Respiratory Dysfunction Flashcards by Grace McNally

what are some factors that affect host resistance?

immunity
nutrition
physical and mental health
barriers
- skin
- mucous membranes
immune system function
age
size
hygiene
comorbidities

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what factors might decrease immune system function?

stress
autoimmune disorders
medications
- chemo
- steroids
bone marrow dysfunction

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what comorbidities might decrease host resistance?

cystic fibrosis
premature
cardiac diseases

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what are the seasons for respiratory infections?

winter
spring

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what are the seasons for mycoplasma infection?

fall
winer

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when is asthmatic bronchitis more common?

cold weather
“September spike”

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what are the seasons for RSV?

winter
spring

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are all babies immunized for RSV?

YES

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what are some clinical manifestations of respiratory dysfunction?

cough
decreased SpO2
increased temperature
work of breathing
- in drawings
shortness of breath
- nasal flare
- tracheal tug
- difficulty talking
cyanosis

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what is the best place to assess cyanosis?

mucous membranes

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cyanosis might appear more ____________________ in someone with pigmented skin

grey/ash

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how can we decrease work of breathing in respiratory dysfunction?

medications (bronchodilators)
oxygen therapy
resp support (bipap, cpap)
positioning
deep breathing
coughing
hydration

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what are the common URT infections?

otitis media
COVID-19
croup
nasopharyngitis
pharyngitis
tonsillitis

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Otits media is common at what age? why?

6 months - 3 years
short, horizontal eustachian tubes

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what are some signs and symptoms of otitis media?

pan
grab/pull ear
discharge

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how is otitis media treated?

Tylenol
antibioticcs
surgical: myringotomy
- tubes to drain

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how can otitis media be prevented?

don’ feed babies lying down
avoid smoke exposure
breast feeding is good

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is COVID-19 common in children?

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what are some signs & symptoms of COVID-19?

fever
cough
fatigue
sore throat
URT symptoms
abdominal pain
headache
loss of taste/smell
rhinorrhea

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what is a major complication of COVID-19?

pneumonia

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what is the incubation period for COVID-19?

14 days
4-5 days after exposure

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what are some lab diagnostics for COVID-19?

increased CRP
decreased leukocytes

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croup is common at what age?

6 months - 3 years

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what are the signs & symptoms of croup?

hoarseness
barking cough
inspiratory stridor
suprasternal reractions

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when is croup worse (time of day)?

at night

what are some complications of croup?

epiglotitis laryngitis tracheitis Laryngotracheobronchitis respiratory acidosis resp failure

what are the treatments for croup?

vaporizers steroids fluids antipyretics humidity

does croup usually require hospitalization?

what is the most REACTIVE part of the respiratory tract?

lower

what are the structures of the lower RT?

bronchi bronchioles

what are the common reasons for LRT infections?

lack cartilage short, narrow airways

what is bronchitis?

inflammation of larger airways (bronchi)

what are the causes of bronchitis?

rhinovirus coronavirus influenza RSV

what are the signs & symptoms of bronchitis?

cough with or w/o sputum

what is the duration of bronchitis?

1-3 weeks

what is bronchiolitis?

inflammation of small airways (bronchioles)

what is the cause of bronchiolitis?

RSV

explain the pathophysiology of bronchiolitis

virus invades mucosal cells causing cell death cell debris obstructs bronchioles airway swells excessive mucus production obstruction --> bronchospasm lung invasion wheezing and crackles

what are the signs & symptoms of bronchiolitis in younger children and infants?

apnea LRT infection

what are the signs & symptoms of bronchiolitis in older children?

