Pediatric Respiratory Dysfunction Flashcards
1
Q
______ FIRST UNLESS THEYRE ALREADY CYANOTIC –GIVE OXYGEN
A
APPLY PULSE OX
2
Q
___________ ________ _____–one q tip swab that goes in both nares of nose comes back in about 45 minutes, measures anything with upper resp, __________________________
A
respiratory panel lab
corona virus, flu, parainfluenza (croup/bronchiole infect), RSV
3
Q
adno
entero
rhino viruses
A
THESE THREE ARE THE MOST COMMON
4
Q
_______________ _______- is only useful if its going to change the plan of care for the patient
A
respiratory panel
5
Q
core concept: most resp illnesses are treated the ______ as far as interventions
A
same
6
Q
What are priority findings for acute streptococcal pharyngitis?
A
exudate
fever
painful swallowing/difficulty swallowing
7
Q
What are nursing care interventions for acute streptococcal pharyngitis?
A
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
8
Q
____________ –HAS EXUDATE
GENERALLY HAS A FEVER (X>100.4)
PAINFUL SWALLOWING
A
acute streptococcal pharyngitis
9
Q
DIFFERENCE BETWEEN NORMAL AND ACUTE STREP IS THE EXUDATE, ______ HAS EXUDATE
A
ACUTE STREP
10
Q
rhumatic fever can accompany strep and can progress to ______ IF BACTERIAL-CAN GO TO THE HEART HAVE
A
endocarditis
11
Q
____________ __________ 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
A
scarlet fever
12
Q
PENICILLIN
AMOXYCYLIN
AMPICILLIN
THREE ANTIBIOTICS USED TO TREAT______
A
STREP USUALLY
13
Q
______ given IM hurts
A
penicillin
14
Q
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
A
TOOTHBRUSH
24 HOURS
15
Q
A
Strep
16
Q
A
tonsillitis
17
Q
Inflamed _______
mouth breathing
drainage leads to otitis media
A
priority findings for tonsillitis
18
Q
What are priority findings with tonsilitis
A
Inflamed tonsils
mouth breathing
drainage leads to otitis media
19
Q
What is nursing care for tonsillitis?
A
soft foods
saltwater gargles
throat lozenges
antipyretics
20
Q
______ –can cause drainage that leads to an ear infection
A
tonsillitis
21
Q
treatment: Tylenol and Motrin most of the time. DO NOT USE ASPRIN BC OF RYES SYNDROMSE WHICH IS A NEURO PROBLEM
A
for tonsillitis
22
Q
Motrin: contraindicated if the child is under ______of age and has to do with the heart
A
6 months
23
Q
can alternate Tylenol and Motrin
tonsillitis does usually not require _____
A
surgery
24
Q
Early sign of ______: continuous swallowing/frequently swallowing
A
bleeding
25
What are late signs of bleeding?
tachycardia and pallor
26
first sign is frequent ______ for bleeding from tonsillectomy –put them on ______ -IS GOING TO BE ON THE EXAM
swallowing, left side lying position
27
_________ is contraindicated with an adenoidectomy bc of apnea/respiratory depression?
codeine
28
_____ filter and protect the respiratory tract
tonsils
29
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
30
: 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
31
originates from the epstein bar virus
Mono
32
seen in middle school/high school age kids
mononucleosis
33
starts with fever, ______ of pharyngitis, petechia, enlarged ______ _________, TRANSMITTED FROM ORAL SECRETIONS
Mononucleosis
starts with fever, exudate of pharyngitis, petechia, enlarged lymph nodes, TRANSMITTED FROM ORAL SECRETIONS
34
MOST INFECTIOUS 24 HOURS BEFORE SYMPTOMS START AND 24 HOURS AFTER SYMPTOMS RESOLVE, CAN BE A PROBLEM FOR CONTACT SPORTS
mononucleosis
35
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
36
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
37
difference between strep and mono –patients with mono usually have some sort of ______
petichea
38
What does this image indicate?
