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peds > resp part 1 > Flashcards

resp part 1 Flashcards

1
Q

describe resp problems in children

A
  • most produce mild symptoms, last a short time, and can be managed at home
  • nurses need to assess current resp status quickly, monitor progress and anticipate potential complications
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2
Q

resp problems may result from structural probs, functional probs, or a combo. whats the difference between structural and functional probs?

A

structural: alterations in size and shape of part of the resp tract
functional: alterations in gas exchange and threats to gas exchange, can be due to irritants or invaders

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3
Q

whats the most common cause of resp infections in children

A

viruses

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4
Q

alterations in immune or neurologic function puts children at a higher risk of…

A

resp function compromise

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5
Q

describe infection rate in birth-3mo of age and what do we do if they have one

A

lower infection rate due to protective function of maternal antibodies

they get a full work up including CBC, electrolyte panel, blood cultures, urine cultures, and lumbar puncture to determine if they are septic, also get a resp swab

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6
Q

describe infection rate in children 3-6months of age

A
  • infection rate increases due to disappearanc of maternal antibodies and initiation of the production of the infants own antibodies
  • theres a little gap in protection
  • they get a resp swab and a full or partial workup
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7
Q

describe infection rate in toddler/preschool years

A

viral infection rate is high

bc they have no sense of hygiene and theyre dirty and snotty and share it with everyone around them

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8
Q

describe the upper airway in newborns

A
  • until 4 weeks of age, they are obligatory nose breathers
  • only breathe through their mouths when theyre crying
  • newborns do not know to voluntarily open their mouths to breath breathe when their nose is occluded
  • nasal patency is essential for beathing and eating
  • frequently require nsasal suctioning
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9
Q

describe differences kids have to adults with their resp systems

A
  • lots of stuff is immatre/shorter/flabby so theres a lot of opportunity for obstruction and aspiration
  • must be careful with neck and head positioning
  • newborns dont have enough smooth muscle to stop irritants
  • children are diaphragmatic breathers until about 6
  • chest wall is less rigid
  • if a child is in resp ditress you will most likely see retractions due to immaturity of the intercostal muscles
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10
Q

describe the airway of the infant

A
  • diameter is much smaller so swelling takes away a lot of it when compared with swelling in adults
  • speed of breathing, irritations/swelling, mucus/secretions all contribute to increasing airway resistance and making breathing harder for the little guys
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11
Q

whats included in the general resp assessment

A
  • pulse ox
  • cardiac resp monitor
  • change in muscle tone
  • behavior
  • color
  • LOC
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12
Q

is acute resp distress generally reversible?

A

yep

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13
Q

what is the most common cause of cardiac arrest in kids?

A

chronic hypoxia

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14
Q

describe using resp monitors with kids

A
  • must validate findings by manually taking HR and RR and comparing
  • initial prioirity is to assess patient if alarm is sounding then determine if its the patient or equipment that needs attention
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15
Q

describe what change in muscle tone may occur with resp compromise

A
  • infants may become floppy
  • older kids become limp with a lack of energy
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16
Q

what are some different changes in LOC that may occur with resp compromise

A
  • irritability and confusion: early signs of hypoxia
  • agitation: difficult to console or more easily bothered
  • lethargy: decrease in LOC and indicates resp distress is worsening
17
Q

what are some things to remember when assessing resp rate

A
  • can use abdominal rise and fall for kids under 6
  • use chest rise and fall for >6
  • can also feel raise w hand on adb or chest or auscultate
  • listen for 30secs then multiply by 2
18
Q

what things are included in the focused resp assessment

A
  • resp rate
  • resp effort
  • air entry
  • adventitious lung sounds
19
Q

whats included in assessing resp effort

A
  • nasal flaring: helps to reduce nasal resistance and maintain patency
  • retractions
  • tracheal tug
  • head bobbing
  • grunting on exhalation
20
Q

what do tight breath sounds indicate

A

small airay has severe bronchoconstriction

typically heard after wheezes

21
Q

what do diminished breath sounds indicate

A

reduced air flow

22
Q

what retractions indicate mild distress

A
  • isolated intercostal
  • sternal
23
Q

what retractions indicate increasing distress

A

substernal and subcostal

24
Q

what retractions indicate severe distress

A

suprasternal and supraclavicular

tracheal tugging

25
Q

what is tracheal tugging

A

retractions on an inward puling movement of the trachea

26
Q

name that adventitious breath sound!

  • high pitched, inspiratory crowing sound
  • originates in larynx or trachea
  • upper airway obstruction
A

stridor

27
Q

name that adventitious breath sound!

  • course low pitched noise, sounds like a snore
  • air passing through thick secretions that partially obstruct bronchi and trachea
  • upper airway sound
A

rhonchi

28
Q

name that adventitious breath sound!

  • muscial squeaking or hissing
  • caused by bronchospasm or anatomic narroing of bronchioles
  • heard continuously through inspiration and expiration (typically louder on expiration)
A

wheeze

29
Q

name that adventitious breath sound!

  • heard on end of inspiration
  • air passing through secretions in alveoli and bronchioles
  • lower airway sound
A

crackles

30
Q

whats included in care management of the resp system

A
  • ease respiratory effort
  • promote rest and comfort
  • prevent spread of infection
  • reduce temperature
  • promote hydration
  • provide nutrition
  • provide family support and home care education
31
Q

what are some ways you can easy resp effort and promote rest and comfort

A
  • positioning to maintain patent airway
  • elevating head/holding upright
  • nasal suctioning
  • apply supplemental O2 as ordered
32
Q

why would you want to reduce body temp

A

fevers cause increase in metabolic demand and resp rate

33
Q

what fam teaching would you want to provide for home care of resp issues

A
  • teach infection prevention
  • nasal suctioning
  • signs and symptoms of worsening distress

peds (15 decks)

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