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Paediatric Nursing > Respiratory system > Flashcards

Respiratory system Flashcards

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1
Q

What organism is responsible for epiglottitis?

A

Haemophilus influenzae

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2
Q

What is epiglottitis?

A

Inflammation of the epiglottis resulting in serious obstruction, usually seen in 2 - 5-year-old.
Bacterial form of croup

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3
Q

Clinical manifestation of epiglottitis?

A

*High fever
*Sore, red and inflamed throat (large, cherry edematous epiglottis)
*Tripod position
* Retractions

The four D’s of epiglottitis
* Drooling
* Dysphagia
* Dyspnea
* Dysphonia

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4
Q

Interventions for Epiglottitis

A
  • Assess respiratory status and breath sounds, noting nasal flaring, the use of accessory muscles and stridor
  • Monitor pulse oximetry
  • Administration of IV antibiotic therapy - Ceftraxone sodium or alternate cephalosporin
  • Administer corticosteroids to decrease inflammation and reduce throat edema
  • Administer humidified supplemental oxygen
  • Have resuscitation equipment available, and prepare for endotracheal intubation or tracheotomy for severe respiratory distress
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5
Q

What is laryngotracheobronchitis?

A

Inflammation of the larynx, trachea and bronchi
Most common croup syndrome
Affects children 6 months to 3 years

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6
Q

Organisms that cause laryngotracheobronchitis

A
  • Parainfluenza virus types 2 and 3
  • Human metapneumovirus,
  • RSV
  • Influenza A and B
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7
Q

Clinical manifestations of laryngotracheobronchitis

A
  • Low-grade fever
  • Hoarseness
  • Seal bark and brassy cough (croup cough
  • Inspiratory stridor
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8
Q

Interventions for laryngotracheobronchitis

A
  • Maintain a patent airway
  • Monitor for adequate respiratory exchange, monitor for pallor or cyanosis
  • Provide humidified oxygen via cool air mist
  • With severe disease, administer racemic epinephrine nebulization which causes vasoconstriction leading to a decreased subglottic edema
  • Administer corticosteroids to reduce inflammation i.e., IM dexamethasone if unable to tolerate oral
  • Maintain hydration status

*Sick child exposed to children less than 4 years old are given rifampin (notice orange urine)

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9
Q

What is bronchiolitis?

A

An inflammation of the bronchioles that causes production of thick mucus resulting in obstruction

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10
Q

Organism that causes bronchiolitis

A

Respiratory syncytial virus is the most common cause
Primarily occurs in winter and early spring
Rarely seen in children older than 2 years old

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11
Q

Clinical manifestations of bronchiolitis

A

INITIAL
* Rhinorrhea
* Otitis media and conjunctivitis
* Coughing
* Wheezing

PROGRESSION OF ILLNESS
* Increased coughing and wheezing
* Tachypnea and retractions
* Cyanosis

SEVERE ILLNESS
* Tachypnea >70 breaths/min
* Listlessness
* Apneic episodes

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12
Q

Interventions of bronchiolitis

A
  • Monitor client for respiratory failure e.g., listless, poor fluid intake, marked retractions, tachypneic or apneic
  • Use contact and standard precautions during care - handwashing, avoiding touching the nasal mucosa or conjunctiva, use of gloves and gowns, droplet precautions
  • Suction nares if secretions are copious. Should be done before feeding and bedtime
  • Administer bronchodilator
  • Monitor pulse oximetry
  • Encourage fluids
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13
Q

What is bronchopneumonia?

A

Inflammation of the alveoli, pulmonary parenchyma or both caused by virus, bacteria or aspiration of foreign substances

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14
Q

Organism that causes primary atypical pneumonia.

A
  • Mycoplasma pneumoniae - most common cause of community acquired pneumonia in children 5 years or older
  • Chlamydial pneumonia is caused by C. trachomatis - treated with azithromycin or erythromycin
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15
Q

Organism that causes bacterial pneumonia

A

Streptococcus pneumoniae

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16
Q

Clinical manifestations of viral pneumonia

A
  • Mild fever
  • Slight cough (non-productive or productive cough with small amounts of whitish sputum)
  • Malaise to high fever
  • Severe cough and diaphoresis
  • Wheezes or fine crackles
17
Q

Clinical manifestations of bacterial pneumonia

A
  • Abrupt fever
  • Rapid and shallow respirations
  • Meningeal symptoms without meningitis
  • Diminished breath sounds or scattered crackles
18
Q

Interventions of bacterial pneumonia

A
  • Maintain patent airway - suctioning, chest percussion and bronchodilator
  • Administration of antibiotic therapy
  • Encourage liberal oral intake of fluids
  • Monitor respiratory rate, rhythm and depth, oxygenation and level of activity
  • Administer antipyretic for fever
  • Administer humified oxygen if child is in respiratory distress via nasal cannula or face mask
  • Monitor for signs of dehydration
19
Q

What is given to prevent bacterial pneumonia

A

PCV13 (13 valent pneumococcal conjugate vaccine) in children ages 6 weeks to 71 months.

