Respiratory Flashcards
aka: infant respiratory distress syndrome (IRDS)
hyaline membrane disease
define INFANT RESPIRATORY DISTRESS SYNDROME
acute hypoxemia caused by infiltrates within alveoli
s/s: infant respiratory distress syndrome
nasal flaring, grunting respirations, sternal retractions, reduced oxygen tension, ineffective gas exchange, cyanotic w/mottled skin
cause: IRDS
baby lacks surfactant to allow alveoli to expand causing inadequate surface area for proper gas exchange
tx: IRDS
- supplemental oxygen
- drug therapy
- exogenous surfactant
prevention methods for IRDS?
inject mom w/corticosteroid 24 hours before delivery
cause of laryngomalacia, tracheomalacia, & bronchomalacia
softened/underdeveloped cartilage causing airway to partially or completely collapse
define BRONCHOPULMONARY DYSPLASIA (BPD)
chronic lung disease causing lungs to be stiff, obstructed, and hard to ventilate in baby after insult to neonate’s lungs
what may be a sequela to IRDS, lung infection, or extreme maturity
bronchopulmonary dysplasia
s/s: bronchopulmonary dysplasia
periods of dyspnea, tachypnea, wheezing, cyanosis, nasal flaring, sternal retractions, O2 sat decrease, heart rate decrease, cough, difficulty feeding, working hard to breathe, poor posture of neck/shoulders/upper body, wet/crackling sounds in lungs
cause: bronchopulmonary dysplasia
- IRDS
- mechanical ventilation w/oxygen
- infection/pneumonia
why does mechanical ventilation w/supplemental oxygen cause bronchopulmonary dysplasia
pressure & O2 damage lung tissue causing overinflation/scarring
how is bronchopulmonary dysplasia diagnosed
- observation for respiratory distress
- abnormal chest xrays (signs of alveolar damage/ground glass appearance)
- low O2 levels & high CO2 levels
tx: bronchopulmonary dysplasia
- replace damaged alveoli
- supportive treatment
- supplemental oxygen
- adequate nutrition
- diuretics, bronchodilators, anitinflammatories
prognosis of bronchopulmonary dysplasia
good w/early & aggressive intervention
complications of bronchopulmonary dysplasia?
pulmonary edema, hypertension, right-sided heart failure, respiratory infections, apnea, tracheomalacia, asthma, GI reflux, aspiration, susceptible to respiratory infections, poor growth, delayed development
prevention for bronchopulmonary dysplasia
none; early weaning from mechanical respiratory
define CYSTIC FIBROSIS
chronic dysfunction of gene affecting multiple body systems
what is the most common fatal genetic disease
cystic fibrosis
sx: cystic fibrosis
- copious thick and sticky mucus blocking glandular ducts
- dry paroxysmal cough
- exercise intolerance
- pneumonia
- bulky diarrhea
- vomiting
- bowel obstruction
- pancreatic changes
- fat & fiber replace normal tissue
- increased concentration of salt in sweat
- normal growth and ability to thrive reduced
- sinus infections
- infertility
cause: cystic fibrosis
autosomal recessive disorder; chronic dysfunction of gene cystic fibrosis transmembrane conductance regulator (CFTR)
how is cystic fibrosis diagnosed
genetic testing, family history, pulmonary function test, chest xray, stool study, sweat test
tx: cystic fibrosis
- high calorie high sodium-chloried diet
- chest physiotherapy
- vitamin A, D, E, and K supplements
- increased fluids
- pancreatic enzyme supplements
- broad-spectrum antibiotics
- percussive therapy
- drugs to thin mucus
- lung transplants
- avoid respiration irritants
what is the life expectancy of someone with cystic fibrosis
30s
define DIPTHERIA
acute disease causing necrosis of mucous membrane in respiratory
sx: diptheria
sore throat, dysphagia, cough, hoarseness, chills, fever, swollen regional lymph nodes, foul breath, cyanosis, grayish patches of thick mucous membranes, impaired swallowing & speech
list potential complications of diphtheria
otitis media, pneumonia, myocarditis, paralysis
how is diptheria diagnosed
culture of throat & stain positive for C. diptheria, schick test, antibodies in serum
tx: diphtheria
diphtheria antitoxin, antibiotics, bed rest, tolerated diet
