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Nursing 3 Exam 3 > Unit 27 Peds Respiratory Disorders > Flashcards

Unit 27 Peds Respiratory Disorders Flashcards

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1
Q

What are the most common cause of illness and death in children?

A

respiratory disorders

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2
Q

What is an indication that you cannot swallow?

A

Drooling

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3
Q

What does grunting with babies indicate?

A

Difficulty breathing, fluid in the lungs

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4
Q

What does stridor indicate?

A

Usually obstruction issue, either swelling or blockage

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5
Q

Describe the pediatric upper respiratory system.

A
  • Obligatory nose breathers if <4 months
  • Eustachian tubes (ear tubes) shorter and more horizontal
  • Epiglottis is large and floppy
  • Trachea shorter
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6
Q

Describe the pediatric lower respiratory system.

A
  • Lack of or insufficient surfactant
  • Faster RR
  • Apnea periods common with newborn
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7
Q

What can cause respiratory compromise?

A 
Upper or lower respiratory infections
Sedative medications
CNS disorders
Musculoskeletal deformities
Congenital anomalies
Aspiration
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8
Q

What are infection preventative teaching measures?

A

-Adequate rest
-Good nutrition
-Good hygiene
(ESPECIALLY HANDWASHING)

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9
Q

What significant past hx could contribute to respiratory disorders?

A
  • Low birth weight/SGA
  • Prematurity
  • Chronic illness, including asthma
  • Previous hospitalization for respiratory illness
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10
Q

Children <6-7 years of age use what kind of breathing?

Children >6-7 years of age use what kind of breathing?

A 
<6-7 = abdominal 
>6-7 = thoracic
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11
Q

What is nasal flaring a sign of?

A

Serious air stuggle

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12
Q

What are some upper airway problems?

A
  • Sinusitis
  • Allergic rhinitis
  • Epistaxis (nose bleeds)
  • Otitis media
  • Tonsilitis
  • Croup
  • Epiglottitis
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13
Q

What are the two types of otitis media?

A

Otitis media Acute

Otitis media w/ Effusion (fluid doesn’t move, no hearing)

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14
Q

What are the symptoms of Otitis media?

A
  • High grade fever
  • Febrile seizure
  • Earache, toddlers may pull on ear, infants may rub ear on things
  • Vomiting, anorexia
  • Irritability, sleep disturbance, persistent crying
  • Otoscope findings: tympanic membrane red and bulging
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15
Q

What are the symptoms of Otitis media with effusion?

A

Tinnitus (ringing in ears)

Conductive hearing loss may occur

Afebrile

Otoscope findings: tympanic membrane dull gray, orange, immobile

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16
Q

What are Otitis media interventions?

A
  • Administer analgesics
  • Administer antibiotics if ordered
  • Promote drainage
  • Promote comfort
  • Encourage fluids
  • Instruct PT about the importance of completing the prescribed medications
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17
Q

Why would you not want want to give something like red jello/anything red to a PT after a tolonectomy?

A

It could be mistaken as blood

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18
Q

What is tonsillitis and the symptoms? What are the

A

Inflammation of tonsils

Symptoms:
Fever
Soar throat
Dysphagia 
Small pus pockets on tonsils
Decreased appetite
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19
Q

What are the nursing interventions for tonsilitis? How about post tonsillectomy?

A
  • Culture to determine viral or bacterial
  • Acetaminophen + Codeine
  • Warm gargle
  • Soft liquid diet
  • Sx if 3-4 cases in past year

Post tonsillectomy:

  • No red food/liquid
  • No milk products (coats throuat which promotes coughing)
  • Monitor for hemmorhage
  • Ice collar, analgesics
20
Q

What is Croup/Acute Laryngotracheobronchitis (LTB) and what is it usually caused by?

A

An upper airway infection that blocks breathing and has a distinctive barking cough.

Usually caused by a virus (slower process)

21
Q

What is croup/LTB management at home?

A
  • Place child in bathroom with hot shower running (steam), followed by blast of cool air
  • Humidifiers
  • Fluids
  • Ibuprofen
22
Q

What is Croup/LTB management in a hospital?

A
  • Assess and monitor ABC’s
  • High flow humidified O2
  • Limit exam/handling to avoid agitation
  • DO NOT place instruments near mouth or throat
  • Be prepared for respiratory arrest and CPR
  • Administer steroids as ordered
23
Q

What is Epiglottitis?

A

Acute inflammation and swelling of the epiglottis and upper respiratory structures caused by BACTERIA H.influenza (not a virus) or strains of strep and staph.

  • Secretions pool and child unable to swallow
  • True medical emergency (happens quickly)
24
Q

What are the defining characteristics of Epiglottitis?

A

The four D’s

Drooling
Dysphagia
Dysphonia (difficulty speaking)
Distressed respiratory efforts

25
Q

What is the management for Epiglottitis?

