RESPIRATORY SDLP

Question 1

Name 2 common pathogens that cause respiratory illness in infants and children?

Answer 1

Adenovirus Influenza A

Respiratory Syncytial virus (RSV)

Question 2

List two different methods of supplying an infant with oxygen

Answer 2

nasal prongs and Headbox

Question 3

What four signs are you observing for when assessing respiratory status?

Answer 3

Oxygen saturation

Respiratory rate

Degree of respiratory effort

Heart rate

Question 4

What is the normal range of oxygen saturation in an infant or child?

Answer 4

<92-100%

Question 5

Name three tests which may diagnose a respiratory illness

Answer 5

Post Nasal Aspirate (PNA)

Chest X Ray (CXR)

Sputum sample

Question 6

What is the difference between aerosol and droplet transmission?

Answer 6

Aerosols are much smaller than droplets, therefore are more easily spread and may be suspended in the air for much longer.

Question 7

What infection control precautions would you take with a child with a respiratory illness?

Answer 7

hand hygiene
Isolate in a single room or cohort with other patients with the same illness
send all samples to the laboratory in a sealed container within a sealed biohazard bag

Question 8

What type of lung sounds would you expect to hear in a child with bronchiolitis

Answer 8

Expiratory wheeze and occasionally crackles

Question 9

When inspecting respiratory effort what are you observing for?

Answer 9

recession

Tracheal Tug

Abdominal breathing

Use of accessory muscles

Nasal flaring

Colour

Degree of restlessness

Conscious state

Ability to speak ie. In words or sentences

Question 10

What are the signs of severe respiratory effort

Answer 10

Unable to feed

Severe respiratory distress with marked chest retraction, nasal flaring & grunting

Respiratory rate >60

Hypoxaemia which may not be corrected with oxygen

May have prolonged apnoeic episodes

May appear tired

Question 11

Children with RSV may be placed in a multiple bed room providing that the other children are?

Answer 11

> 12 months of age;

not immunocompromised

do not have congenital heart disease or severe pulmonary disease

Question 12

How often should an oxygen analyser be calibrated and what is the oxygen percentage of room air?

Answer 12

Once a shift

Room air is 21% oxygen

Question 13

List the equipment required for a headbox

Answer 13

Appropriate sized headbox

Green oxygen tubing

Red air tubing

Y connecter for tubing

High flow oxygen and air meters

Oxygen analyser

Question 14

What is the minimum frequency of observations whilst a child is receiving oxygen therapy

Answer 14

Minimum of hourly observations but may be more often if required

Question 15

Describe the signs that would lead you to consider ceasing oral feeds in an infant with respiratory distress?

Answer 15

Unable to maintain 2/3 of usual oral intake

Decreased urine output

Fatigue

Excessive coughing

Vomiting

Tachypnoea

Increased respiratory effort

Question 16

What is the recommended flow of gas into a headbox

Answer 16

Neonatal: 8L

Small: 12L

Large: 15L

Question 17

When would you make a MET call and how would you do this?

Answer 17

When your child needs an urgent review and the consulting medical team is unable to be reached. LanPage 8917 and state MET call ward __ phone __

Question 18

Who needs to be present when an adrenaline neb is given on the ward and why?

Answer 18

Registered Nurse and either the resident or registrar. As the child may become tachycardic, hypotensive and have a rebound of symptoms within a short period of time.

Question 19

Name four differences between children’s and adults respiratory tracts.

Answer 19

smaller in size

larger soft palate

larger tongue

larynx is higher

Question 20

You are caring for a 11 month old baby with bronchiolitis who is due to be discharged today.
Her mother asks if she can return to daycare tomorrow. What advice would you give her?

Answer 20

You should give the parents bear facts sheet for bronchiolitis and advise her not to return to daycare or play with other babies until the symptoms have gone (usually a week or two).

Question 21

Which immunisation has reduced the incidence of bacterial pneumonia?

Answer 21

Haemophilis influenza B (Hib)

Question 22

You are caring for a 15 year old girl who is due a dTpa immunisation. Her mother says that she doesn’t need it as she had whooping cough as a child. What advice would you give her?

Answer 22

Only immunisation provides lasting immunity, you may develop pertussis more than once

Question 23

Can CLD effect infants born at term?

Yes / No

Answer 23

yes