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Peds - Spring 2016 > Respiratory Dysfunction (Part 2) - Unit 2 > Flashcards

Respiratory Dysfunction (Part 2) - Unit 2 Flashcards

1
Q

What is tonsilitis?

A

Inflammation of the tonsils

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2
Q

If a kid has repeated infections (tonsilitis, etc) and sleep apnea - what are they a candidate for? (think throat surgery)

A

Tonsilectomy/Adenectomy

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3
Q

Pre-op for tonsilectomy - can have all pain meds, especially ibuprofen - T/F?

A

FALSE

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4
Q

Fluids - not important following tonsilectomy. T/F?

A

FALSE - very important.

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5
Q

A week after an Adenoectomy/Tonsilectomy, ear pain is NOT normal. T/F?

A

FALSE - it is.

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6
Q

Excessive swallowing, vomiting bright red blood (follow A&T)- most common 1st __ hours and __ to __ days.

Because of the blood, kids shouldn’t have anything red after. T/F?

A

24 hours and 7-10 days

True!

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7
Q

What are some contraindications for a tonsillectomy?

A

Clef palate, acute infection @ the time of surgery, uncontrolled systemic disease

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8
Q

What are the two types of influenza?

A

A&B

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9
Q

Influenza - spread by __ contact (____ droplet)

A

direct contact, large droplet

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10
Q

Influenza - most infectious __ hours before and __ hours after symptoms 1st appear.

A

24 hours!

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11
Q

What are some manifestations of influenza? Complications?

A

Manifestations = dry cough, sudden onset of fever, croup.

Complications = pneumonia, encephalitis, secondary bacterial infections, etc.

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12
Q

Should we give acetaminophen/ibuprofen/fluids to influenza patients?

A

Yes

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13
Q

Which drug treats which influenza?

Amantadine hydrochloride (Symmetrel) -
Rimantadine -
Zanamivir -
Oseltamivir -

A

Amantadine hydrochloride (Symmetrel) - A
Rimantadine - A
Zanamivir - A & B
Oseltamivir - A & B

(Antadine’s = A)
(Ivir’s are virus fighters and are stronger so they kill both!)

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14
Q

What is foreign body aspiration? What ages are at risk? What are they matriculating that they shouldn’t?

A

Inhalation of any object into the respiratory tract.

Think pincer grasp kids - 9-11 months

Nuts, popcorn, raw veggies, hot dogs, toys, pins, batteries…

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15
Q

What is the most common site for lower airway obstructions? And where are the obstructions typically at?

A

Bronchial/Right Bronchi

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16
Q

What are some manifestations of an airway obstruction?

A

Coughing, choking, dysphonia (can’t speak), dyspnea, respiratory distress, hypoxia associated behavior changes, Xray changes (hyperinflation, object may be seen),

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17
Q

How do we treat an obstruction?

A

Chest thrusts/back blows but DO NOT try to remove the object unless your two eyes see it…or bronchoscopy!

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18
Q

Apnea is the cessation of respirations lasting longer than ___ seconds. It can also be a pause in ___, associated with cyanosis, hypotonia, pallor, or bradycardia.

A

20 seconds.

Respirations.

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19
Q

Apnea with change in color, muscle tone, and/or choking - usually under 4 months, can be caused by reflux, respiratory illness, seizures, etc….should we be on alert for child abuse? Everything else T/F?

A

Yes - T

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20
Q

What are the croup syndromes?

A

Upper airway illness caused by swelling of the larynx and epiglottis, with swelling that usually extends to trachea and bronchi.

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21
Q

What are the three big croups? Which is the worst? Which one is the one we think of?

A

Epiglottitis (THE WORST), Laryngotracheobronchitis (LTB - what we think of), Bacterial tracheitis

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22
Q

Epiglottitis - what is it?

A

A LIFE THREATENING swelling.

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23
Q

Epiglottitis - can obstruct airway within minutes to hours. T/F/

A

Truw

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24
Q

Epiglottitis - peak age of __ to __ years and it progresses ____

A

2-6 years

Rapidly

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25
Q

What are the most common causative organisms for epiglottitis?

A

Streptococcus, staphylococcus aureus, haemophilus influenza type b (HIB)

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26
Q

Epiglottitis - drooling occurs because why? Should we poke and prod them?

A

They can’t swallow :(

DO NOT TOUCH THEM until a doctor is present to intubate.

27
Q

Epiglottitis - Lateral X Ray - what’s present?

A

Thumb Sign

28
Q

Epiglottitis - kids are typically in what position?

A

Tripod

29
Q

What is laryngotracheobronchitis?

A

Viral invasion of the upper airway - extnds to larynx, trachea and bronchi and also inflammation of the submucosa and subglottic area.

30
Q

laryngotracheobronchitis - stridor worsens in the morning. T/F/

A

FALSE - night.