20
Q

What is asthma?

A

Chronic inflammatory disorder of the airways characterized by airway obstruction and bronchial hyperresponsiveness

It is an immunoglobin mediated response

21
Q

Clinical manifestations of asthma

A
  • Shortness of breath
  • Cough (non-productive and becomes productive with frothy, clear sputum)
  • Hyperresonance on percussion
  • Wheezing
  • Crackles
  • Tripod position
  • Use of accessory muscles
  • Barrel chest
  • Deep, dark red lips that may progress to cyanosis
22
Q

Interventions for Asthma

A
  • Assess airway patency and respiratory status
  • Administer humified oxygen
  • Administer quick relief medications e.g., short-acting beta 2 agonists (bronchodilators), systemic corticosteroids (anti-inflammatory to treat reversible airflow obstruction), anticholinergics (relief of acute bronchospasms
  • Encourage adequate rest, sleep and a well-balanced diet.
  • Encourage child to cough effectively.
23
Q

What are the long-term control medications for asthma?

A
  • Inhaled corticosteroids
  • Leukotriene modifiers (to prevent bronchospasm and inflammatory cell infiltration)
  • Long-acting beta 2 agonists
  • Monoclonal antibody (blocks binding of IgE to mast cells to inhibit inflammation)
24
Q

What is cystic fibrosis?

A

A disorder of the exocrine glands resulting in alterations in the respiratory, gastrointestinal and reproductive systems

Exocrine glands produce sweat, mucous and digestive enzymes via DUCTS

It is autosomal recessive as both parents must have the defective gene (CFTR gene).

Diagnosed by sweat chloride test.

25
Q

Cystic fibrosis on respiratory system

A
  • Clogged sinuses and formation of polyps
  • Obstructed airways leading to emphysema, air trapping (hyperinflation)
  • Chronic moist, productive cough; wheezing; coarse crackles
  • Clubbing of fingers and toes
  • Shortness of breath
  • Hemoptysis - coughing up blood
26
Q

Cystic fibrosis on gastrointestinal system

A
  • Damaged pancreatic ducts obstruct enzymes needed for digestion leading to poorly digested food, vitamin KADE deficiencies, poor weight gain and FTT
  • Meconium ileus at birth
  • Abdominal distention

*Greasy, bulky stools (steatorrhea) that are foul smelling and floating

  • Constipation or intestinal obstruction
  • Cystic fibrosis induced diabetes (More so endocrine)
27
Q

Nursing interventions for Cystic fibrosis

A

RESPIRATORY
* Removal of secretions
* Administration of bronchodilators, oxygen and antimicrobial therapy
* Perform chest physiotherapy

GASTROINTESTINAL
* Well balanced diet with high protein and high calories
* Administer pancreatic enzymes
* Observe frequency and nature of stools, abdominal distension
* Monitor weight and failure to thrive
* Administer multivitamins

ENDOCRINE
* Administer insulin therapy to

28
Q

What are the two types of upper respiratory tract infections?

A

Nasopharyngitis and pharyngitis

29
Q

What is nasopharyngitis?

A

A viral infection of the nose and throat (also called the common cold)

Clinical manifestations include nasal congestion, watery rhinitis, low-grade fever and difficulty breathing.

30
Q

What is pharyngitis?

A

An infection (viral or bacterial) and inflammation of the pharynx also referred to as strep throat.

Clinical manifestations include sore throat, fever and general malaise.

31
Q

What bacteria causes pharyngitis?

A

Group A beta-hemolytic streptococci which also causes rheumatic fever or acute glomerulonephritis.

32
Q

Interventions of URI

A
  • Administer analgesia and antipyretics may be given to relieve discomfort and fever
  • Administer saline nasal drops every 3 to 4 hours to relief nasal congestion
  • Encourage adequate fluid intake to prevent dehydration
  • Administer penicillin for 10 days or erythromycin. If viral, antivirals would be used?
33
Q

What is foreign body aspiration?

A

Swallowing and aspiration of a foreign body into the air passages

Physical signs include choking, gagging, wheezing, dyspnea, cough and cyanosis if obstruction becomes worse

34
Q

Interventions for foreign body aspiration

A
  • First aid - back blows, chest thrusts and abdominal thrusts
  • Preparation for endoscopy and bronchoscopy.
35
Q

Cystic fibrosis on reproductive system

A

Males have absence of vas deferens and low sperm count leading to infertility

Females have thick vaginal discharge and decreased cervical secretions so may have issues conceiving.

Paediatric Nursing (12 decks)

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