Respiratory Book Flashcards
aspiration
inhalation of any object into repository tract
most aspirated foreign bodies cause what obstruction
bronchial
aspiration s/s
sudden onset of choking
spasmodic coughing
dysphonia
flaring
retractions
upright position with neck extended
hypoxia
resp failure occurs
when body can no longer maintain effective gas exchange
- poor ventilation imitates process that leads to resp failure
resp failure s/s
worsening distress
dyspnea
tachypnea
irritability
reiterations
flaring
lethargy
cyanosis
bradypnea
as child tires form prolonged effort of breathing this leads to
RR decrease and then arrest
croup definition
broad classification of upper airway illness that results from inflammation and swelling of epiglottis and larynx
viral forms of croup
acute spasmodic laryngitis
LTB
bacterial forms of croup
tracheitis and epiglottis
which form of croup is more dangerous
bacterial
what is the onset of epiglottis
abrupt
initial s/s of all forms of croup
insiraptory stridor
seal like barking cough
hoarsness
what position might epiglottis be in
tripod
prediction of epiglottis
absence of spontaneous cough
drooling
agigitaion
epiglottis sond
frog like croaking
epiglottis apperence
cherry red edemenatos epligotis
acute spastic and LTB tx
oral dexmethsone and nebulizer epi
bacterial trachelitis and epiglottis tx
IV oral antibiotics
- vanco
why is epiglottis rate down
HiB vaccine
mild spasmodic may have relief with
cold or humidity
what is contraibidiated in epiglottis and LTB
throat cultures/visual inspection of inner mouth and throat are contraindicated in children cause this can cause laryngoaspsm that can lead to complete airway obcstrution
if there is suspected epiglottis what does this mean
do not leave bedside until intubation
- continuously observe for inability to swallow, absence of voice, sounds, drooling, change in LOC
a quite child means
more concern
epiglottis is a
medical emergency
bronchiolutis
lower resp tract illness
RSV/bronchiolotis
most common cause of bronchuilotis
- oct - march
direct contact
what happens with RSV
invaded cells die and leads to debris and clogs and obstructs brochures and irritates airway and airway landing swells and provided excessive mucous
s/s of RSV/ bronch
rhinitis
cough
low grade fever
tachypnea
poor feeding
V/D
grundting
wheeze
crackles
RSV/ branch Xr apperence
hyperinflation
patchy atelectasis
inflammation
RSV bronch tx
nebulizer hypertonic saline
supportive
hydration
CPAP
antipyretic
RSV immunization
syngis
RSV course of illness
gets worse before better
pneumonia
inflammation/infection of bronchioles and alveolar spaces of lungs
pneumonia s/s
fever
rhonci
wheeze
dyspnea
tachypnea
chest/abdomina pain
newborn:
grunting
retrations
flaring
bacterial
bands
increase wbc
high fever
pneumonia CXR
infiltration
pneumonia tx
pain and fever control
bacteria: amp/amox
hydration
pneumonia positioning
good lung up
BPD
chronic lung disease of prematurity supplemental O2 for at least 28 days after premature birth
results from positive pressure ventilation since it injuries the immature lungs leading to fewer and larger alveoli and less functional surface area and a smaller vascular bed in lungs
BPD s/s
resp distress
tachypnea
flaring
reiterations
barrel chest
BPD tx
surfactant
steroids
BPD rf
less than 28 weeks gesation
patent ductus arteriosum
asthma
chronic inflam disorder of airway
bronchial constriction, hyper responsive, airway, airway inflam
reversible
asthma trigger
inflam or non inflam stimulis tuta initates an asthma episode
EX: exercise, infection, allergens, fragrance, pollutant, weather change
asthma s/s
wheeze
dyspnea
chest tightness
prolonged expiation
younger: tripod
older: upright with shoulders forward
flaring
retrations
bobbing
barrel chest
SABA example
albuterol, levalbuterol, pirbuterol
when to use SABA
first, before steroid
SABA min between puff
1-2 mins
SABA min until steroid
15 min
SABA is used when
acute episodes
steroids (oral) example
methylprednisonde, prednisone, prensilolone
oral steroids do what
diminishes airway inflammation
oral steroids are used when
acute episodes
anticholingeric med
ipratropium
antichol action
inhibits bronchoconstriction and decrease mucus production
antichol onset
30-90
not for primary emergency
LABA
salmterol , formotorol
LABA action
relaxes smooth muscle
LABA acute or preventative
preventative
LABA is it a monotherpay
no
asthma mag sultafate
emergencies
inhaled steroids med
beclomethasone
budesonide
flunisolide
fluticasone
mometasone
thiamcinolone
inhaled steroids action
antiinflam
exercise induced
allergies
what should we do after inhaled steroids
rinse mouth
what exercise is well tolerated
swimming
wait how long in between puffs of same med
1-2 min
is silent chest good
no its bad, no more air moved in
peak expiratory zone
- breathing out in 1 sec
- green
good, 80-100%
peak expiratory zone
- breathing out in 1 sec
- yellow
caution, may lead to exacerbation 50-80%
peak expiratory zone
- breathing out in 1 sec
-red
bad medical alert SABA use les than 50%
over what age can use MDI
5
do we use ice cold fluids with asthma
no may cause broncho spams
cystic fibrosis
disorder of exocrine gland
- respiratory, GI, reproductive
secretions become thickened
air trapped in small airway which the mucous can harbor bacteria
CF pancreas
duct is obstructed which leads to impeding natural enexymatic flow needed to digest fats, fat soluble vit, and protein
also leads to CFRD
CF diagnosis
elevation of sweat electrolytes
- gold standard
- sodium and chloride
CF treatment
Chest physiotherapy 1-3 times per day
antibitis
vitamins pancreatic enzymes
chance of CF
1/4
autosomal recessive
CF stool
steatorrhea
CF when are pancreatic enzymes taken
with all meals and snacks
CF cal rate
increase due to high metabolic rate
pneumothorax
occurs when air enters the pleural space due to penetrating chest injury or tears in trachealbronchial tree, esophagus or chest wall
open pneumo
penetrating injury that exposes the pleural space to atmospheric pressure
closed pneumo
Chest may be compressed against a closed glottis causing sudden increase in pressure with thoracic cavity
tension pneumio
air leaks into chest during inspiration and cannot escape during expiration
open pneumo s/s
restless
cyansosis
subq emphysema
closed pneum s/s
breath sounds decreased or absent on affected side
tension pneumo s/s
tracheal deviation
decrease cardiac output
paradoxical breathing
resp peds A&P differnces
young Childs neck is shorter
air way is shorter and narrower which is greater potential for obstruction
tracheal deviation of the right and left bronchi is higher in Childs airway and at different angle
airway is more compressed when head is flexed
narrow airway= more resistance
under 6 use diapgram since intercostals are immature
consume more O2 due to metabolic rate and increase when in resp distress
retrations
negative pressure created by they downward movement of the diaphragm is increased in cases of respiratory distress and the chest wall is pulled inward causing retractions
mild r distress retraction
intercostal
after intercostal retractions
substernal subcostal
after substernal and subcostal
supracalvitular and suprasnetral
