Respiratory

Question 1

differences in airways of kids

Answer 1

tongue larger than mouth, epiglottis floppier and U shaped, vocal cords slanted up, larynx anterior and superior, cricoid narrow, trachea narrow not rigid, less lung capacity, mainstem bronchi separates higher at T3, fewer alveoli, diaphragm for inspiration in kids <6yrs, small lungs

Question 2

respiratory assessment

Answer 2

rr rate and rhythm, effort, symmetry, cough, color, pain, breath sounds, odor, mucus, positioning.

Question 3

PAT scoring

Answer 3

if 1/3 get more VS, if 2/3 usually an emergency

Question 4

Nurses role in pediatric rr disorders

Answer 4

open and maintain airway, maintain ventilation, give oxygen, monitor fluids, pain relief, give medications like bronchodilators or steroids, prevent infections, give emotional support.

Question 5

cardinal signs of rr distress

Answer 5

restlessness, tachycardia, tachypnea, diaphoresis

Question 6

rr distress compensatory mechanisms

Answer 6

grunting keeps alveoli open, retractions and head bobbing assist with ventilation, nasal flaring increases diameter of air passages, hyperextension of head opens airway, paradoxical breathing

Question 7

what is respiratory failure

Answer 7

no longer maintaining gas exchange/hypoventilation. either not enough O2 or too much CO2. common cause of cardiopulmonary arrest

Question 8

what is respiratory distress

Answer 8

compensatory mechanism somewhat working, can last for a long time but then deteriorates

Question 9

respiratory failure sx

Answer 9

followed by rr arrest, hypoventilation in alveoli, cyanosis, tachypnea followed by bradypnea, retractions, apnea, altered mental status, extreme tachycardia, cant maintain O2 level, acidotic ph

Question 10

how kids breath

Answer 10

newborns obligatory nose breathers, mouth breathing at 4mo

Question 11

giving oxygen

Answer 11

use nasal cannula first (.25-6L/min), high flow nasal cannula (60L/min and 21-100% FiO2), simple oxygen mask (5-10L/min), non rebreather (10-15L/min), BiPAP, CPAP

Question 12

what is Pertussis

Answer 12

whooping cough, “100 day cough”, highly contagious, bacterial, lasting several weeks

Question 13

pertussis sx

Answer 13

severe frequent coughing fits, post cough vomiting, whooping sound, gasping, face turns blue, tongue out when coughing

Question 14

pertussis tx

Answer 14

prevention with vaccine, abx azithromycin, elevate HOB, give O2

Question 15

acute spasmodic laryngitis

Answer 15

least serious risk, 3mo-3yr old, onset abrupt and peaks at night

Question 16

laryngotracheobronchitis

Answer 16

most common for risk, 3mo-3yr old, gradual onset and progressive

Question 17

laryngotracheitis

Answer 17

serious risk, 3mo-8yr old, gradual onset progresses to rr distress

Question 18

epiglottitis

Answer 18

most serious risk, 2-8yrs, abrupt and progresses rapidly to occlusion

Question 19

what is laryngotracheobronchitis

Answer 19

most common croup, viral in upper airway. sx are brassy cough, dyspnea, stridor, low fever. tx is steroids, fluids, racemic epi

Question 20

what is acute spasmodic laryngitis

Answer 20

unknown cause. sx are barking cough, afebrile, mild rr distress, steeple sign xray. tx is cool mist, its self limiting

Question 21

what is epiglottitis

Answer 21

bacterial, causes infla of epiglottis, medical emergency, airway obstruction in 2-6hrs. sx are toxic appearance, tripod, drooling, stridor, croaking sound, high fever, red epiglottis, unable to speak, thumb sign on xray. tx is avoid crying, ET tube, abx

Question 22

what is pneumonia

Answer 22

infection or infla of lower airways, bacterial or viral, community most common or hospital acquired

Question 23

pneumonia sx

Answer 23

fever, tachypnea, cough, N/V, irritable, restless, lethargic, abdominal pain.

Question 24

pneumonia tx

Answer 24

monitor for rr distress, encourage coughing and deep breathing, give O2, fluids, abx if bacterial

Question 25

bronchiolitis

Answer 25

rsv causes it, cells in bronchioles die then accumulate and obstruct. tx is symptomatic tx, self limiting, abx.

