Pediatric Respiratory Dysfunction Flashcards
______ FIRST UNLESS THEYRE ALREADY CYANOTIC –GIVE OXYGEN
APPLY PULSE OX
______ –one q tip swab that goes in both nares of nose ONLY USED IN ACUTE CARE, not doctors office, comes back in about 45 minutes, measures anything with upper resp, __________________________
RESPIRATORY PANEL LAB
corona virus, flu, parainfluenza (croup/bronchiole infect), RSV
adno
entero
rhino viruses
THESE THREE ARE THE MOST COMMON
______ is only useful if its going to change the plan of care for the patient
respiratory panel
core concept: most resp illnesses are treated the ______ as far as interventions
same
What are priority findings for acute streptococcal pharyngitis?
exudate
fever
painful swallowing/difficulty swallowing
What are nursing care interventions for acute streptococcal pharyngitis?
Obtain a throat culture and/or rapid antigen test (80-90% of cases are viral)
Cold or warm compress to the neck, gargle with warm saline, encourage cool liquids/ice chips
Administer antibiotics if indicated (penicillin for 10 days, amoxicillin, ampicillin)
-return to school note 24 hours after starting antibiotics
-discard/replace toothbrush
____________ –HAS EXUDATE
GENERALLY HAS A FEVER (X>100.4)
PAINFUL SWALLOWING
acute streptococcal pharyngitis
DIFFERENCE BETWEEN NORMAL AND ACUTE STREP IS THE EXUDATE, ______ HAS EXUDATE
ACUTE STREP
rhumatic fever can accompany strep and can progress to ______ IF BACTERIAL-CAN GO TO THE HEART HAVE
endocarditis
_____ can also happen : fever that is a sand paper-like rash, not really in the USA, don’t see it much anymore bc of vaccines
scarlet fever
PENICILLIN
AMOXYCYLIN
AMPICILLIN
THREE ANTIBIOTICS USED TO TREAT______
STREP USUALLY
______ given IM hurts
penicillin
STREP –PATIENT NEEDS TO REPLACE ______ 24 HOURS AFTER THEY START ANTIBIOTICS, CAN RETURN TO SCHOOL ______ AFTER STARDING ANTIBIOTICS -THIS IS GOING TO BE ON THE EXAM
TOOTHBRUSH
24 HOURS
Strep
tonsillitis
Inflamed tonsils
mouth breathing
drainage leads to otitis media
priority findings for tonsillitis
What are priority findings with tonsilitis
Inflamed tonsils
mouth breathing
drainage leads to otitis media
What is nursing care for tonsillitis?
soft foods
saltwater gargles
throat lozenges
antipyretics
______ –can cause drainage that leads to an ear infection
tonsillitis
treatment: Tylenol and Motrin most of the time. DO NOT USE ASPRIN BC OF RYES SYNDROMSE WHICH IS A NEURO PROBLEM
for tonsillitis
Motrin: contraindicated if the child is under ______of age and has to do with the heart
6 months
can alternate Tylenol and Motrin
tonsillitis does usually not require _____
surgery
Early sign of ______: continuous swallowing/frequently swallowing
bleeding
What are late signs of bleeding?
tachycardia and pallor
first sign is frequent ______ for bleeding from tonsillectomy –put them on ______ -IS GOING TO BE ON THE EXAM
swallowing, left side lying position
____ is contraindicated with an adenoidectomy bc of apnea/respiratory depression?
codeine
_____ filter and protect the respiratory tract
tonsils
have to do patient education about norco containing acetaminophen
discourage coughing/blowing the nose which can disrupt the sutures
discourage physical activity that can make bleeding worse
patient education for tonsillectomy/adenoidectomy
: avoid irritating foods, avoid vigorous toothbrushing, discourage coughing/blowing the nose/clearing throat, using analgesics/opioids for pain, limiting activity to decreased bleeding potential.
