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MCN > Respiratory System Disorders > Flashcards

Respiratory System Disorders Flashcards

1
Q

Viral cause of bronchiolitis

A

Respiratory syncytial virus (RSV), adenovirus, parainfluenza

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2
Q

Part Affected (Laryngo-tracheo Bronchitis)

A

Subglottic

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3
Q

Medications for bronchiolitis

A

a. Nebulizer therapy-bronchodilator, corticosteroids and beta agonists
b. Antipyretics(acetaminophen)
c. Mild sedative
d. Antibiotics only if (+) secondary bacterial infection (otitis media)
e. Antiviral therapy
f. RIBAVIRIN (VIRAZOLE)

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4
Q

Diagnosis of croup

A
  1. History (fever, cold symptoms, recent viral infection) and clinical manifestations
  2. X-ray of the neck
  3. WBC and differential count
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5
Q

→ may go undiagnosed until the child presents with persistent unilateral nasal drainage (if the
neonate develops respiratory infection) and seem to have more nasal obstruction not
proportional to the degree of infection
→ careful questioning reveals an unusual susceptibility to upper respiratory symptoms

A

unilateral choanal atresia

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6
Q

Disorders of the respiratory system

A
  1. Choanal atresia
  2. Croup
  3. Bronchiolitis
  4. Cystic Fibrosis
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7
Q

diagnostic tests in cystic fibrosis: insertion of a hollow needle through abdominal wall into the uterus to obtain cells
from amniotic fluid around the baby. The fluid is then tested to see if both of the baby’s CFTR genes
are normal.

A

Amniocentesis

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8
Q

less preferred preventive drugs for bronchiolitis

A

RSV-IGIV

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9
Q

cystic fibrosis is common to what race

A

caucasians (northern Europe)

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10
Q

high-pitched or squeaking noise when breathing in created by narrowing of the
airway

A

inspiratory stridor

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11
Q

complications of cystic fibrosis

A

o Chronic Respiratory infection – pneumonia
o Pneumotho rax
o Chronic respiratory failure
o Cor Pulmonale
o Liver Disease
o DM
o Osteoporosis and arthritis

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12
Q

– loud, harsh, “brassy” or “barking” cough (similar to a the noise of a seal barking)
o the result of swelling around the vocal cords (larynx) and windpipe (trachea). When the cough
reflex forces air through this narrowed passage, the vocal cords vibrate with a barking noise.

A

croupy cough

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13
Q

diagnostic tests in bronchiolitis: shows hyperaeration and consolidation (similar to that of pneumonia); shows collapse
of alveoli/atelectasis
a. major risk factor for COPD in later life

A

Chest X-ray

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14
Q

(a drug that stimulates sweating

A

pilocarpine

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15
Q

A chronic multisystem disorder characterized by exocrine gland dysfunction, inherited as an autosomal
recessive trait

A

cystic fobrosis

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16
Q

diagnostic tests in cystic fibrosis:
* This test is used to evaluate fat absorption as an indication of how the liver, gallbladder,
pancreas, and intestines work. Normal fat absorption requires bile from the gallbladder (or liver
if the gallbladder has been removed), enzymes from the pancreas, and normal intestines.
* 24 hour stool collection (or sometimes 72 hours or days)
* Consume a normal diet containing about 100 grams of fat per day for 3 days before starting the test;
no substances that interfere with result such as enemas, laxatives, mineral oil

A

Fecal fat test

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17
Q

How to maintain patent airway in croup

A

-Assess respiratory status every 2-4 hours or more often as indicated.
-Keep emergency suction and tracheostomy intubation tray at bedside.
-Care of the child in a croupette
-Administer meds as prescribed.
-No to visual inspection of mouth and throat unless when “E” intubation can be done
- .Position head of bed up, not supine.
-.Suction PRN

