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Pediatrics ATI > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

Tonsils

A
  • Found in pharyngeal area
  • Filter pathogenic organisms (viral and bacterial)
  • Helps protect the respiratory and gastrointestinal tracts
  • Contribute to antibody formation
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2
Q

Palatine tonsils

A
  • Located on both sides of the oropharynx

- Removed during a tonsillectomy

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3
Q

Pharyngeal tonsils

A
  • Also known as the adenoids

- Removed during an adenoidectomy

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4
Q

Risk factors for tonsillitis

A
  • Exposure to a viral or bacterial agent

- Immature immune systems (younger children)

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5
Q

Physical findings of tonsillitis

A
  • Mouth odor
  • Mouth breathing
  • Snoring
  • Nasal qualities in the voice
  • Fever
  • Tonsil inflammation with redness and edema
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6
Q

NSG care for tonsillitis

A
  • Provide symptomatic treatment for viral tonsillitis (rest, cool fluids, warm salt-water gargles).
  • Administer antibiotic therapy as prescribed for bacterial tonsillitis.
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7
Q

What medications are given for tonsillitis

A
  • Antipyretics: acetaminophen (Tylenol) or ibuprofen (Advil)

- Antibiotics: IM PCN G, erythromycin, azithromycin, cephalosporins, amoxicillin

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8
Q

Prior to a tonsillectomy a client should maintain _____ status.

A

NPO

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9
Q

Positioning after a tonsillectomy

A
  • Place in side-lying position or on abdomen to facilitate drainage.
  • Elevate head of bed when child is fully awake.
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10
Q

Assessment after a tonsillectomy

A
  • Assess for evidence of bleeding, which includes frequent swallowing, clearing the throat, restlessness, bright red emesis, tachycardia, and/or pallor
  • Assess the airway and vital signs
  • Monitor for difficulty breathing related to oral secretions, edema, and/or bleeding
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11
Q

Comfort measures post-tonsillectomy

A
  • Administer analgesics
  • Provide an ice collar
  • Offer ice chips or sips of water to keep throat moist
  • Administer pain medication on a regular schedule
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12
Q

Diet post-tonsillectomy

A
  • Encourage clear liquids and fluids after a return of the gag reflex, avoiding red-colored liquids, citrus juice, and milk-based foods initially.
  • Advance the diet with soft, bland foods.
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13
Q

Instructions post-tonsillectomy

A
  • Discourage coughing, throat clearing, and nose blowing in order to protect the surgical site.
  • Refrain from placing pointed objects in the back of the mouth.
  • Alert parents that there may be clots or blood-tinged mucus in vomitus.
  • Ensure the child does not put anything
  • Limit strenuous activity and physical play with no swimming for 2 weeks
  • Full recovery usually occurs in approximately 14 days
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14
Q

Complications of a tonsillectomy

A
  • Hemorrhage
  • Dehydration
  • Chronic infection
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15
Q

Nasopharyngitis (common cold)

A

self-limiting virus that persists for 7-10 days

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16
Q

Clinical manifestations of nasopharyngitis

A
  • Nasal inflammation, rhinorrhea, cough, dry throat, sneezing, and nasal qualities in voice
  • Fever, decreased appetite, and irritability
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17
Q

Bacterial tracheitis

A

Infection of the lining of the trachea

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18
Q

Clinical manifestations of bacterial tracheitis

A
  • thick purulent drainage from the trachea that can obstruct the airway and cause respiratory distress
  • fever, croupy cough, stridor
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19
Q

Bronchitis (tracheobronchitis)

A
  • Associated with an upper respiratory infection (URI) and inflammation of large airways
  • Self limiting and requires symptomatic relief
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20
Q

Bronchiolitis

A
  • Mostly caused by RSV
  • Primarily affects the bronchi and bronchioles
  • Occurs at the bronchiolar level
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21
Q

Clinical manifestations of bronchitis

A
  • Persistent cough as a result of inflammation

- Resolves in 5-10 days

22
Q

Clinical manifestations of bronchiolitis

A
  • Rhinorrhean- intermittent fever, cough, and wheezing
  • Coughing that progresses toward wheezing, increased respiratory rate, nasal flaring, retractions, and cyanosis
  • Possible posttussive vomiting due to coughing
23
Q

Allergic rhinitis

A

-Cause by seasonal reaction to allergens most often in the autumn or spring

24
Q

Clinical manifestations of allergic rhinitis

A
  • Watery rhinorrhea
  • nasal congestion
  • itchiness of the nose, eyes, and pharynx
  • watery eyes
  • nasal quality of the voice
  • dry, scratchy throat
  • snoring
  • poor sleep leading to poor performance in school
  • fatigue
25
Q

Clinical manifestations of Pneumonia (RSV, Streptococcus pneumonia, Haemophilus influenza, Mycoplasma pneumonia)

A
  • High fever
  • cough that may be unproductive or productive of white sputum
  • retractions and nasal flaring
  • rapid, shallow respirations
  • report of chest pain
  • adventitious breath sounds (rhonchi, crackles)
  • pale color that progresses to cyanosis
  • irritability, anxiety, agitation, and fatigue
  • abdominal pain, diarrhea, lack of appetite, and vomiting
  • sudden onset, usually following a viral infection (bacterial pneumonia)
26
Q

Clinical manifestations of Croup syndromes: Bacterial epiglottis (acute supraglottitis)

A

MEDICAL EMERGENCY

  • Predictive signs: absence of cough, drooling, and agitation
  • Sitting with chin pointing out, mouth opened, and tongue protruding
  • Dysphonia (hoarseness or difficulty speaking)
  • Dysphagia (difficulty swallowing)
  • Inspiratory stridor (noisy inspirations)
  • Sore throat, high fever, and restlessness
27
Q

