Respiratory Flashcards

1
Q

Purpose of the Respiratory System

A

Provides O2 to the cells
Ventilation
Removal of O2

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2
Q

Respiratory Dysfunction Causes

A

Infection
Trauma- pneumothorax
Oncology- tumor

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3
Q

Upper Airway Anatomy

A

Tongue is a lot larger- sleep apnea- obstruction
Throat is smaller
Pharynx- a lot narrower

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4
Q

Cartilage in Upper Airway

A

Funnel shaped airway- 12 yrs old straightens out

Relevant for nurses who preform intubation

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5
Q

Development of Lower Airway

A

Increases A LOT up into adolescence
With a vent- weight is based on norms when thinking of volume
Bagging- small children = small bag, risk of pneumothorax if too much air!
Increase in diameter of lower airway
Increase in alevoli in 8-10 year olds

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6
Q

Musculoskeletal Development

A

Increase rigidity in the rib cage- uses energy to open the muscles
Babies are belly breathers!

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7
Q

Respiratory Assessment

A

Rate, Rhythm, Depth, Quality

Can assess most visually

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8
Q

Tachypnea

A

Increased rate

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9
Q

Bradypnea

A

Decreased rate

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10
Q

Dyspnea

A

Distress during breathing

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11
Q

Apnea

A

Cessation of breathing

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12
Q

Hypoventilation

A

Decreased depth (shallow) and irregular rate

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13
Q

Hyperventilation

A

Increased rate and depth

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14
Q

Kussmal Respiration

A

Hyperventilation, gasping and labored respiration
Diabetic coma
Respiratory Acidosis

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15
Q

Cheyne- Stokes Respiration

A

Gradually increasing rate and depth with periods of apnea

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16
Q

Seesaw Respiration

A

Chest falls on inspirations and rises on experiation
Upper airway occlusion
Croup, foreign body

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17
Q

Initial Signs of Respiratory Distress

A
Restlessness
Tachypnea
Nasal flaring
Retractions
Color Changes
Head bobbing
Grunting, striddor, wheezing
18
Q

Decompensataion Signs

A
Anxiety Irritability
Decreased level of consciousness
Confusion
Hyper/hypotensioin
Suddenly decompensates because the child can compensate for a long time!
19
Q

Imminent Respiratory Arrest

A
Bradypnea
Bradycardia
Cyanosis
Stupor
Coma
Then quickly into cardiac arrest
20
Q

Respiratory Failure

A
A laboratory diagnosis
PO2 < 60  (normal 80-100)
PCO2 > 50 (normal 35-45)
NEED ABGs to say failure
Interventions: supplemental O2, determine increasing level of O2 by checking pulse ox, positioning, suctioning, cough and deep breathing, percussion and vibration
21
Q

Respiratory Distress Management

A
EARLY RECOGNITION IS KEY
Watch for increase in heart rate and RR
NO change in BP
NPO- risk of aspiration
Position, O2, clear secretions, equipment at bedside, Rapid response team, PICU transfer
22
Q

Respiratory Acidosis

A

Increase CO2
Hypo-ventilation- airway obstruction, neuro-trauma
<7.35 pH
Confusion, lethargy, headache, increase ICP, Coma

23
Q

Respiratory Alkalosis

A

Decrease CO2
Hyperventilation- hypoxia, anxiety, fever
>7.45 pH
Confusion, dizziness, neuromuscular irritability, muscle cramping and spasms

24
Q

Acute Life Threatening Event

A

ALTE
Under 2 months
During feeding, sleep, wide awake
Emergency resuscitation
Does not mean it will turn into SUIDS
Several times a month will see the symptoms
Causation: significant reflex, seizure, infection, acute sepsis

25
Q

Sudden Unexpected Infant Death Syndrome

A

SUIDS

Leading cause of death , No co-sleeping, no extra blankets, no bumpers in bed

26
Q

Risk Factors for SUIDS

A
Low Apgar scores
Viral Infections
Siblings with SUIDS
Male
Native or African American
27
Q

Foreign Body Aspiration

A

Assess patency and ventilation
Positioning is important, CR and pulse ox monitor, supplemental O2
Coins, legos, hot wheel cars, grapes, popcorn
Not always hypoxia

28
Q

Nasopharyngitis/ Pharyngitis

A

Inflammation of the nose and throat
Multiple viral (supportive care) and bacterial (treat with antibiotics)
Lots of strep test, not always necessary to treat
Think about dehydration and pain control

29
Q

Nasopharyngitis/ Pharyngitis Manifestations

A

Feeding poorly/ poor appetite
Lethargy, irritability, restlessness, fever, vomiting, diarrhea, upper airway congestion
THROAT PAIN

30
Q

Tonsillitis and Adenoiditis

A

Common condition in kids
Smaller airway- swelling = pain and upper airway exchange issues
Primary complication- hemorrhage

31
Q

Tonsillitis and Adenoiditis Management

A

Medical- with antibiotics

Surgical- removal of the tonsils and adenoids usually not until after age 3

32
Q

Tonsillitis and Adenoiditis Care

A
Assessment of vitals
Pain management
HEMORRHAGE 
NO aspirin or Motrin for pain or fever
Assess swallowing
33
Q

Epiglottitis

A

EMERGENCY!!!
2-8 years, onset within hours, high fever, intense sore throat, difficulty swallowing, drooling, tripod position for breathing, IS, severe respiratory distress
NPO- could do into a spasm and block airway
Extreme lethargic/ irritable
Treat with antibiotics- IV only

34
Q

Bronchiolitis

A

Viral infection of the lower respiratory tract
Common cold in adults, more severe in children
Most common RSV
Discharge: provide supportive care, nutrition and fluids, supplemental O2, NG tubes due to respiratory stress

35
Q

Pertussis

A

HIGHLY CONTAGIOUS
Bacterial infection of the upper and lower tracts
Most severe in infants and young children
IMMUNIZATION IS KEY!
Treat with antibiotics

36
Q

Asthma

A
Decreases the airways, chronic disorder 
Swelling
Constriction
Mucus Production
50% reduction in a very small airway (like a child)
Do not diagnosis until a few episodes
37
Q

Asthma Management

A

Rescue broncho dilators (beta- agonist)
Systemic and inhaled corticosteroids
Asthma action plan for home management
All three means quality care!

38
Q

Cystic Fibrosis

A

Inherited autosomal recessive disorder of the exocrine glands affecting the respiratory, GI, integumentary, musculoskeletal and reproductive system
Both mom and dad have to be carriers- 25% child will have it
ANY gland that produces mucus can become involved

39
Q

Cystic Fibrosis Technical

A

Mutation of CFTR gene
Chronic accumulation of thick, dry mucus
Primary digestive problems- fats digestion is impaired
Respiratory- lots of congestion, clear out the mucus
Bronchodilators are 1st - then percussion

40
Q

Clubbing

A

Chronic De-oxygenated blood

41
Q

Cystic Fibrosis Care

A

Monitor respiratory rate and depth, VS, LOC and O2 stats
Position of comfort- Elevate HOB
Percussion and postural drainage
Suction nares
Maintain hydration and nutrition
Meds- antibiotics, pancreatic enzymes, bronchodilator
Assess and address anxiety