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families exam 3 respiratory > respiratory > Flashcards

respiratory Flashcards

1
Q

What are priority findings for a patient with tonsillitis?

A
  1. history of ottitis media and hearing difficulties
  2. mouth odor and breathing
  3. sore throat, fever, and difficulty swallowing
  4. tonsil inflammation with redness and edema
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2
Q

what are complications of tonsillitis?

A

hemorrhage which can cause hypovolemic shock so watch for signs of bleeding such as tachycardia, repeated swallowing, hemoptysis–> hypotension is a late sign of shock

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3
Q

what are pre op care points for a patient that will undergo a tonsillectomy?

A

maintain NPO status

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4
Q

what are post op care points for a patient that has undergone a tonsillectomy?

A
  1. elevate HOB when child is awake
  2. assess for signs of bleeding: frequent swallowing, bright red emesis, restlessness, tachycardia, and pallor
  3. provide an ice collar
  4. encourage clear liquids and fluids after a return of the gag reflex- avoid red colored liquids, citrus juice, and milk based foods initially
  5. discourage coughing, throat clearing, and nose blowing in order to protect surgical site
  6. clots or blood tinged mucus in vomit is common
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5
Q

what are important lab findings for a patient with bacterial pneumonia?

A
  1. radiographic exam to see presence of infiltrates
  2. gram stain and culture
  3. nasopharyngeal specimens
  4. elevated antistreptolysin titer if streptococcal infection is present
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6
Q

what are nursing care interventions to perform for a patient with bacterial pneumonia?

A
  1. encourage rest
  2. administer IV antibiotics, oxygen
  3. monitor Is and Os
  4. administer antipyretics for fever
  5. CPT and postural drainage can be helpful
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7
Q

what causes bronchiolitis?

A

bronchiioltiis is caused by RSV (respiratory synsetial virus)

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8
Q

what will the nurse initially see with a patient who has bronchiolitis?

A

rhinorrhea, intermittent fever, pharyngitis, sneezing, wheezing, possible ear or eye infection

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9
Q

what will the nurse see as the bronchiolitis progresses?

A

increased coughing and wheezing, fever, tachypnea, retractions, refusal to nurse or bottle feed, and copious secretions

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10
Q

what will the nurse see bronchiolitis becomes severe?

A

tachypnea >70/min, apneic spells, poor air exchange, cyanosis

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11
Q

what is the plan of care for a patient who has bronchiolitis?

A
  1. supplemental oxygen to keep it above 90 percent
  2. encourage oral intake but if not, give IV fluids until the acute phase has passed
  3. CPT, bronchodilators, and corticosteroids are not rec commended for these patients
  4. give antibiotics if there is a pre existing bacterial infection
  5. encourage breastfeeding
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12
Q

what is bacterial epiglottitis?

A

medical emergency with acute inflammation of the epiglottis

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13
Q

what causes bacterial epiglottitis?

A

usually cause by haemophilus influenza

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14
Q

what are signs of bacterial epiglottitis?

A
  1. ABSENCE OF COUGH, DROOLING, AGITATION
  2. tripod position
  3. dysphonia and dysphagia
  4. suprasternal and substernal retractions
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15
Q

what does the tripod position look like?

A

sitting upright with chin pointing out, mouth open, and the tongue protruding

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16
Q

what is dysphonia?

A

thick, muffled voice and frog like sound

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17
Q

what are nursing care interventions that the nurse should follow when taking care of a patient with bacterial epiglottitis?

A
  1. avoid throat cultures or using a tongue blade because you want to protect the airway
  2. prepare for intubation
  3. administer corticosteroids, IV fluids, and IV antibiotics–> then transition to oral dose to complete a 10 day course
  4. droplet precautions for 24 hours after IV antibiotics have been initiated to let it start working
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18
Q

what are causes of acute laryngotracheobronchitiis?

A

AL is caused by RSV, influenza, and pneumonia

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19
Q

what are causes of acute spasmodic laryngitis?

A

ASL is caused by being a self limting illness that can result from allergens

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20
Q

what are findings for acute laryngotracheobronchitis in infants/toddlers?

A

nasal flaring, intercostal retractions, tachypnea, and continuous stridor

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21
Q

what are findings for acute laryngotracheobronchitis in children?

A

fever, restlessness, barky cough, dyspnea, inspiratory stridor, and retractions

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22
Q

what are findings for acute spasmodic laryngitis?

A

croupy barky cough, restlessness, dyspnea

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23
Q

when does acute spasmodic laryngitis usually occur?

A

ASL usually occurs mainly at night with acute laryngeal obstruction attacks

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24
Q

what nursing care interventions can the nurse provide to patients with AL or ASL?

A
  1. provide humidity with cool mist
  2. administer nebulized racemic epinephrine
  3. administer corticosteroids such as dexamethasone or budesonide
  4. administer IV fluids
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25
Q

what is the peak flowed meter?

A

it measures the amount of air that can be forcefully exhaled in one second

26
Q

what are instructions to give to a child when they are performing the peak flowed meter?

A
  1. have child stand up straight
  2. have nothing in the mouth
  3. make sure marker is zeroed
  4. repeat 3x waiting 30 seconds in between each attempt
  5. record the highest number
  6. do daily at same time each day
27
Q

what are triggers for asthma?