education for adenoidectomy
originates from the epstein bar virus
Mono
seen in middle school/high school age kids
mononucleosis
starts with fever, exudate of pharyngitis, petichea, enlarged lymph nodes, TRANSMITTED FROM ORAL SECRETIONS
Mononucleosis
MOST INFECTIOUS 24 HOURS BEFORE SYMPTOMS START AND 24 HOURS AFTER SYMPTOMS RESOLVE, CAN BE A PROBLEM FOR CONTACT SPORTS
mononucleosis
CAUSES SPLEEN ENLARGEMENT
patient is fatigued and have a ton of loss of energy, significant weight loss, FEVER FOR 10 DAYS (usually the whole cycle), can last up to 6 weeks though
test: looks like FSBS strip
mononucleosis
WATCH AIRWAY, ESPECIALLY FOR STRIDOR
assess left side for tenderness
if patient gets stridor and has difficulty breathing, YOU NEED TO HAVE PHYSICIAN COME IN AND LOOK AT THEM
mononucleosis
difference between strep and mono –patients with mono usually have some sort of ______
petichea
What does this image indicate?
petichea
Fever, exudative pharyngitis, petechiae, enlarged lymphoid, enlarged spleen
s/s of mononucleosis
Assess airway for obstruction/stridor, assess abdomen for tenderness and inflammation
nusing care for mononucleosus
Fever, chills, runny nose, dry cough, muscle pain (myalgia)
s/s of influenza
Spreads through nasopharyngeal secretions (Droplet) 24 hours prior to symptoms and 5-7 days post symptoms
influenza
Symptoms last 4-5 days. Some children have vomiting and diarrhea
influenza
there is flu A, B, and C –flu C is pretty mild compared to flu a and b
influenza is ____ parainfluenza
NOT
s/s: chills, runny nose, dry cough, myalgia (muscle pain), in little kids –vomiting and diarrhea
spread through sneezes, Kleenexes, coughing, USE DROPLET PRECAUTIONS
YOU HAVE TO BE ______ MONTHS TO HAVE IBUPROPHEN OR MOTRIN
6 months
acetaminophen is ___ mg/kg
ibuprofen _____ mg/kg
15, 10
Tamiflu tastes groos –pul it up in a syringe- put chocolate syrup and cherio on it –has to be started within _____ hours of symptom onset or its not going to work –Tamiflu doesn’t work great on kids
if you have the flu and ______ Tamiflu is a really good option, 9 days versus 10 days in the ICU
48, comorbidities
______ will worsen dehydration sometimes –children will get hallucinations from the dehydration
Tamiflu
flu vaccine starts at ___months of age, then you can get a booster around January
6
Fever, pulling infected ear, fluid in the middle ear chamber
Symptoms last 4-5 days. Some children have vomiting and diarrhea
acute otitis media s/s
Spreads through nasopharyngeal secretions (Droplet) 24 hours prior to symptoms and 5-7 days post symptoms
acute otitis media
acute otitis media –usually tugging at the eat –WHERE MIDDLE EAR IS INFECTED, 80% of ear infections are ______ but they give amoxicillin or another antiviotic to prevent conductive hearing loss, BULGING AND REDNESS,
viral
encourage ______(position helps them have less ear infection), discourage smoking, to help prevent acute otitis media
breast feeding
What are treatments for acute otitis media?
antipyretics
antibiotics -amoxicillin, augmentin, IM ceftriaxone
possibly tubes
encourage breastfeeding
______ is an infection on the outside of the ear- known as swimmers ear – patient doesn’t usually have a fever, but have extreme pain, can do antipyretics, can also have ear drops
Otitis externa
benzocaine ear drops are only for ______–don’t solve the issue
can do warm or cool compresses for the ears
anesthesia
______–usually happens from otitis media –is very foul smelling –has potential progressive hearing loss, check vitals, have they had ear drainage?, ear drainage that is grey/yellow in discharge is __________ –THIS PERSON NEEDS ______
cholesteatoma, ANTIBIOTICS
Bulging and redness to the tympanic membrane
-Judicious use of antibiotics
-Encourage breastfeeding, discourage second hand smoke and bottle propping
care for acute otitis media
Ear pain with pinna manipulation
*Pain with pressure application on the tragus
otitis externa
Occurs more in the summer
Swimmer’s ear
irritated ear canal
otitis externa
Antipyretics
Ear wick
Ear drops (5 minutes
otitis externa
Prevention: keep the ear canal dry
-Ear plugs for swimming/showering
-restore pH
otitis externa
Ear drops:
Polymyxin-B sulfate/neomycin sulfate, ciprofloxacin and gentamycin sulfate
otitis externa
Inspiratory stridor
Swelling of the larynx/subglottic airway
Respiratory distress
croup