Question 26

bronchiolitis sx

Answer 26

mild wet cough, rhinorrhea, congestion, worse sx after 2 days, peaks 3-5 days. prophylaxis for those at risk of rsv with palivizumab, suction nose

Question 27

bronchitis

Answer 27

infla of trachea, bronchi, and bronchioles. viral, tx is self limiting, humidification, tx is self limiting, humidification, tx symptoms, can vomit mucus from swallowing secretions

Question 28

bronchitis sx

Answer 28

coarse barking cough, chest pain, thick sputum, cough worse at night

Question 29

tuberculosis latent sx

Answer 29

asymptomatic, not contagious, normal chest xray, tx goal is to prevent it from active, 9mo isoniazid

Question 30

tuberculosis active sx

Answer 30

persistent cough >21days, night sweats, fevers, weight loss, contagious, abnormal chest xray, goal is to tx disease, tx with multiple rx for 4-9mo (rifampin, isoniazid, pyrazinamide, ethambutol)

Question 31

what is tuberculosis

Answer 31

lung infection, r/f are environmental or immune related, airborne droplet spread

Question 32

tuberculosis dx

Answer 32

tb skin testing, chest xray, quantiferon gold test, sputum smear

Question 33

foreign body aspiration

Answer 33

inhalation of object, can develop PNA/fever, cause severe rr distress, common things are food, coins, buttons, toys

Question 34

foreign body aspiration sx, tx

Answer 34

cough, dyspnea, stridor, hoarseness, possibly cyanosis. tx is removal either flexible bronchoscopy or rigid bronchoscopy

Question 35

what is acute rr distress syndrome

Answer 35

high mortality rate, hypoxemia and noncompliant lungs, hypoxemia doesnt improve with O2.

Question 36

acute respiratory distress syndrome causes

Answer 36

direct - pna, aspiration, pulmonary contusion, near drowning, smoke inhalation, vaping indirect - sepsis, pancreatitis, burns, shock, drug overdose, multiple blood transfusion

Question 37

sx of acute respiratory distress syndrome

Answer 37

bilateral lung opacities, tachypnea, tachycardia, increase WOB, decreased O2, cyanosis, decreased breath sounds bilateral, lethargic, somnolent

Question 38

acute respiratory distress syndrome tx

Answer 38

intubation, positive pressure mechanical ventilation, ABG's, chest xray, fluids, abx, diuretics, vasodilators, gastric ulcer prophylaxis

Question 39

pneumothorax

Answer 39

accumulation of air in pleural space. can be spontaneous, traumatic, or tension.

Question 40

pneumothorax sx

Answer 40

tachypnea, dyspnea, rr distress, hypoxemia, pleuritic chest pain, diminished breath sounds on affected side, tracheal deviation

Question 41

pneumothorax tx

Answer 41

chest tube, supplemental oxygen, monitor rr status. open you cover with airtight seal, tension has emergent chest tube placed.

Question 42

asthma

Answer 42

most common chronic condition, either intrinsic or extrinsic leads to infla then either hypersecretion of mucus, airway constriction, bronchial membrane edema then airways narrow. sx are wheezing, coughing, shortness of breath, tightness in chest

Question 43

peak flow meter

Answer 43

measures the amount of air forcefully exhaled in one breath. green is good and red means asthma is severe

Question 44

asthma tx

Answer 44

short acting beta agonist (albuterol), anticholinergic (ipratropium bromide), systemic corticosteroid (prednisone, methylprednisolone), inhaled corticosteroid (beclomethasone, fluticasone, budesonide), long acting beta agonist (salmeterol, formoteral), leukotriene receptor antagonist (montelukast)

Question 45

asthma education

Answer 45

action plan, how to use rx, trigger to avoid

Question 45

cystic fibrosis

Answer 45

autosomal recessive genetic disorder, abnormalities in bodys salt, water and mucus making cells. thick mucus builds up in lungs.

Question 46

cystic fibrosis sx

Answer 46

steatorrhea, failure to thrive, tachypnea, wheezing, retractions, recurrent pneumonia

Question 47

cystic fibrosis tx

Answer 47

sweat chloride testing, pancreatic enzyme replacement, percussion and drainage, mucolytic, diet high protein and high calorie

Question 47

bronchopulmonary displasia

Answer 47

chronic obstructive pulmonary disorder, from long use of supplemental O2 and positive pressure ventilation from premature birth, theres reduced surface area for gas exchange

Question 47

bronchopulmonary displasia sx

Answer 47

tachypnea, tachycardia, nasal flaring, grunting, retractions, wheezing, crackles, failure to thrive, increased O2 demands, irritable, restlessness

Question 48

bronchopulmonary displasia tx

Answer 48

positioning, humidified supplemental O2, chest physiotherapy, bronchodilators, suction, diuretics, may need tracheostomy

Question 48

tracheostomy education

Answer 48

emergency care, suctioning, stoma care, change trach ties, change trach, know size of trach, when to call provider (increase in secretions, purulent, rr distress, fever)