Nebulizer 1. Age for mask.... 2. Duration of treatment.... 3. Can they swallow spit during treatment.... 4. If Albuterol & Pulmicort are given which do you give first... Wash with soap after use & soak in vinegar 1hr every other day

1. <7 yrs 2. 7 - 10 min 3. Yes, swallow spit. It contains medicine 4. Albuterol 1st

Epitaxis (nosebleed) 1. This posistion... 2. Pressure... Dont put anything in the nose Dont blow nose Apply ice packs to bride of the nose.

1. Lean forward- reduce swolling of blood 2. Continous pressure to soft lower portion of nose.

Respiratory Flashcards by Jade Ring

Babies are nose breathers. If their nose is blocked and they are crying could lead to resp distress.

Which ages most apply…

4 - 6 weeks

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Normal tracheal lumen for Peds…

What about when inflammation….

4 - 2mm

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The trachea is more compliant in peds.

What risk does this have….

Trachea collapse

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Underdeveloped ____ cartilage in peds.

Woth a funnel shapped larynx.

Cricoid

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Less alveoli in peds can lead to these problems….

Hypoxia & Co² retention

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Trachea bifurcation is higher T3 -4 in peds compared to adults T4 - 5

What problems can happen due to this…

Higher tracheal bifurcation → increased aspiration risk
(especially into the right bronchus).

✔ Careful suctioning & intubation due to the shorter, more flexible airway.

✔ Respiratory distress develops faster due to the smaller airway diameter.

✔ Adjust postural drainage positions for airway clearance in respiratory illnesses

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Chest wall in infants is highly compliant.

What problems can arisse from this….

Less support to lungs

Prone to Retraction

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Infants use their diaphragm less tjan adults to breath

T or F

They are belly breathers

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A code in infants is more likely (Respiratory/ Cardiac)

Code in adults…

Infant respitory

Adults cardiac

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5 places foe Retractions…

Suprasternal
Substernal
Supracavicular
Intracostals
Subcostal

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Access Cyanosis in dark pigmentation here…

Nail beds & gums

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Acryocyanosis (blueish hands, feet, mouth) is normal when…

First 48 hrs birth

Central Cyanosis is never normal

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When is Grunting an emergency finding….

Always. Seek help immediately

Alveolar collapse

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Describe disease for

Prolonged expiratory phase…

Prolonged inspiratory phase….

Prolonged expiratory phase: Asthma, Broncholitits, Cystic fibrosis- Lower airway obstruction

Prolonged inspiratory phase
Croupe, epiglottis, foreign body Asphyxia

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______ (Laryngotracheobronchitis)

Viral swelling of the upper airway causes stridor and difficulty inhaling.

Croup

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Prolonged expiration

Lower airway: Bronchi & alveoli

Sound…..

Causes….

Management….

Sound: Wheeze

Causes: Asthma, Broncholitits

Management: Bronchodilators

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Prolonged Inspiration

Upper airway (Larynx & trachea)

Sounds…

Causes …

Management….

Sound: Stridor

Causes: Croup, epiglottis, foreign body

Management: Humidfied air, Epinephrine, airway support

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Oxygen delivery devices for peds (2)…

High flow oxygen delivery device provides precise and controlled concentration of oxygen.

Delivers heated and humidified pressurized oxygen and air through nasal canula, adjustable FiO2 and liter of oxygen

Venturi:
High flow oxygen delivery device provides precise and controlled concentration of oxygen.

High Flow Nasal Canula:
Delivers heated and humidified pressurized oxygen and air through nasal canula, adjustable FiO2 and liter of oxygen

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During report pt is on

HFNCGL 30%

What does this mean…

Max flow rate…
FiO² range…
Humidified….
Positive airway pressure…
CO² washout….

