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Peds/OB - Nrsg 206 > Quiz Unit J Respiratory Dysfunction > Flashcards

Quiz Unit J Respiratory Dysfunction Flashcards

1
Q

What do you assess for before drawing an ABG?

A

Respiratory rate, ease, depth, skin color, pain, and do an Allen test prior to drawing

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2
Q

When do babies stop being total nose breathers?

A

After the first month

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3
Q

Why are kids under the age of 8 more prone to aspiration?

A

Epiglottis is long and floppy, more susceptible to swelling. Trachea is shorter and narrower, and about the size of their pinkie finger (4mm in infants)

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4
Q

At what age are the lungs fully developed?

A

12

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5
Q

Kids are abdominal breathers until the age of _____.

A

6

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6
Q

What are the different croup syndromes?

A

Infections that affect the epiglottis and larynx, and bronchi

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7
Q

Most viral URI’s are caused by the _____virus.

A

RSV (Respiratory Syncytial Virus)

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8
Q

What are viral infections so common and severe in kids 6 month to 3 years old?

A

The bronchial and Eustachian tubes are short

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9
Q

When does RSV season occur?

A

Winter and spring

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10
Q

What are some common s/s of a URI?

A

Fever, anorexia, vomiting, diarrhea, abdominal pain, cough, sore throat, nasal discharge/blockage, respiratory sounds

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11
Q

At what point is a temperature addressed in children?

A

At 102 degrees

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12
Q

How are URI’s managed?

A

Ease respiratory effort, hydration/nutrition, rest/comfort, prevent spread, COMFORT measures only (most of the time)

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13
Q

Which symptom needs to be checked further?

A

Sore throat, may be strep, needs antibiotics

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14
Q

What is done for pharyngitis?

A

Usually nothing, unless strep. Soft or cool liquid diet (eases swelling and inflammation)

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15
Q

Who is a flu shot not recommended for?

A

Asthmatics

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16
Q

Who shouldn’t get the nasal mist?

A

Children under 2

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17
Q

Why don’t children get aspirin?

A

Reye’s syndrome

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18
Q

When can the flu virus be spread?

A

24 hrs before symptoms appear and 24 hrs after symptoms disappear

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19
Q

How is the flu spread?

A

By droplet and contact

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20
Q

What are the s/s of the flu?

A

Photophobia, exhaustion, red face, dry hacking cough, aches/pains

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21
Q

What is done for the flu?

A

Hydration, hydration, hydration

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22
Q

What is done for repeated occurrences of otitis media?

A

Tubes in the ears

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23
Q

What is usually done pharmacologically for otitis media?

A

Usually nothing

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24
Q

How can we prevent otitis media?

A

Reduce tobacco smoke exposure, no pacifier, no bottle propping

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25
Q

When is otitis common?

A

Before age 7 and in the winter months

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26
Q

If an antibiotic is needed for otitis media, what is given?

A

Amoxicillin, 80-90 mg/kg/day, divided into 2 doses, for 5-7 days

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27
Q

Describe the average case of mono?

A

Dx witha spot test (Epstein Barr virus), 30-50 days incubation, usually self-limiting

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28
Q

What s/s of epiglottitis is easiest to recognize?

A

Barking cough (also respiratory stridor)

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29
Q

What are some s/s of acute epiglottitis?

A

Tripod position, drooling, restlessness, sore throat, retractions, spontaneous coughing

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30
Q

What is the most important fact to know about acute epiglottitis?

A

Must be addressed by an MD experienced in this, nothing in the throat for any reason by staff. It is an emergent situation!

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31
Q

What is the treatment for acute epiglottitis?

A

IV antibiotics, steroids, HIB vaccine prevents

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32
Q

What do we do for acute epiglottitis?

A

Comfort, support family, NOTHING in the throat, DON’T even look at the throat, stay with the patient at all times

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33
Q

Who gets acute epiglottitis?

A

Usually kids under 7 yrs of age

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34
Q

Who gets LTB?

A

Age 3 months to 3 years

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35
Q

What is a complication of acute LTB?

A

Respiratory acidosis/failure, death

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36
Q

Who gets acute laryngitis?

A

Older children and teens and is more prevalent in males

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37
Q

When are kids with LTB treated in the hospital?

A

When stridor, retractions, or difficulty breathing is present, others treated at home

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38
Q

What does acute spasmodic laryngitis become if it is severe?

A

LTB

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39
Q

What is done for bacterial traceitis?

A

Humidified O2 (due to secretions), antipyretics, antibiotics, may need intubation

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40
Q

What are the s/s of acute bacterial tracheitis?

A

Stridor, barking cough, thick secretions, but no drooling

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41
Q

What is considered the “reactive” portion of the airway?

A

Bronchi and bronchioles (lower portion)

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42
Q

What is RAD and what are it’s manifestations?

