Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

peds > resp part 3 > Flashcards

resp part 3 Flashcards

1
Q

what is asthma

A
  • chronic inflammatory disorder of the airway
  • increased airway responsiveness to stimuli
  • bronchial constriction
  • airway inflammation causes obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

whats going on with asthma

A
  • exposure to triggers causes cells in the airway to release proinflammatory chemical mediators (histamine, prostaglandins, and leukotrienes)
  • the airways overreact to the triggers and an acute asthma episode occurs
  • bronchospasm, inflammation, and mucous production occurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some symptoms associated with asthma

A
  • dypnea and tachypnea
  • inspiratory and expiratory wheezing
  • use of accessory muscles and retractions
  • cough (will be dry and persistent at first, then moist but non productive)
  • c/o feelings of discomfort, irritability, restlessness, and anxiety
  • chest feeling tight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what retractions are seen in mild distress

A

subcostal, substernal, intercostal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what retractions are seen in moderate to severe distress

A

suprasternal and supraclavicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are some possible asthmatic triggers

A
  • exercise
  • food additives
  • emotions
  • temp changes
  • smoking
  • bacteria and viruses
  • dust
  • environmental
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

diagnosis of asthma includes…

A
  • symptoms of wheezing or airflow obstruction
  • improvement of wheezing and airway obstruction with short acting beta adrenergic and oral corticosteroid meds
  • exclusion of an alernative diagnosis
  • PFTs (spirometry) assesses airway function (older than 5-6yrs)
  • there also classification of asthma severity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe status asthmaticus

A
  • doesnt respond to normla treatment
  • high risk for respiratory failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what med is given first with asthma exacerbation and decsribe it

A

beta adrenergic: albuterol
- bronchodilator, soothes smooth muscle
- provides quick relief, onset 5-10min
- given nebulized or MDI
- AE: tachycardia, nervousness, nausea, HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

describe the use of corticosteroids for asthma

A
  • oral or IV
  • prednison/prednisolone orally
  • methylprednisolone: IV solmedrol
  • decreases inflammation to clear up mucus production and obstruction
  • most effective long term control therapy
  • rinse mouth after use d/t risk for thrush
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe using albuterol in a nebulizer

A
  • med is put in the little clear cup
  • tubing is connected to air
  • takes about 10min to finish 1 treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe using albuterol with MDI with spacer

A
  • shake vigorously for 30 secs before using
  • place mouthpiece in mouth, closing lips around it ot place mask over nose and mouth
  • press and release the med one puff, then have child breathe deeply and slowly
  • watch for them to take 6 breaths
  • wait 30 secs between puffs, allows time for lungs to bronchodilate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

whats the purpose of albuterol

A

relax bronchial smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe using anticholinergics for asthma

A
  • inhibits bronchoconstriction
  • short term MDI with exacerbation of asthma
  • the onset of action is 30-90 mins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe using leukotriene receptor antagonist (montelukast) for asthma

A
  • prevents asthmatic episodes
  • daily controller med
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

whats the purpose of leukotriene receptor antagonists

A

prevent asthmatic episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

is asthma common in infants and young children?

A

nope, their wheezing is usually caused by resp infections

usually diagnosed pre-k and school age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

whats the plan of care for asthma exacerbations

A
  • all assessments
  • oxygen with humidifier
  • meds: albuterol and steroids
  • IV therapy- hydration/ I+O
  • pulse ox
  • semi fowlers position
  • labwork
  • calm attitude
  • rest
  • group nursing care
  • parental and child support and education
19
Q

whats a pediatric asthma score

A
  • obtained prior to treatment
  • standardized asthma score
  • objectove assessment of signs and symptoms
  • score obtained related to rep rate, oxygen, retractions, dyspnea, and auscultation
  • score determines treatment
20
Q

what should be included in asthma discharge instructions

A
  • asthma action plan
  • education essential
  • meds
  • environmental control
  • no smoking
  • avoid allergens
  • regular health care visit every 1-6mo
21
Q

describe and asthma action plan

A
  • joint commission standard that every child diagnosed with asthma is discharged with an individualized asthma action plan

green zone: no symptoms
yellow zone: experiencing symptoms and outlines steps to take when to contact HCP
red zone: interventions not working and are experiencing and exacerbation, seek care ED or HCP office

22
Q

describe exercise induced bronchospasm

A
  • history of coughing, breathlessness, chest pain, or wheezing during and after exercise
  • beta adrenergic agents (albuterol) immediately prior to exercise prevents and provides relief for 2-4 hours
23
Q

what is BPD

A
  • bronchopulmonary dysplasia
  • akso known as chronic lung disease
  • affects newborns, mostly premature
  • need for supplemental oxygen for at least 28days after premature birth
  • fewer and larger alveoli with less functional area for gas exchange
  • fibrosis of alveoli
  • abnormal development of cappillaries in alveolar region
24
Q

how is the severity of BPD determined

A
  • resp support interventions required at birth and long term (oxygen and vent)
  • more premature = loger dependence = persisten inflammation of lungs = bad
25
Q

