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CPR II Exam #3 > Respiratory Distress in Children > Flashcards

Respiratory Distress in Children Flashcards

1
Q

What are the 3 components of the Cardiopulmonary Arrest in children?

A

Respiratory (oxygen)

Cardiac (pump, perfusion, BP)

Circulatory volume (perfusion, BP)

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2
Q

Cardiac arrest in children is usually due to what?

What is it often NOT a result of?

A

Progressive respiratory failure or shock (asphyxia arrest)

Rarely a result of primary cardiac etiology.

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3
Q

What is the progression of asphyxia in kids?

A

Asphyxia begins with hypoxemia, hypercapnia and acidosis, which leads to bradycardia and hypotension and culminates in cardiac arrest.

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4
Q

Sudden, unanticipated, non-traumatic cardiac arrests are uncommon in kids, but under what circumstances can they develop? (2)

A

In children with known risks (CHD) or in children with unknown risks (long QT, IHSS, CM).

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5
Q

What appearance is associated with hypoxia?

A

Restlessness
Anxiety
Combativeness

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6
Q

If a child cannot be consoled and their eyes roll around, what does it indicate?

A

Significant illness or hypoxia

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7
Q

Loud cry =

Hoarse/muffled cry =

Weak cry =

A

Loud cry = good

Hoarse/muffled cry = airway obstruction

Weak/no cry = bad

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8
Q

What is the initial response to respiratory compromise in children?

What does it lead to?

A

Tachycardia

Leads to decreased RR and an irregular pattern of respirations.

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9
Q

What is an ominous sign in children who are respiratory compromised?

A

The development of a slower, irregular respiratory pattern in the setting of respiratory distress.

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10
Q

What are the 3 components of the Pediatric Assessment Triangle (PAT)?

A

Appearance

Circulation to skin

Work of breathing

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11
Q

What is stridor?

What causes it?

A

High pitched crowing sound, more prominent in inspiration.

Occurs secondary to narrowing of larynx (croup, laryngomalacia) or trachea (tracheomalacia, vascular ring).

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12
Q

Grunting occurs in an effort to do what?

What are 2 reasons for a child to grunt?

A

It is an expiratory sound heard without a steth and is generated in an attempt to maintain airway patency.

  • Breathing out against a partially closed glottis.
  • A desire for decreased chest wall excursion (pleural pain, intra-abdominal pain).
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13
Q

Pale, mottled, cool or ashen skin are concerning for what? (2)

A

Hypoxemia and shock

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14
Q

What is the best way to check circulatory status in kids?

A

Cap refill

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15
Q

General rule of thumb in HR changes when circulation is compromised:

When the ability to compensate has been exceeded:

A

When compromised, HR will initially see tachycardia to compensate.

When the ability to compensate is exceeded, bradycardia will occur.

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16
Q

3 reasons for cyanosis

A

Oxygenation of blood may be low

Significant blood loss

Poor perfusion

17
Q

Severe upper airway obstruction can occur by (full vs. partial) (3):

What will be heard when there is obstruction (full vs. partial)?

A

Full obstruction: foreign body aspiration, angioedema from anaphylaxis, epiglottitis.
Partial obstruction: foreign body aspiration, infection (croup), injury (thermal or chemical burn).

Full: nothing
Partial: stridor

18
Q

Tension PTX occurs when:

Hallmarks include (5)…

A

Air from lung leaks into the pleural cavity and leads to a shift of mediastinal structures to the opposite side and compresses heart and good lung.

Severe respiratory distress
IL chest hyper-expansion
Dec./absent breath sounds
Mediastinal shift
Hyper-resonance to percussion over collapsed lung
19
Q

Cardiac tamponade is life threatening due to…

What is the most common cause (secondary)? (2)

What classic triad is associated with cardiac tamponade?

A

Compromise of venous return and cardiac stroke vol.

Secondary to fluid build up from a previous infection OR malignancy (leukemia, etc.)

Beck’s triad: JVD, muffled heart sounds, hypotension (1/3 of pts.)

20
Q

Is PE in kids common?

What can cause it?

A

Uncommon in kids.

Central lines/devices
Hyper-coagulability
Congenital heart disease
Trauma
Nephrotic syndrome
SLE
21
Q

Respiratory tract infections

How quickly do they develop?

How do the patients appear?

A

They develop more gradually, unless upper airway structures are highly involved.

Febrile and ill-appearing

22
Q

Retropharyngeal and peritonsillar abscesses

What do they usually cause instead?

Who should be notified?

A

Sore throat, trouble swallowing and local pain, swelling.

ENT

23
Q

Croup (acute laryngotracheobronchitis) is the most common cause of…

What are the 2 etiologies?

What occurs as a secondary bacterial infection to croup?

A

Infectious airway obstruction in ages 6-36 mo.

Viral (parainfluenza virus), less often allergic (spasmodic croup).

Tracheitis is the secondary bacterial infection to croup (kids are febrile and very sick)

24
Q

Most common cause of Epiglottitis is:

Its vaccine has nearly eliminated what 2 infections?

What should be done?

A

H. flu type B

HIB meningitis and HIB epiiglottitis

OR for exam and possible intubation

25
Q

Bronchiolitis is most commonly caused by which 4 viruses?

How old are the children?

What SX characterize bronchiolitis? (3)

A

RSV, influenza, parainfluenza, adenovirus.

Less than 2 y/o.

URI symptoms, progressive cough and wheezing/atelectasis.

26
Q

Most common Pneumonia in children is:

A

Strep. pneumoniae

27
Q

How do bacterial pneumonias vs. viral/atypical pneumonias appear on CXR?

A

Bacterial tend to be lobar

Viral/atypical tend to be more diffuse/interstitial/peribronchial, but can be lobar at times

28
Q

Sudden changes in Asthma can be due to… (2)

A

Alveolar disease and/or atelectasis

29
Q

Anaphylaxis causes _________ which can be life-threatening.

Common SX include (3):

What is given as Tx? (3)

A

Retropharyngeal/laryngeal edema

Facial edema, urticaria and bronchospasm

Epi, oxygen and steroids

30
Q

SX of foreign body aspiration in trachea:

Lower foreign body aspirations:

Esophageal:

A

Stridor, drooling, choking

Coughing, choking, with delayed SX of pneumonia and chronic cough

Drooling, swallowing problems

31
Q

Causes of non-cardiogenic pulmonary edema include (4)

A

Chemical pneumonia
Submersion/drowning
Secondary to airway obstruction
Medication toxicity

32
Q

What 2 systemic diseases can cause respiratory distress in children?

A

Thyroid disease

Metabolic disease

33
Q

What hematologic abnormality can cause respiratory distress in kids?

A

Decreased oxygen delivery secondary to anemia, abnormal Hb

34
Q

Sickle cell disease can lead to:

SX (3)

A

Acute chest syndrome

Sudden onset of respiratory distress and chest pain
New infiltrate on CXR
Fever

CPR II Exam #3 (5 decks)

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