Pediatrics- Respiratory Flashcards
1
Q
What is an expected range for SaO2
A
95 to 100
2
Q
Sao2 of less than 86 means
A
Life-threatening emergency
3
Q
What position maximizes ventilation
A
Semi followers or Fowler’s
4
Q
What is nebulizer aerosol therapy
A
Nebulization breaks up medication’s into minute particles that are dispersed throughout the respiratory track
5
Q
Indications for nebulizer aerosol therapy
A
Respiratory conditions that necessitate bronchodilators corticosteroids Mucolytes lights and anabiotic’s
6
Q
How long does a nebulizer take
A
15 minutes
7
Q
How should a patient use A nebulizer
A
Take a slow deep breaths by mouth
8
Q
What is a metered dose inhaler or dry powder inhaler
A
Handheld devices that allow children to self administer medication on intermittent basis
9
Q
How do you use a MDI
A
Shake the inhaler 5 to 6 times attach spacer play say inhaler between lips take deep breath and then exhale slow deep breaths the last 3 to 5 seconds hold breath for approximately 5 to 10 seconds wait one minute between puffs
10
Q
How do use a dpi
A
Do not shake the device exhale completely place mouthpiece switching lips hold breath 5 to 10 seconds slowly exhale through pursed lips
11
Q
What is chest physiotherapy
A
Techniques that include manual or mechanical percussion vibration cough or forceful expiration
Gravity and positioning loosen respiratory secretions and move them to central air way
12
Q
When would you use chest physiotherapy
A
Client presents with thick secretions with an inability to clear airway
13
Q
Pre-procedure of chest physiotherapy
A
Schedule treatments before meals or at least one hour after meals and a bedtime decrease likelihood of vomiting or aspiration
Administer bronchial dilator
14
Q
Positions for chest physiotherapy
Apical secretions of the upper lobes
A
Fowler’s 
15
Q
Positions for chest physiotherapy
posterior sections of the upper lobes
A
Sitting position with child leaning forward curled over pillows
16
Q
Position for physiotherapy
anterior segment of both upper lobes
A
Supine and rotated slightly away from side being drained
17
Q
Position for chest physiotherapy at
superior segments of both lower lobes
A
Prone with hips elevated on pillows
18
Q
How to perform chest physiotherapy
A
Manually percussion using cup to hand or special device to clap rhythmically on chest wall to break up secretions
electronic percussion is applied by vest device worn by child
19
Q
How long should a child remain in a position for chest physiotherapy
A
20 to 30 minutes
20
Q
What is hypoxemia
A
Inadequate level of oxygen in the blood
21
Q
What is early manifestations of hypoxemia
A
Tachpnea
tachycardia 
restlessness 
pallor
use of accessory muscles
nasal flaring
22
Q
Late manifestations of hypoxemia
A
Confusion
stupor
cyanosis
Brady piña
bradycardia
hypotension or hypertension
23
Q
How do you discontinue oxygen
A
Gradually
24
Q
What is oxygen toxicity
A
Result from high concentrations of oxygen
25
When do you need to use suctioning
To remove mucous plugs and excessive secretions
26
How much time can you suction child in an infant
Limit suction time to less than five seconds for infants in less than 10 seconds for children allow children to rest 30 to 60 seconds after each aspiration
27
When do you need a trach
When there is an obstruction of the upper airway requiring the use of artificial ventilatio
28
Where should you keep an emergency tracheotomy tube
At the bedside
29
How do you clean a trach
Soap and water
30
What happens if a trach is accidentally decannulated
If it is decannulated in the first 72 hours after surgery it is an emergency
31
What is an occlusion in the trach
Occlusion is a situation in which of the two was clogged with secretion and prevents adequate air exchange
32
A nurse is teaching an adolescent a self administer a corticosteroid medication using a metered dose inhaler which of the following instruction should the nurse include (select)
Shake the device prior to use
rinse the expectIrate or after ministration
Inhale slowly with the medication administration
Exhale quickly after medication administration
wait 30 seconds between puffs
Shake the device prior to use
rinse the expectIrate or after ministration
Inhale slowly with the medication administration
33
A nurse is caring for a child who is receiving oxygen therapy Amazon continuous oxygen saturation monitor that is reading 89% which of the following action should the nurse take first
Increase the oxygen flow rate
encourage the child to take deep breaths ensure proper placement of the sensor probe
place a child and Fowlers position
Ensure the proper placement of the sensor probe
34
A nurse is in the emergency department and is assessing a newly admitted infant which of the following findings is an early indication of hypoxemia
Nonproductive cough
hyperventilation
tacky piña
