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Nur 4410 Peds Exam #1 > Unit II > Flashcards

Unit II Flashcards

1
Q
  • Fluid is squeezed from the lungs of the fetus during the birthing process
  • Respiratory center in medulla is stimulated to initiate breathing
  • Decrease of oxygen and increase of carbon dioxide in blood also stimulates respiratory center
A

process of birth

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2
Q

physiological differences btwn pediatric and adult lung

A
  • Bronchi and bronchioles much smaller – airway of an infant is about the size of a cat’s airway
  • Fewer alveoli
  • Eustachian tubes shorter & more horizontal
  • Tonsils and lymphoid tissue enlarged
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3
Q

how do neonates breathe?

A

through nose

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4
Q

difference between children and adults with oxygenation

A
  • Narrower airways increase airway resistance
  • Infant airways have less cartilage
  • Infants have less respiratory mucus
  • Increased respiratory & metabolic rates increase need for oxygen
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5
Q

Cardinal signs of respiratory distress in children

A
  • Restlessness
  • Increased respiratory rate
  • Increased pulse rate
  • Retractions
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6
Q

WET FROG

A
  • Wheezing
  • Effort
  • Tachypnea
  • Flaring (nasal)
  • Retractions
  • Oxygenation
  • Grunting
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7
Q

Medications for Respiratory:

A
  • Bronchodilators
  • Corticosteroids
  • Non-steroidal anti-inflammatories
  • Diuretics
  • Mucolytics
  • Antibiotics
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8
Q

malformation of structures in nose

A

choanal atresia

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9
Q

failure of esophagus to develop, leading to a blind pouch

A

esophageal atresia

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10
Q

abnormal communication between trachea & esophagus

A

tracheoesophageal fistula

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11
Q
  • multisystem disorder of exocrine glands, leading to increased production of thick mucus – mucus is about 3x as thick as a health person’s mucus
  • Autosomal recessive trait
  • Affects bronchioles, small intestines, pancreatic & bile ducts
  • Chronic use of accessory muscles leads to development of barrel chest
A

Cystic Fibrosis

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12
Q

diagnosis of cysctic fibrosis

A

sweat test

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13
Q

Evaluate Cystic Fibrosis

A
  • Family ability to follow home care regimen
  • Child gains weight consistently
  • Child participates in self care
  • Child demonstrates ability to clear secretions, keep sats >94%
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14
Q

Nursing care for Cystic Fibrosis

A
  • Monitor for respiratory distress
  • Encourage coughing and deep breathing
  • Administer meds
  • Provide high calorie, high protein diet
  • Give pancreatic enzymes
  • Administer fat-soluble vitamins
  • Avoid pulmonary treatments immediately after meals
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15
Q

chronic obstructive pulmonary disease occurring in infants after prolonged oxygen therapy and mechanical ventilation

A

Bronchopulmonary Dysplasia

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16
Q
  • chronic inflammatory disorder of airways, characterized by hyper-reactivity to stimuli which results in spasms of bronchial muscles –>resultingin increased respiratory effort and increased airway resistance
  • Bronchial smooth muscle constricts, edema in the lower airways and production of thick mucus increases.
  • Expiration is impaired
A

Asthma

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17
Q

Diagnosis of Asthma:

A
  • Reversible airway constriction (Pulmonary function tests) 20% improvement after bronchodilator administration
  • Chest x-ray
  • Presence of wheezing and dry cough
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18
Q

Viral infection causing inflammation, edema and narrowing of the larynx, trachea and bronchi; usually preceded by a recent upper respiratory infection.

A

Acute laryngotracheobronchitis (LTB) or Croup

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19
Q

What is Acute laryngotracheobronchitis (LTB) or Croup is caused by

A

parainfluenzae virus, influenza A & B, RSV and mycoplasma pneumonia (or many other respiratory viruses)

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20
Q

Acute laryngotracheobronchitis (LTB) or Croup is characterized by:

A

stridor, barking cough, use of accessory muscles, and low-grade fever (occasionally)

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21
Q

In acute laryngotracheobronchitis how do you decrease airway swelling quickly

A

administer racemic epinepherine

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22
Q

what can you administer to decrease inflammation and edema (longer acting) in respiratory problems

A

corticosteroids

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23
Q

what is the cardinal sign of pertussis?

A

paroxysmal cough, which causes bradypnea and bradycardia

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24
Q

what causes pertussis

A

bordatella pertussis

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25
Q

how is pertussis transmitted?

A

droplet, child/adult to a neonate

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26
Q

who is the most vulnerable population for pertussis

A

birth-2months

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27
Q

what does DtaP prevent, when is it given?

A

Pertussis, 2mo

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28
Q

inflammation of the bronchioles, Caused by a respiratory virus, most common from October – May every year, RSV is most common virus, symptomatic care

A

bronchiolitis

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29
Q

viral vs. bacterial, antibiotics may be necessary for improvement, most often occurs secondary to a respiratory illness

A

pneumonia

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30
Q

inflammation of the epiglottis, characterized by tripod positioning and child drooling

A

epiglottitis

31
Q

inflammation of tonsils, most commonly caused by Strep or respiratory viruses

A

tonsillitis

32
Q

What do you do to prevent food particles from entering trach tube whie feeding?

