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349 Peds Exam 2 > Respiratory Textbook Information > Flashcards

Respiratory Textbook Information Flashcards

1
Q

When talking about respiration what are we mainly looking at?

A

The chest & lungs

Airway!

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2
Q

What should the nurse be assessing when talking about respiration?

A

Chest & pattern of movement
Rate
Regularity
Symmetry
Depth
Effort
Accessory muscles

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3
Q

When is respirations determined best in a child?

A

At sleep or quietly awake

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4
Q

The following couple of flashcards will be about terminology according to respiratory
What does Tachypnea mean?

When does it normally occur?

A

Rapid respirations

Anxiety, excitement, metabolic acidosis

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5
Q

What does hyperpnea mean?

A

Too deep in respiration
Like the depth of a respiration

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6
Q

What does hypopnea mean?

A

Too shallow of a depth in respiration

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7
Q

What does retractions mean?

Subcostal retractions?

A

Sinking of soft tissues relative to the cartilaginous and bony thorax and may occur in some pulmonary disorders.

Observed anteriorly at the lower costal margins

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8
Q

What is nasal flaring?

A

A sign of respiratory distressed & enlargment of nostrils help reduce nasal resistance and maintains airway patency

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9
Q

What is head bobbing?

A

Sleeping if exhausted infant is a sign of dyspnea

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10
Q

What is noisy breathing?

A

Snoring!!!

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11
Q

What is stridor?
What is it best heard at inspiration or expirations?

A

High pitch noisy respiration
Narrowing of the upper airway typically

Inspiration

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12
Q

What is grunting?

A

Frequently sign of pain in older children

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13
Q

What is wheezing?
Inspiration or expiration?

A

Continuous musical sound originating from vibrations in narrow airways

Expiration

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14
Q

Color changes of the skin can be from mottling, pallor or cyanosis
But these usually all result from a cardiopulmonary disease

However what does acrocyanosis usually from?

A

Cool environment for the newborn
Causing that bluish discoloration

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15
Q

What is chest pain?

A

Literally pain in the chezt

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16
Q

What is clubbing?

A

Fingers and toe nails have big nail beds usually resulting from chronic hypoxia

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17
Q

What is a cough?

A

Just literally cough

Protective mechanisms and indicator of irritation

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18
Q

General aspects of respiratory tract infections!

A
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19
Q

The upper respiratory tract or upper airway consists of what? (4)

A

Oronadopharynx
Pharynx
Larynx
Upper part of the trachea

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20
Q

What does the lower respiratory tract consists of? (4)

A

Lower trachea
Bronchi
Bronchioles
Alevoli

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21
Q

It’s important to note that respiratory tract infections spread from one structure to another because of the ?

What does this mean for us tho?

A

Continuous nature of the mucuous membrane lining the entire tract

That infections of the respiratory tract involve multiple structures instead of one, although one may be effected more

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22
Q

What are the main infectious that are causing respiratory infections? (5)

A

RSV
influenza
Strep
Pertussis
Pneumonia

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23
Q

In a healthy full term infant, typically younger than 3 months have a lower respiratory tract infection why?

A

Because they still have plenty of antibodies from their mother

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24
Q

Why does the infection rate increase around 3-6months for an infant?

A

Because the maternal antibodies are disappearing and now it’s the infants turn to make them

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25
Q

Why are children more prone to get an infection than an adult?

A

Because their size
Think about how every structural is closer to each other and how it easily spreads throughout the body !

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26
Q

How does resistance play a role in respiratory infection, in CHILDREN?

A

They lack the fully developed immune system

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27
Q

When is the most common time to get a respiratory infection?

A

Winter and spring months

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28
Q

When does mycoplasma infections occur?

A

Autumn and early winter

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29
Q

When does RSV occur?

A

Winter and spring months

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30
Q

When does infection related to asthma occur?

A

Just cold weather really

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31
Q

What are some super common signs and symptoms of associated respiratory tract infections in infants and small children?