when are kids given first dose of diphtheria vaccine
2-3 months
define PERTUSSIS
bacterial infection of respiratory tract
cause: pertussis
bacteria Bordetella pertussis transmitted via respiratory droplets transmitted via direct or indirect contact
how is pertussis diagnosed
PCR test, elevated WBC count
tx: pertussis
erythromycin, increased fluids, nutritious diet, quiet rest
what are possible complications of pertussis
bronchopneumonia, convulsions, hemorrhages
aka: pertussis
whooping cough
t/f: pertussis is not fatal if untreated
false
cause of measles
measles virus (Morbillivirus) spread through direct contact/airborne respiratory droplets
what is the incubation period for measles
8-12 days after exposure
when is a person with measles contagious
4 days before onset rash and 4 days after
aka: measles
rubeola
how is measles diagnosed
history of exposure, clinical picture, Koplik spots
tx: measles
let disease run course, acetaminophen & tepid sponge baths
list complications of measles
pneumonia, otitis media, conjunctivitis, encephalitis, subacute sclerosing panencephalitis
when is the MMR vaccine given
- 1st dose @ 12-18 months
- booster @ school age
describe SUBACUTE SCLEROSING PANENCEPHALITIS (SSPE)
rare form of encephalitis from reactivation of measles
s/s: subacute sclerosing panencephalitis
cerebral infection, atrophy of cortical areas of brain, demyelination, ventricular dilation, brain diffusely inflamed, progressive motor/mental/intellectual deterioration, severe dementia, seizures, blindness, fever, involuntary movements, eventual decerebrate rigidity
how is subacute sclerosing panencephalitis diagnosed
CSF shows elevated gamma globulin levels, antibody titer elevated, history of measles last 2-10 years
aka: rubella
german measles, 3-day measles
cause of rubella
rubella virus transmitted through direct contact w/nasal or oral secretions
what is the incubation period for rubella
14-21 days
when is a pt with rubella contagious
1 week before eruption of rash until 1 week after rash onset
where are sporadic epidemics of rubella seen
college campuses
how is rubella diagnosed
history of exposure, clinical picture, throat culture, serologic studies
tx: rubella
supportive measure (mild analgesic) and quarantine
t/f: rubella can be passed from mother to fetus
true
aka SIDS
crib death
how many infants die of SIDS
1 in 2000
the cause of SIDS is unknown, but list risk factors
- mother age less than 20 years
- poor prenatal care
- smoking and drug abuse during pregnancy
- second hand smoke
- prematurity
- recent URI
- sleeping prone
- sibling w/apnea
- males
- winter
define CROUP
acute severe inflammation and obstruction of respiratory tract
cause of CROUP
virus or bacteria
how is croup diagnosed
blood/throat cultures, laryngoscopy, xrays of airway
tx: croup
treat symptomatically: antipyretic agents, rest, increased fluid, cool air humidification, antibiotics, steroids, intubation, oxygen therapy
cause: epiglottitis
upper respiratory tract infection. heat damage, herpes simplex type 1
epiglottitis is usually caused by an upper respiratory tract infection. What viruses/bacteria are associated with this?
HiB, streptococcus pneumoniae, VZV, haemophilus parainfluenzae, staphylococcus aureus
how is epiglottitis diagnosed
xray of neck
tx: epiglottitis
maintain airway & antibiotics
what is the leading cause of chronic illness and school absences
asthma
cause of asthma
hereditary, hyperactive & hypersensitive bronchial tubes, allergens, irritants, smoke, cold air, emotions, exercise
how is asthma diagnosed
pulmonary function test, chest xray, dermal skin testing, blood test w/CBC
tx: asthma
cromolyn sodium/albuterol/theophylline/aerosol corticosteroids, allergy shots, steroid injections, inhalation therapy, oxygen
t/f: bronchiolitis is not a common disease in infancy
false
how is bronchiolitis diagnosed
pt history, physical exam, chest xray, rapid RSV testing, viral nasopharynx culture
tx: bronchiolitis
supportive care, albuterol, racemic epinephrine, hypertonic saline, oxygen IV fluids