A

Reversible, self-limiting, inflammation, mucous, edema, and bronchospasm of the airways that generally responds to supportive care. (ie, croup, asthma, and bronchiolitis)

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43
Q

What is the most common cause of hospitalization in kids under 1 yr of age?

A

RSV

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44
Q

What does bronchiolitis lead to?

A

Epithelial cells are shed into the bronchioles, causing obstruction/over inflation on exhalation (emphysema). This leads to hyperinflation and patchy atelectasis

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45
Q

What can RSV lead to?

A

Asthma

46
Q

What is done for bronchiolitis/RSV? When is it most common?

A

Rivoviren, Numex, humidified O2, isolation, fluids, no chest therapy or ATB. Winter/spring

47
Q

Where does interstitial pneumonia occur?

A

Alveoli

48
Q

What is pneumonitis?

A

Infection of the lung wall

49
Q

How are kids with pneumonia treated?

A

Postural drainage, antipyretics, fluids, cool mist humidifier. General support

50
Q

What can provide immunity to pertussis?

A

A single episode, but booster now recommeded btwn 10 and 19 years old, if not given at 10-18, can be given up to age 64

51
Q

What is the 2nd leading cause of death from infectious disease in the US?

A

TB

52
Q

What is done if person is non-compliant with TB therapy?

A

DOT therapy (someone watches them take the meds to ensure compliance)

53
Q

What causes resistant strains of TB?

A

Not completing TB therapy

54
Q

How is TB treated?

A

Rifampin, INH, and PZA

55
Q

What is done for resistant TB?

A

Streptomycin IM

56
Q

What are some nursing precautions for TB?

A

Airborne precautions, negative pressure room, respirator for patient contact

57
Q

How long does it take a child to die from aspiration?

A

4 minutes

58
Q

What foods should be avoided when considering aspiration in kids?

A

Grapes, small candy, carrots, BB’s, marbles, apple slices, beads/buttons/batteries, coins, hot dogs, PB, grapes, biscuits

59
Q

When are back blows/chest thrusts used for aspiration?

A

Back blows for >1 year, chest thrusts for <1 year

60
Q

When do you check for gag reflex?

A

Before and after a procedure

61
Q

How can you prevent aspiration?

A

Don’t feed laying down, frequent burping, no powders

62
Q

What is ARDS?

A

Increased permeability of the alveolar and capillary membranes causes edema

63
Q

When does ARDS require an ICU stay?

A

Sepsis, cancer, marrow transplant

64
Q

What nursing measures are needed if a child is in ICU due to ARDS?

A

Monitor closely, examine skin q2hrs, cardiac output, fluid/electrolyte balance, strict I&O (urometer), ABG’s, pulse ox, monitor nutrition (probably enteral/parenteral), ROM/exercise

65
Q

What 3 injuries occur from smoke inhalation?

A

Heat damages the upper airway, chimical damage occurs deep in the tract, and systemic damage occurs from CO

66
Q

How fast does CO bind to hemoglobin?

A

230 times faster than O2

67
Q

What are the 3 stages of smoke inhalation and when do they occur?

A

Pulmonary insufficiency occurs within 12 hrs, pulmonary edema occurs in 6-72 hours, and bronchial pneumonia occurs after 72 hours

68
Q

What CAN’T you use on kids suffering from smoke inhalation?

A

Pulse ox

69
Q

What are some effects of passive cigarette smoke?

A

Increased respiratory problems/asthma, otitis media, LBW/preterm/stillborn, SIDS, lung disease as adults, and a decrease in fetal growth

70
Q

What is asthma?

A

It is a reversible, reactive airway disease

71
Q

What are the most common s/s of asthma in children?

A

Cough/night time, wheeze, SOB

72
Q

What does it mean if a child is having daily asthma symptoms?

A

It is not well controlled

73
Q

What 3 things occur during an asthma flareup?

A

Bronchospasm/constriction, inflammation, mucous production

74
Q

What are some asthma triggers?

A

Lung/sinus/respiratory/ear infection, tobacco/wood smoke, strong odors, allergens, emotions, GERD, cold air, hard exercise

75
Q

What is the key to treating asthma?

A

Know the triggers for each individual child

76
Q

What are some warning signs of asthma?

A

Early: cough/worse at night, expiratory wheezing, listless, itchy eyes/throat/nose, grumpy, decreased appetite, drop in peak flow. Late signs: head bobbing, vomiting, anxiety, rescue med doesn’t help, drop in peak flow below 50% of peak

77
Q

What does it mean if your child has blue lips or blue nails?

A

Call 911

78
Q

Is bronchial constriction normal?

A

Yes, it is a normal reaction to foreign invasion. Asthma is an abnormally severe reaction

79
Q

What is “Step 1” asthma and what is the treatment?