Dont over think it

A

Fever
Anorexia / vomit / diarrhea
Nasal blockage
Nasal discharge
Cough
Respiratory sounds
Sore throat

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32
Q

How do we assess the respiratory function in a child?

A

Rate
Depth
Rhythm
Labored breathing
Ease

How does it sound like it ?
How does it smell like?
How does it look like?

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33
Q

What measurement tool should be placed on all children with respiratory illness as part of the routine physical assessment?

A

Pulse oximeter
Oxygen saturation

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34
Q

What is an at home remedy parents can do to help a child with symptoms of respiratory tract infection?

A

Warm or cool mid to help soothen those mucus membranes

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35
Q

What is a cardinal sign that a child is feeling better from a respiratory tract infection?

A

Increase in activity

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36
Q

How are we going to prevent the spread of respiratory infection?

A

Hand washing!!!
Wearing mask!!
Don’t touch your face !!

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37
Q

Upper respiratory tract infections!!

A
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38
Q

What is acute viral nasopharyngitis?

A

A number of viruses usually rhinovirus that causes the common cold

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39
Q

What are some clinical manifestations of acute viral nasopharyngitis?

Dont over think it!

A

Fever
Decreased appetite & fluid intake
Decreased activity
Nasal inflammation
Coughing
Sneezing

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40
Q

Is acute viral nasopharyngitis usually self limiting? And if so? How long does it last?
And when is the peak of the symptoms?

A

It is self limiting
Usually last 10-14days
2-3 peak

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41
Q

What is the therapeutic management of acute viral nasopharyngitis?

A

Usually it’s self limiting at home
Prescribed antipyretics are given to help aid with fever and discomfort

Decongestants to help open up those nasal airways

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42
Q

It’s important to note to avoid the overusage of decongestations
This is called what?

A

Rebound congestion

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43
Q

To avoid rebound congestion, what should happen?

A

Do not administer for more then 3 days

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44
Q

Nasopharyngitis is so widespread in general population that it is impossible to prevent
However what can we do to try to limit that spread?

A

Hand washing
Avoid touching the face!

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45
Q

How can we educate parents on what to do to help aid their child with nasopharyngitis? (2)

A

Elevate the head of the bed
Suctioning and vaporization

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46
Q

It’s super important to support and reassure the parents that URIs are going to be frequent and like an endless rollercoaster. However we as nurses should understand that this is just a normal part of childhood and will ultimately help the child what?

A

Built immunity!!!

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47
Q

Acute streptococcal pharyngitis!!!

A
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48
Q

What is acute streptococcal pharyngitis?

A

GABHS Infection of the upper airway ( strep throat ) is not itself a serious disease but affect children are at risk for serious illnesses

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49
Q

GABHS infection is famously known for causing acute glomerulonephritis, which is an acute kidney infection.

And causing impetigo and pyoderma

But what is the biggest symptoms it can cause?

A

Scarlet fever !

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50
Q

Scarlet fever may occur from the same group A strep that causes most strep throat
But what is the biggest clinical manifestations?

A

Sand paper like rash

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51
Q

What are clinical manifestations of GABHS? (5)

A

Headache
Fever
Abdominal pain
Tonsils covered with exudate
Pain when swallowing

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52
Q

How do you diagnose acute streptopharyngitis?

A

Culture it
Rapid antigen testing
( vigorous swabbing on both tonsils )

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53
Q

What are the medications we are going to give a patient who has streptopharyngitis?

And for how long?

A

Oral penicillin
Amoxicillin for 10 days

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54
Q

What other medications do we usually use if a child may be allergic to penicillin ?

WHAT IS THE ORHER MEDICATION FHAT YHEY COUOD BE ALLERGIC TO BUT WE CAN TRY GIVINH?

A

Marcolide

Cephalosporins

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55
Q

Notes
IM penicillin G benzathine is appropriate to use for GABHS but it is extremely painful so use with caution

A
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56
Q

What should we teach the parent regarding strep throat?

