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Critical Care Pediatics > Pediatric Respiratory > Flashcards

Pediatric Respiratory Flashcards

1
Q

Respiratory Distress s/s

A

increased RR

accessory muscle use

intercostal recessions

subcostal recessions

nasal flaring

head bobbing

cyanosis

abnormal airway noises

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2
Q

lung resistance

A

determined by airway size, smaller = more resistance / larger = less resistance

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3
Q

lung compliance

A

measurement of how much lungs can expand

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4
Q

tachypnea < 2 months

A

> 60 breaths

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5
Q

tachypnea 2-12 months

A

> 50 breaths

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6
Q

tachypnea 1-5 years

A

> 40 breaths

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7
Q

tachypnea 6-12 years

A

> 30 breaths

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8
Q

tachypnea 12 + years

A

> 20 breaths

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9
Q

pH level

A

7.35 - 7.45`

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10
Q

PaO2 level

A

75 - 100 mmHg

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11
Q

PaCO2 level

A

35 - 45 mmHg

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12
Q

SaO2 level

A

94 - 100%

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13
Q

HCO3 level

A

22 - 26 mEq / L

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14
Q

pH LESS than 7.35

A

acidic pH

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15
Q

PaCO2 MORE than 45

A

acidic level

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16
Q

HCO3 LESS than 22

A

acidic level

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17
Q

HCO3 MORE than 26

A

alkalosis level

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18
Q

ROME

A

respiratory
opposite
metabolic
equal

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19
Q

Respiratory Acidosis levels

A

pH is < 7.35

PaCO2 > 45

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20
Q

Respiratory Alkalosis levels

A

pH is > 7.45

PaCO2 < 35

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21
Q

Metabolic Acidosis level

A

pH is < 7.35

HCO3 < 22

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22
Q

Metabolic Alkalosis levels

A

pH > 7.45

HCO3 > 26

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23
Q

compensated

A

pH is NORMAL

PaCo2 and HCO3 are ABNORMAL

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24
Q

partially compensated

A

pH is ABNORMAL

PaCO2 and HCO3 are ABNORMAL

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25
Q

uncompensated

A

pH is ABNORMAL

PaCO2 is ABNORMAL
or
HCO3 is ABNORMAL

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26
Q

stridor

A

seen with croup

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27
Q

Croup s/s

A

bark like cough
hoarse voice
dehydration
fever
rhinorrhea
stridor on inspiration!!!

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28
Q

racemic epinephrine

A

medication used commonly with croup

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29
Q

racemic epinephrine SE

A

patients often rebound after taking this medication
- if given more than 3x = automatic hospital admission

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30
Q

early s/s of Respiratory Failure

A

pallor
tachycardia
tachypnea
anxious
irritability
delayed capillary refill!!!

31
Q

late s/s of Respiratory Failure

A

hypotension
cyanosis
apnea

32
Q

prolonged apnea periods

A

> 20 seconds

33
Q

Respiratory Failure intervention

A

immediately give pressurized O2

34
Q

Respiratory failure management

A

recognize apnea > 20 seconds
max out vents and O2
treat underlying cause

35
Q

obstructive respiratory failure

A

laryngospasm

CF

COPD

asthma

36
Q

restrictive Respiratory Failure

A

scoliosis

pneumothorax

37
Q

signs of shock

A

tachycardia and delayed capillary refill

38
Q

smaller blood volume

A

leads to hypovolemia and impaired perfusion

39
Q

decrease BP

A

always a late sign of something going wrong

-resp failure or shock

40
Q

post respiratory arrest

A

give O2
check perfusion
neuro care
temperature management
electrolyte
blood sugar

41
Q

chronic respiratory disease

A

cystic fibrosis

bronchopulmonary dysplasia

42
Q

cystic fibrosis

A

genetic disorder, overproduction of mucus throughout the body

43
Q

cystic fibrosis picture

A

salty skin

delayed growth / poor weight gain

frail form

meconium ileus at birth

affects lungs and pancreas

44
Q

CF pancreas

A

does not produce digestive / pancreatic enzymes
-mucus blocks the ducts not allowing enzyme production

45
Q

salty skin CF

A

chloride is not being reabsorbed into the skin due to mucus blockage

46
Q

CF digestive issues

A

cannot break down carbs / fat / protein

-common to have diabetes

47
Q

CF calories

A

these must be 2x more than normal because breathing for them burns calories

48
Q

CF treatment

A

only “treatment” is a lung transplant

49
Q

CF medications

A

bronchodilators

muctolytic

antibiotics

NSAID

contraceptives !!

pancreatic replacement therapy

50
Q

bronchodilators

A

albuterol
levalbuterol hydrochloride

opens airways and relax muscles

51
Q

muctolytic

A

dornase alfa
hypertonic saline

thins / breaks up mucus allowing patients to cough it up!!!
-inhaled

52
Q

antibiotics

A

varies, normally penicillin
-prophylaxis and oral
-tx breakthrough infections

53
Q

NSAID

A

Ibuprofen
piroxicam

decrease pulmonary deterioration
improves FEV1
decrease lung infection reoccurance

54
Q

contraceptives

A

oral, IM, IUD, rings, etc.

condition is genetic so females NEED to be on these

**pregnancy can decrease lung function

55
Q

pancreatic enzyme replacement

A

replaces the pancreatic enzymes that are missing
-taken with every meal and snack!!!

56
Q

other CF meds

A

proton pump inhibitor : GERD tx

stool softener : decrease constipation r/t mucus

corticosteroids : decrease inflammation with infection

57
Q

education for pt with CF and constipation

A

encourage fluids!!

58
Q

CF self image

A

have lots of meds
constant coughing
medical devices
nutritional deficit

59
Q

CF independence concerns

A

vulnerable
loss of power
life shortening
no cure
limited peer interaction

60
Q

what is important to remember about 2 CF patients

A

they CANNOT be near each other!!!

61
Q

CF metabolic concerns

A

delayed puberty
delayed weight gain
delayed menarche
short stature

62
Q

pulmonary toileting

A

using percussion / vibration vest
postural drainage
controlled coughing
hydration

63
Q

vibration vest

A

used for CF patients, done at bedtime and 1-2 hours post meals

64
Q

bronchopulmonary dysplasia

A

respiratory disorder in premature infants
-characterized by stiff lung tissue

**NO SURFACTANT

65
Q

BPD treatment

A

high concentration O2 for weeks to years

-intubated immediately after birth BUT START LOW

66
Q

INSURE

A

intubation
surfactant
extubation

67
Q

BPD interventions

A

alleviate resp effort
ventilation = low setting
nutrition = fluid restriction
meds
intake / output

68
Q

respiratory risk factors

A

air pollutants / quick temperature change - asthma, CF. BPD
malnutrition - CF
genetics - CF and BPD

69
Q

trach diagnosis

A

cystic fibrosis
cerebral palsy
quadrapaligics
spinal muscle atrophy

70
Q

cuffed trachs

A

direct airflow through airway tube into lungs

71
Q

uncuffed trach tubes

A

should be used on children < 8 years

-cuffed causes extubation problems (laryngeal edema)

72
Q

peds trach tubes

A

are flexible to allow for movement with the patient

73
Q

trach suctioning peds

A

only suction for 2-3 seconds (max 5)
sterile in hospital
keep tight around neck - only 1 finger between

74
Q

trach home care

A

clean as possible
teach how to reinsert and suctioning
oxygen when needed
cap for speech

Critical Care Pediatics (4 decks)

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