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NURS 306 - Exam 2 > Respiratory Conditions > Flashcards

Respiratory Conditions Flashcards

1
Q

What factors predispose children to respiratory conditions? (3)

A
  • Fewer alveoli
  • Smaller airways
  • Shorter distance between structures
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2
Q

Oxygen in children must always be delivered by what method?

A

Humidification - maintains moisture of nasal mucosa to prevent bleeding

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3
Q

What RR indicates respiratory failure?

A

> 60

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4
Q

What are the manifestations of WORSENING respiratory condition / decline? (8)

A
  • Cyanosis
  • Tachycardia
  • Tachypnea
  • Restlessness
  • Respiratory failure
  • Nasal flaring / grunting
  • Substernal / intercostal retractions
  • Wheezing / rhonchi
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5
Q

What are the types of upper respiratory conditions? (4)

A
  • Tosillitis
  • Croup
  • Acute epiglottitis
  • Laryngotracheobronchitis (LTB)
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6
Q

Tonsillitis may be either …

A

Viral or bacterial (bacterial caused by strep)

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7
Q

What test is conducted to differentiate between viral and streptococcal infection?

A

Throat culture

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8
Q

What conditions can untreated streptococcal tonsillitis lead to? (2)

A
  • Glomerulonephritis
  • Rheumatic heart disease
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9
Q

What are the manifestations of tonsillitis? (3)

A
  • Enlarged lymph nodes
  • Exudate
  • Snoring
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10
Q

Describe the nursing management of tonsillitis (3)

A
  • Antibiotics
  • Analgesics
  • Cool mist vapor
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11
Q

What is the treatment for recurrent / obstructive tonsillitis?

A

Tonsillectomy

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12
Q

Describe a tonsillectomy

A

Surgical removal of palatine tonsils

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13
Q

______ is often done in conjunction with tonsillectomy

A

Adenoidectomy

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14
Q

What are the indications of an adenoidectomy? (4)

A
  • Chronic otitis media
  • Obstruction
  • Sleep apnea
  • Sinusitis
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15
Q

Why is an adenoidectomy NOT performed during acute infection? (2)

A
  • Risk of bleeding from inflamed tissue
  • Potential spread of infection
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16
Q

Describe the teaching post-op tonsillectomy / adenoidectomy (5)

A
  • Adequate fluid intake *
  • Acetaminophen for pain
  • Avoid suction
  • Bleeding = emergency
  • Ice collar
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17
Q

Why is adequate fluid intake important after a tonsillectomy / adenoidectomy?

A

Dehydration increases risk of bleeding due to scab breakage from surgical site

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18
Q

Describe the preferred positioning for children after a tonsillectomy / adenoidectomy

A

Lateral position with HOB elevated - prevents airway obstruction

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19
Q

Which days post-op tonsillectomy / adenoidectomy are typically the worst?

A

Days 5 - 7

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20
Q

There is a risk of bleeding for up to ______ post-op tonsillectomy / adenoidectomy

A

14 days

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21
Q

Describe nutrition post-op tonsillectomy / adenoidectomy (2)

A
  • Soft diet
  • Cool, clear fluids
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22
Q

What manifestations are considered normal after a tonsillectomy / adenoidectomy? (3)

A
  • Low grade fever
  • Vomiting dark old blood
  • Ear pain - referred pain from throat
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23
Q

______ is the characteristic sign which always indicates an upper airway infection

A

Inspiratory stridor

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24
Q

What are the manifestations of croup? (3)

A
  • Hoarse cry
  • Harsh, barking cough
  • Respiratory distress
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25
Q

What causes manifestations of croup?

A

Laryngeal obstruction due to edema / spasm

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26
Q

Acute epiglottitis most commonly affects children of what age?

A

1 - 8 years

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27
Q

What causes acute epiglottitis?

A

H. influenza type B - get vaccine for prevention

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28
Q

Describe the onset of acute epiglottitis

A

Rapid / abrupt - can progress to life-threatening condition (medical emergency)

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29
Q

What are the 4 D’s of acute epiglottitis?

A
  • Distress
  • Drooling
  • Dysphagia
  • Dysphonia
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30
Q

What are the manifestations of acute epiglottitis? (2)

A
  • High fever
  • Large, cherry red epiglottis
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31
Q

In acute epiglottitis, there is no ______ present

A

Cough

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32
Q

Describe the positioning seen in children with acute epiglottitis

A

Tripod position with mouth open and tongue protruding

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33
Q

During treatment of acute epiglottitis, DO NOT … (4)

A
  • Attempt to visualize the epiglottis
  • Swab the throat
  • Use a tongue blade
  • Lay the child supine
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34
Q

Describe the diagnosis of acute epiglottitis (2)

A
  • Neck x-ray - steeple sign
  • Elevated WBCs
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35
Q

Describe the nursing interventions associated with acute epiglottitis (3)

A
  • Antibiotics
  • Intubation
  • Frequent respiratory assessment
36
Q

______ is the most common croup syndrome

A

Laryngotracheobronchitis (LTB)

37
Q

Laryngotracheobronchitis (LTB) most commonly affects children of what age?