A

Don’t away tooth brushes to prevent recurrent of infection

Follow antibiotic regime

Avoid close contact personal who are sick

Don’t take child to school for 24 hours

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57
Q

How do you prevent acute strep pharyngitis?

A

Hand washing

Avoid close contact with people

Replace tooth brush

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58
Q

Tonsillitis!!

A
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59
Q

What is tonsillitis?

A

Inflammation of the tonsils

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60
Q

What causes tonsillitis?

A

Bacterial or viral infection

Usually paired with pharyngitis

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61
Q

What are clinical manifestations of tonsillitis? (5)

A

Difficult swallowing
Mouth breathing
Mouth odor
Voice is like muffled
Persistent cough

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62
Q

Since tonsillitis is usually self limited, treatment for viral pharyngitis and a positive viral tonsillitis is ?

A

Supportive care truly

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63
Q

Do we use antibiotics on a viral infection?

A

NO!

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64
Q

What do we do first when we see tonsillitis?

A

Culture it

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65
Q

When the culture comes back positive for bacteria what do we usually do!?

A

Antibiotic treatment

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66
Q

Surgical treatment of chronic tonsillitis is controversial, however it may aid in some patients who have recurrent, frequent strep infection !

What is the 2 surgery called that we can perform?

A

Tonsillectomy
( removal of the palatine tonsils )

Adenoidectomy
( remocal of the adenoids )

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67
Q

Is surgery for your tonsils indicated for a child who has recurrent pharyngitis?

A

NO!

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68
Q

What is the nurses job to help the parent and child when they are having tonsillitis?
Think of what type of diet they should and shouldn’t be on?

A

Soft to liquid diet

Avoid milk, ice cream and pudding as they coat the mouth

Avoid citrus& anything hot

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69
Q

What type of pain management will we be doing for these children with tonsillitis?

A

Analgesic- antipyretic drugs
Acetaminophen and anti inflammatory medications ( IB )

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70
Q

After surgery of removing their tonsils, what usually do we do for the patient?

A

Put some coldness on the throat to aid the inflammataion

Rest up to!

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71
Q

What medication is contraindicated in pediatric patients after tonsillectomy and adenoidectomy?

A

Codeine

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72
Q

Infectious mononucleosis !!

A
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73
Q

What is infectious mononucleosis?

A

The Epstein Barr virus
Known as kissing disease!!!

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74
Q

What is the etiology of infectious mononucleosis?

A

Kissing!
Oral secretions

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75
Q

What is the clinical manifestation of mono!? (5)

A

Malaise
Sore throat
Fever
Fatigue /lack of energy
Spleen enlarged 2-3cm

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76
Q

How do we diagnosis mono? (2)

A

CBC
Spot test ( monospot )

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77
Q

What is the therapeutic mangement we are going to do as nurses for these patients?

A

Really not much can help aid with mono since it’s a virus

However we can help with like symptoms of headache fever and malaise

Rest!

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78
Q

What is the prognosis of mono?

A

Usually really good and most children do not find living with the disease to be hard

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79
Q

Influenza !!

A
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80
Q

What is influenza?

How does it spread?

A

A virus normally known as orthomyxovirus

Droplet : direct contact; sneezing talking coughing

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81
Q

What are clinical manifestations of influenza?

A

Dry cough
Fever & chills
Flushed face
Sore throat

82
Q

What are two medications that can help with influenza?

A

Tamiflu
Relenza

83
Q

When should we give Tamiflu and relenza?
Like what is the time frame?

A

48 hours of onset of symptoms
After it doesn’t work
( 2 day onset )

84
Q

Why should children not receive aspirin?

A

Because of reye syndrome

85
Q

How do we prevent influenza?

86
Q

Why is influenza administer yearly?

A

Because of the different strains of influenza

87
Q

When should the flu vaccine start in children?

A

At 6 months

88
Q

When giving the flu vaccine for the first time in a 6 month old
How does it go?
Like why are the steps?

