Respiratory

Question 1

What is the airway diameter in infants vs adults?

Answer 1

Infant: ~4 mm; Adult: ~20 mm.

Question 2

How does swelling affect airway diameter in infants vs adults?

Answer 2

1 mm swelling reduces infant airway by 50% (from 4 mm to 2 mm); in adults, only a 5% reduction (20 mm to 18 mm).

Question 3

Why does airflow resistance increase in infants?

Answer 3

Narrow airway + fast-moving air = more friction, more resistance.

Question 4

What is different about the position of the trachea in children?

Answer 4

Shorter trachea; right bronchus at a more acute angle.

Question 5

When do alveoli begin to differentiate and increase in number?

Answer 5

Around 36 weeks gestation; increase in number until age 5–8.

Question 6

Why do infants rely on the diaphragm to breathe?

Answer 6

Their intercostal muscles are immature until ~6 years old.

Question 7

Why are retractions seen in pediatric respiratory distress?

Answer 7

Flexible ribs + negative pressure from diaphragm = inward chest wall movement.

Question 8

Why do children use more oxygen than adults?

Answer 8

Higher metabolic rate.

Question 9

What is croup?

Answer 9

Inflammation and swelling of the epiglottis and larynx, sometimes trachea/bronchi.

Question 10

What causes LTB?

Answer 10

Viral infection.

Question 11

Who is most commonly affected by croup?

Answer 11

Children aged 3 months to 3 years.

Question 12

What are symptoms of LTB?

Answer 12

Barky seal-like cough, inspiratory stridor, retractions, fever, URI signs.

Question 13

How long does croup typically progress?

Answer 13

Over 24–48 hours.

Question 14

What radiology sign is associated with croup?

Answer 14

“Steeple’s sign.”

Question 15

What is the treatment for LTB?

Answer 15

Dexamethasone, nebulized racemic epinephrine, oxygen, fever reducer.

Question 16

What nursing considerations are key for croup?

Answer 16

Administer meds, hydrate, assess breathing, provide quiet environment.

Question 17

What is epiglottitis?

Answer 17

Bacterial inflammation of epiglottis and larynx — life-threatening.

Question 18

What bacteria most often causes epiglottitis?

Answer 18

Haemophilus influenzae, also Strep and Staph.

Question 19

What has dramatically reduced epiglottitis cases?

Answer 19

HiB vaccine.

Question 20

What are signs/symptoms of epiglottitis?

Answer 20

High fever (>39°C), sore throat, drooling, dysphagia, tripod position, no barky cough.

Question 21

What is the “thumb sign”?

Answer 21

Radiologic sign seen in epiglottitis.

Question 22

What should you NOT do with a child with suspected epiglottitis?

Answer 22

Do NOT touch their mouth or upset them — risk of airway obstruction.

Question 23

What is the treatment for epiglottitis?

Answer 23

IV antibiotics, IV dexamethasone, nebulized racemic epinephrine, oxygen.

Question 24

What is bronchiolitis?

Answer 24

Viral or bacterial inflammation/obstruction of bronchioles.

Question 25

What virus is most commonly responsible for bronchiolitis?

Answer 25

RSV (Respiratory Syncytial Virus).

Question 26

When is RSV season?

Answer 26

October to March.

Question 27

What is “syncytia”?

Answer 27

Clusters of fused cells formed by RSV, clog airways.

Question 28

What are bronchiolitis symptoms?

Answer 28

Cough, congestion, wheezing, tachypnea, retractions, poor PO intake, dehydration.

Question 29

What PE findings are seen in bronchiolitis?

Answer 29

Wheezing, crackles, nasal flaring, retractions, distended abdomen.

Question 30

What is the treatment for bronchiolitis?

Answer 30

Supportive: humidified oxygen, nasal suctioning, IV fluids. No routine antibiotics.

Question 31

Who is eligible for RSV prevention with Synagis?

Answer 31

Premature infants, infants on oxygen, heart/lung disease patients.

Question 32

How often is Synagis given?

Answer 32

Every 30 days for 5 months during RSV season.

Question 33

What does HFNC provide?

Answer 33

Humidified oxygen and “flow” (CPAP effect).

Question 34

Why is humidification needed with HFNC?

Answer 34

Prevents drying from high flow.

Question 35

What is pneumonia?

Answer 35

Infection/inflammation of bronchioles and alveoli.

Question 36

What types of pneumonia exist?

Answer 36

Viral, bacterial, mycoplasmal.

Question 37

Which type is most common in children <5 years?

Answer 37

Viral pneumonia.

Question 38

Which type is most common in children >5 years?

Answer 38

Mycoplasmal pneumonia.

Question 39

What are pneumonia symptoms?

Answer 39

Cough, fever, chest pain, congestion, poor appetite, abdominal pain.

Question 40

What PE findings may be present in pneumonia?

Answer 40

Rhonchi, crackles, diminished breath sounds, WOB signs.

Question 41

What labs may be used to assess pneumonia?

Answer 41

CBC, RSV/flu swabs, blood culture.

Question 42

What does pneumonia look like on CXR?

Answer 42

Focal consolidation, airspace opacity, lobar consolidation.

Question 43

How is pneumonia treated?

Answer 43

Bacterial: Ampicillin (inpatient), high-dose amoxicillin (outpatient), Ceftriaxone (high-risk). Mycoplasma: Azithromycin.

Question 44

What causes asthma?

Answer 44

Airway hyperresponsiveness → mucus, swelling, smooth muscle contraction.

Question 45

What are asthma triggers?

Answer 45

Allergens, viral illness, smoke, exercise, environmental factors.

Question 46

What happens during an asthma attack?

Answer 46

Vasodilation, edema, mucus overproduction, bronchoconstriction, air trapping.

Question 47

What are asthma symptoms?

Answer 47

Wheezing, cough, SOB, tachypnea, intercostal retractions.

Question 48

What are the “Rules of Two” in asthma?

Answer 48

Use inhaler >2x/week, awaken >2x/month, refill >2x/year = Poor control.

Question 49

What meds treat acute asthma?

Answer 49

SABA (bronchodilation), corticosteroids (reduce inflammation), anticholinergics (reduce mucus/bronchoconstriction).

Question 50

What is the 5-10-5 rule for inhaler use?

Answer 50

Inhale for 5 sec, hold 10 sec, exhale for 5 sec.

Question 51

What is cystic fibrosis?

Answer 51

Autosomal recessive disease causing thickened secretions due to CFTR mutation.

Question 52

What does a CFTR mutation impair?

Answer 52

Chloride-ion transport → decreased water movement → thick secretions.

Question 53

What organs are affected in CF?

Answer 53

Lungs, pancreas, GI tract.

Question 54

What is the median lifespan of someone with CF in the U.S.?

Answer 54

Mid-40s.

Question 55

How is lung inflammation treated in CF?

Answer 55

SABA, corticosteroids, antibiotics (e.g., Tobramycin, Cefepime).

Question 56

How is mucus managed in CF?

Answer 56

Hypertonic saline, Pulmozyme.

Question 57

How is nutrition supported in CF?

Answer 57

Pancreatic enzymes, ADEK vitamins.

Question 58

What nursing interventions support CF care?

Answer 58

Respiratory therapy planning, med schedules, nutrition, financial support, exercise planning.