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18
Q

Medications for bronchiolitis: for high risk infant/child

A

antiviral therapy

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19
Q

sex affected in cystic fibrosis

A

male and females are equal

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20
Q

-decreases viscosity of mucus

A

dornase alfa

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21
Q

diagnosis of choanal atresia:
to determine the exact location of obstruction

A

Radiography using contrast material

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22
Q

croup is most common at what age

A

3mos to 5yrs

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23
Q

clinical manifestations of bronchiolitis

A

o Preceded by URI, manifested as nasal stuffiness, mild fever progressing to increased respiratory
distress (after 1-2 days)
➢ Tachypnea
➢ Nasal flaring
➢ Intercostal and subcostal retractions in inspiration
➢ Dyspnea
➢ Apnea
➢ Mild fever
➢ Tachycardia results from hypoxia

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24
Q

affected individual married to unaffected individual will have =

A

all children will be carriers

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25
Q

Manifestation (Laryngo-tracheo Bronchitis)

A

Low grade fever
Non toxic appearance

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26
Q

diagnostic tests in cystic fibrosis to check absence of pancreatic enzymes

A

a. FECAL FAT TEST/ QUANTITATIVE STOOL FAT DETERMINATION
b. TRYPSIN AND CHYMOTRYPSIN IN STOOL
c. SECRETIN STIMULATION TEST/ PANCREATIC FUNCTION TEST

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27
Q

Route of RSV-IGIV

A

IV (infused in 3-4 hours)

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28
Q

40% of patients with cystic fibrosis are diagnosed at what age

A

18 y/o and above

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29
Q

what results from unabsorbed food fractions excreted in the stool

A

steatorrhea

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30
Q

Croup management
a. Mild cases are managed at home
✓ Cool air vaporizer in child’s room
✓ Sometimes spasm relieved by sudden exposure to cold air- Breathing in cool night air/air
from open freezer/taking child to a cool basement/garage
✓ Warm mist by steam from hot running water in a closed bathroom could be helpful
✓ Hot steam in a pan because of hazards (burns)
b. When condition does not improve or becomes severe, needs to be hospitalized

A
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31
Q

surgeries for choanal atresia

A

-transnasal
-transpalatal

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32
Q

Treatment (Laryngo-tracheo Bronchitis)

A

Humidity
Racemic epinephrine

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33
Q

Bacterial cause of bronchiolitis

A

Mycoplasma pneumonia

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34
Q

Onset (Acute Epiglotitis)

A

rapidly progressive
(hours)

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35
Q

sex at risk in choanal atresia

A

females

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36
Q

Severity in Acute Laryngitis Spasmodic

A

least serious

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37
Q

Causative
Agent (Acute Epiglotitis)

A

Bacterial: usually HIB

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38
Q

Where do you take temperature?

A

Axillary

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39
Q

cystic fibrosis is inherited as

A

autosomal recessive trait

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40
Q

Types of choanal atresia

A

unilateral and bilateral

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41
Q

chest physiotherapy: high frequency chest wall oscillation to loosen secretions

A

Devices Thairapy rest device

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42
Q

peak year of croup

A

2nd year

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43
Q

diagnostic tests in cystic fibrosis for Chronic pulmonary involvement

A

a. CHEST X-RAY
b. PULMONARY FUNCTION TEST

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44
Q

Part Affected in Acute Laryngitis Spasmodic

A

glottic

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45
Q

anti-inflammatory effects decrease subglottic edema

A

corticosteroids

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46
Q

nursing care for choanal atresia

A
  1. Airway support
  2. Hydration and nutrition
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47
Q

when to suction in croup

A

bacterial tracheitis

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48
Q

complication of choanal atresia

A

restenosis

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49
Q

diagnostic tests in bronchiolitis

A
  1. History (exposure to cold the previous week) and physical exam
  2. Nasal or nasopharyngeal culture
  3. Chest X-ray
  4. Pulse oximetry
  5. ABG
  6. CBC
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50
Q

what results from absence of enzymes that causes malabsorption of CHO,
fats and CHON

A

malnutrition

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51
Q

diagnostic tests in cystic fibrosis which are Prenatal genetic tests can find out if baby has CF:

A

amniocentesis

chorionic villus biopsy

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52
Q

In sweat test, how many hour is it in paraffin before transferring into the weighing jar