A

They receive 2 shots
1 month apart

So baby is 6 months in August
1st shot

Then they get another shot in September

89
Q

How do we prevent the spread of influenza? There are 2 ways ?

A

Hand washing
Vaccination

90
Q

Otitis media!!!

91
Q

What is otitis media?

A

Fluid in the middle ear along with acute signs of illness and symptoms of middle ear inflammation

An inflammation of the middle ear without reference to etiology or pathogenesis

92
Q

Breastfed infants have less OM or more OM than bottle feed infants?

93
Q

What is the patho behind OM?

A

Primarily result of a dysfunction Eustachian tube

94
Q

What’s the biggest complication behind OM?

A

Hearing loss

95
Q

What is the clinical manifestation behind OM? (4)

A

Pain or discomfort when pulling or holding the ears

Fever
Loss of appetite
Vomiting : diarrhea

96
Q

How do we diagnose OM?

A

Visualization of the ear

97
Q

What is the treatment for OM?

A

Antibiotics !

98
Q

What is the first line antibiotics for OM?

A

amoxicillin

99
Q

What is the second line of antibiotics? (2)

A

Augmentin
( amoxicillin clavulanate )

Cephalosporins

100
Q

According to the textbook
____ vaccine has reduced the rates of OM in infants and children

A

Pneumococcal vaccine

101
Q

If the child is feeling pain in the ear, what do we usually recommended too? (2)

A

Acetaminophen
IB ( only 6 months and above )

102
Q

What do we not give to OM? (4)

A

Steroids
Antihistamines
Decongestants
Antibiotic ear drops

103
Q

There is a surgery we can do, called?
Which helps how for OM?

A

Myringotomy

Which simply helps alleviate the severe pain by draining the infected ear

104
Q

Otitis externa!

105
Q

What is otitis externa common referred to? And what is it?

A

Swimmers ear

Infections of the external ear canal

106
Q

What is otisis externa usually caused by?

A

Staphylococcus or corynebacterium

107
Q

What is the clinical manifestation of otisis externa? (2)

A

Pain at the tragus ( pinna )

Odor can be present

108
Q

Croup syndrome !

109
Q

What is croup syndrome?

A

Resonate cough described as barking or brassy
Varying degreases of inspiratory stridor and varying degrees of respiratory resulting from swelling and obstruction of the larynx

110
Q

Epiglottitis!!

111
Q

What is acute epiglottis?

A

A serious medical emergency in which where we can see the eplogittis in the children throat

112
Q

What is the clinical manifestation of epiglottis? (8) !!!!!!!

A

Abrupt onset of cold symptoms
Sore throat
Tripod positing
Retractions
Inspiratory stridor
Mild hypoxia
Distress
Fever

113
Q

Nurses who suspect epiglottis should not attempt to what? (2)

A

Look with a tongue depressor or take a culture !!

114
Q

If the child is better off sitting in tripod position, why does the nurse encourage this behavior for epiglottis?

A

Because it’s an emergency and if the epiglottis were to get worse
We have complete respiratory distress

115
Q

What should always be at the bed side of things with epiglottis ?

A

Tracheostomy kit

116
Q

How do we prevent epiglottis?

A

HIB VACCINE!!!!

117
Q

Acute laryngitis

118
Q

What is acute laryngitis?

Usually caused by?

A

Acute infectious inflammation of the larynx

Virus

119
Q

Acute laryngitis is most common in who?

A

Older children and adolescents

120
Q

What is the main complaint about acute laryngitis?

A

Hoarseness

121
Q

How do we usually treat acute laryngitis?

A

It’s generally is self limited so we usually just do supportive care

Like fluids and humidified air

122
Q

Acute laryngotracheobronchitis

123
Q

What is Acute laryngotracheobronchitis ?

A

It is a common type of croup you see in children, typically they go to bed and then wake up with this bark sounding cough

124
Q

What is the management of LTB?

A

Maintaining airway and provide adequate respiratory exchange

125
Q

What do we teach parents about LTB?

