Respiratory 1 Flashcards
are children or adults at a higher risk for respiratory illness
children d/t smaller airway which creates greater resistance and makes the upper airway more prone to obstruction
what are some of the other pediatric differences related to lungs/respiratory
- less alveolar surface are (decreased area for gas exchange)
- more diaphragmatic breathing (flexible chest reduces air intake)
- chest wall stiffens w/ age (less retraction with distress)
at what age can children start to use intercostals for breathing
about 6 yrs
why do children’s chest draw inward or have retractions when breathing
d/t their flexible ribs and chest
what is higher in children than adults that increases with respiratory distress
O2 consumption
when do tonsils start to atrophy
in teenage years (before that, they cause almost an obstruction in the airway because they are so large in children)
how do infants breathe until about 4-6 wks
obligate nose breathers
their high respiratory rate are associate with what
risk for heat and fluid volume loss
what are some more respiratory differences in pediatric pop
- epiglottis is longer and flaccid (more susceptible to swelling)
- intercostal muscles immature (use diaphragm to breathe)
- aspiration d/t primary bronchus more vertical than left (risk for occlusion
what is important to remember about children’s trachea
*biforcation of trachea @ T3 level
in adults biforcation is T6
how large is a child’s airway
very small
diameter of airway is about 18 mm while an adult is 20
causes resistance
what are the diagnostic tests for resp
- chest x ray
- CT scan
- bronchoscopy
- pulmonary function test
- sputum culture
- arterial blood gases
- pulse ox
what is important to consider about diagnostic tests on children
not always east to do these test in children
may need sedation or distraction
are OTC meds recommended for kids
no, resp OTC meds are not recommended
what is included in the assessment History
birth history: gestational age, on ventilator support? past med: history ROS: resp illness, TB (PPD), chest x ray family hx: asthma, cystic fibrosis social hx: smoking
smoking and day care put children at risk for what
ottis media or other resp issues
what is included in resp hx of present illness
- onset
- chronology (progression)
- S/S: nasal congestion, flaring, grunting, SOB, couhg, tightness of chest, retractions, apnea
- current meds
- medical treatment
what is the best cough medicine
water
if child has a fever what should they be given
acetaminophen
what is the physical exam for resp
- vital signs: RR decrease with age (count while child is sleeping NOT cryings/coughing)
- look for s/s of resp illness
- chest: normal shape/symmetry, no increase in AP diameter, no retractions, resp. unlabored
lungs: clear to auscultation, no adventitious, no diminishes, no dyspnea, tachypnea, cough
what is the first sign of resp problem
increased RR
describe foreign body aspiration
- <3 yrs (younger)
- lodge in R main bronchus
- hot dogs, candy, nuts, grapes
what is the complication you are at risk for if foreign body aspiration
aspiration pneumonia
s/s of foreign body aspiration
- sudden coughing/gagging
- hoarseness
- wheezing
- stridor
- croupy cough
- dyspnea
- cyanosis
- difficulty swallowing/speaking
