Peds Airway Disorders Flashcards
Can a child with a penicillin allergy take piperacillin/tazobactam (Zosyn) (multi drug)?
No, because piperacillin/tazobactam (Zosyn) is a type of extended-spectrum penicillin, which could cause an allergic reaction in a child with a penicillin allergy.
- Together they are an extended-spectrum antibiotic used to treat more resistant bacterial infections.
Nursing Management of pediatric clients with acute and chronic respiratory alterations.
- Accurate assessment
- Maintaining & promoting airway for gas exchange
- Promoting comfort
- Administering medications
- Performing swabs for cultures
- Pt. / family education (Immunizations)
- Evaluation of the care related to patient outcomes
9 S/S of Immunization reactions
- Redness, swelling, or pain at the injection site
- Hardness or a lump at the site
- Low-grade fever
- Fatigue or tiredness
- Irritability or fussiness (in children)
- Loss of appetite
- Headache
- Muscle aches
- Anaphylaxis reaction
What med is given if an allergic reaction occurs?
SUB Q Epi
(small tiny doses for children- tuberculin syringes)
-1st line treatment for anaphylaxis (severe allergic reaction) by reversing airway swelling and hypotension
Normal Vital Signs
know
Respiratory dysfunction (lungs & airways fail to function properly) in children tends to be more ____ than in adults
severe
What is babies’ preferential way of breathing?
- Nose breathers until at least 4 WEEKS of AGE.
- Young infants cannot automatically open their mouths to breathe if the nose is obstructed.
Why do infants and children have an increased incidence of airway obstruction?
- The tongue of an infant relative to the oropharynx is larger than in adults.
- Additionally, children tend to have enlarged tonsillar and adenoidal tissue even in the absence of illness, which contributes to an increased incidence of airway obstruction.
Trachea is ___ in children than adults.
smaller.
* So, a small reduction in the airway will result in increased resistance in airflow. This increases the work of breathing.
Why do pediatric patients have a higher risk of hypoxemia?
(related to lungs)
- due to a smaller number of alveoli
- Child develops the adult number of alveoli between ages of 3 - 8 yo
- Hypoxia = EASIER & FASTER
Why are infants more prone to frequent respiratory infections?
- Due to the LACK of Immunoglobulin A (IgA) in the mucosal lining of the UPPER respiratory tract
-antibody found in mucosal lining & secretions (saliva,breast milk). Provides 1st LINE OF DEFENSE. - This reduces their ability to defend against pathogens.
Adult O2 demand is
3-4 L
Pediatric O2 demand is
6-8 L
(Doubled than adults)
What respiratory rate description indicates that an acutely ill child may be in respiratory distress?
Slow & Irregular (inconsistent pattern) RR
-this is a medical emergency
Why is humidification important when delivering oxygen to pediatric patients?
Prevent drying of nasal passages and help liquefy secretions, which aids in easier clearance and improves comfort.
What is the recommended liter flow for a nasal cannula in children?
4 liters per minute.
Types of O2 masks and their concentration delivery
Be familiar
Medical tx: Respiratory disorder
Q: When should chest physiotherapy and postural drainage be avoided in children?
Should be avoided after a meal, and the timing needs to be precise to prevent discomfort or aspiration.
Q: At what age is foreign body aspiration most common in children?
children between 6 months and 3 years of age.
Q: What type of obstruction does a child have if they ⁰cannot speak or cry when something is lodged in their airway?
It likely means they have a complete airway obstruction from a foreign object
- This is a MEDICAL EMERGENCY
What is the FIRST thing you do if suspected foreign body aspiration.
Remove foreign body- get ready for surgery STAT
What are assessment findings for a child with suspected foreign body aspiration?
- History: Sudden onset of symptoms and increased work of breathing.
-
Breath sounds:
-Stridor
-Cough
-Wheezing
-Rhonchi
-Decreased aeration on the affected side
Foreign Body Aspiration:
Breath sound that suggests the foreign body is lodged in the upper airway.
Stridor
Foreign Body Aspiration:
Often present as the body attempts to clear the obstruction.
Cough
Foreign Body Aspiration:
May indicate partial obstruction, often in LOWER airways
Wheezing and Rhonchi
Foreign Body Aspiration:
Common on the affected side of the lung due to impaired airflow.
Decreased aeration
* refers to reduced airflow reaching certain parts of the lungs, which can be detected during auscultation as diminished breath sounds
A child with PARTIALLY blocked airways will present with what s/s?