A

Humidors
Cool night air
Stand in front of an open freezer

126
Q

She mentioned in class that kids usually will do a whole lot better when they go to the hospital because they got exposed to the cold air

When having LTB

127
Q

acute spasmodic laryngitis

128
Q

What is acute spasmodic laryngitis?

A

Midnight croup

To differentiate from laryngitis and LTB, this is only at night!!

129
Q

What do we usually treat with these kids ?

A

Cool mist!!

130
Q

Bacterial tracheitis

131
Q

What is bacteria tracheitis?

A

Infection of the mucosa and soft tissues of the upper trachea

132
Q

What is the clinical manifestations?

A

Stridor
Toxicity
Drooling
Dysphagia

133
Q

How do we manage bacteria tracheitis? (3)

A

Antibiotics, steroids and antipyretics

134
Q

Infections of the lower airway!!!!!!

135
Q

What is bronchitis?

A

Inflammation of the large airways ( trachea and bronchi )

136
Q

What is the clinical manifestation of this?

A

Dry hacking nonproductive cough

137
Q

Is bronchitis mild and self limiting?

Usually the use of analgesics, antipyretics and humidity help

138
Q

Bronchiolitis and RSV

139
Q

What is bronchiolitis?

A

Acute viral infection that is caused by RSV

140
Q

When is bronchiolitis most common to get?

A

Winter and spring months

141
Q

Who is at risk for getting RSV?

A

Premature infants
Congenital heart or lung disease
Immune compromised
Neuromuscular disorder

142
Q

RSV occurs less frequently in who?
Breast or formula?

A

Breast feed babies

143
Q

What is the transmission of RSV?

A

Direct contact with respiratory secretions

144
Q

What are some clinical manifestation of RSV?

A

Rhinorrhea
Wheezing
Fever
Ear /eye infection
Copious secretions
Cyanosis is severe

145
Q

How do we diagnosis RSV?

A

Usually look at a culture test for it

146
Q

How do we help manage bronchiolitis ? (3)

A

Adequate fluid intake
Airway Maintance
Medications

147
Q

There is one thing that is a 100% cure of RSV but it’s super hard to get because it’s expensive and it’s called what?

A

Palivizumab

148
Q

Patients with RSV will be in seperate rooms in order to what?

A

Avoid further complications or possible infection spreading

Hand washing is a must with these babies too

149
Q

Pneumonia

150
Q

What is Pneumonia?

A

Inflammation of the pulmonary parenchyma

151
Q

What is viral pneumonia?

A

Vital that causes inflammation of the pulmonary parenchyma

152
Q

What is the clinical manifestation of viral pneumonia?

A

Fever
Slight cough
Fatigue

153
Q

How do we treat viral pneumonia?

A

Genuinely with oxygenation and comfort

154
Q

What is primary atypical pneumonia ?

A

Bacteria causing pneumonia
Also known as community acquired pneumonia

155
Q

What is the clinical manifestation of atypical pneumonia?

A

Muscle pain ( myalgia)
Fever
Headache

156
Q

What is management for atypical pneumonia?

A

Macrolides treatment
Erythro
Azthrio
Clairtho

157
Q

What is bacterial pneumonia?

A

Aspiration or Hematogenous dissension
Serious infection

Strep usually caused it

158
Q

What is the biggest clinical manifestation of bacteria pneumonia?

A

Meningism ( meningal symptoms )

159
Q

How do you diagnose any pneumonia?

A

The crackles in the chest
Radiography

160
Q

How do you treat bacterial pneumonia!?

A

Anti microbial

161
Q

What is mycoplasma pneumonia or chapdmyial pneumonia!?

A

Caused by mycoplasma bacteria

162
Q

What is the manifestation of chlamydia pneumonia?

A

Same as others really
Fever
Malaise
Tachypnea
Cough
Chest or abdominal pain
Nausea

163
Q

How do we diagnosis the chlamydia pneumonia?