what are some clinical manifestations of BPD

A
  • persistent signs of increased resp effort
  • tachypnea and duspnea
  • retractions
  • nsala flaring
  • grunting
  • irritability
  • wheezing/crackles
  • pulmonary edema
  • failure to thrive
26
Q

whats the clinical therapy for BPD

A
  • symptomatic treatment that support rep function
  • good nutirition which helps accelerate lung maturity
  • infants with BPD may ougrow it with lung development or if BPD is severe, they will have chronic lung disease
  • treatment focuses on preventing complications and further damage and providing support
27
Q

describe home care for BPD

A
  • depending on severity of the BPD, the infant may need some or all of the following at home: oxygen, meds, apnea monitor, tube feedings
  • oxygen
  • multiple meds
  • nutirition: high calorie, NG/PO
  • home nursing
  • early intervention
  • emotional support/financial support
  • synagis
  • BPD clinic every 6mo
  • normal activities create increased oxygen demands that are difficult for the infant to meet
  • oxygen may be needed with sleeping or wih eating
28
Q

what med may be used for BPD

A
  • bronchodilators
  • corticosteroids: dcrease inflammation
  • diuretics: remove excess fluid from lungs if they have pulmonary edema
29
Q

describe the genetics of cystic fibrosis

A
  • autosomal recessive trait: affected child inherits the defective gene from both parents
  • incidence of 1:4
  • survival rates: 1966: 12yrs, 2023: mid 40s
  • gender is not a factor
  • progressive and incurable
30
Q

describe diagnosing cystic fibrosis

A
  • newborn screening high for immunoreactive trypsinogen (IRT) (available in all 50 states)
  • second IRT may be done at 2-3wks
  • sweat chloride test by pilocarpine iontophoresis is gold standard for diagnosis (stimulating the production of sweat to collect and measure chloride level)
  • genetic testing for adults with positive family history, partners of individuals with CF and couples to identify carriers as prenatal testing
31
Q

what are some clinical manifestations of cystic fibrosis in the resp system

A
  • secretions very thick
  • decreased ciliary action in resp tract
  • increased obstruction with mucous
  • moist but ineffective cough
  • frequent resp infections
  • wheezes and crackles
  • clubbing of fingers later on with chronic hypoxia
32
Q

what are some clinical manifestations of cystic fibrosis in the GI system

A
  • foul smelling stools and flatus
  • excess stool fat (steatorrhea)
  • difficulty maintaining weight
  • meconium ileus
  • constipation
33
Q

what body systems does cystic fibrosis effect?

A

eventually all of em

34
Q

describe hoe cystic fibrosis effects the pancreas

A
  • thickened mucous damages pancreatic ducts and obstructs enzymes to digest fats, fat soluble vitains, and proteins
  • deficiency of ADEK (fat soluble vitamins)
  • pancreas becomes damaed and fails to produce adequate insulin
  • development of CF related DM
  • failure to thrive
  • delayed puberty
35
Q

what kind of diet is everyone with cystic fibrosis on?

A

high calorie

36
Q

how does cystic fibrosis effect the female reproductive system

A
  • normal fallopian tubes and ovaries
  • feritlity inhbited due to thick cervical secretions and dereased cervical secretions
37
Q

how does cystic fibrosis effect the male reproductive system

A

sterile due to blockage or absence of vas deferens

38
Q

how does cystic fibrosis effect the sweat glands

A
  • skin salty due to high sodium and chloride in the sweat
  • excessive oss of elctrolytes in perspiration, saliva, and muscous secretion
  • at risk for hyponatremia
39
Q

describe bronchial hygiene therapy

A
  • performed before meals
  • 1-3 times a day
  • facilitates removal of secretions from the lungs

chest physiotherapy: for infants and toddlers, percussion and vibration on multiple areas of lung in different positions

therapy vest: for 4 and older, provides high frequency chest wall oscillation

takes about 20-30mins

40
Q

name and describe the aerosol meds for cystic fibrosis in order per the cystic fibrosis foundation

A
  1. bronchodilator
  2. hypertonic 7% NS: mobilize mucous and improve airway clearance
  3. dornase alfa (pulmozyme): thins secretions
  4. bronchial hygiene therapy
  5. inhaled antibiotics: tobramycin for chronic pseudomonas infection, given every other month twice daily
  6. inhaled steroid
41
Q

whats the plan of care for cystic fibrosis

A
  • physical assessment
  • oxygen with humidification/pulse ox
  • bronchial hygiene therapy: before eating
  • sputum culture and sensitivity
  • labwork
  • IV antibiotics
  • Ivacaftor (improves regulation of water and salt)
  • ibuprofen (slows rate of pulm decline)
  • acid suppression meds (preven reflux)
  • nutritional needs
  • management of CF related DM
  • physical and exercise as tolerated
  • contact and droplet isolation: gown, gloves, and mask
  • psychosocial and developmental assessment
  • discharge planning/CF team
42
Q

what nutritional suppleentation is essential for cystic fibrosis patients?

A

will need enzyme supplements prior to any meals or snacks

also will need vitamin ADEK and multivitamin supplements

43
Q

will two CF patients ever share a room?

A

nope

peds (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions