sleeping?

A

Oxygenation

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11
Q

What do you note upon auscultating lungs?

A

Quality of air movement, any adventitious breath sounds, may breath shallow at night.

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12
Q

What are the common kinds of adventitious breath sounds?

A

Wheezing, Course crackles (rhonci), fine crackles (rales), stridor (audible wheeze)

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13
Q

What is sinusitis?

A

Infection and inflammation of the sinus cavaties, usually from a staph, strep, or H. flu infection.

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14
Q

How do you treat sinusitis?

A

Antipyretics, analgesics, antibiotics, nasal spray, (advil, tylenol)

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15
Q

What are some complications of sinusitis?

A

osteomylitus of facial bones.

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16
Q

Does sinusitis affect upper or lower airway?

A

Upper.

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17
Q

What is Laryngitis?

A

Usually caused by a virus that causes hoarseness and URI symptoms.

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18
Q

How do you treat laryngitis?

A

Treat symptoms- fluids, pain and fever relievers.

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19
Q

Which part of the airway does laryngitis affect?

A

Upper.

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20
Q

What is acute laryngotracheobronchitis?

A

Croup- swelling or obstruction of the larynx, trachea, and bronchi caused by parainfluenza virus, flu type A and B, adenovirus, RSV, and mycoplasm pneumoniae.

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21
Q

What are symptoms of croup?

A

Hoarseness, barking, brassy, croupy cough, inspiratory stridor, low grade fever, wheezing, retractions.

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22
Q

Does croup affect the upper or lower airway?

A

Upper.

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23
Q

What is spasmodic croup, or midnight croup?

A

Paroxysmal attacks of laryngeal obstruction that occurs mainly at night, mild/no inflammation, lasts 2-5 days.

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24
Q

What are symptoms of midnight croup?

A

No fever, no inflammation, lasts 2-5 days, awaken by barking cough, hoarseness, noisy respiration, well during the day besides hoarseness.

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25
Q

How do you manage croup at home?

A

Mist, either warm or cool- whichever works. Humidity, possibly exposure to cold air.

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26
Q

How do you manage croup in the hospital?

A

Maintain airway, high humidity, cool mist, fluids, nebulized epinephrine, corticosteroids.

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27
Q

What is acute epiglottitis?

A

Supraglottic obstruction that results in severe respiratory distress and requires immediate attention.

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28
Q

What are symptoms of acute epiglottitis?

A

Fever, tripoding, drooling, irritable, thick and muffled voice, retractions

29
Q

How do you diagnose acute epiglottitis?

A

Portable lateral neck X-ray

30
Q

How do you treat acute epiglottitis?

A

Bring down swelling with IV antibiotics and corticosteroids

31
Q

How do you prevent acute epiglottitis?

A

H. Influenza type B Vaccine.

32
Q

What is bronchiolitis?

A

An acute viral infection at bronchiolar level, usually caused by RSV, can develop into pneumonia very quickly.

33
Q

Is bronchiolitis a lower or upper airway problem?

A

Lower

34
Q

What is RSV infection?

A

The bronchiolar mucosa swells and lumina are filled with mucous and exudate, then are obstructed and lead to hyperinflation, obstruction, and atelectasis- mimics emphysema.

35
Q

What does RSV mimic?

A

Emphysema.

36
Q

How is RSV diagnosed?

A

With a nasopharyngeal washing.

37
Q

What kind of precautions is an RSV patient placed on?

A

Contact and droplet isolation.

38
Q

How is RSV transmitted?

A

Through direct contact of respiratory secretions, can survive on countertops, gloves, tissues for hours

39
Q

What are clinical manifestations of RSV?

A

Begins as URI- runny nose, low fever, cough, pink eye, poor feeding, then progresses to a lower respiratory infection with coughing, wheezing, tachypnea, retractions, cyanosis.

40
Q

What is the pharmalogical treatment of RSV?

A

Ribavirin.

41
Q

What is Ribavirin?

A

An aerosolized antiviral that is given in a mist tent for 12-18 hours/day for 3-5 days. Pregnant women should avoid this med.

42
Q

What is some prophylactics for RSV?

A

Respigam- IV for high risk infants

Synagis- IM to high risk infants.

43
Q

What is management of bronchiolitis?

A

Managed at home unless in distress or dehydrated, maintain airway, mist therapy, adequate fluid intake, contact precautions.

44
Q

What is pneumonia?

A

Lower respiratory inflammation of the alveoli and bronchioles involving a lobe or large segment of the lung- viral or bacterial.

45
Q

What is viral pneumonia?

A

Associated with viral URI, more common, treat symptoms.

46
Q

What is bacterial pneumonia?

A

Very ill appearance with high fever, difficulty breathing, cough, chest pain.

47
Q

What kind of patients are at risk for pneumonia?

A

High risk infants, premature infants, RSV patients.

48
Q

What are complications of pneumonia?

A

Tension pneumothorax, pleural effusion

49
Q

Treatment of pneumonia

A

Antibiotics, antipyretics, fluids, calories, rest, oxygen prn, chest tube care if needed, activity as tolderated

50
Q

What is otitis media?

A

Inflammation of the middle ear

51
Q

What infants are at risk?

A

Formula fed, smoking, households with many members, and history.

52
Q

What is acute otitis media?

A

Rapid onset of an ear infection lasting 3 weeks.

53
Q

What is otitis media with effusion?

A

Fluid in the middle ear.

54
Q

What is chronic otitis with effusion?

A

Persistent ear infection with fluid lasting longer than 3 weeks.

55
Q

What is the pathophysiology/cause of otitis media?

A

Results from dysfunctioning eustachian tube

56
Q

What does the eustachian tube do?

A

Protects middle ear from secretions, drains secretion from middle ear to nasopharyngeal section, ventilates middle ear to equalize air pressure.

57
Q

What are clinical manifestations of otitis media?

A

Pain, fever, runny nose, vomitting, diarrhea, loss of appetite, full feeling

58
Q

How do you diagnose an ear infection?

A

Assess tympanic membrane

59
Q

Upon assessing tympanic membrane, what does it look life if there is an ear infection?

A

intact membrane that is bright red, building, with obscure landmarks.

60
Q

What does an ear infection with effusion look like upon assessment?

A

dull, grey membrane with visible fluid.

61
Q

How do you treat otitis media?

A

Careful use of antibiotics- amoxicillin, augmentin, azithromycin, cephalosporins, tylenol for pain

62
Q

What are the tonsils and what do they do?

A

Masses of lymphoid tissue in pharyngeal cavity that filter and protect respiratory and alimentary tracts from organisms

63
Q

What is tonsillitis?

A

Inflammation of palatine tonsils, may be viral or bacterial, obstructs passage of air and food

64
Q

How do you treat viral tonsillitis?

A

self limiting- treat symptoms.

65
Q

How do you treat bacterial tonsillitis?

A

Antibiotics, and treat symptoms.

66
Q

Indications for tonsillectomy

A

recurrent, frequent strep infections, massive hypertrophy that causes difficulty eating and breathing.

67
Q

When is a tonsillectomy contraindicated?

A

Cleft palate, acute infection

68
Q

Nursing care post tonsillectomy

A

VS- tachycardia, observe for pallor, frequent clearing of throat, vomit bright red blood, restlessness, assess pain, assess anxiety, assess dehydration, educate pt and family

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