Respiratory- Peds Flashcards

1
Q

Structure and Function of the Respiratory System in Children

A
  • Nasal cavity
  • Trachea
  • Right/Left Lung
  • Diaphragm
  • Pleura
  • Pharynx
  • Epiglottis
  • Larynx
  • Bronchus
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2
Q

Purpose of the respiratory system

A
  • Supply sufficient oxygen to meet the metabolic demands of the body
  • Remove carbon dioxide from the body
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3
Q

Development of the Upper Airway

A
  • Tongue is larger in proportion to mouth
  • Pharynx is smaller
  • Epiglottis is larger and floppier
  • Larynx is more anterior and superior
  • Narrowest at cricoid
  • Trachea narrow and less rigid
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4
Q

Development of the lower airway

A
  • Increase in lung volume
  • Increase in diameter of lower airway structures
  • Proliferation of alveoli across development
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5
Q

Musculoskeletal Development

A
  • Increased rigidity of rib cage
  • Changing position of ribs to spine across development.
  • Rib cages are flexible, use energy to open those muscles
  • Babies are belly breathers because of this
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6
Q

Evaluation of respirations

A

Rate, rhythm, depth, quality

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7
Q

Dyspnea

A

Distress during breathing

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8
Q

Apnea

A

Cessation of breathing

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9
Q

Hypoventilation

A

decreased depth (shallow) and irregular rhythm

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10
Q

Hyperventilation

A

Increased rate and depth

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11
Q

Kussmaul respiration-

A

Hyperventilation, gasping and labored respirations;usually seen in diabetic coma or other states of respiratory acidosis

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12
Q

Cheyne-Stokes respiration

A

Gradually increasing rate and depth with periods of apnea

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13
Q

Seesaw (paradoxic) respirations

A

Chest falls on inspiration and rises on expiration

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14
Q

Agonal-

A

Last gasping breaths before death

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15
Q

Respiratory distress initial signs

A

Restlessness, tachypnea, nasal flaring, retractions, color changes, head bobbing, grunting, stridor, audible wheezing

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16
Q

Decompensation

A

Anxiety,irritability, decreased in LOC, confusion, hyper/hypotension

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17
Q

Imminent respiratory arrest

A

Bradypnea, bradycardia, cynosis, stupor, coma

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18
Q

Most common cause of cardiac rest in kids

A

hypoxia

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19
Q

Respiratory failure: ABG values

A

PaO2 < 60

PaCO2 > 50

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20
Q

Interventions for respiratory failure

A

Oxygen

  • checking pulse ox
  • Clear airway secretions
  • Assess respiratory rate,effort, HR
  • position them so airway is open
  • suctioning
  • coughing, having kids blow bubbles, IS, harmonicas, percussion, vibration
  • Keep pt NPO
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21
Q

Inadequate gas exchange leads to

A

hypoxemia and hypercapnia

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22
Q

Respiratory alkalosis

A

Low CO2, high pH. hyperventilation

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23
Q

Respiratory acidosis

A

Elevated CO2, low pH. hypoventilation

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24
Q

pH

A

7.35-7.45

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25
Q

PCO2

A

35-45

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26
Q

HCO3

A

22-26

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27
Q

PO2

A

80-100

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28
Q

SaO2

A

93-100

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29
Q

Causes of hypoventilation

A

Airway obstruction, neuro-trauma

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30
Q

Cause of hyperventilation

A

Hypoxia, anxiety, fear

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31
Q

Clinical manifestations of respiratory acidosis

A

confusion, lethargy, headache, increased ICP, Coma (depressed kind of condition)

32
Q

Clinical manifestations of respiratory alkalosis

A

Confusion, dizziness, neuromuscular irritability, muscle cramping/spasms (Hyper excitement)

33
Q

ALTE

A
  • occurs in infants 2-months of age
  • May occur during feeding, sleep, or awake
  • CPR may be needed
  • Cause of event is identified in approximately 50% of cases
  • May be caused by reflux, seizures, infection
34
Q

SUIDs

A
  • Leading cause of death after 1 month

- Cause of death unknown

35
Q

Risk factors of SUIDs

A
  • low apgar scores
  • viral infections
  • siblings with SIDs
  • male gender
  • Native American, African American
36
Q

Protective interventions of SUIDs

A
  • Safe sleep practices
  • Pacifier use
  • Caregiver smoking cessation
37
Q

Foreign body aspiration interventions

A
  • Assess patency of airway and adequacy of ventilation
  • CR and pulse ox monitor
  • supplemental oxygen
  • anticipate bronchoscopy
  • child safety education
  • good positioning
38
Q