A

1 hour

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53
Q

loosens and liquefies pulmonary secretions

A

mucolytics

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54
Q

Management of fluid and electrolyte balance in cystic fibrosis

A
  1. add salt to all meals, especially in summer
  2. give salty snacks
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55
Q

NURSING DIAGNOSES for croup

A

➢ Altered tissue perfusion (cardiopulmonary) r/t partially obstructed airway
➢ High risk for fluid volume deficit r/t inability to meet body requirements and increased
metabolic demands
➢ Fear/anxiety r/t acute illness, hospitalization and uncertain course of illness and treatment
➢ Knowledge deficit r/t diagnosis, treatment, prognosis and home care needs

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56
Q

at what year of age can surgery be done in unilateral choanal atresia

A

2-3 y/o

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57
Q

Part Affected (Acute Epiglotitis)

A

Supraglottic

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58
Q

most common age of affected in bronchiolitis

A

6mos, rare after 2yrs

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59
Q

CLINICAL MANIFESTATIONS of choanal atresia

A

➢ Difficulty of breathing following birth which may result in cyanosis (unless infant is crying
➢ Inability to nurse and breathe at the same time
➢ Unable to pass a catheter through each side of the nose into the throat
➢ Persistent one-sided nasal blockage/discharge

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60
Q

depth of insertion of catheter in choanal atresia

A

3-4 cm in nasopharynx

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61
Q

cystic fibrosis is characterized by

A

exocrine gland dysfunction

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62
Q

cause of cystic fibrosis

A

defect in the gene cystic fibrosis transmembrane conductance regulator (CFTR)

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63
Q

Lower respiratory illness that occurs when an infecting agent causes inflammation and
obstruction of the bronchioles

A

BRONCHIOLITIS

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64
Q

Manifestation in Acute Laryngitis Spasmodic

A

Afebrile Mild distress
respiratory

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65
Q

Disadvantage/advantage of PALIVIZUMAB

A

▪ Does not interfere with
MMR, and varicella vaccine
▪ Pain and mild transient
erythema at the site

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66
Q

Nursing care for croup

A

A. Maintain patent airway and provide for adequate respiratory exchange
B. Promote balanced fluid and nutrition
C. Promote rest and comfort
D. Support and educate child and parents

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67
Q

opens large and small airway

A

bronchodilators

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68
Q

o causes mucosal vasoconstriction and subsequent decrease in edema
o rapid action but sometimes symptoms “relapse” within 2 hours (assessment is
important)

A

racemic epinephrine (nebulized)

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69
Q

surgeries for choanal atresia: requires less operative time and causes slightly less morbidity
related to the incision, but the risk of the nasal passages closing later may be higher.

A

transnasal

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70
Q

70% of patients with cystic fibrosis are diagnosed at what age

A

2 y/o

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71
Q

Manifestation (Bacterial Tracheitis)

A

High fever
Thick purulent
tracheal secretions URI
appears as viral
croupy cough but no
response to LTB
therapy

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72
Q

In pancreatic function test,
* An NGT is inserted into the duodenum. Secretin is given through this tube, and the contents of
the released material from the duodenum are removed through the tube over a period of
about 2 hours.
* Fast for 12 hours prior to the test

A
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73
Q

most croup is caused by

A

virus

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74
Q

In sweat test, The negative
electrode is covered with gauze and saturated with

A

bicarbonate solution

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75
Q

cause of croup

A

virus
bacteria/allergic reaction

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76
Q

4F’s of Cystic Fibrosis

A

❖ Frothy (bulky and large quantity)
❖ Foul-smelling
❖ Fat-containing (greasy)
❖ Float

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77
Q

risk factors for bronchiolitis

A

o Children in day care
o Kids who are exposed to cigarette smoke
o Formula-fed infants
o Those at high risk for asthma
o exposed to an adult or another child with a cold in the previous
week.

