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Peds > Peds Respiratory > Flashcards

Peds Respiratory Flashcards

1
Q

babies are nose breathers until when?

A

4 weeks old

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2
Q

what are larger in infants and children even when well?

A

tonsils and adenoids

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3
Q

what do wheezes sounds like?

A

high pitched usually on expiration

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4
Q

what do rales sound like?

A

crackling sound

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5
Q

what is the cause of acute nasopharyngitis (common cold)?

A

RSV, rhinovirus, adenovirus,
enterovirus, influenza, and
parainfluenza viruses

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6
Q

what are the clinical manifestations of acute nasopharyngitis (common cold)?

A

More severe in infants and
children than in adults.

Nasal mucus (abundant)
causing mouth breathing

Irritability/restlessness

Fever is common in young and
older children

Duration 7 to 10 days

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7
Q

Acute nasopharyngitis therapeutic management

A

Rest, cool mist humidifier,
fluids, decongestants (if age-
appropriate), elevate head of
bed, saline to nose, bulb
syringe suction, hand washing,
family support and education

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8
Q

prevention of acute nasopharyngitis

A

Frequent
handwashing, avoid sick
contacts

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9
Q

potential complications of acute nasopharyngitis

A

Bacterial infections of ears,
throat, sinuses, or lungs

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10
Q

why are children more susceptible to acute otitis media?

A

Infants and children more susceptible due to
shorter and more horizontal eustachian tubes

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11
Q

what is the pathophysiology of acute otitis media?

A

Fluid and pathogens travel upward from the nasopharyngeal area

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12
Q

is acute otitis media viral or bacterial?

A

can be either viral or bacterial

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13
Q

what are the symptoms of acute otitis media?

A

fever and pain

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14
Q

what is the treatment of acute otitis media?

A

antibiotic if bacterial viral will resolve without treatment

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15
Q

acute otitis media prevention

A

Breastfeed infants if possible
Avoid second-hand smoke
Routine childhood immunizations

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16
Q

what is the cause of influenza?

A

influenza virus

spread by inhalation of droplets or contact with fine particle aerosols

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17
Q

what are the clinical manifestations of influenza?

A

fever
chills
body aches
runny nose
cough
diarrhea
fatigue

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18
Q

what is the duration of influenza?

A

4-5 days

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19
Q

what are the complications of influenza?

A

Secondary bacterial infections
(OM, sinusitis, pneumonia)

Myositis (pain and tenderness in
legs and refusal to walk)

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20
Q

therapeutic management of influenza

A

Therapeutic management-
symptomatic, antipyretic medication,
antiviral influenza medication (when
appropriate)
Honey for cough in children >2 years old

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21
Q

Prevention of influenza vaccines

A

Essential for prevention

High-risk children with chronic
conditions are at most risk of severe influenza

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22
Q

causes of Acute Infectious Pharyngitis

A

multiple viruses, group A B-
hemolytic streptococci (GABHS)

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23
Q

clinical manifestations of Acute Infectious Pharyngitis

A

pharyngitis, headache, fever and
abdominal pain.

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24
Q

group A strep throat

A

Inflamed tonsils with exudate

Sandpaper rash (scarlatina),
cervical lymphadenopathy with
tenderness, pain

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25
Q

what are some complications of strep throat?

A

Rheumatic fever

Acute glomerulonephritis onset

Peritonsillar or retropharyngeal
abscess

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26
Q

what are the diagnostics for acute infectious pharyngitis?

A

Rapid strep test & throat culture (swab
same time to minimize trauma)

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27
Q

what is the therapeutic management for acute infectious pharyngitis?

A

 Oral penicillin. Azithromycin/
cephalosporin if allergic to PCN
 Pain management
 Encourage fluid intake.
 Saline Gargles
 Lozenges
 Cool liquids

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28
Q

what is mononucleosis caused by?

A

Self-limiting, caused by
Epstein-Barr virus

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29
Q

what are the symptoms of mononucleosis?

A

 Fever
 Malaise
 Sore throat
 Lymphadenopathy

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30
Q

what is mononucleosis transmitted by?

A

oropharyngeal secretions

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31
Q

what is the treatment for mononucleosis?

A

Symptomatic care; NSAIDs,
lozenges, saltwater gargles

32
Q

what are the complications of mononucleosis?

A

Splenic Rupture-no
contact sports for 3
weeks

Guillain-Barre
syndrome

Aseptic meningitis

Viral hepatitis

Increased risk of
some types of
cancers later in life

33
Q

what is croup

A

causes swelling of the airway

stridor - high pitched creaking (sounds like a seal)

34
Q

what age does croup typically affect?

A

children 3 months to 3 years old

35
Q

what are the causes of croup?

A

Viral: Parainfluenza often but can be caused by other viruses

36
Q

what are the clinical manifestations of croup?

A

Stridor,
retractions, nasal flaring, barky or seal-
like cough, hoarseness, tachypnea, slight
increased temp, mild URI symptoms
Symptoms most often at night

37
Q

how long does croup typically last?

A

lasts about 3 to 5 days

38
Q

what is the therapeutic management of croup?

A

Cool mist
vaporizer, nebulized racemic epinephrine,
steroids, saline to nose if congestion,
educate and reassure paren

39
Q

is epiglottis a medical emergency?

A

yes

40
Q

what is epiglottis?

A

inflammation of the epiglottis that can lead to upper airway obstruction

41
Q

what causes epiglottitis?

A

H. influenzae

42
Q

what are the clinical manifestations of epiglottitis?

