Pediatric Respiratory Flashcards
What are some nursing interventions we can do for a child that is in moderate respiratory distress? (early decompensation)
*CALL RAPID RESPONSE
-Oxygen
-Suctioning if required (do I need to remove any secretions)
-Keep child’s head up to avoid tongue falling back (Ped’s have larger tongues)
In the pediatric assessment triangle, under circulation what are we looking for/at?
Looking at the colour of the skin around their mouth (cyanosis) – Ask caregiver if the child appearance looks different (Ex.) are they pale?), we can look at cap refill
What are some symptoms of a child that is in mild respiratory distress?
Restlessness: – Crying (is this a normal cry for them, if they are unshootable/can we console them) – This means that this is something out of the normal for them
Tachypnea – 24 – 40 (is their Resp rate above that)
Tachycardia – Their BP will start low – above 160 BPM
Diaphoresis – Excessive perspiration without activity – sweating head to toe from something that we have NOT caused
What are some nursing interventions for a child that in in severe respiratory distress?
-Rapid response – if we think they need an airway we are going to call someone
-Medication (bronchodilator)
-Bring in crash cart/rescestation bundle
-Start IV/lines – largest line considering age – have lines, pumps, etc prepped and ready
-Rapid will take child to ICU
-Document EVERYTHING that happened
Ex of a mild, acute, and chronic pediatric resp alternation?
Mild: Common cold, sore throat, runny noise, ear infection
Acute: Bronchiolires, warm body asperations (Object in airway)
Chronic: Asthma, Cystic fibrosis
In the pediatric assessment triangle, under appearance, what are we looking for/at?
We are looking at their muscle tone (are they moving, playing, flat), How much are they fighting their caregiver, Their iratiablitly and consoolability (how any are they and can the parents console them- unconsoalbutly is a problem), we will look at their look (gaze, are they making eye contact, glazed over), Speech/cry (do they know what kind of cry the baby has)
What is the normal resp rate range for an infant?
30 - 60
What is the pediatric triangle made up of?
1.) Appearance
2.)Work of breathing
3.) Circulation
How do we diagnose Bronchiolitis?
We don’t have a diagnostic test - we usually take a health history and monitor the appearance of the secretions
What nursing interventions can we do for a child in mild respiratory distress?
-Change position (tripod/over shoulder)
-Clear airway if needed/required
-The cause of the distress needs to be addressed! – this means removing the blockage/secretion, etc
*Administer Oxygen
-If patient cant tolerate nasal prongs we will put them in an O2 ritch environment
-Keep O2 stats above 92%
-For meds we would administer bronchodilators if ordered, antipyretics, diuretics, antibiotics
What is the number one cause of viral pneumonia in peds?
RSV (Peds are most likely admitted and kept in the hospital due to resp issues
-The steps between mild to life-threatening are quick!)
What kind of compensation effect does a pediatric body have?
It has none!!! This population body will try its best to compensate and work with what it has but as soon as it is done it is done and will completely give up/shut down
What are the 7 assessment guidelines for children in respiratory distress?
Position of comfort:
-Do they need one? Are they in one? What is it? Are they consolable – will changing the position cause a reaction from the child?
-We let the child tell us what position is comfortable for them
Vitals + ABG:
-They are going to be off the chart
Resp effort:
-Goes back to the triangle!!!!
Colour:
-Look at mucus membranes for POC
-We will see coloured patches
Behaviour changes
Mild – will be more restless (not wanting to sit still) – unconsolable
Moderate – severe – less energetic, not crying, not fighting us, glazed daze
Hydration status: The abililty to produce tears, are they drooling, do they have a depressed fontenle?
History: Do they have any chronic conditions, were they pre-term or full term, do the parents smoke, have they been around anyone that’s been sick (this is the main one!!!)
What is Bronchiolitis?
Inflammation (swelling) of the bronchioles
-99% of the time in kids it is RSV
In the pediatric assessment triangle, under work of breathing, what are we looking for/at?
Looking to see if we can hear their respirations (We usually don’t hear their respiration (if we hear wheezing, noise, labour)
What is the normal resp rate range for a school-age child?
12-25
At what stage do we want to intervene in when a child is in respiratory distress?
We want to intervene when they are in the mild-moderate stage
Signs and symptoms of a child that is in moderate respiratory distress?
Nasal flaring
Retractions
Grunting, wheezing
Anxiety, irritability,
mood changes, confusion
Signs and symptoms of a child that is in severe respiratory distress? What is imminent?
Dyspnea
Bradycardia
Cyanosis (late sign)
Stupor, coma
Cardiac arrest is imminent when a child goes into resp arrest/failure
What are some examples of common acute pediatric conditions?
1.) Foreign body aspiration
2.) Croup (the child needs to come into hospital for treatment)
3.) Viral and bacterial respiratory infections (RSV)
What is happening/going on if we hear a child grunting or snoring?
If we start to hear snoring or have issues speaking (not resp distress) or if they’re horse there is something blocking the way
Grunting – There is something blocking the way – this is their system trying to push extra pressure/air out
What is the normal resp rate range for a toddler?
24 - 40
What is the normal resp rate range for an adolescent child?
12 - 16
How do we treat Bronchiolitis?
We typically don’t treat it with medications!!!
We only do treatment for those who are at greater risk of contracting it again, have multiple co-morbities, or if it has caused major health problems
Risk factors for Bronchiolits?
Main one is the child being exposed to someone who is sick
-Pre mature baby (under developed)
-Pre eixisting condition (cystic fibriosis)
-Exposure (daycare)
-Lack of hand hygine
-Smoker in house (second hand smoke) – Third hand smoke is the smoke that gets in the fibers of cloting
What is the normal resp rate range for a preschooler?
20 - 30
What are some symptoms of a child that is in respiratory distress?
THE CHILD IS NOT BREATHING IN THIS SITUATION
Unresponsive, no muscle tone
No visible chest rise
Absent work of breathing
Cyanosis
Cardiac arrest will follow quickly!!
