Respiratory Flashcards
Respiratory rate greater >60 make them what?
NPO
use un-cuffed trach in children under 8 years old, t or f
true
creates functional seal
why are kids prone to respiratory infections
their trachea is very short, bacteria gets into lungs
narrowness of chest
infant airway measurement
smaller in diameter = 4mm
shorter in length
adult airway measurement
8mm
assess patient for signs of working breathing
children can only keep working for so long before respiratory arrest
clubbing of nails equates to
chronic hypoxemia
grunting is sign of*
impending respiratory failure
infants can have 20 sec without breathing is called
periodic breathing - normal
alte-apnea period beyond 20 seconds stands for
apparent life threatening event
sweat chloride test is used for (dx test)
cystic fibrosis
>60 is usually positive for cystic fibrosis
never prop a bottle, t or f
true
most common location for aspiration of foreign bodies
right main-stem bronchus
croup
acute upper airway obstruction
caused by viral infection
typically mild
seen in children from 6 mos-5 years old
croup s/s
bark cough fever may/may not stridor on inspiration & expiration gradual onset retractions hyperventilation
croup dx
xray (steeple sign)
most common type of croup requiring hospitalization
laryngotrachobronchitis (LTB)
usually have URI symptoms prior to croup
croup nursing interventions
cool mist nebulized epinephrine (in ER) dexamethasone (reduces edema in airway) heliox (in ICU) helium & oxygen decreases work of breathing hydration
RSV - respiratory syntactical virus
season = October through April highly contagious (isolation) transmitted by hands & resp droplets
most common cause of bronchiolitis
RSV
This population is a greatest risk for RSV
premature infants
congenital heart disease
BPD (broncho pulmonary dysplasia)
most frequent cause of hospitalization in children
RSV
peak incidence of RSV
2-7 mos
RSV nursing interventions
isolation precautions freq hand washing assess respiration's iv corticosteroids encourage mom to pump & store milk control secretions (before eating/bedtime)
what is Ribavirin
Inhaled antiviral agent - approved specified therapy in children w/ RSV
Expensive - Conflicting results
what is palivizumab
Approved RSV drug in the US
Given IV or IM q30 days during RSV season
$1200 per dose
what is asthma
chronic inflammatory disorder of the airway causing broncho-constriction
asthma risk factors
boys>girls hereditary factor exposure to smoke allergies trigger/exacerbation's (environment)
asthma s/s
wheezing/retractions
SOB
what is status asthmaticus
acute asthma exacerbation w/ bronchial obstruction
severe & continues to worsen despite treatment
leads to respiratory failure
s/s of status asthmaticus
diaphoretic (sweating)
anxious
use of accessory muscles
respiratory failure
mgmt of asthma
educate parents
medication admin.
asthma action plan (kids over 5)
medications for asthma include
treatment for long term care & acute exacerbation’s
oral steroids
mast cell stabilizers
inhalers
controller asthma medications
single inhaled corticosteroids (flovent, pulmicort, QVAR, asmanex)
combined asthma medications
advair
dulera
symbicort
rescue asthma medications
q4hr PRN albuterol (proair, ventilin, proventil) albuterol nebulizer levalbuterol (xopenex) levalbuterol nebulizer
asthma spacer devices provide
better delivery for inhaled medications in children
peak expiratory flow meter measures/use
max flow of air forcefully exhaled in 1 sec
measured in liters/min
result shown in green, yellow, red
establish baseline when stable - chart (3 occurences)
age 5+
required for severe patients
what is cystic fibrosis
chronic multi-system condition
autosomal recessive (1 in 4 births if parents carry gene)
long arm of chromosome 7
screened in 50 states
life expectancy (40’s)
may or may not display symptoms at birth - can develop
cystic fibrosis manifestations
sticky mucous which blocks ducts
improper salt balance, sweat has elevated Na+ and Cl
abnormal ion concentration
dx test for cystic fibrosis
sweat chloride test
children with cystic fibrosis develop
chronic sinus issues nasal polyps pancreatic dysfunction malabsorption prone to infections delayed puberty in girls mild to severe symptoms
mgmt of cystic fibrosis
multi-disciplinary team preventative labs auditory - hearing loss from antibiotics? test at 6+ mos brain-stem hearing test (asleep) assessments (baseline)
cystic fibrosis s/s
gray/fatty stools (steatorrhea)
digestive problems (decreased absorption)
recurrent URI
medications for cystic fibrosis
vitamins a,e,d,k inhaled antibiotics regardless of age (found beneficial) mucolytic enzymes pancreatic enzymes bronchodialators oral/iv antibiotics
nursing interventions for cystic fibrosis
patient/parent education nutrition assessment percussion/postural drainage - cough - spit out mucous chest p/t q4hrs support groups supplemental feedings at night chronic - never ends
child life therapist is someone who holds a
bachelors degree in growth and development
bibliotherapy
a communication tool to help prepare a child for trt
reduces fear of the unknown
2 huge philosophies that drive pediatric nursing practice
atraumatic care - avoid distressing (treatment room)
patient/family centered care - collaborate/communicate with the family