Nasopharyngitis/Pharyngitis

A
  • Inflammation of the nose and throat

- Multiple viral or bacterial organisms

39
Q

Nasopharyngitis/Pharyngitis

clinical manifestations

A
  • Feeding poorly/poor apetite
  • Lethargy
  • Irritability
  • Restlessness
  • Fever
  • Upper airway congestion
  • THROAT PAIN
40
Q

Nasopharyngitis/Pharyngitis

Goals

A
  • Comfort

- Maintain adequate fluid and nutritional intake

41
Q

Nasopharyngitis/Pharyngitis

Nursing management

A
  • Saline drops with nasal suction prior to feedings
  • Cool-mist room humidifier
  • Quite play and rest
  • Encourage fluids
  • Teach family good hand hygiene
42
Q

Croup and Epiglottitis

A

Could be anything- inflammation of upper airway.

DO NOT PUT ANYTHING IN THEIR MOUTH

43
Q

Epiglottitis

clinical manifestations

A
  • 2-8 years
  • Onset is rapid
  • High fever
  • Intense sore throat
  • Dysphagia
  • Drooling
  • Prefers upright sitting position
  • Inspiratory stridor
  • Severe respiratory distress
44
Q

Epiglottitis Care

A
  • Do not put anything in their mouth
  • Allow child to determine position of comfort
  • Plan for tracheostomy or endotracheal intubation
  • Oxygen
  • IV fluids
  • Antibiotics
45
Q

Bronchiolitis

A
  • Common viral infection of the lower respiratory tract
  • Common cold in adults
  • More severe disease in young infants
  • Respiratory syncytial virus most common
  • wont go home well, just no more supportive care is needed
  • Will have NG tubes
46
Q

Bronchiolitis care

A
  • Supportive management
  • Ensure adequate nutrition and fluid intake
  • Supplemental oxygen
  • Monitor oxygen saturation
  • Nasal/nasopharyngeal suctioning
47
Q

Pertussis

A
  • Highly contagious acute bacterial infection of the upper and lower respiratory tract
  • Immunizations provides protection
48
Q

Pertussis Care

A
  • Antibiotics
  • Airway management, supplemental oxygen
  • Nutrition management
  • Fluid management
  • Respiratory assessment
  • Family education, hand washing
49
Q

Asthma

A

1) airway obstruction/secretions
2) constriction of the airway
3) inflammation in the airway

50
Q

Asthma management

A

1) Rescue bronchodilators (beta-agonist)
2) Systemic and inhaled corticosteroids
3) Asthma action plan for home management

51
Q

Cystic fibrosis

A

A common inherited autosomal recessive disorder of the exocrine glands affecting the respiratory, GI, integumentary, musculoskeletal, and reproductive systems.
-Recessive disorder

52
Q

Cystic fibrosis cause

A
  • Caused by mutation in the CFTR gene
  • Exocrine & epithelial cells have a defective chloride ion transport and decrease in the amount of water that can flow across the cell membrane
53
Q

Cystic fibrosis manifestations

A

Chronic assumulation of thick. dry mucus in the respiratory, GI, and genitourinary systems.
-All body organs w/mucous ducts are damaged and obstructed in time

54
Q

Cystic fibrosis nursing interventions

A
  • Monitor respiratory rate,depth,VS, LOC, and O2 saturation
  • Supplemental, humidified O2
  • Position of comfort-Elevate HOB
  • Suction nares
  • Maintain hydration and nutrition
  • Medications
  • Assess and address anxiety
55
Q

Can ride a tricycle

A

age 3

56
Q

can jump

A

age 3

57
Q

Climbs stairs with alternate foot pattern

A

age 3

58
Q

Skips

A

Age 4

59
Q

Hops on one foot

A

Age 4

60
Q

throws ball

A

age 4

61
Q

descends stairs with alternate food pattern

A

age 4

62
Q

can throw and catch

A

age 5

63
Q

jumps rope

A

age 5

64
Q

increased balance

A

age 5

65
Q

builds large tower

A

age 3

66
Q

builds bridges

A

age 3

67
Q

copies circles

A

age 3

68
Q

cannot make stick figure may do circle with facial features

A

age 3

69
Q

begin to use scissors

A

age 4

70
Q

copies basic figures

A

age 4

71
Q

adds 3 parts to a stick figure

A

age 4

72
Q

can tie shoes

A

age 5

73
Q

use scissors

A

age 5

74
Q

copies figures has 7-9 parts on stick figrue

A

age 5

75
Q

printing numbers and letters

A

age 5