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78
Q

In sweat test, positive electrode is covered by
gauze and saturated with

A

pilocarpine

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79
Q

A term applied to a broad classification of UPPER AIRWAY illness that result from inflammation and
narrowing of the larynx (voice box), the trachea (windpipe) and the bronchi (larger branching air tubes)

A

croup

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80
Q

closure of a normal opening

A

Atresia

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81
Q

diagnosis of choanal atresia: done to evaluate the extent of the choanal atresia once a feeding tube fails to pass through the nasal
passage; it detects the composition (membranous or bony) and thickness of the atresia, the depth of the
nasopharynx and any associated skull base anomalies

A

CT scan

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82
Q

preventive drugs for bronchiolitis

A

RSV-IGIV (RESPIGAM)
PALIVIZUMAB

83
Q

diagnostic tests in cystic fibrosis:
* These tests are most often done in young children suspected of having cystic fibrosis.
* This test is used as a screening tool for cystic fibrosis but it does not diagnose it. Other
testing is needed to confirm a diagnosis of cystic fibrosis

A

TRYPSIN AND CHYMOTRYPSIN IN STOOL

84
Q

Why avoid inspection of mouth and throat in croup

A

to avoid laryngopasm

85
Q

what side is more common in unilateral choanal atresia

A

right (60%)

86
Q

after how many weeks the doctor removes the stents under general anesthesia.

87
Q

Onset (Laryngo-tracheo Bronchitis)

A

gradual; starts as URI,
progresses to
symptoms of
respiratory distress

88
Q

concentrations of ***** highly suggestive-repeat test

A

40-60 mEq/L

89
Q

Management of GIT problem in cystic fibrosis

A
  1. Administer pancreatic enzymes with meals and do not mix enzymes until ready to use
  2. Provide nutritional supplements
  3. Teach on high calorie, high protein and moderate fat diet
90
Q

Treatment in Acute Laryngitis Spasmodic

A

Humidity
Severe: Racemic
epinephrine
Mild: home but must
seek medical help if
(+)s/s of respiratory
distress

91
Q

Manifestation (Acute Epiglotitis)

A

High fever Toxic
appearance 4Ds
Dysphonia
Dysphagia Drooling
Distressed
respiratory effort

92
Q

long-term support to child and family client teaching and discharge planning on cystic fibrosis

A
  • genetic counseling
  • promotion of child’s independence
  • no cigarette smoking in the house
  • availability of support groups/agencies
93
Q

Infection control measures for bronchiolitis

A

a. Isolation
b. Handwashing, avoid touching nasal mucosa/conjunctiva
c. Decrease number of hospital personnel, visitors and uninfected patients in contact with the
child
d. Making patient assignments so that nurses assigned to children with RSV are not taking
care of other patients who are considered at risk
e. SPAG-wait for a few moments before opening tent

94
Q

Medications for bronchiolitis: which act directly on
inflamed and obstructed airways

A

Nebulizer therapy-bronchodilator, corticosteroids and beta agonists

95
Q

proteolytic enzymes released from the pancreas during
normal digestion

A

Trypsin and chymotrypsin

96
Q

Causative
Agent in Acute Laryngitis Spasmodic

A

Viral with allergic/
psychosomatic
component

97
Q

Causative
Agent (Bacterial Tracheitis)

A

Bacterial: usually
staphylococcus aureus

98
Q

surgeries for choanal atresia: provides better exposure and more accurate bone removal.

A

transpalatal

99
Q

diagnostic tests in cystic fibrosis:
* This test measures the ability of the pancreas to respond to secretin.

A

SECRETIN STIMULATION TEST/ PANCREATIC FUNCTION TEST

100
Q

croup usually occur in what season

A

winter or early spring

101
Q

size of catheter for confirmation of choanal atresia

102
Q

Onset in Acute Laryngitis Spasmodic

A

sudden; typically
occurs at night; tends to
recursudden; typically
occurs at night; tends to
recur

103
Q

viruses most commonly involved in croup are

A

PARAINFLUENZA VIRUS
(accounting for most cases), adenovirus, respiratory syncytial virus, influenza, and measles.