Age 6 months-3 years
(small diameter of the airway)
croup [lung issues in general are worse in this age group though]
Home: Prednisone
Cool Mist Humidifier
treatment for croup
Hospital: racemic epinephrine, positive airway pressure, dexamethasone/Decadron (orally) *single dose
possible treatments for croup
IS A VOICE TYPE OF BREATHING, HAPPENS AT 3 AM OR 4 AM IN THE MORNING, IF AT HOME ENCOURAGE THEM (AS LONG AS THEIR VITALS ARE OK) HAVE THEM BREATHE MIST IN FROM THE SHOWER, COOL AIR CAN HELP WITH ____
CROUP
NOTIFY PYSICIAN: IF THE PATIENT HAS ____ OR HAS A RESP RATE ABOVE ___ RESP RATE NOTIFY THE PHYSICAN IMMEDIATELY
STRIDOR, 60
WITH CROUP THE DISTINGUISHING FACTOR IS _______________ –can produce respiratory distress, cool mist humidifier doesn’t improve or worsen things but it does moisten upper airway area so there could be less nasal bleeding and help keep secretions moist and thin,
INSPRIATORY STRIDOR
croup can happen in lots of ages but is WAY WORSE FROM__________OF AGE because of the diameter of the airway, the diameter is the size of the patients pinky finger
6 MONTHS TO 3 YEARS
to get rid of croup a lot of it is going to be steroids, IF IN THE HOSPITAL, ONLY IF IN THE HOSPITAL THEY CAN GET _________________________ –but it can cause rebound croup and go back into inspiratory stridor and get worse ______ AFTER MED ADMINISTRATION, DO HOURLY assessments
RACEMIC EPINEPHRINE, FOUR HOURS
Drooling (inability to swallow secretions)
Fever
Tripod positioning
Mouth open with tongue protruding
Restlessness, irritability, agitation
Froglike croaking
Hypoxia
cherry red throat
acute epiglottitis
SpO2 (pulse ox monitoring)
Intubation supplies close by
Antibiotics
Suction equipment available (excessive drooling)
nursing care for acute epiglottitis
Allow the child to assume a position of comfort
If intubation is needed a skill provider is necessary
-cricothyrotomy supplies should be available for an unsucessful intubation
Acute epiglottitis
STREP COULD CAUSE THIS, USUALLY PARAINFLUENZA THOUGH
acute epiglottitis
patient is excessively drooling, can swallow secretions, can clear secretions, may bein tripod position, may have tongue protruding, restless or irritable,
acute epiglottitis
don’t see this in USA often bc of the H. influenzae type B vaccine which is given at 2 months of age –patient is usually not vaccinated, patient has probably had some type of viral illness within the last few weeks
acute epiglottitis
NO ______ DO NOT PUT ANYTHING IN THE THROAT, NO THROAT CULTURES, DO NOT PISS THE KID OFF BC THE KID WILL GO INTO AN AIRWAY OBSTRUCTION, GET THE DIFFICULT AIRWAY CART, USUALLY ONLY HAS ONE CHANCE TO GET INTUBATED AFTER THAT YOU HAVE TO GO TO A CHRICH, ON A CHILD THAT IS LESS THAN 8 YOU CANNOT CHRICH THEM SO YOU HAVE TO USE AN 18 GAGUE ANGIO CATH AND CONNECT TO A BAG . THIS IS GOING TO BE A TEST QUESTION
TONGUE DEPRESSORS,
PREVENT: GET VACCINE
IF ITS HAPPENING: APPLY OXYGEN VERY CAREFULLY, ASSUME ANY POSITION OF COMFORT THEY WANT, HAVE THEM REMAIN CALM, YOU NEED TO REMAIN CALM, DO THROAT INSPECTIONS IF YOU CAN –WILL LOOK CHERRY RED
acute epiglottitis
Starts with: rhinorrhea and low-grade fever
Occurs less in breast fed babies
May progress to pneumonia
RSV
Severe RSV with in the 1st year of live is linked with ______ development
asthma
Prevention: palivizumab (monoclonal antibody given every 30 days November-March)*must have a heart/lung disease/born before 29 weeks
RSV prevention
Rapid ______ antigen detection with nasopharyngeal secretions
Nasal suctioning
SpO2 (pulse ox monitoring)
90% or lower requires oxygen
Heated high flow nasal cannula
Nursing/bottle feeding is difficult
Droplet precautions: direct contact with respiratory secretions
Tachypnea, weakness, and fatigue: IV fluids
RSV
starts with rhinorrhea dn low grade fever
RSV & pneumonia is usually when hypoxia occurs
if the child has RSF withing the 1 st year of life, it is linked with asthma development
there is a vaccine [monoclonal antibodies] for RSF but only given to children that has significant ______(need heart surgery, cystic fibrosis, or born before 29 weeks of age)
comorbidities
if O2 drops below 90% you need to apply some oxygen, a little bit goes a long way, the patient will usually just get a nasal canula unless they have some other stuff going on that’s decreasing their O2. HEATED HIGH FLOW OXYGEN IS RECOMMENDED.