A

abrupt onset usually starts with fever and sore throat and then progresses to drooling, anxiety, irritability, respiratory distress

43
Q

what is the treatment of epiglottitis?

A

position of comfort

oxygen in the least invasive manner

prepare for intubation and have emergency airway equipment at the bedside

intensive observation

corticosteroids

antibiotics

44
Q

what is the prevention for epiglottitis?

A

HIB vaccine

45
Q

what causes bronchiolitis?

A

Viral. Most often RSV
but adenovirus, parainfluenza,
and human meta-pneumovirus
may also be the cause.
Most often occurs in winter
and spring

46
Q

what are the clinical manifestations of bronchiolitis?

A

Rhinorrhea, pharyngitis,
coughing, wheezing, low-
grade fever, retractions, apnea

47
Q

ELISA assay, IFA staining,
Chest x-ray to show
hyperinflation on the lungs,
but is not routinely
recommended in diagnosing what disease?

A

bronchiolitis

48
Q

what is the therapeutic management of bronchiotitis?

A

Humidified oxygen, fluids, airway
maintenance, saline to nose,
suction, positioning, medications,
handwashing, contact isolation,
pulse oximetry.
Monitor respiratory rate and rhythm

49
Q

how do we prevent bronchiolitis?

A

Palivizumab
(Synagis)-only if meet criteria.
Given once monthly during RSV
season

50
Q

what is the cause of pneumonia?

A

Viral, bacterial (streptococcus
pneumoniae), mycoplasma (school-age and adolescents), fungal, or aspiration

51
Q

what are the clinical manifestations of pneumonia?

A

Viral generally is better
tolerated while bacterial may be more toxic appearing.

High fever, cough, tachypnea, crackles, malaise,
lethargy, anorexia, abdominal pain. CXR- diffuse or
patchy infiltratio

52
Q

if recurrent pneumonia, child should be evaluated for what?

A

chronic lung disease such as asthma or cystic fibrosis

53
Q

what are the complications of pneumonia?

A

Empyema, pneumothorax,
pleural effusion, abscess, bacteremia

54
Q

what is the therapeutic management of pneumonia?

A

Promote oxygenation, position of comfort, fluids, family
support, antibiotics if bacterial, pulse oximetry

55
Q

how can we prevent pneumonia?

A

handwashing

prevnar 13 – a vaccine for pneumococcal bacterial

56
Q

what is pertussis also called?

A

whooping cough

57
Q

what is pertussis?

A

a highly contagious acute resp disorder

58
Q

what are the symptoms of pertussis?

A

 Paroxysmal cough (whooping cough)
 Copious secretions
Children under 1 year are most vulnerable
Incubation 6-21 days
“100 day cough”

59
Q

what are the complications of pertussis?

A

Hypoxia, apnea, pneumonia, seizures, encephalopathy,
and death

60
Q

what are the nursing considerations of pertussis?

A

Droplet precautions

Monitor oxygenation

Supportive care (NG tube if unable to tolerate feeds)

61
Q

how is pertussis diagnosed?

A

Bordetella pertussis PCR

62
Q

what is the treatment for pertussis?

A

Azithromycin

63
Q

what is the prevention for pertussis?

A

vaccination

64
Q

what causes tuberculosis?

A

Very contagious. Caused
by inhalation of droplets of
Mycobacterium tuberculosis

Incubation period 2 to 10 weeks

65
Q

what are the clinical manifestations of tuberculosis?

A

Fever, malaise, anorexia, weight loss, cough, diminished breath sounds, pallor, weakness, night sweats

66
Q

what are the diagnostics for tuberculosis?

A

TB skin test
(positive induration), Chest x-ray,
cultures

If positive TB test but no
symptoms and negative CXR,
have latent infection

67
Q

what is the therapeutic management for tuberculosis?

A

Adequate nutrition, Isoniazid,
rifampin and pyrazinamide daily,
prevent exposure to other
infections, airborne isolation with
negative pressure room for
active/infectious

68
Q

how do you prevent tuberculosis?

A

Avoid contact with
the tubercle bacillus. Increased
incidence in crowded living
conditions, +HIV

69
Q

what are the causes of asthma?

A

Chronic inflammation of airways with
characteristics of:
 Airway hyperresponsiveness (bronchoconstriction)
 Airway edema
 Mucus production

70
Q

what are the clinical manifestations of asthma?

A

Recurrent cough; shortness of
breath; wheezing; exercise intolerance; hypoxia

71
Q

what is a long term complication of asthma?

A

airway remodeling

72
Q

what are the diagnostic evaluations for asthma?

A

Pulmonary function tests
(PFTs); Peak expiratory flow rate (PEFR); skin testing or
RAST to assess for allergic triggers; chest x-ray (hyperinflation)

73
Q

what is the stepwise approach?

A

increasing medications as condition worsens then reducing as symptoms improve

74
Q

what is the cause of cystic fibrosis?

A

Inherited autosomal recessive gene from both
parents

75
Q

Salty taste of skin, alterations in electrolyte balance
and dehydration
 Meconium ileus
 Bulky, greasy stools
 Pancreatic enzyme activity is lost, malabsorption of
nutrients, failure to thrive
 Mucus plugs in small airways
 Chronic or recurrent respiratory infections
 Decreased fertility

are all clinical manifestations of what disease?

A

cystic fibrosis

76
Q

what does the GI management of CF consist of?

A

Pancreatic enzyme replacement to help break down fats– pancrelipase (Pancrease, Creon)

Well-balanced, high-protein, high caloric diet

Peds (4 decks)

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