Test 3 - Respiratory Dysfunction Flashcards
General Aspects of Respiratory Infections
Described according to the anatomical area involved:
Upper respiratory tract Nose, pharynx, larynx, upper trachea Lower respiratory tract Lower trachea, bronchi and bronchioles, alveoli Croup syndromes Infections of the epiglottis or larynx
In infants younger than __ months, maternal antibodies offer some protection.
In infants younger than 3 months, maternal antibodies offer some protection.
Espeically if the mom is breast feeding
In infants age __ to ___ months, the infection rate increases.
In infants age 3 to 6 months, the infection rate increases.
They don’t have immune system, exposure to more things, and losing maternal antibodies, mother may go back to work - baby go to daycare
In toddlers and preschoolers, there is a high rate of viral infections
Preschool, touching things,eating things, picking their nose, poor hygene and spread germs
In children older than __ years, there is an increase in GABHS and Mycoplasma pneumoniae infections.
In children older than 5 years, there is an increase in GABHS and Mycoplasma pneumoniae infections.
In school, it gets passed around
Increased immunity develops with age.
Size to children’s respiratory tract
Diameter of airways is smaller
Distance between structures is shorter, allowing organisms to rapidly move between
Short and open eustachian tubes
How do children get respiratory diseases
Immune system deficiencies Allergies, asthma Cardiac anomalies Cystic fibrosis Exposure to infections in daycare Exposure to second-hand smoke
Seasonal Variation - respirtaory infection are most common during which seasons?
Seasonal Variation
Most common during winter and spring
Mycoplasma infections more common in which seasons?
Mycoplasma infections more common in fall and winter
Asthmatic bronchitis more frequent in which in of weather?
Asthmatic bronchitis more frequent in cold weather
RSV season typically which season?
RSV season typically winter and early spring
Generalized signs and symptoms and local manifestations differ in young children are…?
Apnea
Fever - you see it in younger children due to initial immune response (in neonate you see drop in temperature)
Anorexia, vomiting, diarrhea, abdominal pain
Cough, sore throat, nasal blockage or discharge
Respiratory sounds
Respiratory assessment should include:
RR, depth, rhythm,and effort
HR, O2 sat, hydration status,
Body temperature
Activity level and comfort
Nursing Interventions for Respiratory Infections
Ease the respiratory effort
Positioning (lay them up), suction, oxygenation (decrease effort), having them cough, trying to calm the toddler down, turn the lights down and put on a movie (distraction), managing fever
Manage fever
Tylenol, uncover them, put fan in the room, wet/cool towel on forehead and axella
Promote rest and comfort
Decrease metabolic demand - turn off the light, give transitional object, help them feel secure, distractions (movies, music)
Control infection
Make sure the visitor wash hands, make sure the visitors aren’t sick, keep kids out of the room, clamp down on visitors during flu seasons
Promote hydration and nutrition
Offer snacks (pt often don’t have appetite), if hard to breath usually don’t offer water but rather ice chips so they don’t aspirate.
Hydration over nutrition - push them to drink not to eat
Provide family support and teaching
Home management for Upper Respiratory Tract Infections (URIs)
Clear secretions -parents make sure knows how to use ball syringes (suction the kid’s nose)
Humidification - Cool mist only (warm causes bacteria and mold growth, and dangerous bc mist can burn them)
Small, frequent feedings
Fever management
Avoid OTC “cold” medicines
Pharyngitis - what is causes and risks
what is the clinical manifestations?
Causes and risks
Often viral
Gr A β hemolytic strep(strep throat)
Risk for Rheumatic fever, Acute Glomerulonephritis
Clinical manifestations
Abrupt onset, fever, HA, sore throat
Tonsils, pharynx inflamed, covered with exudate
What is diagnosis of pharyngitis
Diagnostics
Although 80-90% are viral, rapid strep test should be done
Therapeutic management for pharyngitis is…?
Oral PCN if strong suspicion of bacterial infection
Nursing considerations for pharyngitis is…?
Nursing considerations
Warm saline gargles, cool compresses, tylenol/motrin, encourage PO fluids, rest
Teach about administration of meds
Strep is contagious for 24 hours after antibiotics are started
Etiology and clinical manifestation for Tonsillitis?
Tonsillitis
Etiology: often occurs with pharyngitis, common in young children, viral or bacterial
Clinical Manifestations: Enlarged tonsils (“kissing”) Difficulty swallowing/breathing Mouth breathing Sleep apnea
Therapeutic management for Tonsillitis?
Therapeutic management - antibiotics
Tonsillectomy/Adenoidectomy
Nursing care: pain relief, minimize bleeding, close observation of breathing, cool clear fluids, observe for bleeding, avoid emesis and clearing of throat
avoid chips or things that can scratch the throat, or vomiting, causing the scab to come off.
Observe for frequent swallowing - that may be due to bleeding
Influenza Clinical manifestations
Clinical manifestations
Mild mod or severe, dry throat, cough, general myalgia and malaise, fever, and chills (every fiber of your body hurts)
Lasts 4-5 days minimum
Therapeutic management for influenza
Symptomatic treatment - fluids, tylenol
Antiviral medications lessen severity
Prevention for influenza
Yearly flu vaccines in children over 6 months of age
Family are the “vaccines for the young infant” - infant can’t get the flu vaccine, so people around the baby need to be vaccinated
Health care worker vaccines
Croup Syndromes
Croup Syndromes - fall and winter
Croup
croup won’t kill you, more towards infants
Croup gets worst for 3 nights and then gets better
Make sure to get a good history for pt w stridor - inspiratory sound (hear it on inspiration, sounds like a gasp)
Causes: foreign body - potato chips, lego, etc
Epiglottitis
Epiglottitis
Sicker, drooling, and can kill you, you want to leave them alone - never stick anything in mouth or cause pain, dont stick a tongue blade, it would reflexively swell
Get steroids
Characterized by hoarseness, barking cough (sounds like a seal), inspiratory stridor, and varying degrees of respiratory distress
Croup syndromes affect the larynx, trachea, and bronchi
Epiglottitis, laryngitis, laryngotracheobronchitis (LTB), tracheitis
Acute Epiglottitis-
Acute Epiglottitis- A Medical Emergency
Clinical manifestations
Rapid progression
Sore throat, pain, tripod positioning, retractions
Inspiratory stridor, mild hypoxia, distress
Watch for: absence of spontaneous cough, drooling, agitation/anxiety
Therapeutic management
Potential for respiratory obstruction
Nursing considerations – do not attempt to inspect the throat! Keep child as calm as possible.
Allow position of comfort
Prevention requires Haemophilus influenzae type b (Hib) vaccine, incidence greatly decreased since vaccine