A

allergens, exercise, changes in environment and temperature, animal hair, medications, and strong emotions like anger

28
Q

what are examples of indoor allergens?

A

mold, cockroach antigen, dust and dust mites

29
Q

what are examples of outdoor allergens?

A

grasses, pollen, trees, shrubs, mold, spores, air pollution, and weeds

30
Q

what are examples of irritant causing allergens?

A

tobacco and wood smoke, odors, and sprays

31
Q

what are medications that can trigger asthma attacks?

A

NSAIDs, betablockers, and antibiotics

32
Q

what are clinical manifestations of asthma?

A

audible wheezing, coarse lung sounds, wheezing throughout crackles, use of accessory muscles, anxiety, dyspnea, and decreased oxygen

33
Q

what does albuterol do for a patient with asthma?

A

albuterol is a short acting beta 2 agonist that is used for acute exacerbation and prevents exercise induced asthma

34
Q

what do corticosteroids do for a patient with asthma?

A

they decrease airway inflammation and prevents further attacks and is given only AFTER albuterol (B before C)

35
Q

explain meconium ileus in an infant with cystic fibrosis?

A

meconium ileus causes a distended abdomen, vomiting and inability to pass meconium and is the earliest indication that a newborn has cystic fibrosis

36
Q

what are early respiratory signs that a patient has cystic fibrosis?

A

wheezing, rhonci, and dry nonproductive cough

37
Q

what are increased respiratory signs that a patient has cystic fibrosis?

A

dyspnea, paraoxysmal cough, and obstructive emphsyema and atelectasis on x-ray

38
Q

what are advanced respiratory signs that a patient ahs cystic fibrosis?

A

cyanosis, barrel shaped chest, and clubbing

39
Q

what are GI findings that show a patient has cystic fibrosis?

A

steatorrhea, large appetite early on and then loss of appetite later on, and failure to gain weight

40
Q

what are integumentary signs that a patient has cystic fibrosis?

A

sweat, tears, and saliva have an excessive high content of chloride and sodium in it

41
Q

what is the purpose of a CF patient to take pancrealipase?

A

pancrealipase treats pancreatic insufficiency associated with cystic fibrosis

42
Q

what are important nursing actions to do when giving pancrealipase to a CF patient?

A
  1. monitor stools
  2. increase dosage when eating high fat foods
  3. administer pancrealipase within 30 minutes of eating a meal of snack
  4. can swallow or sprinkle on the food
43
Q

what are important nutrition that a CF patient should follow?

A
  1. provide diet high in protein and high in calories

2. administer fat soluble vitamins (K,A,D,E)

44
Q

what is the sweat chloride test?

A

a device that uses an electrical current which stimulates sweat production, and confirms CF if chloride is > 40 for infants less than 3 months, and greater than >60 for all others, and sodium is >90

45
Q

what is the purpose of taking dornase alfa?

A

decreases the visocity of mucus and improves lung function

46
Q

when should dornase alfa be given?

A

should be given twice a day and give before ACT therapy

47
Q

when should ACT therapy be performed?

A

BID in the morning and evening, and avoid immediately before or after meals

48
Q

what is chest phsyiotherapy?

A

manual percussion

49
Q

what is positive expiratory pressure?

A

it is a flutter mucus membrane device that encourages patient to breathe with forceful expirations

50
Q

what is a high frequency chest compression?

A

high frequency chest compression is a mechanical device + nebulizer

51
Q

what is aerosal therapy?

A

a bronchodilator and is usually performed prior to ACT therapy

52
Q

what is special about pediatric tracheal tubes?

A

pediatric trach tubes soften with body temperature to shape to the contour of the child’s trachea. no inner cannula is necessary because this material resists the accumulation of dried secretions

53
Q

what is the purpose of a tracheostomy?

A

establishes an airway

54
Q

what are suctioning points to note for a child with a tracheostomy?

A
  1. limit suction time to less than 5 seconds for infants and less than 10 seconds for children
  2. only suction as needed (PRN) because suctioning too much can cause mucosal damage, bleeding, and bronchospasm
  3. maintain surgical aseptic technique
55
Q

when should oral hygiene be provided for an infant with a trach?

A

oral hygiene should be given every 2 hours

56
Q

when should trach care be provided for an infant?

A

trach care should be provided every 8 hours

57
Q

how much should the cuff pressure be set at for a trach patient?

A

for cuffed tubes, keep the pressure below 20 mm Hg to reduec the risk of tracheal necrosis due to prolonged compression of tracheal capillaries

58
Q

what should be kept at the bedside for a trach patient?

A

keep an emergency tube that is one size smaller at the bedside

59
Q

when can an accidental decannulation occur?

A

accidental decannulation can occur in the first 72 hours after surgery and is a medical emergency cause the trach tract has not matured and replacement can be difficult

60
Q

what are the aminoglycosides?

A

tobramycin helps treat cystic fibrosis and administer through IV or aerosol

61
Q

what are complications of inhaled corticosteroids?

A

watch for redness, sore or white patches in mouth (thrush)

families exam 3 respiratory (1 decks)

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