A

Cultures
- sputum test , blood culture
Lung aspiration and biopsy
WBC

164
Q

How do we prevent pneumonia?

A

PCV vaccine !

165
Q

When do we see chlamydia pneumonia?

A

Usually 2-19 weeks after delivery

Comes from the mom via ascending infection or during delivery

166
Q

Notes
All babies with a fever before age 2 need a full Septic work!

167
Q

Pertussis !!

168
Q

Pertussis is caused by what?

A

Bordetella pertussis
Bacteria

169
Q

What is the one way to prevent pertussis ?

A

vaccine!!
Dtap and Tdap

170
Q

What is the biggest clinical manifestation of pertussis?

A

Whooping cough!!

172
Q

What is TB?

A

M.tuberculosis which is a bacterial infection gets into the lungs

173
Q

What is the clinical manifestation of tuberculosis?

A

Fever
Cough
Night sweats
Delayed growth
Crackles

174
Q

How do we diagnosis TB?

A

Culture
X ray
Blood
Skin test

175
Q

What is the TB vaccine?

A

BCG vaccine

176
Q

BCG vaccine is also known to cause what in test?

A

Positive result

177
Q

How does a positive site look like when doing a skin TB test?

A

Induration of 10-15mm

And a small bump

178
Q

When should you come back to be assess for a skin test?

A

48 hours !!!

179
Q

What is a negative TB test?

A

Anything below 5mm
And simply no bump

180
Q

What is latent TB?

A

No symptoms
Just have bacteria

181
Q

What is active tb?

A

Symptoms
And infected

182
Q

What do we normally do for immunologic testing for tb?

A

Quantiferon and T-spot

183
Q

How do we management TB? 4 medications

A

INH
ethmabutol
Rifampin
Pyrandixe

184
Q

What is the recommend test we use for TB?

A

Mantoux test
Uses ppd ( purifed protein derivative )

185
Q

Since TB is so resistant we have something called DOT
What is that?

A

Where people literally come to your house and look at you drink the pills

186
Q

Notes
Foreign body ingestion and aspiration
Where a child ingest something they aren’t suppose to, it can be toxic and they could potentially choke

Keep things away from the babies!!
Keep an eye on them!!

187
Q

What is aspiration pneumonia?

A

When food, secretions go into the lungs and cause inflammation

188
Q

What do we avoid for aspiration pneumonia?

A

Oily nose drops and petroleum distillates

Solvents
Talcum powder

189
Q

What do we educate parents on with aspiration pneumonia?

A

Better feeding habits
And proper sitting up

190
Q

Suspicion for inhalation injuries !!

191
Q

Notes
HOARSE VOICE AND COUGH!!!
Soot around the nose and sputum

Heat injury
- reflex glottis closure

Local chemical injury
- insoluble gases in the lower respiratory tract

Systemic injury
- carbon monoxide causing tissue hypoxia

Therapeutmic management
- scope of the problem
- typically 100% oxygen!!!

192
Q

Congenital diaphragmatic hernia

193
Q

What is congenital diaphragmatic hernia?

A

Results when the diagram does not form completely, resulting in an opening between the throat and abdominal cavity

194
Q

What is the clinical manifestations?

A

Respiratory distress and pneumothorax

195
Q

How do we diagnosis it?

A

Ultrasound

196
Q

What is the management for this?

A

Surgery
Fetoscopic endoluminal tracheal occlusion

197
Q

After birth we do bag and mask for ventilation

A

They can’t breathe on their own
It’s hard
We need surgery on the mean time too

198
Q

What is allergic rhinitis?
Seasonal allergies

OTC medications
Zyrtec or clartin
Flonase
Eye drops

199
Q

Asthma !

200
Q

What is asthma main characteristic?

What is it doing ? (2)

What do we treat first and with what?

What do we help with inflam?

What is first?

A

Wheezing

Constriction & inflammation

Constrictioj & albuterol

Corticosteroid

Albuterol

349 Peds Exam 2 (7 decks)

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