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Pediatrics > Respiratory and ABG's > Flashcards

Respiratory and ABG's Flashcards

1
Q

pH

A

7.35 - 7.45

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2
Q

PACO2

A

45-35

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3
Q

HCO3

A

22-26

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4
Q

Respiratory

A

PACO2

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5
Q

Metabolic

A

HCO3

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6
Q

Children chest shape

A

round - flattens with growth

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7
Q

Children lung capacity

A

alveoli # is diminished at birth

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8
Q

Children respiratory structurally….

A

supple and compliant. Retractions are common for infant through age 5. They are abdominal breathers.

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9
Q

Respiratory Rate in Children

A

as infant it is irregular
normalizes as they get older
O2 consumption is higher in proportion to their body size when compared to adults.

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10
Q

Increased CO2 levels in children….

A

-are toxic. S/S are increased restlessness and solemnance.

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11
Q

W.O.B.

A

work of breathing

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12
Q

Clubbing

A

only seen with chronic hypoxia

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13
Q

Retractions

A 
intercostal
suprasternal
clavicular
substernal
subcostal
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14
Q

Diagnostic Studies used for respiratory disorders

A 
cbc/diff
abg
oximetry
bronchoscopy
ventilator scan
cxr
pft
throacentesis
sputum culture
nasal-pharyngeal swab
** when cbc shows low hgb, packed rbcs may be needed.**
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15
Q

Methods of O2 delivery:

A

Hoods
Tents: wet, cold air. Change wet bedding, prevent chill
Nasal Cannula
Masks
NRB: can deliver up to 100% O2
Ventilators
ECMO: heart/lung machine. Seen with ARDs, meconium asperation

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16
Q

Methods of Tx:

A

incentive spirometer
postural drainage aka pulmonary toileting
Aerosols: MDIs
Tracheostomy: 2-person procedure; 1 finger under the tie; xtra trach - 1 sm, 1 same size

17
Q

Psychosocial Implications of respiratory illness

A
  • frightening to child and family
  • acute episodes and chronic stress
  • developmental needs must be met/maintained with optimal activity and exercise levels while still managing the respiratory problem.
18
Q

Complications of strep

A
  • upper respiratory
  • acute rheumatic fever & acute glomerulonephritis
  • heart, joints, valves take a hit!
  • Tx: antibitoics for 10 days. (PCN, E-MYCIN)
19
Q

Tonsillectomy

A
  • upper respiratory
  • no straws
  • no ibuprofen or ASA x 1 wk before surgery
  • removal of palatine tonsils
  • post op: cool liquids, no dairy, no suction, ice collar, no spicy foods, Tylenol 3
  • Monitor for bleeding (swallowing, tachycardia, pallor, emesis of frank blood)
  • Side lie position
20
Q

Otitis Media

A
  • middle ear infection
  • decrease after age 5
  • small child’s anatomy is different. ET is short, straight, wide.
  • don’t let bottle deed in supine position
  • smoking in the house is also a trigger
21
Q

Untreated ear infections can lead to:

A

hearing loss
meningitis
mastoiditis
perforated ear drum

22
Q

Treatment of ear infections:

A
  • reduce pain and fever
  • antibiotics
  • myringotomy with tubes
  • adenoidectomy (pharyngeal tonsils)
  • hearing screening
  • eliminate tobacco smoke
  • feed infants in upright position

Myringotomy w/ tubes: avoid lake water, no diving, use ear plugs, don’t blow nose, tubes out does not constitute and emergency.

23
Q

croup

A

is a term used to describe a symptom complex of acute respiratory manifestations:

  • seal bark cough
  • hoarseness
  • inspiratory stridor
  • respiratory distress from edema of laryngeal area
24
Q

LTB

A
  • laryngeotracheo bronchitis

- is a viral infection of the larynx, trachea, and bronchi

25
Q

Epiglottitis

A

is a bacterial infection of the epiglottis and surrounding area; potentially fatal

  • cherry red and swollen epiglottis
  • covered by H flu

Croup: normally seen 3mos to 3 yrs, boys more than girls, Fall/Winter, follows URI.

26
Q

LTB Physical findings

A 
inspiratory stridor
tachypnea
tachycardia
restlessness
cyanosis
retractions
barky cough
low-grade fever
previous URI
27
Q

Epiglottitis physical findings

A 
high fever
muffled voice
sore throat
difficulty swallowing
excessive drooling
refusal of food and fluids
sniffing position
breathing through mouth
28
Q

Bronchitis

A
  • lower airway
  • associated with URI, allergies, environment
  • persistent non-productive cough
  • more than 10 days suspect pneumonia
29
Q

RSV

A
  • respiratory syncytial virus bronchitis
  • acute viral infection
  • fall through winter
  • affects epithelial cells causing infiltration of the bronchi and bronchioles with mucous and exudate; varying degrees of obstruction
30
Q

RSV Transmission

A
  • through direct contact
  • RSV cases can room together
  • Respigam: RSV immunoglobulin given Nov-Apr
  • NP swab for ELISA test
  • TX: symptoms
31
Q

Pneumonia

A
  • lower respiratory tract
  • Viral (usually RSV)
  • Bacterial: lobar involvement, consolidation
  • Pneumococcal: immunize now
  • Foreign body aspiration: meconium, formula, objects, hydrocarbonds.
32
Q

Asthma

A

an intermittent, reversible, obstructive disorder of the respiratory tract caused by bronchial smooth muscle constriction, mucosal edema, and excess mucous production.

33
Q

Asthma Triggers

A 
allergens
weather changes
URI
irritants
exercise
emotions
food/medications
34
Q

Asthma medications

A 
beta adrenergic agents
corticosteroids
chromalyn sodium
serevent
methylaxanthines
MDI/nebulizer
fluids
35
Q

Bronchopulmonary Dysplasia (BPD)

A

immature lungs suffer barro trauma/injury
prolonged ventilation is cause
-defined as a chronic pulmonary disease that may develop in VLBW and premature infants, infants with PHTN, pneumonia and cyanotic heart disease.

36
Q

CF defined

A
  • multisystem disorder related to aberrant exocrine gland dysfunction
  • most common lethal genetic disorder among white children
  • 1 in 29 Caucasians are carriers
  • Life expectancy is 30 years
  • autosomal recessive
    1: 4 to have it
    2: 3 risk of carrying it
  • Lungs, pancreas, reproductive organs affected
  • Pancreas may auto-digest itself.
37
Q

CF testing

A
  • management is supportive
  • lung transplantation is possible
  • amalayxe, lipase, protease
  • Vit A, D, E, K
  • Fatty stools
  • Sweat chloride test
  • Males: sterile
  • Females: plugged/blocked cervix
38
Q

S/S of pneumothorax

A 
tachycardia
pallor
dyspnea
cyanosis
increased work of breathing

Pediatrics (8 decks)

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