Respiratory Flashcards
upper respiratory
nose
pharynx
larynx
upper trachea
lower respiratory
bronchi
alveoli
lower trachea
croup syndromes
infections of epiglottis or larynx
viral infection rate increases at…
3-6 mo of age, as maternal antibodies are no longer present
why are toddlers and preschoolers at increased risk for illness?
shorter ear canals
shorter tracheas
larger tonsils
upper respiratory infections (URI)
nasopharyngitis
pharyngitis
tonsilitis
influenza
otitis media
infectious mononucleosis
lower respiratory infections (LRI)
bronchiolitis and RSV
asthma
cystic fibrosis
croup syndromes/middle resp infections
acute epiglottitis
laryngotracheobronchitis (LTB)
acute spasmodic laryngitis
bacterial tracheitis
nasopharyngitis
common cold
fever and runny nose!
pharyngitis
“strep throat”
caused by GABHS or virus
dx: throat culture/rapid stress test
CM: sore throat, exudate, fever, lymphadenopathy, HA, muscle soreness, lethargy
treat: abx
RN interv: isolation until on abx for 24hrs (droplet/droplet contact), new toothbrush, gargle salt water, drink warm/cold liquids, warm/cold neck compress
complication: AKI or rheumatic fever
tonsilittis
inflammation of tonsils
viral or bacterial
CM: enlarged tonsils, “frog in throat”, difficulty swallowing, snoring, mouth breathing
treat: tonsillectomy if more than 3 yrs or severe snoring and apnea
monitor for: bleeding and dehydration.
postop= soft foods for 2 weeks, pain meds, avoid activities that increase pressure
influenza
C is milder than A and B
transmission: contact and droplets
vaccine: IM inactivated for 6mo+, nasal live for 2yr+
manage w antipyretics and hydration
antiviral (oseltamivir) within 48hrs of symptoms or exposure
otitis media
malfunctioning eustachian tubes
usually viral
dx: otoscope (purulent, red and bulging membrane)
CM: tugging at ear, earache, irritable, fever
risk factors: down syndrome, cleft palate, day care, smoking at home
treat: abx for bacterial, surgically placed tubes for recurrent.
for 6mo+ wait 72hrs before intervening
prevent by no bottle propping
infectious mononucleosis
epstein barr virus
transmitted via saliva
common in adolescents
dx: blood test (+ if blood clumps)
CM: fever, fatigue, lymphadenopathy, exudative pharyngitis
manage: hydration, tylenol, ibuprofen, rest
complication: splenomegaly (rupture- medical emergency, severe abd pain)
acute epiglottitis
medical emergency
severe obstructive inflammation
CM: absence of spontaneous cough, drooling, agitation, inspiratory stridor, sore throat, tripod positioning, retractions, pain
treat: abx, steroids, oxygen
do NOT exam airway
prevent: Hib vaccine
acute laryngotracheobronchitis (LTB)
most common croupe
common in under 5yrs
viral
CM: seal like cough, hoarseness, low grade fever
manage: maintain airway, cool humidified air, steroids
acute spasmodic laryngitis
“midnight croup”
recurrent paraoxysmal attack
kids 1-3 at night
viral
bacterial trachitis
infection of mucosa of upper trachea
5-7yrs
CM: thick, purulent secretions, respiratory distress
manage: fluids, sleep sitting up, abx
bronchiolitis and RSV
common in infants
CM: fever, cough, wheeze, coarse lung sounds, tachypnea, lethargy, poor feeding
dx: nasopharyngeal swab
manage: NP suctioning, O2, hydration
most common reason for hospitalization w RSV
dehydration
low O2 sat
asthma
chronic inflammatory disorder
dx: pulm function tests
cause: genetics, 2nd hand smoke, being black, premature birth
risk factors for exacerbation: URI, allergies, exercise
CM: wheezing, diminished lung sounds, cough at night, breathlessness, chest tightness, feel better after rescue inhaler
severity classification in kids 5yrs+
step 1- intermittent asthma, less than 2x/week
step 2- mild, persistent asthma, 2+x/week
step 3- moderate, persistent asthma, symptoms daily
step 4- severe, persistent asthma, continual symptoms
status asthmaticus
medical emergency
epinephrine
continuous albuterol nebulizers
mag sulfate
steroids
uncontrolled asthma can lead to
COPD
long term controller meds
preventative
inhaled steroid (QVAR)
theophylline (has narrow TI, monitor serum level)
leukotriene modifiers (for allergies, Montelukast)
anticholinergics (Atrovent)
quick release meds
rescue
beta adrenergic antagonist (albuterol, Xopenex, terbutaline)
oral corticosteroid (fluticasone)
asthma goal
less than 2 symptomatic days per week
monitor function w peak flow meter (blow out hard and fast, do 3 attempts, zero out before each use, stand upright)
cystic fibrosis
exocrine glands produce thick mucus that obstruct respiratory passages
lethal, progressive genetic illness (autosomal recessive. need CTFR gene from both parents)
dx: newborn screening, sweat chloride test (elevated Cl and Na)
CM: meconium ileus, steatorrhea, weight loss, increased appetite, progressive COPD, repeated bouts of URIs, gradual resp deterioration, electrolyte deficiency
manage: vigorous daily resp routine (chest physiotherapy, bronchodilator nebs), aggressive infection treatment, replace pancreatic enzymes w meals, high protein/high calorie diet, treat constipation, salt supplementation
prognosis- 37.4 yrs
can do lung, heart, liver, pancreas transplants
peak flow results
good= green, 80%+
caution= yellow, 50-79%
emergent= red, less than 50%