High flow nasal canula gas flow
Oxygen 30%

Max flow rate Up to 60L/min
FiO² 21 - 100%
Humidified Yes
Positive Airway Pressure Yes
CO² Washout Yes (Reduces Rebreathing)

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Nebulizer

Age for mask….
Duration of treatment….
Can they swallow spit during treatment….
If Albuterol & Pulmicort are given which do you give first…

Wash with soap after use & soak in vinegar 1hr every other day

<7 yrs
7 - 10 min
Yes, swallow spit. It contains medicine
Albuterol 1st

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Epitaxis (nosebleed)

This posistion…
Pressure…

Dont put anything in the nose

Dont blow nose

Apply ice packs to bride of the nose.

Lean forward- reduce swolling of blood
Continous pressure to soft lower portion of nose.

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Foriegn body aspiration

<1 yrs old

> 1 yrs old

<1 yrs old.

Face down, lower than their chest

Posistion infant on your forearm

Heel of hand 5 back blows

Turn over and place on thigh

2 fingers press in & up just below nipples

Repeat till effective Or unresponsive CPR

> 1 yrs

Heimlich

Behind pt, hold fist and pull Inward & Upward.

Posistion above navel & Below sternum

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A one time event when an infant <1 yrs old stops breathing fir 20 - 30 sec.

Cyanosis
Change in tone
Altered LOC

Then baby comes back like nothing happened.

Drs rule out explinations

What is the problem…

What is the treatment…

BRUE

Breif Resolved Unexplained Event

No need for treatments

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Accidental death of infant <1 No known cause, but may be related to Biomarker enzyme BCHE being low. SIDS To prevent 1. This posistion.... 2. Mattress considerations... 3. Pacifier.... 4. In same bed as parents... 5. Breastfeeding... 6. Increased airflow (fans, window)

1. Flat, supine 2. Firm mattress 3. Pacifier Yes 4. Not same bed, but same room 5. Yes, breastfeeding 6. Yes increased airflow

Cystic fibrosis is an Autosomal Recessive gene mutation. Explain how it is passed on...

2 genes are needed for expression of CF

Cystic fibrosis Transmembrane Conductance Regulator Mutation results in Lung problem.... ____ secretion of pancreas enzymes and ____ secretion of gastric Acid _____ chloride & water secretion into the intestine

Lung problem: Thick mucus Infection & air trapping Decreases secretion of pancreas enzymes and increased secretion of gastric Acid Decreased chloride & water secretion into the intestine

How can CF be detected during preggers...

DNA testing

GERD Liver failure Portal HTN Gallstones Válvulas Intussusception Bowel obstruction Infertility Chronic Resp infection Pneumothorax Seen in this problem...

It is best to cohabite 2 pts with CF....

False They need to be 6 ft from eachother atleast Avoid infection

Type of precautions for CF.... When CF pts leave room why do they wear a mask...

Contact always Droplet if they have resp infection Wear mask to protect themselves

Recombinant human Dnase (Pulmozyme) is used for this disease ..... It has this affect....

CF Thin mucus

What function does a chest physiotherapy vest have... Type of pt...

Manually breaks up mucus CF

Type of diet for CF pt... Vitamins.... When to give pancreatic enzymes....

High Calorie/ High Protein Fat sol. Give enzymes with meals

Most common cause of missing school/ hospitalization fir children....

Asthma

Severity of Asthma ✔ Symptoms: ≤2 days/week ✔ Nighttime Awakenings: ≤2 times/month ✔ Rescue Inhaler Use: ≤2 days/week ✔ Physical Activity Limitation: None ✔ Lung Function: FEV₁ >80% predicted, normal between exacerbations 🔹 Management: No daily controller medication needed; use SABA (short-acting beta-agonist, e.g., albuterol) as needed

Intermittent Asthma (Mildest Form)

Severity of asthma.... Mild Persistent Asthma ✔ Symptoms: >2 days/week (but not daily) ✔ Nighttime Awakenings: 3-4 times/month ✔ Rescue Inhaler Use: >2 days/week (but not daily) ✔ Physical Activity Limitation: Minor ✔ Lung Function: FEV₁ >80% predicted 🔹 Management: Low-dose inhaled corticosteroid (ICS) (e.g., fluticasone)