petichea
39
Fever, exudative pharyngitis, petechiae, enlarged lymphoid, enlarged spleen
s/s of mononucleosis
40
Assess airway for obstruction/stridor, assess abdomen for tenderness and inflammation
nusing care for mononucleosus
41
Fever, chills, runny nose, dry cough, muscle pain (myalgia)
s/s of influenza
42
Spreads through nasopharyngeal secretions (Droplet) 24 hours prior to symptoms and 5-7 days post symptoms
influenza
43
Symptoms last 4-5 days. Some children have vomiting and diarrhea
influenza
44
there is flu A, B, and C –flu C is pretty mild compared to flu a and b
influenza is ____ parainfluenza
NOT
45
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
Influenza
6 months
46
acetaminophen is ___ mg/kg
ibuprofen _____ mg/kg
15, 10
47
Tamiflu –has to be started within _____ hours of symptom onset or its not going to work
if you have the flu and ______ Tamiflu is a really good option, 9 days versus 10 days in the ICU
48, comorbidities
48
______ will worsen dehydration sometimes –children will get hallucinations from the dehydration
Tamiflu
49
flu vaccine starts at ___months of age, then you can get a booster around January
6
50
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
51
Spreads through nasopharyngeal secretions (Droplet) 24 hours prior to symptoms and 5-7 days post symptoms
acute otitis media
52
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
53
encourage ______(position helps them have less ear infection), discourage smoking, to help prevent acute otitis media
breast feeding
54
What are treatments for acute otitis media?
antipyretics
antibiotics -amoxicillin, augmentin, IM ceftriaxone
possibly tubes
encourage breastfeeding
55
_________ _______ 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
56
benzocaine ear drops are only for ______–don’t solve the issue
can do warm or cool compresses for the ears
anesthesia
57
______–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
58
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
59
Ear pain with pinna manipulation
*Pain with pressure application on the tragus
otitis externa
60
Occurs more in the summer
Swimmer’s ear
irritated ear canal
otitis externa
61
Antipyretics
Ear wick
Ear drops (5 minutes
otitis externa
62
Prevention: keep the ear canal dry
-Ear plugs for swimming/showering
-restore pH
otitis externa
63
Ear drops:
Polymyxin-B sulfate/neomycin sulfate, ciprofloxacin and gentamycin sulfate
otitis externa
64
______________ stridor
Swelling of the larynx/__________ airway
Respiratory distress
croup
Inspiratory stridor
Swelling of the larynx/subglottic airway
Respiratory distress
65
Age 6 months-3 years
(small diameter of the airway)
croup [lung issues in general are worse in this age group though]
66
Home: Prednisone
Cool Mist Humidifier
treatment for croup
67
Hospital: racemic epinephrine, positive airway pressure, dexamethasone/Decadron (orally) *single dose
possible treatments for croup
68
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
69
NOTIFY PYSICIAN: IF THE PATIENT HAS ____ OR HAS A RESP RATE ABOVE ___ RESP RATE NOTIFY THE PHYSICAN IMMEDIATELY
STRIDOR, 60
70
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
71
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
72
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
73
Drooling (inability to swallow secretions)
Fever
Tripod positioning
Mouth open with tongue protruding
Restlessness, irritability, agitation
Froglike croaking
Hypoxia
cherry red throat
acute epiglottitis
74
SpO2 (pulse ox monitoring)
Intubation supplies close by
Antibiotics
Suction equipment available (excessive drooling)
nursing care for acute epiglottitis
75
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
76
STREP COULD CAUSE THIS, USUALLY PARAINFLUENZA THOUGH
acute epiglottitis
77
patient is excessively drooling, can swallow secretions, can clear secretions, may bein tripod position, may have tongue protruding, restless or irritable,
acute epiglottitis
78
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
79
NO ______
TONGUE DEPRESSORS,
80
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
81
Starts with: rhinorrhea and low-grade fever
Occurs less in breast fed babies
May progress to pneumonia
RSV
82
Severe RSV with in the 1st year of live is linked with ______ development
asthma
83
Prevention: palivizumab (monoclonal antibody given every 30 days November-March)*must have a heart/lung disease/born before 29 weeks
RSV prevention
84
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
85
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
86
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
87
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
88
Inflammation, edema, mucus in the _______
80% of this disease begins with RSV
Signs/Symptoms: sneezing, coughing, nasal congestion, intermittent fever, apneic spells
bronchiolitis
bronchioles
89
Keep oxygen saturation 90% or higher
Keep respiratory rate less than 60 per min.
Ensure adequate oral intake
Droplet precautions
Bronchiolitis
90
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
Bronchiolitis
APNEIC SPELLS
91
WHEN A KID IS SICK, THEIR SUGAR WILL DROP, USUALLY GIVE ______ SO THAT THEY HAVE A GOOD BLOOD SUGAR
D5
92
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
93
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
94
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
95
Most often occurs in children who have not been immunized
Lasts 6-10 weeks
pertussis (whooping cough)
96
Persistent cough with a characteristic __________ sound
Antibiotics-limits the spread of other infections
pertussis (whooping cough)
whooping
97
Prevention: DTaP
Booster: TDaP
Highly contagious
pertussis
98
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)
99
Choking, gagging, coughing
Cyanosis
Stridor, wheezing
Sternal retractions
Inability to speak: choking (Back/Abd thrusts <1year)
foreign body ingestion
100
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
101
Prevention: toys that fit in a toilet paper tube can be swallowed, keep small batteries (hearing aid) away from children
foreign body ingestion
102
what is this and what is it used for?