IF RESP IS 60 OR ABOVE, DO NOT LET THEM EAT OR GIVE VERY SMALL AMOUNTS OF WATER –AT A HIGH RISK FOR ASPIRATION ON PAGE 905
RSV
epiglottitis has excessive ______, this is the difference between epiglottitis and RSV
retractons, restlessness, increased heart rate, increased resp rate can occur
encourage small frequent sips of water
DROPLET PRECAUTIONS
drooling
Inflammation, edema, mucus in the _______
80% of this disease begins with RSV
Signs/Symptoms: sneezing, coughing, nasal congestion, intermittent fever, apneic spells
bronchioles
Keep oxygen saturation 90% or higher
Keep respiratory rate less than 60 per min.
Ensure adequate oral intake
Droplet precautions
Bronchiolitis
ONE THING THAT IS DIFFERENT FROM RSV IS THAT THE PATIENT GETS __________ WITH BRONCHIOLITIS, LOSS OF CONSCIOUSNESS AND STOPS BREATHING FOR A WHILE
WILL SHOW UP ON A CHEST X RAY
DROPLET PRECAUTIONS
APNEIC SPELLS
WHEN A KID IS SICK, THEIR SUGAR WILL DROP, USUALLY GIVE ______ SO THAT THEY HAVE A GOOD BLOOD SUGAR
D5
Can be a complication from another disease
*Fever, chills, malaise, anorexia, muscle pain, headaches, dry cough that progresses to a productive cough, low SpO2, rapid shallow respirations
bacterial pneumonia
Identify crackles in the lungs
Obtain a chest x ray
Administer antibiotics (high dose amoxicillin, Augmentin, ceftriaxone, erythromycin)
Blood culture
White blood cell count (WBC)
Sputum culture
bacterial pneumonia
when you go to listen to their lung sounds you will hear crackles, _______can be a complications from any of the other resp conditions
fever, chills, DRY COUGH THAT PROGRESSES TO A PRODUCTIVE COUGH, THESE KIDS ARE COUGHING SO MUCH THEYRE VOMITTING, WILL LIKELY HAVE LOW SP02, RAPID SHALLOW RESPIRATIONS
will get a chest X ray
usually started on high dose of amoxicillin
patient will need blood cultures, use chloraprep, suppose to do 15 minutes in between the draws (some only do one depending
sputum cultures are possible
purple top -CBC –WBC will usually increase and the neutrophils will as well with bacterial pneumonia
there is a vaccine for one type of ______
bacterial pneumonia
Dyspnea, decreased oxygen saturation, labored respirations, tachycardia, chest/back pain.
Chest x ray
No lung sounds on affected side
Intervention: needle decompression/Chest tube
pneumothorax
Intervention: needle decompression/Chest tube
pneumothorax
IF BP DROPS, YOU’VE GOT TO DO SOMETHING QUICK FAST
PUT ON A NONREBREATHER AT THE HIGHEST RATE OF OXYGEN POSSIBLE
YOU CAN DO A NEEDLE DECOMPRESSION THAT IS A NURSING INTERVENTION MHMMMM
pneumothorax
Most often occurs in children who have not been immunized
Lasts 6-10 weeks
pertussis (whooping cough)
Persistent cough with a characteristic whooping sound
Antibiotics-limits the spread of other infections
pertussis (whooping cough)
Prevention: DTaP
Booster: TDaP
Highly contagious
pertussis
lasts a very long time 6-10 weeks
usually in very small kids (younger than age four) who haven’t got the chance to get their vaccines, or on kids who aren’t vaccinated
persistent cough, whooping sound, will be placed on antibiotics to prevent pneumonia etc
the prevention is : DTAP and the booster is TDaP
pertussis (whooping cough)
Choking, gagging, coughing
Cyanosis
Stridor, wheezing
Sternal retractions
Inability to speak: choking (Back/Abd thrusts <1year)
foreign body ingestion
Priority: assess the airway
Batteries: immediate surgical intervention
Chest x ray won’t reveal plastic/vegetable matter
Chest x ray will reveal opaque images
Bronchoscopy
Most of the time the child will pass in their stool
foreign body ingestion
Prevention: toys that fit in a toilet paper tube can be swallowed, keep small batteries (hearing aid) away from children
foreign body ingestion
what is this and what is it used for?