Clinical manifestations of Croup syndromes:

Acute laryngotracheobronchitis

A
  • Low-grade fever
  • Restlessness
  • Hoarseness
  • Barky cough
  • Dyspnea
  • Inspiratory stridor
  • Retractions
28
Q

Clinical manifestations of Croup syndromes:

Acute spasmodic laryngitis

A
  • Barky cough
  • Restlessness
  • Difficulty breathing
  • Hoarseness
  • Nighttime episodes of laryngeal obstruction
29
Q

Clinical manifestations of Influenza A and B

A
  • Sudden onset of fever and chills
  • Dry throat and nasal mucosa
  • Dry cough
  • Flushed face
  • Photophobia
  • Myalgia
  • Fatigue
30
Q

Pt centered care of Nasopharyngitis

A
  • Give antibiotic for fever
  • Rest
  • Provide vaporized air (cool mist)
  • Give decongestants for children older than 1 yr
  • Give cough suppressants wit caution (avoid over sedation)
  • Antihistamines are not recommended
  • Antibiotics are not indicated
31
Q

Pt centered care of Bacterial tracheitis

A
  • Adminster oxygen as prescribed
  • Monitor continuous oximetry
  • Administer antipyretics for fever
  • Administer IV antibiotics as prescribed
32
Q

Pt centered care of Bronchitis

A
  • Give antipyretics
  • Give cough suppressant
  • Provide increased humidity (cool mist vaporizer)
33
Q

Pt centered care of Bronchiolitis

A

-Provide humidified oxygen as prescribed
-Monitor continuous oximetry
-Encourage fluid intake if tolerated
-Administer IV fluid intake if tolerated
-Administer IV fluids if oral intake not tolerated
-Suction nasopharynx as needed
-Administer nebulizer bronchodilator
Corticosteroids and antihistamines are not recommended
-Antibiotics are not recommended for RSV
-Chest percussion and postural drainage is not recommended
-Ribavirin administration is controversial

34
Q

Pt centered care of Allergic rhinitis

A
  • Avoid allergens
  • Give antihistamines
  • Give nasal corticosteroids
35
Q

Pt centered care of Pneumonia (viral)

A
  • Administer oxygen with cool mist as prescribed
  • Monitor continuous oximetry
  • Administer antipyretics for fever
  • Monitor intake and output
36
Q

Pt centered care of Pneumonia (bacterial)

A
  • Encourage rest
  • Promote increased oral intake
  • Monitor I&O
  • Administer antipyretics for fever
  • Chest percussion and postural drainage is controversial
  • Administer IV fluids as prescribed
  • Administer oxygen as prescribed
  • Monitor continuous oximetry
  • Administer IV antibiotics as prescribed
37
Q

Pt centered care of Bacterial epiglottitis

A
  • Protect airway
  • Prepare for intubation
  • Provide humidified oxygen
  • Monitor continuous oximetry
  • Administer racemic epinephrine, corticosteroids, and IV fluids as prescribed
  • Administer antibiotic therapy
38
Q

Pt centered care of Acute laryngotracheobronchitis and acute spasmodic laryngitis

A
  • provide humidity with cool mist
  • adminster oxygen if needed
  • monitor continuous oximetry
  • administer nebulized racemic epinephrine, corticosteroids, and IV fluids as prescribed
  • Encourage oral intake if tolerated
39
Q

Pt centered care of Influenza

A
  • Promote increased fluid intake
  • Rest
  • Give medications as prescribed
  • Influenza vaccine- prevention
  • Antipyretic (pain or fever)
40
Q

Pneumothorax

A

accumulation of air in the pleural space

41
Q

Clinical manifestations of pneumothorax and pleural effusion

A
  • dyspnea
  • chest pain
  • back pain
  • labored respirations
  • decreased oxygen saturation
  • tachycardia
42
Q

NSG interventions for pneumothorax and pleural effusion

A
  • prepare for an emergent needle aspiration with insertion of chest tube or closed drainage
  • provide for chest tube management
  • assess respiratory status
  • administer oxygen as prescribed
43
Q

Pleural effusion

A

accumulation of fluid in the pleural space

44
Q

Asthma

A

A chronic inflammatory disorder of the airways that results in intermittent and reversible airflow obstruction of the bronchioles.

45
Q

Intermittent asthma

A
  • Symptoms occur two or fewer times per week
  • No interference with normal activity
  • Uses short-acting B-agonist less than two times per week
46
Q

Mild persistent asthma

A
  • Symptoms occur more than twice a week, but not daily
  • Minor limitations with activity
  • Use of short-acting B agonist more than two days per week but not daily
47
Q

Moderate persistent asthma

A
  • Daily symptoms
  • Some limitations in activity
  • Uses short-acting B-agonist daily
48
Q

Severe persistent asthma

A
  • Symptoms occur continually
  • Limited activity
  • Use short-acting B agonist several times per day
49
Q

Risk factors for asthma

A
  • Family history of asthma
  • Family history of allergies
  • Allergies
50
Q

How to use a peak flow meter

A
  • Ensure the marker is zeroed
  • Have the child stand up straight
  • Close lips tightly around the mouthpiece (ensure the tongue is not occluding)
  • Blow out as hard and quickly as possible
  • Read the number on the meter
  • Repeat two more times (wait at least 30 seconds between attempts)
  • Record highest number
51
Q

Pt education for pts with asthma

A
  • encourage fluids
  • encourage taking oral corticosteroids with food
  • Instruct child to rinse mouth after corticosteroid use
  • Instruct to watch for redness, sores, white patches in the mouth
  • Follow prescription (dosage, tapering off, length of time to take)

Pediatrics ATI (2 decks)

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