nasal stuffiness
Tachypnea
35
A nurse is caring for a child who is receiving oxygen which of the following findings indicates oxygen toxicity
Increase blood pressure
hyperventilation
decrease PaCO2
unconsciousness
Unconsciou
36
A nurse is caring for a child who is receiving a bronchodilator medication by nebulized aerosol therapy which of the following action should the nurse take( select)
Instruct the child that the treatment will last 30 minutes
obtain vital signs prior to the procedure tell the child to take slow deep breaths determine if the child should use a mask attach a device to an air source
obtain vital signs prior to the procedure tell the child to take slow deep breaths determine if the child should use a mask attach a device to an air source
37
 What are tonsils and what do they do
Masses of limit type tissue found in the pharyngeal area that filter pathogenic organisms to protect the respiratory and G.I. track
Protect against infection
38
What are palatine tonsils
Located on both sides of the ortho pharynx tonsils removed during a tonsillectomy
39
What are pharyngeal tonsils
Also known as adenoids are removed during an adnoidectomy
40
What is the problem with enlarged tonsils
They can block the nose and throat which can interfere with breathing drainage, sleeping, swallowing, and speaking
41
Preoperative nursing actions for tonsillectomy
Maintain NPO status
42
Postoperative nursing actions after a tonsillectomy
Please patient in position to facilitate drainage elevate head of bed check for bleeding monitor for difficulty breathing offer ice chips
43
Diet after a tonsillectomy
Encourage clear liquids and fluids after return of the gag reflex avoid red colored liquids Citrus juice and milk base foods 
44
Instructions after a tonsillectomy
Discourage coughing throat clearing a nose blowing in order to protect the surgical site
avoid straws
45
Why do people get respiratory illnesses
Events between ages three and six short now airways short respiratory tract compromised immune system chronic medical condition asthma
46
What is nasopharyngitis 
The common cold usually last 4- 10 days
47
What is GABHS 
Infection of the upper airway strep throat
48
Expected finding in testing in strep throat
Tonsils and pharynx covered with exudate get a throat culture to determine
49
Treatment for strep throat
Oral penicillin for at least 10 days
50
What is bronchitis
Associated with upper respiratory infection and inflammation of large airways
51
Expected findings in bronchitis
Persistent dry hacking cough as a result of inflammation resolves in 5 to 10 days
52
Treatment bronchitis
Increased humidity cough suppressant
53
Bronchiolitis
Mostly caused by respiratory syncytial virus RSV Primarily affects the bronchi and bronchioles occurs in the bronchial level 
54
Expected finding in bronchiolitis
Rhinorrhea wheezing possible ear infection increase coughing retractions refusal to feed tacky piña poor air exchange cyanosis
55
What is allergic rhinitis
Caused by seasonal reaction to allergens most common in autumn or spring
56
Expected findings in allergic rhinitis
Watery rhinorrhea nasal obstruction itchiness of the nose conjunctivitis snoring Molise headache
57
Treatment of allergic rhinitis
Give nasal corticosteroids
58
What is bacterial pneumonia findings
High fever cough with whites beautiful retraction nasal flaring don’t mess with percussion advantageous breath sounds pale color
59
How to determine you have bacterial pneumonia
Gram stain and culture of sputum an older children
60
Treatmentof viral pneumonia
Oxygen with cool mist
61
Treatment for bacterial pneumonia
Encourage rest IV antibiotics fluids
62
What is a pneumothorax
Accumulation of air in the pleural space
63
Manifestations of pneumothorax
Chest pain back pain labored breathing decreased oxygen saturations
64
Plural effusion
Accumulation of fluid in the pleural space
65
Manifestations of plural effusion
Chest pain back pain labored respirations decrease oxygen saturations tachycardia
66
Bacterial epiglottis is
Medical emergency usually caused by HIP 
67
Expected findings in bacterial epiglottitis
Absence cough
drooling
agitation
sitting upright with chin pointed out in mouth open
thick muffled voice like the frog life croaking sound
dysphasia
stridor
68
Nursing care of bacterial Epiglottitis
Avoid throat culture or using tongue blade
prepare for intubation
provide humidified air
droplet isolation precautions for first 24 hours
69
What causes Acute laryngotracheobronchitis
Causative agent including RSV influenza a and B and pneumonia
70
Another name for Laryngotracheobronchitis
Croup
71
Expected findings in croup
Restlessness
hoarseness
barky cough
dyspnea
strider
retractions
nasal flaring
night time episodes of obstructions
72
Nursing care for croup
Provide humidified oxygen with coolmist nebulize Eppinette friend as prescribed administer corticosteroids dexamethasone