A
  • Assess and monitor ABC’s, oxygen saturation
  • Have child sit up
  • Maintain patent airway
  • High flow humidified O2; “blow by” if child won’t tolerate mask
  • Artificial airway may be necessary
  • Administer antibiotics
  • Epinephrine may be required
  • Limit examinations/handling to avoid agitation
  • Be prepared for respiratory arrest, assist ventilations and/or CPR
26
Q

What are some lower respiratory problems?

A 
Bronchitis 
Bronchiolitis (Respiratory syncytial virus)*
Pneumonia
Pertussis (whooping cough) 
Tuberculosis
Asthma*
Cystic Fibrosis*
Sudden Infant Death Syndrome (SIDS)*
27
Q

What is Bronchiolitis? How is it Dx’d?

A
  • Respiratory infection of bronchioles
  • Occurs in early childhood (younger than 1 year)
  • Caused by VIRAL infection
  • Dx by nasal swab
28
Q

What is the most common cause of Bronchiolitis and (pneumonia)?

A

Respiratory syncytial virus (RSV)

Most children recover in 8-15 days

29
Q

What are the manifestations of Bronchiolitis/RSV?

A
  • Acute respiratory distress
  • Tachypnea
  • May have intercostal retraction
  • Nasal flaring
  • Cyanosis
  • Fever and dry cough
  • May have inspiratory and expiratory wheezes
  • Nasal disharge
30
Q

What is the management for Bronchiolitis/RSV?

A
  • Assess and maintain airway
  • Clear nasal passages if necessary
  • IV LR or NS
  • Contact precautions
  • Intubate if airway management becomes difficult or fails

(High risk infants also receive RSV immunoglobulin Respigam)

31
Q

What is Sudden Infant Death Syndrome? (SIDS)

A

Sudden and unexplained death of a seemingly healthy baby

Most SIDS deaths usually occur in children between 2-4 months old

32
Q

What are the two chronic lower airway problems discussed?

A

Asthma

Cystic fibrosis

33
Q

What is Asthma?

A

Chronic reoccurring lower airway disease with episodic attacks of bronchial constriction

34
Q

What are possible causative factors for asthma?

A 
Dietary habits
Time indoors
Energy efficient homes
Decrease in breastfeeding
Survival of Low birth weight babies
35
Q

What are physical assessments of asthma?

A

Tripod-ing

SOB, shallow irregular respirations

Pale, cyanotic, cherry red lips

Restless and scarred

Non productive cough

Wheezing

36
Q

What are the manifestations of status asthmaticus?

A

Sweating profusely

Insists on sitting upright

Severe respiratory distress

Bronchospasm

Hypoxic

(All of symptoms of asthma)

37
Q

What is the management of Asthma in a hospital?

A
  • Administer bronchodilators
  • Administer corticosteroids
  • Assess and monitor ABC’s
  • Apply O2
  • Provide IV LR or NS
  • Assess Pulse ox
  • Intubate if airway management becomes difficult or fails
38
Q

What is cystic fibrosis?

A
  • Multisystem disorder effecting exocrine glands
  • A chronic, sometimes fatal disease
  • Deletion of chromosome 7

Tenacious amounts of mucus that leads to the obstruction of small passageways of the bronchioles, small intestines, and pancreatic and bile ducts.

39
Q

What is the best way to Dx Cystic Fibrosis? (and other exams as well)

A

**Sweat test is the best way to diagnose CF

Other exams include:
72 hr fecal fat
Family hx of CF or positive newborn blood screening
Sputum culture
Prenatal chorionic villi sampling
Liver enzymes
40
Q

What are the manifestations of CF?

A
  • Recurrent respiratory infections
  • Use of accessory muscles, nasal flaring
  • Productive cough
  • Barrel chest
  • CHF
  • Deficiencies in fat soluble vitamins
  • Salty taste of skin due to high concentrations of sodium and chloride in sweat.
41
Q

What are CF interventions?

A
  • Promote airway clearance and gas exchange
  • Administer bronchodilators, antibiotics (inhaled and systemic)
  • Perform chest physical therapy
  • Promote cough
  • Administer IV and PO fluids as ordered
  • Assess VS
  • Monitor WBCs
  • Assess color, odor, amount of sputum.
42
Q

What is a medication that you would NOT give to someone with CF?

A

Robitussin becomes it would suppress coughing

think about what’d it’d do to someone with CF

43
Q

How would you prevent complications of CF?

A
  • Teach WITH diet/meals to administer pancreatic enzymes!
  • No dairy
  • Good hand washing
  • Take antibiotics and do pulmonary hygiene as ordered
  • Keep immunizations up to date
44
Q

What are antibiotics for respiratory disorders?

A

Penicillins - used commonly for ear infections

Macrolides - used when PT has Penicillin allergy

Cephalosporins- also used in ear infections, often 2nd line

45
Q

What would alert the nurse to post operative tonsillectomy hemorrhage?

A

Frequent swallowing

Nursing 3 Exam 3 (8 decks)

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