38
Q

What are the manifestations of laryngotracheobronchitis (LTB)? (3)

A
  • Harsh, brassy cough
  • Suprasternal retractions
  • Rhinorrhea
39
Q

A child with laryngotracheobronchitis (LTB) is at risk for developing ______

A

Hypoxia - monitor for increasing restlessness

40
Q

Describe the pharmacologic management of laryngotracheobronchitis (LTB) (2)

A
  • solumedrol (corticosteroid)
  • racemic epinephrine (nebulized epinephrine)
41
Q

What side effects are associated with corticosteroid use? (2)

A
  • Elevated WBCs
  • Elevated glucose
42
Q

Describe the therapeutic management of laryngotracheobronchitis (LTB)

A

Cool air / steam to reduce inflammation

43
Q

What are the types of lower respiratory conditions? (4)

A
  • RSV
  • Asthma
  • Bronchiolitis
  • Cystic fibrosis
44
Q

RSV is the causative agent of ______

A

Bronchiolitis

45
Q

Why is RSV so communicable? (2)

A
  • Patients remain contagious for up to 1 month
  • RSV can survive on surfaces for days
46
Q

When is bronchiolitis / RSV most common?

A

Fall / early spring

47
Q

Why is bronchiolitis / RSV less severe after age 2?

A

Larger airways

48
Q

What are the manifestations of bronchiolitis / RSV? (4)

A
  • Congested cough
  • Diminished appetite
  • Nasal drainage
  • Sneezing
49
Q

Describe the reason for diminished appetite due to bronchiolitis / RSV

A

Inability to breathe while eating - infants are mouth breathers until 3 months

50
Q

As a child becomes exhausted from breathing, respiratory failure can lead to ______

A

Cardiac failure

51
Q

Describe the diagnosis of bronchiolitis / RSV (2)

A
  • RSV swab
  • Chest x-ray - hyperinflation
52
Q

What method is used to clear congestion in bronchiolitis / RSV?

A

Bulb suctioning

53
Q

What medication is given to premies and children with cardiopulmonary neuromuscular disease for RSV prevention?

A

Palivizumab

54
Q

Why is it important to ensure a thorough physical assessment for child with bronchiolitis / RSV?

A

Condition can decline suddenly

55
Q

Asthma is caused by ______

A

Environmental triggers

56
Q

What are the main airways responses that occur in asthma? (4)

A
  • Edema
  • Bronchoconstriction
  • Accumulation of secretions
  • Airway hyperresponsiveness
57
Q

Describe the diagnosis of asthma (3)

A
  • PEFR
  • Pulmonary function test
  • Chest x-ray - hyperinflation
58
Q

What are the manifestations of asthma (impending attack)? (4)

A
  • Chest tightness
  • Exercise intolerance
  • Increased sputum
  • Paroxysmal cough
59
Q

What causes vomiting related to asthma?

A

Excessive mucus production

60
Q

When is wheezing related to asthma worst?

A

At night - narrowing of airways

61
Q

What does PEFR measure?

A

The amount of air that can be forcefully exhaled in one breath

62
Q

Describe the use of PEFR for a child with asthma

A

Establish a baseline during a period without symptoms

63
Q

What does a low PEFR reading indicate?

A

Increased risk of exacerbations

64
Q

How often should children using controller inhalers measure PEFR?

65
Q

What class of drugs is used to decrease inflammation in asthma?

A

Corticosteroids

66
Q

Describe the pharmacologic management of asthma (3)

A
  • claritin (antihistamine)
  • budesenide (control inhaler)
  • albuterol (rescue inhaler)
67
Q

What are the types of medication delivery devices used for asthma? (3)

A
  • Nebulizer
  • Metered dose inhaler / spacer
  • Diskhaler - dry powder
68
Q

Describe the pathophysiology of cystic fibrosis

A

Abnormal salt / water / mucus producing cells

69
Q

Cystic fibrosis affects the ______ glands of the body

70
Q

What type of inherited condition is cystic fibrosis?

A

Autosomal recessive

71
Q

Describe the diagnosis of cystic fibrosis (2)

A
  • Sweat chloride test
  • Stool sample (pancreatic enzyme dysfunction)
72
Q

At what age can a sweat chloride test be conducted?

A

4 - 6 weeks

73
Q

Describe the sweat chloride test

A

Measures the amount of chloride present in sweat - elevated levels of chloride suggests cystic fibrosis

74
Q

What are the pulmonary manifestations of cystic fibrosis? (7)

A
  • Atelectasis / emphysema
  • Barrel chest
  • Cyanosis
  • Clubbing
  • Dyspnea
  • Dry cough
  • Wheezing
75
Q

Cystic fibrosis is associated with recurrence of what conditions? (2)

A
  • Bronchitis
  • Bronchopneumonia
76
Q

What are the pulmonary complications associated with cystic fibrosis? (2)

A
  • Hemoptysis
  • Pneumothorax
77
Q

What methods are used to improve ventilation for cystic fibrosis? (3)

A
  • Bronchodilators
  • Chest percussion (QID)
  • Postural drainage
78
Q

What aerosolized medication is used to decrease the viscosity of mucus in a child with cystic fibrosis?

79
Q

What are the GI manifestations of cystic fibrosis? (5)

A
  • Meconium ileus
  • Malabsorption
  • Irregular stools
  • Rectal prolapse
  • Weight loss
80
Q

______ is the earliest manifestation of cystic fibrosis in a newborn

A

Meconium ileus

81
Q

What are the manifestations of meconium ileus? (4)

A
  • Abdominal distention
  • Absence of stool
  • Dehydration
  • Vomiting
82
Q

Describe the recommended diet for a child with cystic fibrosis (4)

A
  • Well balanced
  • High protein
  • High calories
  • High vitamins
83
Q

For a child with cystic fibrosis, it is important to ______ before meals / snacks

A

Replace pancreatic enzymes

84
Q

What condition is atelectasis seen in?

A

Cystic fibrosis

85
Q

What conditions is rhonchi seen in? (3)

A
  • Asthma
  • Bronchiolitis
  • Cystic fibrosis
86
Q

What conditions in wheezing seen in? (3)

A
  • Asthma
  • Bronchiolitis
  • Cystic fibrosis

NURS 306 - Exam 2 (5 decks)

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