Respiratory Dysfunction Flashcards
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
what factors might decrease immune system function?
stress
autoimmune disorders
medications
- chemo
- steroids
bone marrow dysfunction
what comorbidities might decrease host resistance?
cystic fibrosis
premature
cardiac diseases
what are the seasons for respiratory infections?
winter
spring
what are the seasons for mycoplasma infection?
fall
winer
when is asthmatic bronchitis more common?
cold weather
“September spike”
what are the seasons for RSV?
winter
spring
are all babies immunized for RSV?
YES
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
what is the best place to assess cyanosis?
mucous membranes
cyanosis might appear more ____________________ in someone with pigmented skin
grey/ash
how can we decrease work of breathing in respiratory dysfunction?
medications (bronchodilators)
oxygen therapy
resp support (bipap, cpap)
positioning
deep breathing
coughing
hydration
what are the common URT infections?
otitis media
COVID-19
croup
nasopharyngitis
pharyngitis
tonsillitis
Otits media is common at what age? why?
6 months - 3 years
short, horizontal eustachian tubes
what are some signs and symptoms of otitis media?
pan
grab/pull ear
discharge
how is otitis media treated?
Tylenol
antibioticcs
surgical: myringotomy
- tubes to drain
how can otitis media be prevented?
don’ feed babies lying down
avoid smoke exposure
breast feeding is good
is COVID-19 common in children?
NO
what are some signs & symptoms of COVID-19?
fever
cough
fatigue
sore throat
URT symptoms
abdominal pain
headache
loss of taste/smell
rhinorrhea
what is a major complication of COVID-19?
pneumonia
what is the incubation period for COVID-19?
14 days
4-5 days after exposure
what are some lab diagnostics for COVID-19?
increased CRP
decreased leukocytes
croup is common at what age?
6 months - 3 years
what are the signs & symptoms of croup?
hoarseness
barking cough
inspiratory stridor
suprasternal reractions
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?
NO
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)