104
Q

the medical term for HOARSENESS
o As laryngeal involvement often dominates the clinical picture

105
Q

Cause of bronciolitis

A

Viral (generally)
Bacterial

106
Q

type of preparation of PALIVIZUMAB

A

monoclonal antibody

107
Q

condition in which the posterior nares are obstructed by membranous septum or bone either
bilaterally or unilaterally

A

Choanal atresia

108
Q

chest physiotherapy: a small handheld plastic pipe with a stainless steel on the inside
that facilitate removal of mucus.

A

Flutter Mucus device

109
Q

what precedes partial obstruction in bronchiolitis

A

complete obstruction-atelectasis-resp acidosis-hypoxia

air trapping-emphysema-resp acidosis-hypoxia

110
Q

what is primarily affected in pancreatic enzyme deficiency

A

acinar cells

111
Q

diagnosis of choanal atresia: to look into the nose to make sure the airways are open and to assess healing after
surgery.

A

Fiberoptic endoscope

112
Q

sex at risk in bronchiolitis

113
Q

viral cause in most cases in bronchiolitis; easily spread direct contact/droplet

A

Respiratory syncytial virus

114
Q

Medications for bronchiolitis:only if (+) secondary bacterial infection (otitis media)

A

Antibiotics

115
Q

Alternative names for sweat chloride test

A

Sweat Test; Sweat Chloride; Iontophoretic Sweat Test; Pilocarpine
Iontophoresis

116
Q

Severity (Acute Epiglotitis)

A

Most life threatening

117
Q

diagnostic tests in bronchiolitis: Respiratory acidosis =Hypercapnea (↑pCO2); hypoxemia (↓pO2)

118
Q

Early s/s of impending airway obstruction

A
  • Tachycardia
  • Tachypnea
  • Substernal, suprasternal and intercostals retractions
  • Flaring of nares
  • Increasing restlessness
119
Q

Management of croup

A
  1. HUMIDITY
  2. MEDICATIONS
  3. IVF for hydration
  4. ARTIFICIAL AIRWAY = ET intubation/tracheostomy
120
Q

what happens in respiratory system in cystic fibrosis

A
  • repeated
    episodes of bronchitis and pneumonia
  • emphysema and atelectasis
    pulmonary hypertension (cor pulmonale)
    -s/s dyspnea, cyanosis, clubbing of the fingers and toes
    -death (lung failure)
121
Q

Severity (Laryngo-tracheo Bronchitis)

A

most common; most
serious viral croup;
progresses if
untreated

122
Q

→ Feeding tube for bilateral choanal atresia until defect is corrected.
→ For unilateral, feed infant slowly with a small nipple in upright position and with frequent pauses to
permit breathing

123
Q

MANIFESTATIONS (triad symptoms) of cystic fibrosis

A
  1. progressive chronic lung disease
  2. pancreatic enzyme deficiency
  3. sweat gland dysfunction
124
Q

(the top of the airway narrows to a point)

A

steeple sign

125
Q

route of PALIVIZUMAB

126
Q

diagnostic tests in bronchiolitis: leukocytosis, ↑ESR

127
Q

nursing diagnosis for cystic fibrosis

A

➢ Ineffective airway clearance r/t thick mucus in lungs
➢ Altered nutrition: less than body requirements r/t inability to digest nutrients
➢ Knowledge deficit (parent/child) r/t diet, therapies and follow-up care

128
Q

Diagnosis of croup : (usually not required but used to rule out foreign body obstruction /
epiglottitis) = steeple sign (the top of the airway narrows to a point)

A

xray of the neck

129
Q

3 chest physiotherapy

A

o (+) postural drainage
o Devices Thairapy rest device
o Flutter Mucus device

130
Q

Disadvantage/advantage of RSV-IGIV

A

▪ Interferes with MMR and varicella
vaccines (live virus vaccines)- deferred
for 9 months after Respigam infusion
▪ Volume of drug may not be well
tolerated by infants (not given to
children with
congenital heart
defects)