katz extractor used to get a bead or other object out of the nose
TEST QUESTIONS ON THIS ONE: WHAT IS A SIGN THAT A CHILD IS TRULY CHOKING? ON PAGE 918 –
IS THE INABILITY TO SPEAK
______ ARE AN IMMEDIATE SURGICAL INTERVETION, WILL KILL THEM
BATTERIES
ASSESS AIRWAY, IF THEYRE CHOKING THEY CANT TALK
BATTERIES –GOING IMMEDIATELY TO SURGERY
ASPIRATION -
foreign body ingestion
Shortness of breath/dyspnea, nasal flaring, retractions, grunting, cyanosis
aspiration
Could lead to ______ pneumonia (coughing/vomiting immediately after ingestion)
-_______ risk is why nurses provide education prior to surgery about when to stop eating/drinking
aspiration
Dullness, wheezes and crackles
aspiration
Use activated charcoal for accidental/purposeful ingestions to decrease the risk of ______. Inducing vomiting increased the risk of aspiration
aspiration
High humidity
Supplemental oxygen
Hydration
Treat secondary infections
Intubation: if child develops respiratory failure
aspiration
SOB and dyspnea, GRUNTING, cyanocis and nasal flaring
aspiration
watch for resp over 60
can ______ hydrocarbons, and petroleum disolates, antifreeze
antidote to antifreeze is ethanol
use activated charcoal for accieental/purposeful ingestions to decrease the risk of ______. inducing vomiting increased the risk of aspiration
high humidity oxygen
if patient develops respiratory failure –if on 15 liters with a non rebreather and its not working, theyre probably going to intubate
aspiration
Constant and consistent sneezing
No fever
Seasonal
Itchy eyes/nose
allergies s/s
Weekly: wash bed sheets in hot water
allergies prevention
for ______ there is no fever, is usually pretty seasonal
prevention is weekly washing of bed sheets in hot water
WBC the lymphocytes go up, but the rest of the cells are in normal range
monitor for drowsiness with drug used for this
there are ______ shots
allergies, allergy
breathing is good
no cough or wheeze
can work and play
green -go
use preventive medicine for this color
green
cough
wheeze
tight chest
wake up at night
yellow -caution
What do you do for yellow color?
take quick relief medicine to keep an asthma attack from getting bad
if symptoms do not return to green zone after 1 hour take short acting beta agonist and an oral steroid -call doc if symptoms dont improve within __ hours after taking the oral steroid or if they progress to the red zone
medicine is not helping
breathing is hard an fast
nose opens wide
cant walk
ribs show
cant talk well
red zone, stop -danger
what do you do if youre in the red zone
get help from a doctor now GO TO THE ER
take ___ meds untill you talk with the doctor
difficulty walking or breathing
mental confusion
fingernails or lips are blue
these signs signal DANGER in an asthma attack CALL THE AMBULANCE
_______ is happening with asthma : IMMEDIATE NURSING INTERVETION IS REQUIRED
intercostal retractions
Limited airflow or obstruction that reverses spontaneously or with treatment
Occurs frequently during the night/early morning
Dyspnea
Wheeze
Cough
Intercostal retractions require immediate interventions (Need more oxygen for body functions)
asthma
Child that refuses to lie down, is quiet, diaphoretic, and pale: ______
severe distress
RSV can trigger ______
Allergies can trigger ______ (remove clothes/wash sheets)
Household/caregiver smoking
asthma,
*reduce underlying inflammation
Rescue Medication (bronchospasms): Ventolin HFA (albuterol sulfate), Duoneb (ipratropium-albuterol)
Long term: inhaled corticosteroids (wash mouth after administration)
Oral steroids
Epi-pen (Status Asthmaticus)
Magnesium sulfate: relaxes muscles to decrease inflammation in the bronchioles
Theophylline: monitor serum levels
Chest physiotherapy (CPT)
Heliox: 70% helium 20-30% oxygen (decrease airway resistance)
Breathing exercises
nursing care for asthma
______ will reverse spontaneously or with treatment
usually occurs at nigh or in early morning –SOB, wheezing, coughing, intercostal retractions
asthma
child may refuse to lie down. if patient is pale, theyre in severe respiratory distress
main care for ______: anything you can do to reduce inflammation
asthma
status asthmaticus will usually have an ______ given sub Q at 0.15 mg
epi pen
magnesium sulfate –given IV and goes in over 2 hours
theophylline –monitor serum levels
chest physiotherapy – a vest that vibrates
Heliox can be given
potential drugs given for asthma
what is stage I asthma?
