Respiratory 4

Question 1

long term daily control of asthma

Answer 1

• long acting beta 2 agonists (salmeterol)
• low to high dose corticosteroids (beconase)
• mast cell inhibitors (cromolyn)
• leukotrine modifiers (montelukast/singulair)

Question 2

asthma education

Answer 2

• understand basic facts (children and adults)
• medications (esp rescue inhaler)
• daily management plan
• action plan
• school health care plan(ie/ 504 plan)

Question 3

asthma treatment outcomes

Answer 3

• optimal pulmonary function
• able to perform daily activities
• able to participate in sports/endurance activites

Question 4

describe chronic lung disease or BPD

Answer 4

• chronic pulmonary obstructive disease occuring in infants (esp preterm)
• associated with prolonged oxygen therapy and mechanical ventilation causing bronchial, alveolar, and epithelial damage
• *chronic low oxygenation (similar to COPD)

Question 5

s/s of chronic lung disease

Answer 5

tachypnea
wheezing
rales/retractions
tachycardia
increased work of breathing
barrel chest
pallor
poor feeding
poor activity tolerance **

Question 6

medications for CLD or BPD

Answer 6

• bronchodilators
• corticosteroids
• diuretics
• anti inflammatory

Question 7

discharge of CLD or BPD

Answer 7

• goal is maintain adequate oxygenation and ventilation
• trach care
• oxygen therapy
• CPR training for family
• nutritional support
• developmental stimulation program
• know warning signs of illness

Question 8

describe cystic fibrosis

Answer 8

• autosomal recessive disorder of exocrine gland dysfunction
• median life expectancy (40 yrs)
• CF transmembrane regular defective affecting sodium chloride transport and water does not move across cell membrane

Question 9

further describe cystic fibrosis

Answer 9

• abnormal mucus secretion and obstruction causing
• marked elevation of sweat electrolyte(sodium and chloride)
• overactive exocrine gland from abnormal automatic NS function
• if BOTH parents have recessive gene, 25% chance will get this

Question 10

what systems can be affected with cystic fibrosis

Answer 10

• multiples
• respiratory: increased mucus secretion blocks airway and ideal for bacterial growth
• GI: pancreatic ducts are blocked by mucus
• reproductive: ovarian ducts may be blocked/may be infertile
• *increased loss of sodium causing salt depletion

Question 11

CF diagnosis

Answer 11

• can be diagnosed with amniocentesis
• *sweat chloride test, if >60mEq = positive
• 72 hr stool collection test for fecal fat
• must be take to a registered CF clinic

Question 12

CF s/s

Answer 12

• meconium ileus
• salty tasting skin
• profuse sweating
• dry, non productive cough
• increased secretions
• fatty stool
• clubbing
• cyanosis, wheezing
• muscle wasting and inability to thrive
• look a LOT younger than their actual age

Question 13

CF treatment

Answer 13

• take lots of meds
• pancreatic enzymes: need with each meal**
• vitamins (ADEK)
• antibiotics (prophylaxis)
• mucolytics (pulmozyme)
• CPT (vest or cupping motion to break up secretions)
• oxygen therapy
• preventative vaccines
• high calorie/protein diet and decreased fat

Question 14

goals of CF

Answer 14

• minimize pulmonary complications
• ensure adequate nutrition for growth
• encourage physical activity
• promote reasonable quality of life (ie/ isolation)
• multidisciplinary approach(many HC providers working together)
• in hosptial for 21 days for “tune up” for IV antibiotics

Question 15

CF causes _____

Answer 15

pancreatic insufficiency

• treat with pancreatic enzymes
• 1-5 capsules with meal
• adjusted level for growth and to decrease stool to 1 or 2

Question 16

because they have pancreatic insufficiency with CF what can occur

Answer 16

diabetes (typically on insulin therapy)

Question 17

life threatening problem of CF

Answer 17

pulmonary complications (ie/ infection, cannot keep O2 level where it should be)
-may need lung transplant

Question 18

hospital care for CF pt

Answer 18

• HAND WASHING
• contact isolation (gowns and gloves)
• decrease spread of nosocomial infections

Question 19

meds to treat CF

Answer 19

• bronchodilators
• antibiotics
• dornase alfa
• hypertonic saline
• ibuprofen
• pancreatic enzyme
• vitamins

Question 20

describe influenza and s/s

Answer 20

viral infection
s/s: URI
**sudden onset of fever and chills
dry throat and nasal mucosa 
dry cough
hoarseness

Question 21

how long does influenza last

Answer 21

4-5 days

Question 22

treatment of flu

Answer 22

**fluids
antipyretic (no ASPIRIN)
antitussive (tamiflu)
prevent with flu vaccine

Question 23

what are the only times you can use aspirin with children

Answer 23

rheumatic fever and kawasaki’s

Question 24

describe infectious mono

Answer 24

cause: EBV
- transmission: direct contact with saliva or through blood transfusion
- can take 4-6 wks to resolve

Question 25

s/s of mono

Answer 25

fever, sore throat, **fatigue, hepatosplenomegaly, posterior cervical lymphadenopathy

Question 26

treatment of mono

Answer 26

supportive care | no contact sports

Question 27

what is pertussis

Answer 27

aka whooping cough - acute respiratory illness (seen in children <4 d/t lack of immunizations) - highly contagious

Question 28

s/s of pertussis

Answer 28

nasal congestion, runny nose, cough (whooping cough)

Question 29

nursing care of pertussis

Answer 29

droplet precautions, monitor resp status and O2 sat, remain with child during coughing spells

Question 30

what can second hand smoke lead to problems in

Answer 30

ear infections, lung infections, asthma and other allergic reactions