Respiratory- Peds Flashcards
Structure and Function of the Respiratory System in Children
- Nasal cavity
- Trachea
- Right/Left Lung
- Diaphragm
- Pleura
- Pharynx
- Epiglottis
- Larynx
- Bronchus
Purpose of the respiratory system
- Supply sufficient oxygen to meet the metabolic demands of the body
- Remove carbon dioxide from the body
Development of the Upper Airway
- 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
Development of the lower airway
- Increase in lung volume
- Increase in diameter of lower airway structures
- Proliferation of alveoli across development
Musculoskeletal Development
- 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
Evaluation of respirations
Rate, rhythm, depth, quality
Dyspnea
Distress during breathing
Apnea
Cessation of breathing
Hypoventilation
decreased depth (shallow) and irregular rhythm
Hyperventilation
Increased rate and depth
Kussmaul respiration-
Hyperventilation, gasping and labored respirations;usually seen in diabetic coma or other states of respiratory acidosis
Cheyne-Stokes respiration
Gradually increasing rate and depth with periods of apnea
Seesaw (paradoxic) respirations
Chest falls on inspiration and rises on expiration
Agonal-
Last gasping breaths before death
Respiratory distress initial signs
Restlessness, tachypnea, nasal flaring, retractions, color changes, head bobbing, grunting, stridor, audible wheezing
Decompensation
Anxiety,irritability, decreased in LOC, confusion, hyper/hypotension
Imminent respiratory arrest
Bradypnea, bradycardia, cynosis, stupor, coma
Most common cause of cardiac rest in kids
hypoxia
Respiratory failure: ABG values
PaO2 < 60
PaCO2 > 50
Interventions for respiratory failure
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
Inadequate gas exchange leads to
hypoxemia and hypercapnia
Respiratory alkalosis
Low CO2, high pH. hyperventilation
Respiratory acidosis
Elevated CO2, low pH. hypoventilation
pH
7.35-7.45
PCO2
35-45
HCO3
22-26
PO2
80-100
SaO2
93-100
Causes of hypoventilation
Airway obstruction, neuro-trauma
Cause of hyperventilation
Hypoxia, anxiety, fear