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Peds > respiratory function pt. 2 (1) > Flashcards

respiratory function pt. 2 (1) Flashcards

1
Q

what is the old term for brief resolved unexplained event (BRUE)

A

aparent life-threatening event

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2
Q

at what ages do BRUEs occur?

A

infant-1 yr

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3
Q

symptoms of BRUE

A
  • pale or cyanotic
  • irregular, dec, absent breathing
  • changes in tone
  • altered responses
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4
Q

how long does a BRUE last

A

less than a minute, self resolving

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5
Q

when is extensive testing reccomended for BRUE?

A

only for…
* high risk infants
* suspected abuse
* suspected infection
* recurrent episodes of fam hisotry of genetic or metabolic cionditions

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6
Q

what would the priority be with the family if an ambulance brought in a 3 m.o. who died in the crib?

A
  • family support
  • answer questions
  • allow fam time with the baby
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7
Q

what is sudden death, during sleep, of an infant less than a year old

A

SIDS

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8
Q

how is SIDS explained after autopsy/death scene investigation?

A

unexplained

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9
Q

what ages is SIDS most common

A

2-4 months

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10
Q

leading cause of infant mortality

A

SIDS

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11
Q

clinical manifestations of SIDS

A
  • evidence of a struggle or change in position (prone)
  • presence of frothy blood tinged secretions from the mouth and nares
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12
Q

do parents notice disturbance or cry when a baby dies of SIDS

A

no

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13
Q

what is possible etiology and pathophysiology of SIDS

A
  • abnormality of medulla oblongata with serotonin
  • may interfere with brainstem mediated protective responses during sleep
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14
Q

why can prone sleeping cause SIDS

A

cerebral oxygenation depressed

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15
Q

which of the following are infant risk factors for SIDS?
a) meternal smoking, alcohol or substane use
b) preterm or low birth weight
c) native maerican of black infants at higher risk
d) females at higher risk

A

a,b,c (males more at risk)

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16
Q

which of the following are environmental factors of SIDS
a) sleeping prone or side-lying
b) soft bedding
c) sleeping supine
d) overheating
e) bed sharing
f) second hand smoke

A

all except sleeping supine!

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17
Q

who/when was the back to sleep reccomendation initiated?

A

american acedemy of pediatrics in 1992

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18
Q

when was back to sleep recommendation revised and what did it say

A

only sleep on back!

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19
Q

what did the back to sleep recommendation initially say?

A

sleep on back or side

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20
Q

which campaign involved prevention of all sleep related causes of death?

A

safe to sleep campaign (2012)

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21
Q

what were the 2 main AAP recommendations for safe sleep

A
  1. should sleep in same room, not bed as mom ideally for a year, at least 6 m.o.
  2. mothers and fathers should do skin/skin with newborns
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22
Q

what is molding of the head by continued pressure against a surface

A

plagiocephaly

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23
Q

how is plagiocephaly resolved?

A

rotating side of head that infant sleeps on, place the infant prone while awake and supervised (tummy time)

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24
Q

what is due to suffocation in pillow, bumpers, or blankets

A

suddent unexpected infant death (NOT SIDS)

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25
Q

how to prevent sudden unexoected infant death?

A

no pillows, bumpers, blankets, animals
sleep alone
no swaddle after 2 mo

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26
Q

a 6 mo old was admitted with dyspnea, hoarse barky cough, and insp. stridor.
what is diagnosis?

A

acute laryngotracheobronchitis (croup)

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27
Q

what is a viral invasion of upper airway and extneds through larynx, trachea, and bronchi. includes inflammation of mucosal lining of larynx/trachea: narrowing of airway

A

acute laryngotracheobronchitis (croup)

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28
Q

what is the most common age group and oeak age group for laryngotracheobrinchitis (croup)

A
  • most common under 6 y.o.
  • peaks between 7-36 months
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29
Q

manifestations of laryngotracheobronchitis (croup)

A

fever, tachypnea, tachycardia, barky cough!, hoarse voice, dyspnea, insp. stridor, possible retractions

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30
Q

what is the priority intervention with laryngotracheobronchitis?

A

do as little as possible! (touch agitates child, stridor and irritation worsens)

31
Q

assessment includes RR 76, HR 180, pale pink color, severe insp stridor, frequent harsh barky cough, moderate intercostal retractions, POX 93

what is the plan of care?
what is priority?

A

call HCP for nebulized epinephrine (laryngotracheobronchitis)

32
Q

what are alpha adrenergic effects?

A

vasoconstriction and decrease edema

33
Q

what are beta adrenergic effects

A

bronchodialtor

34
Q

when and why is dexamethasone given?

A

laryngotracheobronchitis (croup)
given in ED, anti-inflamamtory corticosteroid, decreases edema

35
Q

what is the duration adn peak of dexamethasone

A

duration= 72 hours
peak= 1-2 hours

36
Q

when do most children go home from the hospital after laryngitracheobroncitis (croup)?