complete sentences
stage II asthma?
complete sentences and wheezes
stage III asthma?
pale and wheezing
stage IV asthma?
pale and decreased breath sounds
Autosomal recessive genetic disease (long arm of chromosome 7)
Respiratory: increased viscosity of mucous gland secretion
Thick secretions: difficult to expel (bacteria and mucus are stagnant)
Decreased O2/CO2 exchange (hypoxia)
Progressive lung dysfunction
Clubbing of fingers/toes, emphysema, wheezing, dry cough
cystic fibrosis
Why are cystic fibrosis patients so small? (Failure to thrive)
GI tract: prevents pancreatic enzymes from reaching duodenum
CF patients need help digesting their food: pancreatic enzymes are provided to help children digest the fat in foods and gain weight
Thick, sticky poop: meconium ileus
stool of a patient with cystic fibrosis
What do you do to test for CF?
sweat chloride test
when is chest physiotherapy done for patients with CF?
in the morning before feeding to prevent aspiration
What is the goal for patients with CF?
to minimize pulmonary complications, may include a lung transplant
Diet: High protein and high calories with pancreatic enzymes
Genetic testing prior to conceiving children
Patient with _____: sterility in males/delayed puberty females
Decreased life expectancy
CF
PATIENTS HAVE SUPPER THICK SECRETIONS –CONTAIN BACTERIA AND MUCUS THAT ARE STAGNANT, decreased O2 and CO2 but are use to it
CF
the way to test for CF is through a ______ test
sweat chloride
CF also prevents _______ from reaching the duodenum, patients need help digesting their food, the diet is to increase protein and calories, the patient comes in and have a cough and wheeze, clubbing on end of fingers, thicker stickier poop.
pancreati enzymes
______ works really well but needs to be done in the morning before they eat to prevent aspiration
requires a lot of family involvement and therapy
decreased life expectancy
chest physiotherapy
main complaint from parent is that their child tastes salty –go ahead and do the sweat chloride test
CF
What are the two core concepts for all respiratory dysfunctions?
Pulse ox: all respiratory illnesses
motrin/ibuprofen: have to be older than 6 months (can cause premature close of the ductus arteriosus in less than 6 months of age)
WITH MOST RESP ILLNESSES: will all be treated somewhat the same.
apply pulse ox
oxygen
suction
motrin and Tylenol
carbon monoxide –house fire or car left on –cherry red in face, tachycardic, confused, apply nonrebreather at 100% oxygen, if its still not working they will go into a hyperbaric chamer
____- try to get adequate oxygen but theyre usually septic
ARDES
________________________ – needs a surgical intervention, their bowler are pushed up into their lung area, can happen from a trauma such as a car accident as well
congenital diaphragmatic hernia
childhood ______: may remove tonsils or adenoids
obesity
nasal cannula –up to ___
4 liters
oxy mask –_____________________________ –can eat and drink with holes, YOU DON’T KNOW HOW MUCH OXYGEN THEYRE ACTUALLY GETTING
can put at almost any liter
nonrebreather –has to be at at least _______ –the bag has to be _______ before putting them on
10 L, inflated
simple mask -_______L –rarely used
5-8 liters
nasal canula
up to 4 L
oxy mask
can put at almost any liter –can eat and drink with holes, YOU DON’T KNOW HOW MUCH OXYGEN THEYRE ACTUALLY GETTING
way to do a breathing treatment
way to do breathing treatment for adults
nonrebreather –has to be at at least 10 L –the bag has to be inflated before putting them on
