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Peds > respiratory assessment (1) > Flashcards

respiratory assessment (1) Flashcards

1
Q

what do most respiratory problems in children look like?

A

mild, short, managed at home

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2
Q

what kind of problems involve alterations in the size and shape of parts of the respiratory tract

A

structural problems

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3
Q

what kind of problems involve alterations in gas exchange and threats to gas exchange (irritants and invaders)

A

functional problems

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4
Q

what is the infection rate like in kids less than 3 months old?

A

lower infection rate due to protective function of maternal antibodies (do a full work up)

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5
Q

what is a “full work up”

A

CBC, electrolytes, blood cultures, lumbar puncture (meningitis), urinalysis

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6
Q

describe resp infection rate at 3-6 months

A

infection rate increases due to disappearance of maternal antibodies and initiation of the production of the infants’ own antibodies (full work up)

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7
Q

describe resp infection rates at toddler/school age years

A

viral infection rate high (cough and touch)

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8
Q

why are peds at greater risk for airway obstruction?

A

shorter/narrow airway

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9
Q

what is the approximate size of an infant airway

A

4mm, size of a drinking straw

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10
Q

how big is the adult airway

A

20mm

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11
Q

how does the trachea grow during the first 5 years

A

in length rather than diameter (4mm)

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12
Q

newborns are obligatory nose breathers until how old

A

4 months

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13
Q

do infants 2-3 months old open mouth to breathe when nose is obstructed?

A

no

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14
Q

which parts of the resp system are bigger than others?

A

tongue and epiglottis (can cause obstructiob)

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15
Q

how many alveoli are there at birth and adulthood

A

birth= 25 million, not fully developed
adult= 300 million

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16
Q

at what age to alveoli increase in size and complexity

A

8 years old

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17
Q

at what age does the infant have enough muscles to react to irritants by bronchospasm and muscle contraction

A

5 months

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18
Q

how long are children diaphragmatic breathers?

A

6 years old

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19
Q

what are ribs like in pediatrics

A

mostly carilage

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20
Q

what do you visually assess in respiratory?

A
  • symmetry of chest
  • abdomen breathing
  • color of skin
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21
Q

how long of not breathing classifies true apnea?

A

20 sec

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22
Q

normal respiratory rate of a child 1day-1 year old

A

30-60

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23
Q

what is the normal respiratory rate of a child 1 year-3 years old

A

24-40

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24
Q

what is the normal respiratory rate of a child 3 years-5 years

A

22-34

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25
Q

what is the normal respiratory rate of a child 5 years-12 years

A

18-30

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26
Q

what is the normal respiratory rate of a child 12 years and older

A

12-18

27
Q

what do you assess for in respiratory palpation

A

deformities of chest wall and tactile fremitis

28
Q

what part of the stethoscope do you use to listen

A

diaphragm

29
Q

what parts of the lungs do you listen to anteriorly

A

upper and middle lobes

30
Q

what parts of the lungs to you lsiten to posteriorly

A

upper and lower lobes

31
Q

what are low pitched, swishing, soft expiratory sounds heard in older children

A

vesicular

32
Q

What are medium pitched, hollow, blowing breath sounds that are heard equally on inspiration and expiration, heard in all ages

A

Bronchovesicular

33
Q

What are hollow and higher pitched breath sounds than vesicular

A

Bronchial/tracheal

34
Q

what is a normal pulse ox for children?

A

95-98

35
Q

What can a change in muscle tone, becoming floppy, mean?

A

Hypoxia

36
Q

What kind of sounds are from the lower airway, are heard at the end of inspiration, and is air passing through secretions in alveoli and bronchials

A

Fine crackles

37
Q

What is a musical squeaking or hissing noise that is continuously heard during inspiration or expiration: louder on expiration. It is a Bronchospasm or anatomic narrowing of the bronchials

A

Wheeze

38
Q

what is a coarse low pitched noise that sounds like a snore that is air passing through thick secretions that partially obstruct the larger bronchi and trachea

A

Sonorous rhonchi

39
Q

what is a high pitched inspiratory crowing sound that originates in the layrynx or trachea. From Upper Airway Obstruction from swollen inflamed or lodged foreign body. Croup or epiglottis

A

Stridor

40
Q

What are tight breath sounds?

A

High pitched or squeaking sounds. small Airways have more constriction

41
Q

What are diminished or absent breath sounds

A

When the Airways become completely closed or almost closed

42
Q

what is the sinking in of soft tissues relative to the cartilaginous and bony thorax

A

retractions

43
Q

what retractions are below the ribcage “using abdominal muscles”

A

subcostals

44
Q

what retractions are below the sternum

A

substernal

45
Q

what retractions are between the ribs (anterior and posterior)

A

intercostals

46
Q

what retractions are above the sternum

A

suprasternal

47
Q

what retractions are above the clavicles

A

supraclavicular

48
Q

which retractions indicate mild distress?

A

subcostal, substernal, mild intercostal

49
Q

which retractions indicate moderate distress

A

subcostal, substernal, moderate intercostal

50
Q

which retractions indicate severe distress?

A

subcostal, substernal, severe intercostal, suprasternal, supraclavicular

51
Q

what is enlargement of the nostrils that helps reduce nasal resistance and maintain airway patency

A

nasal flaring

52
Q

what does nasal flaring indicate?

A

severe distress

53
Q

what does head bobbing indicate

A

severe distress

54
Q

what does grunting indicate?

A

severe distress

55
Q

what color changes indicate distress?

A

mottling, pallor, gray, cyanosis

56
Q

when assessing a 4 year olds chest the nurse would expect:
a) movement of the chest wall to be symmetrical bilaterally and coordinated with breathing
b) respiratory movement to be throacic
c) anteroposterior diameter to be equal to the transverse diameter
d) retraction of the muscles between the ribs on respiratory movement

A

A

57
Q

of the following respiratory system structures which one does not distribute air?
a) bronchiole
b) alveolus
c) bronchus
d) trachea

A

b) alveolus

58
Q

the infant primarily relies on
a) mouth breathing
b) intercostal muscles for breathing
c) diaphragmatic abdominal breathing
d) all

A

c) diaphragmatic abdominal breathing

59
Q

room air is what percent oxygen?

A

21%

60
Q

what is the best way to stimualte deep breathing in a child

A

use games to extend expiratory time and pressure

61
Q

what is an early and subtle sign of early hypoxia?

A

mood changes and restlessness

62
Q

what is cardiac arrest in the pediatric population usually resulting from?

A

prolonged hypoxia

63
Q

what is the cause of most respiratory infections in children

A

viruses

64
Q

what is the reason that infection rate drastically increases in 3-6 months?

A

maternal antibodies have disappeared and the infants own antibody production is immature

Peds (30 decks)

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