Mild persistent

Severity of asthma.... ✔ Symptoms: Daily ✔ Nighttime Awakenings: >1 time/week (but not nightly) ✔ Rescue Inhaler Use: Daily ✔ Physical Activity Limitation: Some ✔ Lung Function: FEV₁ 60-80% predicted 🔹 Management: Low-to-medium dose ICS + LABA (long-acting beta-agonist, e.g., salmeterol) Alternative: Leukotriene receptor antagonist (e.g., montelukast)

Moderate Persistent Asthma

Severity of asthma ✔ Symptoms: Continuous, throughout the day ✔ Nighttime Awakenings: Almost nightly ✔ Rescue Inhaler Use: Several times per day ✔ Physical Activity Limitation: Extreme ✔ Lung Function: FEV₁ <60% predicted 🔹 Management: High-dose ICS + LABA + Oral corticosteroids if needed May require biologic therapy (e.g., omalizumab for allergic asthma)

Severe Persistent Asthma (Most Serious)

Wheezing, SOB, cough, tight chest are symptoms of asthma - a chronic inflammatory disorder of the airway with reversible airway obstruction. When do symptoms manifest....

Niggt & Early morning

Asthma Inflammation causes _____ to a variety of stimulation. Viral infection Cold air Exercise Emotions Environmental allergens Pollutants

Hyperreactivity

3 main physiological Manifestions of asthma...

Increased mucus production Bronchospasm Bronchial smooth muscle inflammation

Asthma Cough Hacking Paroxysmal... Define Irritating Productive or nonproductive...

Paroxysmal (Sudden burst / Attacks) Nonproductive

Asthma SOB Speaks in short,panting, broken phrases Prolonged _____ phase

Expiratory

Status Asmatcus is a serious condition in which asthma doesn't respond to short Acting bronchodilators (Albuterol) What is the treatment..

IV mag Sulfate to relax smooth muscles High doses of inhaled or intravenous bronchodilators (e.g., albuterol) Systemic corticosteroids (e.g., prednisone) to reduce inflammation Oxygen therapy to maintain oxygen saturation Sometimes, mechanical ventilation if respiratory failure occurs

How to use peak flow meter... Describe the various results and what they mean clinically...

Blow hardest into 3 times and record best value Green zone >80% No treatment Yellow zone 50 - 80% Take rescue med and call MD Red zone<50% - take rescue med & seek medical attention

Inhaled ______ medications commonly used to provide quick relief from acute asthma symptoms or bronchospasm. They work by relaxing the smooth muscles around the airways, which helps open up the airways and makes breathing easier.

short-acting beta agonists (SABAs)

Perennial allergic rhinitis happens when... Why....

Year round Due to indorr environment allergies- Mold, Pets

Allergic shiners- Gray/Blue area below the eye Red rimmed eyes Allergic salute - crease in the nose from rubbing Clear mucosidad nasal drainage Are associated with...

Allergic rhinitis

Medications for allergic rhinitis.... (3)

Flonase (Nasal Corticosteroids) - Suppresses the release of histamine Antihistamine Allergy shots

Commonly seen in premature infants who need oxygen in the first month of life. Chronic Lung disease is treated with these meds... Oxygen..

Anti inflammatory inhaled agents Short Acting bronchodilators Low dose oxygen. Maybe 0.25 L

Chronic Lung Disease is permanent damage that occurs typically in premature babies How does this disease happen... Describe lung compliance & alveoli....

Due to injury or respiratory distress syndrome Decreased lung compliance (stretchyness) & Decreased alveoli

SS Fever Sore throat HA Ab pain Inflammation of pharynx Exudate Palate petechiae Strawberry tongue Enlarge cervical lymph nodes This problem...

Group A Streptococcal pharyngitis

Type of antibiotics given for bacterial pharyngitis....

Moxicillin Kephlex

Type of precautions for Group A Streptococcus pharyngitis....

Isolation Droplet until 24 hrs of treatment

Diagnosis Group A Streptococcal pharyngitis.... What is an ASO....