A

24-72 hr

37
Q

how long does laryngotracheobronchitis last?

A

several days to weeks

38
Q

how can mild croup be managed at home?

A
  • take child outside to breathe in cold air (wear jacket) (decreases edema)
  • maintain hydration and I&O
  • calm the parents by educating
  • teach s/sx of resp distress
39
Q

can epiglottitis be life threatening?

A

true

40
Q

how can epiglottitis be life threatening?

A

inflammation of upper airway, edema is rapid (mins/hrs) can obstruct

41
Q

non resp symptoms of epiglottitis

A

muffled voice, dysphagia, drooling

42
Q

resp symptoms of epiglottitis

A

dyspnea, insp stridor, high fever, high RR

43
Q

clinical therapy of epiglottitis

A

immediate intubation and antibiotics

44
Q

when is a child with epiglottitis extubated

A

1-2 days

45
Q

what is a child sent home with after being extubated for epiglottitis

A

full course of antibiotics

46
Q

if youre working in february, a large percent of infants have the same resp diagnosis, what is it? does it occur every year?

A

bronchiolitis, annual outbreak

47
Q

when does bronchiolitis anually outbreak?

A

octiber-march

48
Q

what is the main cause of bronchiolitis?

A

RSV, other viruses too

49
Q

how does bronchiolitis airway obstruction occur

A

virus invades bronchi and bronchioles, cells die inside, fuse and collect cells, obstructing bronchioles, airway swells

50
Q

describe ibstruction in bronchiolitis

A

air allowed in but mucus and edema does not allow air out, air trapping and hyperinflation of alveoli

51
Q

which symptoms are in bronchiolitis?
1. wheezing
2. stridor
3. dry cough
4. nasal drainage
5. retractions
6. poor feeding
7. dyspnea, tachypnea, tachycardia

A

1, 4,5,6,7

52
Q

what is always a characteristic of brinchiolitis?

A

moist cough

53
Q

describe when a child is hospitalized for bronchiolitis?

A
  • most not hospitalized
  • if they have a history of congenital heart disease, lung disease, BPD, prematurity, congenital disorder, young age
54
Q

how is bronchiolitis diagnosed?

A

history and physical, nasal swab for isolation

55
Q

what is not recommended to diagnose bronchiolitis and why?

A

CXR, nonspecific lung inflammation

56
Q

acetaminophen vs. ibuprofen use

A

acetaminophen at any age, ibuprofen only if older than 6 mo old

57
Q

what meds are used for brinchiolitis?

A

nebulized hypertonic saline!!!
antipyretics
corticosteroids
bronchodilators (not as much)

58
Q

why is nebulized hypertonic saline used?

A
  • softens secretions, induce cough, reduces edema, dislodges material
  • can lead to shorter hospitalization
59
Q

what is an IG1 antibody that neutralizes and inhibits RSV replication and reduces hospitalization

A

synagis (palivizumab)

60
Q

how is synagis given?

A

IM, use emla cream to numb

61
Q

when is the first synagis dose given and how is it given after that

A

first dose prior to start of RSV season and then monthly IM until season finishes (october through march)

62
Q

how is bronchiolitis transmitted?

A

direct contact with secretions

63
Q

how long does brinchilitis last on surfaces and on stethoscopes?

A

12h surfaces, 6h steth

64
Q

what is the main major source of transmission for bronchiolitis, and how long does it live on that surface

A

hands, 30 min

65
Q

what is the incubation period for bronchiolitis and how long does it take to shed it

A

incubation 2-8 days, shed in 3-8 days

66
Q

how long does it take for bronchiolitis symptoms to abate?

A

24-72 hours, full resolution may take weeks

67
Q

which of the following are symptoms of pneumonia?
a) high fever
b) crackles in effected lung
c) dyspnea and tachycardia
d) abdominal pain
e) diarrhea

A

all

68
Q

what is a rating scale based on behavior, cardiovascular status, and resp status. the score determines intervention

A

pediatric early warning scale

69
Q

which of the following are risk factors for SIDS
1. prone sleeping
2. maternal smoking
3. breast feeding
4. bed sharing
5. use of pacifier
6. premature infant

A

1,2,4,6

70
Q

what is the cause of SIDS?

A

suffocation

71
Q

laryngotracheobronchitis (croup) has which of the following symptoms?
a) bilateral inspiratory and expiratory wheezing
b) insp stridor and hoarse barky cough
c) crackles in effected lung
d) copious nasal secretions

A

b

72
Q

what is the benefit of taking a child outside to breathe in cold air when they have croup?

A

decrease edema in the airway

73
Q

what isolation is used for bronchiolitis?

A

contact isolation

Peds (30 decks)

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