73
Influenza a and B expected findings
Fever and chills dry throat dry cough flushed face photophobia myalgia(pain in muscles) fatigue
74
A nurse is caring for a child who has bronchiolitis which of the following action should the nurse take (select) 
Administer oral prednisone
Initiate chess percussions and posterior drainage
administer humidified oxygen
suction the nasopharynx as needed administer oral penicillin
administer humidified oxygen
suction the nasopharynx as needed
75
A nurse is caring for a child who is postoperative period following a tonsillectomy which of the following is a clinical finding of postoperative bleeding
HGB 11.6 and HCT 37%
inflamed and red in throat frequent swallowing and clearing of the throat
Blood tinged mucus
Swallowing and clearing of the throat
76
A nurse is caring for a child in the postoperative period following a tonsillectomy which of the actions should the nurse take
Encourage the child to blow their nose gently administer analgesics on a schedule
offer orange juice
position the child supine 
Administer analgesics on the schedule
77
A nurse is assessing a child who has epiglottitis which of the following findings should the nurse expect (select)
Hoarseness in difficulty speaking
difficulty swallowing
low-grade fever
drooling
dry barking cough
stridor 
Hoarseness in difficulty speaking
difficulty swallowing
drooling
stridor
78
What is asthma
A chronic childhood inflammatory disorder of the airways that result in intermittent and reversible airflow obstruction of the bronchioles 
79
What is the leading cause of hospitalizations among children
Asthma
80
Risk factors for asthma
Family history of asthma + allergies
sex- boys are affected more than girls in adolescence than greater in girls
tobacco smoke
low birthweight
being overweight
81
Triggers to asthma
Mold dust grass pollen trees smokes exercise cold air animal hair medication allergies
82
Expected findings in asthma
Chest tightness audible wheezing crackles mucus production use of accessory muscles decreased O2 in audible breath sounds
83
Intermittent asthma
Findings 0 to 2 times a week
nighttime findings - from 0 to 4 none
from 5 to 11 two times a month
no activity limitations
use of short acting beta agonist is less than twice a week
84
Mild persistent asthma
Findings more than twice a week but not daily
nighttime findings from 0 to 4- 1 to 2 times a month from 5 to 11 - 3 to 4 times a month
minor activity limitations
use of short acting beta agonist more than two days a week but not daily
85
Moderate persistent asthma
Frequency daily
nighttime findings 0 to 4 - 3 to 4 times a month 5 to 11 more than once a week but not daily
some activity limitations
daily use of short acting beta agonist
86
Severe persistent asthma
Frequency continual
nighttimes findings frequent
extreme activity limitations
several times a day use of short acting beta agonist
87
Pulmonary function test
The most accurate test for diagnosing asthma and its severity
test every 1 to 2 years
88
Nursing care for asthma
Assess airway patency 
respiratory rate
use of accessory muscles
breath sounds
SOB
dyspnea
audible wheezing
absence of wheezing can indicate severe constriction of alveoli
89
Medication for asthma That prevents exercise-induced asthma
Short acting beta agonist albuterol
90
Medication for asthma especially used at night
Long lasting beta agonist formoterol 
91
What is a peak flow meter and how does it work
Use at the same time each day
ensure the mark is zero
have child stand up straight
close lips around mouthpiece
blow out as hard as quickly as possible read number
repeat 2 to 3 times record highest number
92
What is status asthmaticus
A life-threatening episode of airway obstruction that is often unresponsive to common treatment it is considered a prolonged severe asthma attack
93
Manifestations of status asthmaticus
Wheezing labored breathing nasal flaring lack of movement in lungs use of accessory muscles hypoxia diaphoresis
94
What is respiratory failure
Persistent hypoxemia related to asthma can lead to respiratory failure
95
The nurse is assessing a child who has asthma which of the following indications of deterioration in the child’s respiratory status (select)
Oxygen saturation is 95%
wheezing
retractions of sternal muscles
warm extremities
nasal flaring
Wheezing
retraction of sternal muscles
nasal flaring
96
The nurse is teaching an adolescent about the appropriate use of his asthma medication which of the following medication should the nurse instruct the client to use as needed before exercise
fluticasone/ salmeterol
Montelukast
Prednisone
Albuterol
Albuterol
97
A nurse is planning for a care for a child who has asthma which of the following intervention should the nurse include in the plan of care( select)
Perform chest percussions