131
Q

Most common congenital malformation of the nose

A

Choanal atresia

132
Q

diagnosis of choanal atresia

A
  1. Physical exam for obstruction of the nose
  2. Radiography using contrast material
  3. Fiberoptic endoscope
  4. CT scan
133
Q

what happens in skin in cystic fibrosis

A

a. abnormally increased concentrations of Na and Cl in sweat
b. parents report that infants taste salty when kissed (with salt frosting)
c. dehydration and electrolyte imbalances especially during hotseasons=heat exhaustion during summer

134
Q

o Generally extubated untilspasm and edema are no longer a problem and the child can
manage secretions successfully (Usually within 24-36 hours)

A

ARTIFICIAL AIRWAY = ET intubation/tracheostomy

135
Q

Types of croup

A

-Acute Laryngitis
Spasmodic
-Laryngo-tracheo
Bronchitis
-Bacterial Tracheitis
-Acute Epiglotitis

136
Q

in surgery of choanal atresia, In both approaches, the doctor stitches tubes (small plastic) called *** into the passages
to keep it open

A

nasal stents

137
Q

Diagnostic test for cystic fibrosis

A
  1. History and clinical manifestations
  2. Sweat chloride test
  3. Fecal Fat test/ Quantitative stool fat determination
  4. Trypsin and chymotrypsin in stool
  5. Secretin stimulation test/ Pancreatic function test
  6. Chest X-ray-shows hyperinflation
  7. Pulmonary function test
  8. Upper GI and small bowel series
  9. Serum Immunoreactive trypsin (IRT)
  10. Prenatal genetic tests-amniocentesis, chorionic villus sampling
138
Q

Diagnosis of croup : to distinguish between bacterial and viral illnesses

A

WBC and differential count

139
Q

when to prescribe NPO

A

severe resp distress (>60bpm)

140
Q

a hormone
produced by the small intestine when partially digested food has moved into the intestine from
the stomach.
- causes the pancreas to release a fluid with a high concentration
of bicarbonate. Acting as an antacid, this fluid works against the acid in the material from the
stomach, so that enzymes in the small intestine can work properly. These enzymes are responsible for breaking down food and helping in the absorption of nutrients.

141
Q

Severity (Bacterial Tracheitis)

A

guarded; observation
required close

142
Q

Normal value of fecal fat test

A

less than 7 g of fat per 24 hrs

143
Q

In sweat test, how many mins is current applied

144
Q

PEDIATRIC DIFFERENCES
UPPER AIRWAY

A
  1. Small cavity and large tongue
  2. Rapid growth of lymph tissue (tonsils and adenoids) during early childhood; atrophy after 12 y/o
  3. Larynx and glottis high in neck
  4. Thyroid, cricoid and tracheal cartilages immature and incomplete
  5. Large amount of soft tissues and loosely anchored mucus membrane lining length of airway
  6. Long, floppy epiglottis
  7. Fewer functional muscles in the airways
145
Q

factors of choanal atresia

A
  • Genetic factor
  • Environmental factor
  • Developmental factor
  • Trauma
  • Idiopathic
146
Q

Pediatric Differences
LOWER AIRWAY

A
  1. Trachea is shorter and higher
  2. Angle of right bronchus is more acute that in the adult (sleeper slope) intercostal muscles immature.
  3. Alveoli changes in size, shape and increases in number until maturity is altered at 12 years old
  4. Newborns don’t have enough smooth muscle bundles to help trap airway invaders
147
Q

Nursing care for bronchiolitis

A
  1. Maintain respiratory function
  2. Promote rest and comfort
  3. Promote balanced fluid and nutrition
  4. Infection control measures
148
Q

normal sweat chloride concentration

A

less than 40 mEq/L

149
Q

earliest manifestation of cystic fibrosis in NB

A

meconium ileus

150
Q

Causative
Agent (Laryngo-tracheo Bronchitis)

A

Viral: parainfluenza,
influenza A & B, RSV,
Mycoplasma pneumonia

151
Q

mucus produced by the exocrine glands is abnormally thick, causing
obstruction of the small passageways of the affected organ

A

exocrine gland dysfunction

152
Q

2 important changes in the upper airway in croup

A
  1. the epiglottis and larynx swells thereby occluding the airway
  2. the trachea swells against the cricoid cartilage causing restriction
153
Q

diagnostic tests in cystic fibrosis: uses ultrasound to guide a thin tube through the vagina and cervix into the
uterus and remove a tiny piece of the placenta to biopsy. The cells of the placenta are then tested to
see if the baby has CF.

