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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
what are some complications of strep throat?
Rheumatic fever Acute glomerulonephritis onset Peritonsillar or retropharyngeal abscess
26
what are the diagnostics for acute infectious pharyngitis?
Rapid strep test & throat culture (swab same time to minimize trauma)
27
what is the therapeutic management for acute infectious pharyngitis?
 Oral penicillin. Azithromycin/ cephalosporin if allergic to PCN  Pain management  Encourage fluid intake.  Saline Gargles  Lozenges  Cool liquids
28
what is mononucleosis caused by?
Self-limiting, caused by Epstein-Barr virus
29
what are the symptoms of mononucleosis?
 Fever  Malaise  Sore throat  Lymphadenopathy
30
what is mononucleosis transmitted by?
oropharyngeal secretions
31
what is the treatment for mononucleosis?
Symptomatic care; NSAIDs, lozenges, saltwater gargles
32
what are the complications of mononucleosis?
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
what is croup
causes swelling of the airway stridor - high pitched creaking (sounds like a seal)
34
what age does croup typically affect?
children 3 months to 3 years old
35
what are the causes of croup?
Viral: Parainfluenza often but can be caused by other viruses
36
what are the clinical manifestations of croup?
Stridor, retractions, nasal flaring, barky or seal- like cough, hoarseness, tachypnea, slight increased temp, mild URI symptoms Symptoms most often at night
37
how long does croup typically last?
lasts about 3 to 5 days
38
what is the therapeutic management of croup?
Cool mist vaporizer, nebulized racemic epinephrine, steroids, saline to nose if congestion, educate and reassure paren
39
is epiglottis a medical emergency?
yes
40
what is epiglottis?
inflammation of the epiglottis that can lead to upper airway obstruction
41
what causes epiglottitis?
H. influenzae
42
what are the clinical manifestations of epiglottitis?
abrupt onset usually starts with fever and sore throat and then progresses to drooling, anxiety, irritability, respiratory distress
43
what is the treatment of epiglottitis?
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
what is the prevention for epiglottitis?
HIB vaccine
45
what causes bronchiolitis?
Viral. Most often RSV but adenovirus, parainfluenza, and human meta-pneumovirus may also be the cause. Most often occurs in winter and spring
46
what are the clinical manifestations of bronchiolitis?
Rhinorrhea, pharyngitis, coughing, wheezing, low- grade fever, retractions, apnea
47
ELISA assay, IFA staining, Chest x-ray to show hyperinflation on the lungs, but is not routinely recommended in diagnosing what disease?
bronchiolitis
48
what is the therapeutic management of bronchiotitis?
Humidified oxygen, fluids, airway maintenance, saline to nose, suction, positioning, medications, handwashing, contact isolation, pulse oximetry. Monitor respiratory rate and rhythm
49
how do we prevent bronchiolitis?
Palivizumab (Synagis)-only if meet criteria. Given once monthly during RSV season
50
what is the cause of pneumonia?
Viral, bacterial (streptococcus pneumoniae), mycoplasma (school-age and adolescents), fungal, or aspiration
51
what are the clinical manifestations of pneumonia?
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
if recurrent pneumonia, child should be evaluated for what?
chronic lung disease such as asthma or cystic fibrosis
53
what are the complications of pneumonia?
Empyema, pneumothorax, pleural effusion, abscess, bacteremia
54
what is the therapeutic management of pneumonia?
Promote oxygenation, position of comfort, fluids, family support, antibiotics if bacterial, pulse oximetry
55
how can we prevent pneumonia?
handwashing prevnar 13 -- a vaccine for pneumococcal bacterial
56
what is pertussis also called?
whooping cough
57
what is pertussis?
a highly contagious acute resp disorder
58
what are the symptoms of pertussis?
 Paroxysmal cough (whooping cough)  Copious secretions Children under 1 year are most vulnerable Incubation 6-21 days “100 day cough”
59
what are the complications of pertussis?
Hypoxia, apnea, pneumonia, seizures, encephalopathy, and death
60
what are the nursing considerations of pertussis?
Droplet precautions Monitor oxygenation Supportive care (NG tube if unable to tolerate feeds)
61
how is pertussis diagnosed?
Bordetella pertussis PCR
62
what is the treatment for pertussis?
Azithromycin
63
what is the prevention for pertussis?
vaccination
64
what causes tuberculosis?
Very contagious. Caused by inhalation of droplets of Mycobacterium tuberculosis Incubation period 2 to 10 weeks
65
what are the clinical manifestations of tuberculosis?
Fever, malaise, anorexia, weight loss, cough, diminished breath sounds, pallor, weakness, night sweats
66
what are the diagnostics for tuberculosis?
TB skin test (positive induration), Chest x-ray, cultures If positive TB test but no symptoms and negative CXR, have latent infection
67
what is the therapeutic management for tuberculosis?
Adequate nutrition, Isoniazid, rifampin and pyrazinamide daily, prevent exposure to other infections, airborne isolation with negative pressure room for active/infectious
68
how do you prevent tuberculosis?
Avoid contact with the tubercle bacillus. Increased incidence in crowded living conditions, +HIV
69
what are the causes of asthma?
Chronic inflammation of airways with characteristics of:  Airway hyperresponsiveness (bronchoconstriction)  Airway edema  Mucus production
70
what are the clinical manifestations of asthma?
Recurrent cough; shortness of breath; wheezing; exercise intolerance; hypoxia
71
what is a long term complication of asthma?
airway remodeling
72
what are the diagnostic evaluations for asthma?
Pulmonary function tests (PFTs); Peak expiratory flow rate (PEFR); skin testing or RAST to assess for allergic triggers; chest x-ray (hyperinflation)
73
what is the stepwise approach?
increasing medications as condition worsens then reducing as symptoms improve
74
what is the cause of cystic fibrosis?
Inherited autosomal recessive gene from both parents
75
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?
cystic fibrosis
76
what does the GI management of CF consist of?
Pancreatic enzyme replacement to help break down fats– pancrelipase (Pancrease, Creon) Well-balanced, high-protein, high caloric diet

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