respiratory peds Flashcards
A term that refers to cases where hospital personnel fail to notice symptoms or respond adequately or swiftly enough to clinical signs….when a patient is dying of preventable complications in a hospital?
Failure to Rescue (FTR). This is a reportable incident.
T or F. In FTR cases, hours of time go by before the patient crashes ?
True. Literature shows that in about 50% of codes, evidence of clinical worsening was present for many hours.
You’ve just been assigned a new patient and need to assess them for Respiratory Distress. What signs and symptoms should you pay close attention to in your peds patient?
Tachypnea, Retractions (subcostal and intercostal), GRUNTING, Wheezing, Rhonchi, Crackles/ Rales, Decreased O2 sat, Increased WOB (use of accessory muscles), Cough, Nasal flaring (mouth often closed), Stridor, Color
T or F. An oxygen saturation of 95% on RA is adequate for a pediatric patient?
False. 95% is very low, PaO2 would be very low also. Because of their new lungs, it should be 100%
During your assessment of Baby Jim, you notice “head bobbing” during your respiratory assessment. Why is this significant?
Head bobbing is an example of increased WOB (use of accessory muscles) and a common sign of respiratory distress.
Foreign body aspiration is most amongst who?
Children between the ages of 1-3 and adults that are older than 50.
T or F. Food is the most commonly aspirated material?
True. Foods such as raisins, nuts, and grapes are the most common. Coins and balloons are also commonly aspirated objects.
What signs and symptoms would indicate that food or even a coin was in the trachea?
Coughing and/ or wheezing, Retractions, Stridor, and often NO symptoms at all.
In regards to symptoms of foreign body aspiration, why is the presence of wheezing important?
Wheezing on one or both sides could indicate foreign body aspiration.
A young dad rushes into the ED and reports that his daughter is having difficulty breathing. In order to appropriately assess this child, what action should you perform first?
Your first action should be to undress/ uncover the child in order to observe their chest movement. It will help to tell a lot about what’s going on with that patient, especially if subcostal retractions are present.
2 common procedures that help to evaluate the airway and also determine the cause of foreign body aspirations include?
Bronchoscopy and Endoscopy. They help the MD see what needs to be removed.
An immediate, life- threatening reaction that causes vasodilation, bronchoconstriction, and increased capillary permeability?
Anaphylaxis
What are the 3 most common reasons for Anaphylaxis?
Allergies, Insect stings, and medications.
In regards to treating patients suffering from Anaphylaxis, what 5 interventions are the most important to perform?
Rapid recognition, maintain/ secure airway, get Epi pen (IM epinephrine), administer boluses of NS (20ml/kg) to get BP up, give Bronchodilators (Albuterol) and Benadryl.
Asthma
An obstructive, inflammatory, reversible airway disease characterized by hyper- responsiveness of the trachea and bronchi. It causes edema of mucosa, increased secretions, and spasm of smooth muscle of the bronchioles. Air trapping also occurs in the alveoli.
Coughing, Dyspnea, and Wheezing are all classic symptoms of which disease?
Asthma
In infants, what is the #1 precipitating factor for Asthma?
Viral infections.
There are 4 cardinal signs of respiratory distress. What are they?
Restlessness, Increased respiratory rate, Increased pulse rate, and Diaphoresis.
T or F. The cause of asthma is unknown, but it’s associated with a strong family history?
True
Identify 7 common precipitating factors associated with Asthma.
Viral infection, Allergens, Environmental factors (weather changes, home environment), GERD, Emotional factors, Medications, Exercise.
When does wheezing typically occur for patients with asthma?
During expiration when airway closes.
Common medications used to treat Asthma include?
Bronchodilators (Albuterol) and Anti-inflammatories, such as Flovent/ Pulmicort.
T or F. Inhaled corticosteroids must have warning about reduced rate of growth?
True. Reduced rate of growth is related to use of inhaled corticosteroids, but only by a very small percentage. The ability to breathe outweighs this concern, however.
As you’re walking into a patient’s room, you notice that they have a peak flow meter, incentive spirometer, spacer, and MDI at their bedside. This equipment is common for patients with _____________?
Asthma
Identify 6 important asthma control measures that you can teach during discharge?
Care at home should include avoiding triggers; getting annual flu vaccinations; treating rhinitis, sinusitis, and GERD; using prescribed medications properly; having an action plan, and home monitoring
An acute bacterial infection of the lower respiratory tract that begins with upper respiratory symptoms, such as paroxysmal cough
Pertussis (Whooping Cough). It is transmitted by direct contact, DROPLET spread, or freshly contaminated objects.