katz extractor used to get a bead or other object out of the nose
103
TEST QUESTIONS ON THIS ONE: WHAT IS A SIGN THAT A CHILD IS TRULY CHOKING? ON PAGE 918 –
IS THE INABILITY TO SPEAK
104
______ ARE AN IMMEDIATE SURGICAL INTERVETION, WILL KILL THEM
BATTERIES
105
ASSESS AIRWAY, IF THEYRE CHOKING THEY CANT TALK
BATTERIES –GOING IMMEDIATELY TO SURGERY
ASPIRATION -
foreign body ingestion
106
Shortness of breath/dyspnea, nasal flaring, retractions, grunting, cyanosis
aspiration
107
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
108
Dullness, wheezes and crackles
aspiration
109
Use activated charcoal for accidental/purposeful ingestions to decrease the risk of ______. Inducing vomiting increased the risk of aspiration
Nursing Care
aspiration
110
High humidity
Supplemental oxygen
Hydration
Treat secondary infections
Intubation: if child develops respiratory failure
aspiration
111
SOB and dyspnea, GRUNTING, cyanocis and nasal flaring
aspiration
112
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
113
Constant and consistent sneezing
No fever
Seasonal
Itchy eyes/nose
allergies s/s
114
Weekly: wash bed sheets in hot water
allergies prevention
115
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
116
breathing is good
no cough or wheeze
can work and play
green -go
117
use preventive medicine for this color
green
118
cough
wheeze
tight chest
wake up at night
yellow -caution
119
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
120
medicine is not helping
breathing is hard an fast
nose opens wide
cant walk
ribs show
cant talk well
red zone, stop -danger
121
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
122
difficulty walking or breathing
mental confusion
fingernails or lips are blue
these signs signal DANGER in an asthma attack CALL THE AMBULANCE
123
_______ is happening with asthma : IMMEDIATE NURSING INTERVETION IS REQUIRED
intercostal retractions
124
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
125
Child that refuses to lie down, is quiet, diaphoretic, and pale: ______ ________
severe distress
126
RSV can trigger ______
Allergies can trigger ______ (remove clothes/wash sheets)
Household/caregiver smoking
asthma,
127
*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
128
______ will reverse spontaneously or with treatment
usually occurs at nigh or in early morning –SOB, wheezing, coughing, intercostal retractions
asthma
129
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
130
status asthmaticus will usually have an ______ given sub Q at 0.15 mg
epi pen
131
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
132
what is stage I asthma?
complete sentences
133
stage II asthma?
complete sentences and wheezes
134
stage III asthma?
pale and wheezing
135
stage IV asthma?
pale and decreased breath sounds
136
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
137
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
138
Thick, sticky poop: meconium ileus
stool of a patient with cystic fibrosis
139
What do you do to test for CF?
sweat chloride test
140
when is chest physiotherapy done for patients with CF?
in the morning before feeding to prevent aspiration
141
What is the goal for patients with CF?
to minimize pulmonary complications, may include a lung transplant
142
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
143
PATIENTS HAVE SUPPER THICK SECRETIONS –CONTAIN BACTERIA AND MUCUS THAT ARE STAGNANT, decreased O2 and CO2 but are use to it
CF
144
the way to test for CF is through a ______ test
sweat chloride
145
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
146
______ 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
147
main complaint from parent is that their child tastes salty –go ahead and do the sweat chloride test
CF
148
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)
149
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
150
____- try to get adequate oxygen but theyre usually septic
ARDES
151
________________________ – 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
152
childhood ______: may remove tonsils or adenoids
obesity
153
nasal cannula –up to ___
4 liters
154
oxy mask –_____________________________ –can eat and drink with holes, YOU DON’T KNOW HOW MUCH OXYGEN THEYRE ACTUALLY GETTING
can put at almost any liter
155
nonrebreather –has to be at at least _______ –the bag has to be _______ before putting them on
10 L, inflated
156
simple mask -_______L –rarely used
5-8 liters
157
nasal canula
up to 4 L
158
oxy mask
can put at almost any liter –can eat and drink with holes, YOU DON’T KNOW HOW MUCH OXYGEN THEYRE ACTUALLY GETTING
159
way to do a breathing treatment
160
way to do breathing treatment for adults
161
nonrebreather –has to be at at least 10 L –the bag has to be inflated before putting them on
