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N348 Peds > Respiratory Conditions > Flashcards

Respiratory Conditions Flashcards

1
Q

respir failure v cardiac

A

kids respir driven, lungs will fail b4 heart

inc risk cardiopulm failure if breathing compromised

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2
Q

upper airway- anatomy

A

nasopharynx and oropharynx

epiglottis

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3
Q

larynx function

A

voice box

separates upper and lower airways

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4
Q

lower airway fun

A

allow for oxygenation and gas exchange

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5
Q

upper airway- fun

A

pathway for gas exchange

allows for ventilation

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6
Q

lower airway- anatomy

A

alveoli, lungs, trachea, bronchi and bronchioles

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7
Q

child alterations in upper airway anatomy

A

big tongue
vocal cords slant upwards
larynx higher in the neck (easier to occlude airway)
long floppy epiglottis
lungs dec capacity (dec SA for gas exchange)
cartilage in neck more flexible
shorter and narrower= inc airway resistence

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8
Q

child alterations in lwr airway

A

mainstem bronchi separate higher (T3 not T6)
fewer, immature alveoli (dec gas exchange)
narrower bronchioles
< 6yrs use diagram for inspiration
smaller lungs
immature intercostal muscles (prone to retractions)

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9
Q

assessment- respirations

A

rate/rhythm
depth and symmetry
effort (WOB retractions, head bobbing, nasal flaring etc)

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10
Q

assessment- cough

A

charac, effort and timing

ex. after eating can aspirate

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11
Q

risk w/ mid clavicular and tracheal tugging

A

indicate extreme respir. distress

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12
Q

assessment- color

A

location/shade
effect of crying
presence of cyanosis

around lips- circumoralcyanosis
hands/feet- acrocyanosis

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13
Q

assessment- pain

A

location, origin and severity

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14
Q

assessment- advent. sounds

A

wheeze- lower (swelling and asthma)
stridor- upper (obstruction, bac or viral)
crackles- lower (alveoli stick together)

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15
Q

assessment- odors/mucus

A

color, consistency, breath

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16
Q

assessment- positioning

A

shoulder roll

jaw thrust

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17
Q

respiration range for age

A 
newborn- 33-50
1- 25-40
3- 20-30
7- 16-22
10- 16-20
17- 12-20`
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18
Q

cardial s/s of respir distress

A

restlessness
tachycardia
tachypnea
diaphoresis

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19
Q

compensatory mechanisms and function- grunting

A

most scary sign
last ditch effort to keep alveoli open
present upon expiration

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20
Q

compensatory mechanisms and function- retractions

A

assist w/ ventilation

open lungs and drops diaphragm

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21
Q

compensatory mechanisms and function- head bobbing

A

assist w/ ventilation

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22
Q

compensatory mechanisms and function- nasal flaring

A

inc diam of air passages

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23
Q

compensatory mechanisms and function- hyperextension of neck and head

A

opens airway (too much tilt up/down can pinch off airway)

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24
Q

respir distress- interventions

A 
assess airway
supplemental o2 (cpap or ambu bag)
25
Q

respir failure- s/s

A 
altered mental status
tachypnea (turns into bradypnea)
extreme tachycardia (turns to bradyardia)
acidotic pH
cant maintain o2 stats
retractions and apnea
cyanosis or gray color
26
Q

respir failure early signs

A

occurs fast when compensatory mech fail (head bobbing,nasal flaring etc)
stimulated by hypoventilation of the aveoli

27
Q

flow chart of respir distress if not trted

A 
compensatory mech
respir distress
respir arrest
cardiac arrest
dec ventilation= inc co2 accum= inc acidity= dec pH (respir. acidosis)
28
Q

newborn breathing pattern

A

periodic
obligatory nose breathers (can only get air in through nose)
make sure it’s not plugged!