A

Chorionic villus biopsy

154
Q

respiratory therapy for cystic fibrosis: for all lung segments usually BID or often if with respiratory infection
(bilateral percussion-vibration and forceful coughing) to mobilize secretions to bronchi for
expectoration

A

chest physiotherapy

155
Q
  • both parents are unaffected but carry trait
  • occurs in 1 of 4 children
A

autosomal recessive inheritance

156
Q

In trypsin and chymotrypsin in stool,
* When there is decreased pancreas function, smaller-than-normal amounts of these enzymes
are detected in the stool. =An abnormal result is if the trypsin or chymotrypsin levels in the
stool are below the normal range
* A drop of emulsified stool is placed on a thin layer of gelatin. If trypsin or chymotrypsin are
present, the gelatin will be digested, which will produce a clearing of the gelatin.

157
Q

chloride concentration greater than *****is a (+) test result

158
Q

what happens in reproductive system in cystic fibrosis

A

a. delayed puberty in females
b. males are usually sterile (due to persistent plugging and blocking of the vas deferens from tenacious
seminal fluid)
c. mucus plug-females can conceive but increased mucus in the vaginal tract makes conception difficult
d. pregnancy causes increased stress on respiratory system of the mother

159
Q

Age affected in bronchiolitis

160
Q

GENERAL CLINICAL MANIFESTATIONS in croup

A

➢ CROUPY COUGH
➢ DYSPONIA
➢ INSPIRATORY STRIDOR
➢ RESPIRATORY DISTRESS

161
Q

Management of pulmonary problem in cystic fibrosis

A
  • Administer meds
  • Cautious administration of oxygen
  • Encourage deep breathing exercises
    -Encourage physical exercise
162
Q

Part Affected (Bacterial Tracheitis)

A

Upper Trachea

163
Q

what happens in gut/pancreas in cystic fibrosis

A
  • meconium ileus
  • malnutrition
  • failure to thrive
  • steatorrhea
  • rectal prolapse
164
Q

nebulization treatments in cystic fibrosis

A

mucolytics, bronchodilators, dornase alfa

165
Q

diagnostic tests in cystic fibrosis: determine the extent of lung involvement- atelectasis and emphysema are present ( increased
airway resistance)

A

pulmonary function test

Alternative names: PFTs; Spirometry; Spirogram; Lung function tests

166
Q

Medications for bronchiolitis: * Controversial-cost, benefit, safety and variable efficacy (APA, 2000) = case to case basis
* Aerosolized, delivered via small particulate generator thru mask, ventilator tubing or
tent
* Pregnant health care providers should not care for a child receiving ribavirin
* If with contact lenses, wear goggles-may dissolve it
* Wait for a few moments before opening tent to prevent contamination

167
Q

Signs and symptoms are typically most severe in children ***** because their airways
are narrower and more likely to become blocked when there is infection

A

age 3 and younger

168
Q

cool, moist air with oxygen provides needed extra oxygen and
moisture

A

Mist tent/croupette

169
Q

associated congenital anomalies in choanal atresia

A

-craniofacial syndrome
-skull-based defects (encephalocele)

170
Q

in, surgery of choanal atresia, The fenestrated opening was stented with ***** which was inserted from
posterior choana and anchored external to the collumella.