URT symptoms may develop LRT infection

how is bronchiolitis diagnosed?

chest x-ray to detect inflammation aspiration of nasal secretions

how is bronchiolitis treated?

supportive care - cpap - bipap nebulizers - loosen mucus normal saline suctioning (last resort)

what is the goal of treatment for bronchiolitis?

decrease mucus

what is pneumonia?

acute inflammation of bronchioles, alveolar ducts and sacs, and alveoli causes impaired gas exchange

what are the causes of pneumonia?

bacterial viral fungi mycoplasma aspiration

what is a sign of BACTERIAL pneumonia?

prolonged fever

FUNGAL pneumonia is more common in _______________ individuals

immunocompromised

how is pneumonia diagnosed?

chest x-ray sputum tests

what is the major risk for ASPIRATION pneumonia?

feeding difficulties

how can we prevent aspiration pneumonia?

proper positioning NG tube to keep sphincter open avoid: - hydrocarbons - solvents - lipids - talcum powder

what is asthma?

chronic inflammation of airways bronchial hyperresponsiveness

what are the causes/riggers of asthma?

allergies exercise cold air infections

wha are some signs & symptoms of asthma?

wheezing cough chest tightness

what is used to assess asthma severity?

PRAM score

why do children often outgrow asthma?

airways get bigger

what are the 2 forms of treatment for asthma?

1) rescue/short acting - bronchodilators (beta agonists) - albuterol (Ventolin) 2) maintenance/long-term - corticosteroids - flovent

what type of inhaler should a < 6 year old use?

MDI + spacer + mask

what type of inhaler can a 7+ year old use?

MDI + spacer + mouthpiece

what is the purpose of the "whistle" in the inhaler spacer?

whistles when inhaling too fast

what are some considerations for inhaler use?

exhale completely before inhaling medication inhale deep and slow hold breath for 10 sec rinse mouth after using corticosteroid inhalers

why should you wash your mouth after corticosteroid inhaler use?

risk of oral thrush

what is cystic fibrosis?

exocrine gland dysfunction causing excess mucus production leading to obstruction affects the pancreas, liver, ad intestines causing malabsorption and digestive issues autosomal recessive trait (both parents are carriers)

what are the respiratory manifestations of CF?

thick mucus decreased O2/CO2 exchange hypoxia hypercapnea respiratory acidosis recurrent lung infections pulmonary blood vessel compression pulmonary HTN cor pulmonale respiratory failure --> death

what are the common recurrent lung infections in CF?

pneumonia bronchitis

what are the respiratory presentations of CF?

wheezing dry, nonproductive cough obstructive emphysema atelectasis cyanosis clubbing

what are the GI manifestations of CF?

thick mucus blocks secretion of pancreatic enzymes - steatorrhea - impaired protein digestion and absorption - weight loss - fat malabsorption - fat soluble vitamin deficiency pancreatic fibrosis diabetes biliary obstruction --> multi lobular biliary cirrhosis impaired salvation

what are the G presentations of CF?

meconeum ileus intestinal obstruction syndrome - pain - distension - constipation rectal prolapse

what are some other signs and symptoms of CF?

salty skin dehydration females: delayed puberty males: sterility hypoalbuminemia

what is the #1 sign of CF?

meconium ileus

what is the median age of survival for CF?

61 years

what are the treatments for CF?

IV antibiotics mucolytics - thin mucus chest physio - vests - breaks up mucus puffers aerosols high calorie, high protein diet

what is the normal RR for newborns?

30-60

what is the normal RR for infants?

25-50

what is the normal RR for toddlers?

20-40

what is the normal RR for preschoolers?

20-30

what is the normal RR for school age?

18-25

what is the normal RR for adolescents?

12-20

infants have a higher RR which means ______________ metabolic demand

iincreased

what are some EARLY signs of respiratory distress?

tachypnea tachycardia nasal flaring retractions (intercostal, subcostal, suprasternal) grunting restless irritable

what are some LATE signs of respiratory distress (resp failure)

bradypnea bradycardia cyanosis decreased LOC silent chest

what causes croup?

RSV

what should you NOT do for croup? why?

examine throat risk of airway spasm

what is an airway EMERGENCY?

epiglottitis

what causes epiglottitis?

haemophilus influenzae

what are the signs & symptoms of epiglottitis?

drooling dysphagia high fever stridor tripod position

what are the interventions for epiglottitis?

keep calm (no crying) prep for intubation IV antibiotics no tongue depressors (risk of spasm)