31
Q

laryngotracheobronchitis - large amounts of thin secretions can lead to airway obstruction. T/F?

A

TRUE

32
Q

Croup - Ap X-ray - what do we look for?

A

Steeple sign - this is for CROUP, not Epiglottitis - don’t get confused.

33
Q

Should we use cool mist for croup?

A

Yes

34
Q

Croup - racemic epinephrine - given how? What does it do?

Albuterol.? What does it do?

Corticosteroids - what do they do?

Heliox - what do they do?

A

Epi - constrictions capillaries of subglottic mucosa (given throuh inhalation - keep for an hour after because they can have rebound issues - usually done in ER).

Albuterol - bronchodilator.

Steroids - decrease airway edema.

Heliox - helium & O2 - typically in an ICU.

35
Q

Bacterial tracheitis - secondary infection of the ___ trachea after viral infection.

A

Upper trachea

36
Q

What are the typical causative organisms for bacterial tracheitis?

A

Staphylococcus aurues, MRSA, group A b-hemolytic streptococci, H influenza

37
Q

airway edema and thick secretions - not a part of bacterial tracheitis. T/F?

A

FALSE - it is- can lead to obstruction!

38
Q

Bacterial tracheitis - croupy cough and stridor - T/F/

A

True

39
Q

Bronchiolitis - what is it? How is it spread?

A

Inflammation of lower respiratory tract causing an obstruction of small airways.

Spread through direct contact with repsiratory secretions.

40
Q

Who is at risk for bronchiolitis?

A

Premies, those not breast fed, those in crowded conditions and those exposed to smoke.

41
Q

What are the two subtypes of RSV?

A

Type B (Mild) & type A (more virulent/aggressive)

42
Q

RSV - infection restricted to respiratory mucosa. T/F/

A

True

43
Q

RSV - forms a layer impairing cilia function and causes submucosal edema. T/F/

A

True

44
Q

RSV - epithelia cells die and are shed into the bronchioles, causing obstruction (typically on expiration) and leads to hyperinflation and patchy areas of atelectasis) - T/F?

A

True

45
Q

how is RSV transmitted?

A

Direct contact with nasal secretions, contact with contaminated items, no long term immunity so the kids are sunk….etc.

46
Q

How do we diagnose RSV?

A

based on clinical picuture - enzyme immune assay (nasal aspirate, results come quick), WBC is slightly elevated, chest x-ray that might show patchy areas or consolidation, airtrapping, etc.

47
Q

What are some manifestations of bronchiolitis?

A

History of URI, fever, may progress to lower tract, respiratory distress (tachypnea, retractions, wheezing, prolonged expirations, rales)

48
Q

For bronchiolitis, should we monitor the respiratory system, suction with a bulb syringe and do CPT (percussion) for selected cases?

A

Yes

49
Q

Bronchiolitis - bronchodiolator, corticosteroids, antiviral/antibiotic in severe cases, O2 if needed?

A

Yes

50
Q

Bronchiolitis - is it contact isolation?

A

YES

51
Q

Brocnhiolitis - handwashing isn’t imporatant. T/F?

A

FALSE

52
Q

Bronchiolitis - should people/kids who have colds be allowed in?

A

NO

53
Q

RSV vaccine - when? What diseases/risk factors?

A
54
Q

What is synagis (palivizumab) ?

A

RSV vaccine - given IM and given monthly during RSV season (about 5 doses) - may not prevent disease but reduces severity!

55
Q

What is tracheoesaphageal atresia?

A

Occurs when the trachea and esophagus fail to separate and develop as 2 isolated tubes — can occur with polyhydramnios (increased amniotic fluid).

56
Q

What is tracheoesaphageal atresia a component of? (hint - syndrome!)

A

VATER syndrome - anomolies of vertebrae, anus, trachea, esophagus, radial/renal. VACTERAL includes cardiac and limbs.

57
Q

What is type A tracheoesaphageal atresia?

A

missing mid segment - just doesn’t connect to stomach.

58
Q

what is type B tracheoesaphageal atresia?

A

Risk of aspiration - no connection to stomach but esopaghus and trachea are communicating together.

59
Q

what is type C tracheoesaphageal atresia?

A

Stomach is connected to trachea

60
Q

What is type D tracheoesaphageal atresia?

A

All connected by esopaghus is improperly connected to the trachea

61
Q

what is type E tracheoesaphageal atresia?

A

Almost right, just that the trachea and esophagus have a fistula

62
Q

What are some manifestations and things to do for tracheoesaphageal atresia?

A

Frothy saliva, drooling, choking, coughing,

NPO, frequent suctioning, antibiotics, surgical correction

63
Q

The most profound complication of prolonged middle ear disorders is :

A

loss of hearing.

64
Q

What is an appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temp?

A

Give small amounts of favorite fluids frequently to prevent dehydration

Peds - Spring 2016 (29 decks)

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