List 4
- coughing
- stridor/wheezing : HIGH pitched whistling sound heard during EXPIRATION- due to narrowed airways
- watery eyes
- trouble speaking
A child with fully blocked airway will present with
- More panicked
- Inability to make any sound
- cyanotic
- Silent chest- MEDICAL EMERGENCY!!!
- unconscious
-low O2 to brain = brain damage can start after a FEW MINS w/o O2
No. 1 PREVENTION for Foreign body Aspiration
prevention!!!- EDUCATE!!
-no meds needed-all is education to prevent!!
The rest of the Nursing Interventions for Foreign Body Aspiration
- Education at well-child visits through the age of 5 on aspiration prevention
- Avoid allowing the child to play with small parts and coins
- Do not feed peanuts or popcorn to the child until they are at least 3 years old.
- Chop all foods so that they are small enough to pass down
- Carrots grapes and hot dogs should be cut into small pieces
- Keep harmful liquids out of reach
A 2-year-old child arrives at the emergency department with suspected foreign body aspiration. The child is coughing, has stridor, and is showing signs of respiratory distress. What is the nurse’s priority action to reduce the risk of complications?
A. Monitor oxygen saturation and administer humidified oxygen
B. Encourage the child to cough to attempt self-clearance of the obstruction
C. Prepare the child for immediate intervention to remove the foreign body
D. Obtain a detailed health history and assess for pre-existing respiratory conditions
C. Prepare the child for immediate intervention to remove the foreign body
Rationale: Immediate intervention to remove the foreign body is crucial to prevent complete airway obstruction and potentially fatal complications. Monitoring oxygen and encouraging coughing (options A and B) may provide temporary relief but do not address the obstruction. Delaying to gather more history (option D) is not appropriate in this emergency.
What surgical procedure is commonly used for the removal of a foreign body from the airway?
bronchoscopy
Q: What are the nursing interventions for a child with a foreign body aspiration?
- Obtain an adequate history from the parents or caregivers to understand the situation.
- Provide supplemental oxygen, as ordered, to help with breathing.
- Insert a peripheral IV line and keep it open, as ordered, for any necessary treatments.
- Keep the child nothing by mouth (NPO) until instructed otherwise by the doctor.
- Reassure the child continually, explaining all tests and treatments in an age-appropriate way.
- Assist with diagnostic imaging and lab tests as needed to help identify the foreign body.
- Monitor for signs of respiratory distress, such as difficulty breathing or changes in oxygen levels.
- Provide support to the child and family by listening actively, answering questions, and being empathetic.
- Encourage positive coping strategies to help the family manage stress.
- Collaborate with social services to offer counseling, community resources, and additional support.
Q: How is apnea defined in infants and young children?
- Apnea is defined as the absence of breathing for longer than 20 seconds
- Often accompanied by bradycardia (slow heart rate) or oxygen desaturation (low oxygen levels)
Q: How is apnea in infants treated?
Addressing the underlying cause
-such as treating an infection if present.
Q: What is an Acute life-threatening event (ALTE) in infants?
An ALTE is a serious, potentially life-threatening episode in an infant or child lasting GREATER than 1 min
-It is characterized by a combination of symptoms that apear life-threatening:
* apnea
* color change
* muscle tone alteration: floppy or muscle stiffness
* gagging **
What is Cystic Fibrosis
- Genetic disorder that primarily affects the lungs and digestive system.
- leads to thick, sticky mucus in various organs, which** can clog airways in the lungs and block ducts in the digestive system**.
Q: Patho for Cystic fibrosis (CF)?
- Decreased secretion of chloride leads to water transport abnormalities
- Increased reabsorption of water and sodium in ALL EXOCRINE secretions.
- Results in thick, sticky mucus in the lungs, pancreas, and other organs.
- Sweat glands produce higher amounts of chloride, causing a salty taste on the skin.
- Loss of pancreatic enzyme activity leads to poor growth and the production of large, malodorous stools due to nutrient malabsorption.
What is usually the first 2 sign in NEWBORNS with cystic fibrosis?q1
-
Meconium ileus: meconium is viscous and sticky causing a blockage in the small intestine, specifically in the ileum
- Noticed when meconium stool (1st stool) fails to appear within 24-48 hrs
- belly will be distended - Meconium stool
Maintaining Cystic Fibrosis
- INHALERS (bronchodilators) should be given before chest physiotherapy to help open the airways.
- CPT can be performed using the vest airway clearance system, flutter-valve device, or positive expiratory pressure (PEP) therapy to help mobilize and clear secretions from the lungs.