Rapid strep or throat culture ASO (Antistreptolysin O) titer. Only detects past infections

Differentiating Pharyngitis _____ No cough, sudden onset, high fever, exudative tonsillitis, swollen lymph nodes. Cough, runny nose, conjunctivitis, hoarseness, gradual onset. Viral Pharyngitis / GAS Pharyngitis

GAS Pharyngitis No cough, sudden onset, high fever, exudative tonsillitis, swollen lymph nodes. Viral Pharyngitis: Cough, runny nose, conjunctivitis, hoarseness, gradual onset.

Group A Streptococcus (GAS) (Streptococcus pyogenes) is the bacteria responsible for strep throat and can lead to serious complications like....

rheumatic fever and scarlet fever if left untreated

Most common cause of Acute Otitis Media....

Viral hemo influenzia / strepto pneumonia

Difference between Acute Otitis Media and Otitis Media

Acute = infected fluid of the middle ear Otitis media effusion is fluid collection that is not infected

Acute Otitis Media is usually preceded by....

URI

Acute Otitis Media is commonly caused by hemo influenza & strepto pneumonia The AAP recommends what when it comes to antibiotics treatment...

Watchful waiting of 2-3 Avoid antibiotics resistance

Hearing loss Speexh delay Chronic drainage Intracranial infections Acute mastoiditis Complications of...

Acute Otitis Media

Prevent Acute Otitis Media (3)

Breastfeeding No 2nd hand smoke Immunization

Otitis Media can be treated using these antibiotics...

Amoxicillin Augmentin - a amoxicillin combination drug

Bilateral myringotomy and tubes involves places tubes in a small opening created in the ear drum. Why.... What happens if tubes come out..

To allow drainage for Otitis Media NBD. Just tell the dr

Laryngotracheobronchitis Is edema to larynx, trachea, and bronchi Is aka...

Croup

Croup: edema to larynx, trachea, and bronch Most common 3 months - 3 yrs Is most commonly caused by...

Parainfluenza

SS Inspiratory Stridor Barking cough Hoarseness Worse at night Name problem.... Treatments....

Croup Cool mist humidity Corticosteroids Epinephrine Racemic

Haemophilus influenzae type b (Hib) Vaccine protects against...

Epiglottis

SS Rapidly progress Drooling Dysphagia Distress Fever Look sick Refuse to lie down

Epiglottis

Epiglottis is a Medical Emergency Tyoe of inspection... Tyoe of oxygen delivery... Intubation is likely, if intubation fails...

Dont touch! No tongue depressor or throat culture Blow by Tracheostomy

Oct - March is RSV season This problem often cones from RSV...

Bronchiolitis

You can cohort 2 RSV pts together....

True

SS Rhinorrhea Pharyngitis Cough Sneeze Eye / Early Drainage Progessive illness / peaks at 5 days Severe Tachypnea >70 Retraction Diminished breathing Problem.... Cause.... Treatment....

Bronchiolitis RSV Suppotive care. Oxygen & IV hydration

RSV / Broncholitits precautions...

Both Contact & Droplet

Heated high flow nasal canula maybe used for infants & young kids with bronchiolitis...

True

Bronchiolitis/ RSV When to nasal suction...

Before feeding with saline

RSV there is a vaccine that can be given to preggers mom to protect baby

PEEP Positive end expiratory pressure is a ventilator setting that keeps alveoli open. Used for this problem...

ARDS

ARDS happens how...

Sepsis Pneumonia Smoke Drowning

Nurse ratio to an ARDS pt...

2/1

Last line support for ARDS...

Extracorporeal membrane oxygenation

Inflammation of tonsils can be viral or bacteria...

Should you wake a child up in the iddle of the night post tonsillectomy to give pain meds..

Yes

Post op tonsilectomy nursing considerations....

Fluid Pain Bleeding Diet

Emergency trach kit includes...

2 spare trachs (1 same size & 1 smaller) Suction catheter & machine Bag & mask Saline Spare ties

Nurse considerations for trach tie removal...

2 person job

How tight should a trach tie be...

1 finger width between tie and neck

Tach cleaning is a sterile procedure..

Suction trach how long

10 sec

Which cannula in rhe trach can be removed..

Inner