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NUR720 FNP Review > Pediatric respiratory issues and disorders > Flashcards

Pediatric respiratory issues and disorders Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

Egophany

A

E->A during auscultation indicated PNA

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2
Q

what age can you start PFTs

A

at age 8 if cooperative

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3
Q

obstructive lung disease characteristics

A

characterized by reduced airflow rates; lung volumes within normal range or larger
Typical of a child having trouble exhaling air (air trapping) which results in decreased rated and FEV1 (asthma, bronchiolitis, cystic fibrosis)

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4
Q

restrictive lung disease characteristics

A

characterized by reduced volumes and expiratory flow rates. Typical of a child that has trouble inhaling air, thus affecting the volume (PNA)

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5
Q

Bronchiolitis definition

A

A disease of the lower respiratory tract that causes inflammation leading to obstruction of the small respiratory airways. noted in children

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6
Q

s/sx of bronchiolitis

A 
URI symptoms lasting for several days, moderate fever of 102F, gradual development of respiratory distress (nasal flaring, grunting, cyanosis, prolonged expiration)
Tachypnea (60-80 bpm)
non productive cough
paroxysmal wheezing
progressive stridor
restlessness; changes in mental status
cyanosis
palpable liver and spleen (pushed down due to hyperinflation)
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7
Q

chest xray presentation for bronchiolitis

A

hyper inflated lungs, may have scattered areas of consolidation

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8
Q

Management of bronchiolitis

A

infants with mild distress can be treated as outpatients with supportive care
Prevention of high risk infants with (palivizumab) SYNAGIS IM monthly

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9
Q

Intermittent asthma- sx, nighttime awakenings, rescue inhaler use, interference with normal activity, lung function

A

80% predicted and normal between exacerbations

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10
Q

Mild persistent asthma- sx, nighttime awakenings, rescue inhaler use, interference with normal activity, lung function

A

> 2 days/ week
Nighttime awakenings 3-4/month
rescue inhaler use >2 days/week but not daily
interference with normal activity- minot limitation
Lung function is FEV1>80% of predicted

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11
Q

Moderate persistent asthma- sx, nighttime awakenings, rescue inhaler use, interference with normal activity, lung function

A

symptoms are daily, nighttime awakening are more than once per week but not nightly
rescue inhaler use is daily
some limitation and interference with normal activity
FEV1 60%-80% predicted

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12
Q

Severe persistent asthma- sx, nighttime awakenings, rescue inhaler use, interference with normal activity, lung function

A

Symptoms throughout the day, nightly awakenings, rescue inhaler use several times per day, extremely limited interference with normal activity, and lung function less than 60% of predicted

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13
Q

treatment in intermittent asthma

A

step 1- SABA + PRN for all age groups

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14
Q

Treatment in mild persistent asthma

A

Step 2- Low dose ICS. Alternative: Cromolyn or monteukast

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15
Q

Treatment for 0-4 yo with moderate or severe asthma

A

Refer beyond mild persistent

Step 3- medium dose ICS option and consider short course of oral systemic corticosteroids

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16
Q

treatment for moderate persistent asthma fort he 5-11 yo

A

step 3: Medium dose ICS option and consider short course of oral systemic corticosteroids

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17
Q

treatment for the severe persistent asthma in the 5 -11yo

A

Step 3: Medium dose OR

step 5 ICS option and consider short course or oral systemic corticosteroids

18
Q

How long to see patient back after initiating or changing asthma medications? How long before you can try to decrease ICS?

A

Bring back in 2 weeks for follow-up. Wait for 3 months of controlled before decreasing the ICH, then recheck in 2 weeks

19
Q

FEV1/FVC values for intermittent, mild persistent, moderate persistent, severe persistent

A

intermittent: >85%
mild persistent: FEV1/FVC: >80%
Moderate persistent: FEV1/FVC: 75%-80%
Severe persistent: FEV1/ FVC:

20
Q

FEV1 values for intermittent, mild persistent, moderate persistent, severe persistent

A

Intermittent: >80%
mild persistent: >80%
Moderate persistent: 60-80%
Severe persistent:

21
Q

What age do you not consider lung function for asthma

A

0-4 years

22
Q

Most common agent of PNA in newborns

A

Group B strep, chlamydia, E.coli

23
Q

most common agent of PNA in infants and young children

A

RSN and H. Influenzae, strep pneumoniae (community aquired)

24
Q

most common agent of PNA in preschool through young adulthood

A

Strep pneumoniae, mycoplasma, chlamydia

25
Q

how much % of PNA is viral?

A

70%-80%

26
Q

Radiograph for H. Influenzae

A

Lobar consolidation

27
Q

Radiograph for S. Pneumonaie

A

lobar consolidation

28
Q

Radiograph for Klebsiella

A

lobar consolidation

29
Q

CXR for pneumocystis

A

diffuse interstitial, alveolar, apical or upper lobe infiltrates

30
Q

radiograph for E.Coli

A

Patchy infiltrates, pleural effusion

31
Q

Radiograph for staphylococcus

A

Patchy infiltrates

32
Q

Radiograph for Pseudomonas

A

Patchy infiltrates

33
Q

TX for CAP S. Pneomoniae

A

PCN

34
Q

TX for CAP M. Catarrhalis (walking PNA)

A

macrocodes such as azithromycin (zithromax)

35
Q

TX for CAP H. Influenze

A

Amoxicillin or cephalosporin

36
Q

TX for viral PNA

A

supportive measures: hydration and antipyretics
ANX if secondary infection
Humidified o2 and chest physiotherapy
Bronchodilators

37
Q

Cystic fibrosis definition

A

a autosomal recessive disorder that causes a defect in epithelial chloride transport resting in dehydrated, thick secretions leading to chronic multi system disorder affecting the respiratory tract, GI, hepatobiliary and reproductive tracts

38
Q

s/sx of cystic fibrosis

A 
viscid meconium or ileus in newborns, recurrent URI, 
large, liquid bulky, foul stool (steatorrhea)
salt-tasting skin
chronic cough
rhinorrhea
hepatosplenomegaly
fat-soluble vitamin deficiencies 
FTT
Delayed pubery 
infertility
39
Q

labs for cystic fibrosis

A

pilocarpine sweat test, PFTs with obstructive patter, hyponatremic hypochloremic dehydration (alkalosis)
Chest radiograph: cystic lesions, atelectasis

40
Q

s/sx of croup

A

clear lungs, barking cough, low grade fever, recent uri, dyspnea

41
Q

steeples sign (narrowing of the trachea) on radiograph is indicative of

A

croup

NUR720 FNP Review (24 decks)

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