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Pathology 2 > Pediatric Respiratory > Flashcards

Pediatric Respiratory Flashcards

1
Q

What is respiratory distress

A

Increased work of breathing to maintain oxygenation and/or ventilation.
-Compensated state in which increased work of breathing results in adequate pulmonary gas exchange

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2
Q

What are the three classifications of respiratory distress

A

-mild
-moderate
-severe

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3
Q

What are the hallmarks of respiratory distress

A

-Retractions
-Abdominal breathing
-Nasal flaring
-Grunting

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4
Q

What is respiratory failure

A

Patient can no longer compensate for underlying pathologic or anatomical problem by increased work of breathing
-Hypoxia and/or carbon dioxide retention may occur

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5
Q

Signs of respiratory failure

A

Decreased or absent retractions due to chest wall retractions due to chest wall fatigue
Altered mental status due to inadequate oxygenation and ventilation of the brain
Abnormally low RR

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6
Q

Respiratory Arrest

A

Pt not breathing spontaneously
BVM immediately
Resuscitation is often successful

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7
Q

How to assess work of breathing

A

Patients position of comfort
Presence or absence or retractions
Grunting or flaring

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8
Q

How to assess the airway

A

Listen for stridor
Check for obstructions

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9
Q

How to assess breathing

A

Determine the RR
Listen to the lungs for adequacy of air entry and abnormal breath sounds
Check SPO2

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10
Q

Management of foreign body aspiration or obstruction

A

-position of comfort
-providing supplemental O2
-Avoid agitation
-Transport

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11
Q

Severe airway obstruction management

A

Five back slaps and five chest thrusts

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12
Q

If the child is still apneic after the obstruction is removed

A

Assess for a pulse and preform CPR if needed

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13
Q

What is the dose for IM epi

A

0.01mg/kg of 1:1000 up to a max dose of 0.5mg

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14
Q

Treatment for anaphylaxis

A

-IM epi
-supplemental O2
-fluid resuscitation for shock
-Diphenhydramine (1mg/kg)
-Bronchodilators for wheezing

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15
Q

Croup (laryngotracheabronchitis)

A

Viral infection of the upper airway
Most common cause of upper airway emergencies in children under five
Transmitted through respiratory secretions

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16
Q

What is the hallmark sign of croup

A

Stridor

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17
Q

What does the sample history for croup usually reveal?

A

-several days of cold symptoms and low-grade fever, followed by barky cough, stridor, and trouble breathing

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18
Q

PAT of a child with croup

A

-Audible stridor
-Barky cough
-increased WOB
-Normal skin colour

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19
Q

Treatment of croup

A

Position of comfort

20
Q

When is the use of nebulized epinephrine indicated

A

Stridor at rest
Moderate to severe respiratory distress
Poor air exchange
Hypoxia
Altered appearance

21
Q

Dose for racemic epinephrine (2.25%)

A

0.5ml in 3ml of saline

22
Q

Epiglottitis

A

Life-threatening inflammation of the supraglottic structures, usually due to bacterial infection

23
Q

Why is epiglottitis rare now

A

The vaccine against Haemophilus influenzae type B

24
Q

Epiglottitis PAT

A

-Child will look sick and anxious
-sniffing position
-drooling due to inability to swallow
Increased work of breathing
Pallor or cyanosis

25
Q

Signs of epiglottitis

A

Stridor upon auscultation of the neck
Muffled voice
Decreased or absent breath sounds
Hypoxia
Sudden onset of high fever or sore throat in preschool or school-age children

26
Q

Epiglottitis management

A

-do not look in the mouth
-do not put in an IV
-be prepared with a BVM and an ET tube one or two sizes smaller than normal

27
Q

Bacterial Tracheitis

A

Invasive exudative bacterial infection of the soft tissues of the trachea
Typically presents with cough, stridor and respiratory distress of varying degree with a history of preceding viral infection
Toddlers are at an increased risk of complications due to their relatively narrow airway diameter and may present in extremis
Pts are often febrile and prefer the sniffing position

28
Q

Bacterial tracheitis treatment

A

POC
Do not look in the mouth
Do not insert IV
Try to keep pt calm and quiet
Have a BVM and ET tube one to two sizes smaller than required ready

29
Q

What is an upper airway emergency

A

Restriction of airflow into the lungs

30
Q

What is a lower airway obstruction

A

Respiratory emergencies that involve restriction of air flow out of the lungs

31
Q

What are the three components of asthma that lead to poor gas exchange

A

-Bronchospasm
-Mucus production
-Airway inflammation

32
Q

Why does asthma cause hypoxia

A

Ventilation - perfusion mismatch
Blood flowing to parts of the lung is poorly oxygenated

33
Q

What are some triggers for an asthma attack

A

-Upper respiratory infections
-Environmental allergies
-exposure to cold
-changes in weather
-second hand smoke

34
Q

Clinical signs of asthma

A

-wheezing
-frequent cough
Respiratory distress

35
Q

Mild to moderate respiratory caused by asthma (presentation)

A

-child will be awake and alert, sometimes preferring a seated posture
Increased work of breathing may be evident by retractions and nasal flaring, circulation will be normal

36
Q

Signs of severe respiratory distress and impending respiratory failure

A

-Decreasing
-Tripod position
-Deep retractions
-Cyanosis

37
Q

Primary assessment findings for asthma

A

-inability to speak in full sentences
-increased RR
Prolonged expiration phase
Wheezes noted on auscultation
Expiratory wheezes may be audible in moderate to mild attacks
Inspiratory and Expiratory wheezes in severe cases

38
Q

Dose of salbutamol

A

2.5mg of salbutamol premixed with 3ml of normal saline
4 puffs MDI

39
Q

Treatment for asthma

A

Salbutamol
Atrovent (ACP)
Supplemental O2
Epi 1:1000 (SEVERE CASES ONLY)

40
Q

Bronchiolitis

A

Inflammation or swelling of the small airways (bronchioles) in the lower resp tract
Common in winter
Usually occurs in children under 2
Highly contagious

41
Q

Symptoms of bronchiolitis

A

Similar to asthma
Retractions
Tachypnea
Diffuse wheezing
Diffuse crackles
Mild hypoxia

42
Q

Severe bronchiolitis signs

A

-sleepy or obtunded
-severe retractions
-diminished breath sounds
-moderate to severe hypoxia (SpO2 less than 90)

43
Q

Management of bronchiolitis

A

Position of comfort
Supplemental oxygen

44
Q

Signs of pneumonia

A

-Nasal flaring
-tachypnea
-crackles
-chest pain
-hypothermia /fever

45
Q

Pertussis - Whooping cough

A

Highly contagious, potentially deadly
Caused by bacteria
Presents as a common cold

46
Q

Whooping cough

A

The distinctive whoop sound heard during the Inspiratory phase
-the cough can be so severe that it can cause post cough vomiting, conjunctival hemorrhage, and cyanotic

47
Q

BVM rate for children

A

12 to 20bpm
One breath every 3 to 5 secs
Only squeeze the bag until chest rise is seen

Pathology 2 (13 decks)

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