place the child in an upright position
monitor oxygen saturation
administer bronchodilators
administer dornase Alfa daily
Place patient in upright position
monitor oxygen saturation
administer bronchodilators
98
A nurse is teaching a client who has asthma how to use a peak flow meter which of the following information should the nurse include in the teaching (select)
Zero to meter before each use
record the average of attempts
perform three times
deliver a long slow breath into the meter
sit in the chair with feet on the floor
Zero to meet her before each use perform three times
99
A nurse is discussing risk factors for asthma with a group of newly licensed nurses which of the following condition should the nurse include in the teaching (select)
Family history of asthma
family history of allergies
exposure to smoke
low birthweight
being underweight
Family history of asthma
family history of allergies
exposure to smoke
low birthweight
100
What is cystic fibrosis
Cystic fibrosis is a respiratory disorder that results from inheriting a mutated gene it is characterized by mucous glands that secrete an increase in the quantity of thick tenuous mucus which leads to mechanical obstruction of organs
101
What organs does cystic fibrosis affect
Pancreas lungs liver small intestine and reproductive system
102
What are two common findings of cystic fibrosis
Increased sodium in sweat salty sweat and fatty stools
103
What is a risk factor for cystic fibrosis
Both biological parents carry the recessive trait for cystic fibrosis
104
What is meconium ileus
Distention of the abdomen vomiting and inability to pass stool
105
What is the earliest indication of cystic fibrosis in newborn
Meconium ileus
106
Respiration findings in cystic fibrosis
Wheezing
rhonci
cough
obstructive emphysema
actelectasis on x-ray cyanosis
barrel shaped chest
clubbing a fingers and toes
107
G.I. expected findings in cystic fibrosis
Large frothy bulky Gracie foul smelling stools (steatorrhea-fatty stools)
Failure to gain weight or weight loss
delayed growth patterns
distended abdomen- infants
Thing arms and legs - infants
deficiency of fat soluble vitamins
prolapse rectum-infants 
108
Integumentary expected findings in cystic fibrosis
Sweat tears and saliva have excessively high content of sodium
109
Diagnostic procedures for cystic fibrosis
DNA testing to isolate the mutation
stool analysis for presents a fat collection of sweat from two different sites for adequate sample
110
Diagnosis confirmation of cystic fibrosis
Chloride greater than 40 for infants less than three months of age and greater than 60 for all of us sodium greater than 90
111
Management in cystic fibrosis
Airway clearance therapy
avoid ACT immediately before and after meals
high in protein and calories diet
have three meals a day
administer pancreatic enzymes within 30 minutes of eating
encourage add salt
related to diabetes monitor glucose levels
112
Medication‘s that help treat pancreatic insufficiency
associate with cystic fibrosis
Pancreatic enzymes 
monitor stools while taking
113
A nurse is reviewing a diagnostic signing for preschool age child who is suspected of having cystic fibrosis which of the following findings should the nurse identify as an indication of cystic fibrosis
Sweat chloride Contant 85
increase blood levels of fat soluble vitamins
72 hours to analysis sample indicated hard packed stools
chest x-ray negative for atelectasis 
Sweat chloride Contant 85
114
A nurse is admitting a child who is cystic fibrosis which is the following medication should the nurse expect to include in the plan of care (select)
Tobramycin
Loperamide
Fat-solvable vitamins
Albuterol
Dornase Alfa
 Tobramycin
Fat-solvable vitamins
Albuterol
Dornase Alfa
115
A nurse is performing in administration assessment for a clock child who is cystic fibrosis which of the following findings should the nurse expect (select)
Wheezing
clubbing of the fingers and toes
barrel shaped chest
thin watery mucus 
rapid growth spurts
Wheezing
clubbing of the fingers and toes
barrel shaped chest
116
A nurse is providing discharge teaching for a child who has cystic fibrosis which of the following instruction should the nurse include
Provide a low calorie low protein diet administer pancreatic enzymes with meals and snacks
implement a fluid restriction during times of infection
restrict physical activity
Administer pancreatic enzymes with meals and snacks
117
A nurse is teaching a group of guardians about influenza which of the following information should the nurse include in the teaching
Amantadine will prevent the illness
Roma ya done is administered intrmuscularly
Zanamirvir can be given to children 1 year and older
Oseltamivir shoild be given within 48 hours of onset of Manifestations
Oseltamivir shoild be given within 48 hours of onset of Manifestations