29
Q

supplemental o2- NC

A

24-35%

  1. 25-6 L/min
    * humidify
30
Q

supplemental o2- simple mask

A

35-50%

5-10L/MIN

31
Q

supplemental o2- non rebreather

A

70-100%

10-15L

32
Q

supplemental o2- BIPAP or CPAP

A

bipap- bilevel posit. airway pressure

cpap- contin. posit. airway pressure

33
Q

supplemental o2- %

A

RA= 21%

34
Q

Laryngotracheobronchitis (LTB)

A

CROUP
3 mo- 8yr
cold air calms inflamm, get worse when inside
viral infection upper airway
s/s seal cough, dyspnea, stridor on inspir., fever
trt- steroids, racemic epi (nebulized) for immed. effect
trts localized swelling (risk for rebound swelling)

35
Q

spasmodic laryngitis

A

3mo- 3yrs
night
barkingn cough, mild respir distress
trt- cool, mist, self limiting

36
Q

epiglottitis def

A

inflammation/ swelling
MEDICAL EMERGENCY
bacterial infection (influenza B) can be avoided w/ vaccinations

37
Q

epiglottitis- s/s

A 
tripod position
drooling
stridor
high fever
steeple sign on x ray (airway narrows)
38
Q

epiglottitis- trtment

A

immediate endotrach tube for airway patency
antibotics
keep kid calm

39
Q

tracheitis def

A 
bac or viral
common in fall/winter
more common in males
often secondary to a already existing dis
determined after intebated
40
Q

tracheitis- s/s

A

croupy cough, hoarse
high fever
stridor
thick, purulent secretions

41
Q

tracheitis- trtmnt

A

antib
fluids
mucolytics

42
Q

pneumonia

A

infection lower airway
bac or viral (or b/)
fever, cough, tachypnea, n/v, lethargic

trt- monitor for distress
encourage cough/deep breathing (can suction of chest physiotherapy)
antib if bac.

43
Q

respiratory syncytial virus- bronchiolitis

A 
common during winter
RSV
cells in bronchioles slough and clog alveoli
mid cough, rhinorrhea and congestion
worse after 2 days
symptomatic trtmnt (suction, fluids, o2)
44
Q

respiratory syncytial virus- bronchitis

A

inflamm trachea, bronchi and bronchioles
more widespread than bronchiolitis

viral
barking cough, chest pain, thick sputum
may vomit thick mucus
trt symptomatically (fluids, rest, hydration)

45
Q

foreign body aspiration

A

s/s- cough, dyspnea, stridor, hoarse
can cause severe distress
remove surgically
common foods- popcorn, seeds, carrots, hot dogs, grapes, coins, marbles, caps

46
Q

acute respir. distress syndrome

A

diffuse, inflammatory lung injury
common after bac/viral infection
direct or indirect
bilat. opacities on xray

47
Q

acute respir distress- trt

A 
intubation
positive pressure (CPAP, BiPAP)
antib, diuretic (pull fluid out lungs), vasodil
dec pulmon vasc resistance
gastric ulcer prophylaxis
48
Q

pneumothorax

A

accum air in pleural space
spontaneous, tension or traumatic
high risk- 12-16 white males skinny

49
Q

pneumo- s/s

A

dyspnea

tachypnea, respir distress, hypoxemia, trach deviation

50
Q

pneumo- trt

A

chest tube, suppl 02, pain management

emergent needle aspiration (if tension)

51
Q

asthma- patho

A

bronchoconstriction, inc mucus production, airway remodeling

52
Q

asthma- trtment

A

meds, control triggers
education (asthma action plan)
common triggers- tobbaco, pollen, mold, exercise, anxiety, pet dander

53
Q

cystic fibrosis

A

autosomal recessive genetic disorder
abnormal in body’s salt, water, and mucus making cells
can asymptomatically carry gene (only 1 parent needs be carrier)
most lethal inherited disorder in white ppl

sticky mucus builds up in lungs, sinuses, liver, pancr, intestines and reproductive organs

54
Q

cystic fibrosis- manif

A

failure to thrive, tachypnea, wheezing, retractions, recurrent pneumonia
posit. sweat chloride test
failure to pass meconium w/in 48hr (or if stool is foamy or immisible)

55
Q

cystic fibrosis- trtmnt

A 
pancr enzyme replacement
percussion/drainage
mucolytics
high protein, high calorie, high fat
take ADEK vitamins
cant absorb fat sol. vitamins
56
Q

bronchopulmonary dysplasia (BPD)

A

chronic obstructive disorder
dec SA for gas exchange
cause- prolonged use supp 02 and CPAP after premature birth

57
Q

bronchopulmonary dysplasia (BPD)- s/s

A

tachypnea, tachycardia, nasal f, grunting, retractions, wheezing, crackles, failure to thrive, inc 02 demands
23-25 wks
diagnosed during flare up

58
Q

bronchopulmonary dysplasia (BPD)- trtmnt

A

positioning, humidified suppe 02, chest physiotherapy, bronchodil, suction
cluster cares
diuretics (prevent fluid overload)
can require trach

N348 Peds (5 decks)

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