A

modified endotracheal tube

171
Q

nursing responsibilities in croupette

A

✓ Keep the child dry
✓Tuck loose edges under mattress to prevent oxygen and moisture loss within the tent
✓Roomed near nurses station and resuscitation equipment at bedside
✓No to battery/friction/fur toys=fire hazard

172
Q

medications for croup

A

a. RACEMIC EPINEPHRINE
b. CORTICOSTEROIDS
c. ANTIBIOTICS for bacterial croup
d. ANTIPYRETICS for fever

173
Q

type of preparation of RSV-IGIV

174
Q

Diagnostic test for cystic fibrosis to determine Increased electrolyte concentration of sweat

A

SWEAT CHLORIDE TEST

175
Q

Medical management for cystic fibrosis

A
  1. Respiratory therapy
    a. Nebulization treatments
    b. Chest physiotherapy
    c. Oxygen administration
  2. Infection
  3. Nutritional needs
  4. Lung transplant
176
Q

Management of choanal atresia

A
  1. airway support – oral intubation or tracheostomy
  2. cure the obstruction through SURGERY
177
Q

preferred preventive drugs for bronchiolitis

A

PALIVIZUMAB

178
Q

NURSING DIAGNOSES for bronchiolitis

A

➢ High risk for fluid volume deficit r/t inability to meet body requirements and increased
metabolic demands
➢ Fear/anxiety r/t acute illness, hospitalization and uncertain course of illness and treatment
➢ Knowledge deficit r/t diagnosis, treatment, prognosis and home care needs

179
Q

other diagnostic tests in cystic fibrosis:

A

a. Upper GI and small bowel series for obstruction
b. Serum Immunoreactive trypsin (IRT) increased in NB with CF because pancreas is obstructed
even during fetal life

180
Q

Management of bronchiolitis

A
  1. Cardiorespiratory monitor and pulse oximetry
  2. Oxygen therapy
  3. Hydration (oral/IV)
  4. Medications
181
Q

what cause rectal prolapse

A

large bulky stools and lack of supportive fats

182
Q

Neonates become apneic or cyanotic at birth and require resuscitation in order to prevent
asphyxia/severe hypoxia (artificial airway)

A

Bilateral choanal atresia

183
Q

Post op care for choanal atresia

A
  1. Adequate nasal cleaning & suctioning frequently
  2. Antibiotics & decongestants as ordered
  3. Frequent follow up check-up
184
Q

time of the year risk for brinchiolitis

A

late fall, early spring (Oct-Mar)

185
Q

Treatment (Acute Epiglotitis)

A

Antibiotics
Airway protection

186
Q

diagnostic tests in cystic fibrosis: shows hyperinflation

A

chest xray

187
Q

standard diagnostic test for CF

A

SWEAT CHLORIDE TEST

188
Q

what happens when airway is irritated

A

swelling, increased mucus production, bronchospasm

189
Q

Onset (Bacterial Tracheitis)

A

Progressive from URI

190
Q

Treatment (Bacterial Tracheitis)

A

antibiotics

191
Q

what results from loss of nutrients and inability to absorb fat soluble
vitamins

A

failure to thrive

192
Q

diagnostic tests in bronchiolitis:presence of RSV through enzyme linked immunosorbent assay
(ELISA)/immunoflourescent antibody ( IFA)

A

Nasal or nasopharyngeal culture

193
Q

sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.

A

Sudden infant death syndrome

194
Q

Peak age of sids

A

2-4 months

195
Q

Age where sids occurs 90%

196
Q

Sex at risk with SIDS

197
Q

Time of the year risk for SIDS

A

Winter (peaks at January)

198
Q

Race greater of incidence of SIDS

A

Native Americans and African Americans

199
Q

Triple risk model of SIDS

A
  1. Critical development period
  2. Vulnerable infant
  3. External stressors
200
Q

Pathological findings in autopsy of SIDS

A

Pulmonary edema and intrathoracic hemorrhage

201
Q

Nursing care for SIDS

A

-Emotional support for parents
-family counseling
-referral to support group
-provide reading materials for them to understand the phenomenon and reassure it is not their fault

202
Q

Prevention of SIDS

A

-always put baby to sleep on its back
-only put babies to sleep in crib
-let baby sleep in the same room with parents but not the same bed
-avoid soft bedding materials
-make sure room temp is not too hot
-let baby sleep with pacifier

203
Q

Recommendations from SIDS experts

A

-keep baby in smoke-free environment
-breastfeed baby if possible
-never give honey to baby less than 1y/o
-parents and caregivers trained in CPR

MCN (6 decks)

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