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CPR Exam 3 > Respiratory Distress in Children > Flashcards

Respiratory Distress in Children Flashcards

1
Q

What are the 3 components of of the pediatric assessment triangle?

A
  1. appearance
  2. breathing
  3. circulation
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2
Q

What are the 3 components of cardiopulmonary arrest in children?

A
  1. respiratory (O2) ***
  2. cardiac (pump, perfusion, BP)
  3. circulatory volume (perfusion, BP)
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3
Q

What is the terminal results of progressive respiratory failure/shock in children?

A

cardiac arrest

-also called an asphyxial arrest

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4
Q

What does somnolence or lethargy suggest in a child?

A

severe hypoxia, hypercarbia and/or respiratory failure

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5
Q

What does the development of a slower, irregular respiratory pattern indicate?

A

it is an ominous sign**

- respiratory arrest will quickly develop if no intervention is made

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6
Q

What is stridor usually secondary to?

A

a narrowing of the larynx (laryngomalacia) or trachea (tracheomalacia), or a vascular ring

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7
Q

what is a squeaking noise made by air passing through narrowed tracheobronchial airways?

A

wheezing

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8
Q

what is a moist sound heard upon auscultation resulting from air passing through narrowed bronchi?

A

rales

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9
Q

what is a high pitched crowing sound, most prominent with inspiration?

A

stridor

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10
Q

what is an expiratory sound heard without a stethoscope, generated in an attempt to maintain airway patency?

A

grunting

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11
Q

What are the heart rate changes (general rule of thumb)?

A

when compromised, will initially see tachycardia to compensate
- when ability to compensate is exceeded, will see bradycardia

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12
Q

What is the clinical presentation of a severe/complete upper airway obstruction?

A

no audible speech, cry, or cough

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13
Q

What will you likely hear with a partial upper airway obstruction?

A

stridor with inspiration

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14
Q

What are the hallmarks of severe a tension pneumothorax?

A

severe respiratory distress

  • ipsilateral chest hyper-expansion
  • decreased/absent breath sounds on the side of the collapsed lung
  • mediastinal shift
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15
Q

What is Beck’s Triad, and when does it present?

A
  1. JVD
  2. muffled cardiac sounds
  3. hypotension

Is seen with cardiac tamponade

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16
Q

What is the most common cause of airway obstruction in kids ages 6-36 months?

A

croup

- most often vial (parainfluenza virus), less often allergic (spasmodic croup)

17
Q

What is the most common cause of pneumonia in kids?

A

Strep pneumo
- bacterial, more localized (lobar), generally higher fever, ill-appearance

NOTE: viral and atypical pneumonia (mycoplasma and chlamydia) tend to be diffuse interstitial/peribronchial, but can be lobar at times

18
Q

what causes bronchiolitis in kids?

A
  1. RSV
    - children less than 2 years old
    - URI symptoms -> progressive cough -> wheezing/atelectasis
19
Q

What are the most common causes of anyphylaxis in children?

A

food or medications

  • always ask what happens when exposed to the allergen
  • Tx: Epi oxygen, steroids
20
Q

When would you see acute chest syndrome?

A

patient with sickle cell disease

  • sudden onset respiratory distress and chest pain
  • new infiltrate on CXR
  • fever
21
Q

What are the signs and symptoms of asthma?

A
  • cough
  • wheezing
  • chest tightness
  • prolonged exhalation
  • SOA
22
Q

What is the most common triggers of asthma?

Non specific triggers?

A
  • exposure to allergens

- exercise, URI, sinusitis, allergic rhinitis, aspiration, GER, air pollution, NSAIDs, occupational, obesity

23
Q

What are curschmann spirals?

A

characteristic finding in sputum or broncho-alveolar lavage specimens
- extrusion of mucus plus from sub-epithelial mucous gland ducts or bronchioles

24
Q

What are Charcot-Leyden crystals?

A

also found in sputum or broncho-alveolar lavage specimens

- composed of an eosinophil protein called galectin-10

25
Q

What differentiates asthma from COPD?

A

symptoms under age 35, waking at night with breathlessness or wheeze, FEV and FEV/FVC ratio return to normal with drug therapy

26
Q

What does the asthma volume curve look like compared to the vocal cord dysfunction curve?

A
  • asthma (obstructive) looks like a scooped out chair

- VCD has a truncated inspiratory loop that is flat/shallow at the bottom

27
Q

What is the rescue medication for asthma?

A

SABA (b2 agonist) albuterol

NOTE: ICS is NEVER a rescue medication!

28
Q

What are the most common long-term asthma medications?

A

inhaled corticosteroids
- fluticasone, beclomethasone, budesonide

leukotriene modifiers

  • montekulast, zafirlukast
  • zileuton
29
Q

What are the signs that respiratory arrest are imminent in the following:

  • respiratory rate
  • body position
  • accessory muscle use
  • wheeze
  • pulse
A 
>30 minute
unable to recline
paradoxical thoracoabdominal movement
absent
bradycardia

CPR Exam 3 (6 decks)

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