A

Step system used in kids 5 and older. Step 1 = mild intermittent asthma; defined as s/s occurring 2 days per wk (only 1 per day), and 2 nights per nomth. It is treated with rescue meds only

80
Q

What is “Step 2” asthma and what is the treatment?

A

This is mild persistent asthma, and is defined as s/s 2 days per wk (1 per day at most) and more than 2 times a month at night. It is treated with low dose inhaled steroids

81
Q

What is “Step 3” asthma and what is the treatment?

A

This is moderate persistent asthma, and is defined as daily symptoms, with symptoms at night greater than 1 per week. It is treated with low to medium dose inhaled steroids and long acting Beta 2

82
Q

What is “Step 4” asthma and what is the treatment?

A

This is severe persistent asthma and is defined as continual symptoms during the day and frequently at night. Treatment is high dose inhaled steroids and long acting Beta 2

83
Q

What is done after a treatment involving steroids?

A

Brush teeth, rinse/spit, wash face if mask used

84
Q

What are some risk factors for asthma?

A

More common in boys before puberty, girls after puberty. Exposure to chemicals, parent with asthma, silicon exposure, LBW, obesity, GERD

85
Q

What is usually used for long term asthma control?

A

Prednisone, methylprednisone

86
Q

What meds is normally used as a rescue med for asthma?

A

Short acting Beta 2 like Proventyl, Ventalyn, Maxiair

87
Q

What are some examples of long acting Beta 2’s?

A

Formoterol and Budesonide = Symbicort, Salmeteraol and Fluticasone = Advair Formoterol and mometason = Dulera

88
Q

What is done for exercise induced asthma?

A

Use a rescue inhaler before exercise

89
Q

What does status asthmaticus require and what is it?

A

Ventilation. It is an asthma attack that does not subside with treatment

90
Q

What is done for status asthmaticus?

A

Epinephrine (Epi Pen) 0.01 mL/kg SubQ - Max dose is 0.03 mL/kg

91
Q

Why use a spacer with inhaled steroids?

A

With a spacer, only 22% of the med reaches the lungs. Without it, only 9%

92
Q

How long do you wait between puffs on an inhaler?

A

1 minute

93
Q

What is CF?

A

Cystic fibrosis is an exocrine gland dysfunction that produces multisystem involvement. It is the most common genetic illness in children

94
Q

How does CF affect the sexes differently?

A

Delayed puberty in females and sterility in males

95
Q

CF is an _____ _____ trait that affects 1 in 4 of the offspring if both parent have the defect.

A

Autosomal recessive

96
Q

What does CF cause (respiratory), and what is the treatment for it?

A

CF causes mechanical obstruction of the airways and is treated with giving the child a thumping

97
Q

What else does CF affect besides the respiratory tract?

A

Pancreatic, reproductive, and digestive tracts

98
Q

Why do CF patients develop anemia?

A

Lack of vitamins A, D, E, K (fat soluble)

99
Q

What does inspissated mean?

A

To thicken or congeal (mucous).

100
Q

What are some respiratory manifestations of CF?

A

Infection, difficulty expectorating secretions, decreased O2 exchange, hypoxia, pulmonary hypertension, cor pulmonale, failure and death

101
Q

What is cor pulmonale?

A

Hypertrophy or dilation of the right ventricle

102
Q

What pathogen can’t alveolar microphages destroy in CF patients?

A

Pseudomonas

103
Q

How does CF affect the GI tract?

A

It impairs the absorption of proteins and fats, causing steatorrhea and azotorrhea

104
Q

What test is used to determine if a child has CF?

A

Sweat test

105
Q

What drug is used to stimulate sweating for the sweat test?

A

Pilocarpine

106
Q

What are some manifestations of CF?

A

COPD, sweat gland dysfunction, FTT, weight loss, wheezing, dry cough, patchy atelectasis, clubbing repeated bronchitis/pneumonia, bulky/frothy/foul smelling stools, rectal prolapse, dehydration, alkalosis, hypoalbuminemia

107
Q

How is CF managed?

A

CPT, bronchodilator, home IV antibiotics therapy, transplantation, steroids, replace pancreatic enzymes, high protein diet, salt

108
Q

What is the prognosis for kids with CF?

A

Life expectancy of 36.5 years. Lung transplant = 75% at 1 year and 55% at 3 years

109
Q

What is sleep apnea and what are the treatments for it?

A

Cessation of breathing for more than 20 seconds due to mechanical obstruction of the airway while sleeping. It is treated with CPAP/BIPAP or surgery

110
Q

What are the classic s/s of respiratory failure?

A

Restlessness, tachypnea, tachycardia, diaphoresis

111
Q

What happens if tachycardia turns into bradycardia?

A

Bradycardia is s/s of severe hypoxia, so you better act fast

112
Q

What is a major cause of cardiac arrest in children?

A

Drowning

Peds/OB - Nrsg 206 (7 decks)

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