A

cloth bib over trach

33
Q

how to bathe a child with a trach tube

A

baths, make sure to keep water from entering tube, showers not recommended

34
Q

what is a cause of tracheal spasms

A

strong wind and cold, cover loosely to prevent

35
Q

what can you use to clean around trach tube daily?

A

half strength saline and hydrogen peroxide and cotton-tipped applicators

36
Q

how often do you change trach ties?

A

weekly

37
Q

pulmonic valve

A

R. Ventricle to Pulmonary Artery

38
Q

aortic valve

A

left ventricle to aorta

39
Q

tricuspid valve

A

right atrium to right ventricle

40
Q

mitral valve

A

left atrium to left ventricle

41
Q

umbilical vein carries oxygenated blood from placenta to fetus, bypassing the liver. After the umbilical cord is clamped, ductus venosus closes and blood flows through the liver.

A

ductus venosus

42
Q

systemic blood enters right atrium; oxygenated blood flows from right to left atria through the foramen ovale, bypassing the lungs.

A

foramen ovale

43
Q

fistula between aorta and pulmonary artery allowing for mixing of blood

A

ductus arteriosus

44
Q

oxygen is bound to hemoglobin on?

A

RBCs

45
Q

Cardiac output is dependent on heart rate until child is how old?

A

5years old

46
Q
  • Heart conditions that do not cause deoxygenation or low oxygenation levels; skin and mucus membrane color is normally pink.
  • Blood shunts from L  R
  • Pressure in left side of heart greater than right side
  • Many of the septal defects close spontaneously on their own.
A

Acyanotic defects

47
Q
  • dyspnea, fatigue, poor growth, increased pulmonary blood flow.
  • L to R shunting leads to hypertrophy in right side of heart; this in turn can lead to congestive heart failure
  • Loud harsh murmur
A

Ventricular Septal Defect, most common defect

48
Q
  • foramen ovale fails to close - sometimes more of the atrial wall is missing
  • L to R shunting
  • Loud harsh murmur
A

Atrial Septal Defect

49
Q
  • Normal in fetal circulation
  • Fails to close after birth
  • Results in increased pulmonary blood flow (L to R shunt)
  • Machine-like murmur
  • Wide pulse pressure
  • Bounding pulses
A

Patent Ductus Arteriosus

50
Q
  • Narrowing of aortic valve
  • Infantile symptoms: faint pulses, hypotension, tachycardia, intolerance to feeding
  • Symptoms in children: intolerance to activity, dizziness, chest pain, possible ejection murmur
A

Aortic Stenosis

51
Q
  • Narrowing of the pulmonary valve/artery
  • Results in obstructed outflow from the right ventricle
  • Variable cyanosis
  • Systolic ejection murmur
A

Pulmonary Stenosis

52
Q
  • A narrowing of the descending aorta; restricts blood flow leaving the heart
  • Obstructive Lesion
A

Coarctation of the Aorta

53
Q
A
54
Q

Symptoms:

  • Blood pressure higher in upper extremities than lower extremities
  • Upper pulses full, lower pulses weak
A

Coarctation of the Aorta

55
Q

Management of symptoms of congestive heart failure:

A
  • Furosemide
  • Digoxin
  • Ultimately, if the child is symptomatic and the defects fail to close on their own, surgery will be warranted.
  • Child will require prophylactic antibiotics for any surgery or dental work
56
Q
  • Heart conditions that cause blood to contain less oxygen than required
  • Skin and mucus membranes are usually bluish gray in color.
  • R  L shunting of blood means that unoxygenated blood mixes in with oxygenated blood and pumped throughout the body.
A

Cyanotic Heart Defects

57
Q

Classic signs of cyanotic heart defects:

A

polycythemia, clubbed fingers, cyanosis of mucus membranes

58
Q
  • Aorta is connected to R ventricle instead of L
  • Pulmonary artery is connected to L ventricle instead of R or a PDA must be present to oxygenate blood
  • Variable cyanosis depending on size of defect
  • Murmur
A

Transposition of Great Arteries

59
Q

defect allows pooling of blood from left and right ventricles

A

ventricular septal defect

60
Q

prevents blood in right ventricle from getting to lungs

A

pulmonic stenosis

61
Q

causes pressure in right ventricle to be greater than that in left ventricle

A

Right Ventricular Hypertrophy

62
Q

allows unoxygenated blood to be transferred all over the body

A

Displacement of aorta over ventricular septal defect

63
Q

Classic symptoms of Tetrology of Fallot

A
  • “Tet” spell caused by exertion; mucus membranes and extremities turn blue,
  • Children will draw their legs up to their chest to improve blood flow.
64
Q
  • Complete closure of tricuspid valve resulting in mixed blood flow
  • An ASD needs to be present to allow blood to enter L atrium
A

Tricuspid Atresia

65
Q

Symptoms:

  • Infant: cyanosis, dyspnea, tachycardia
  • Children: hypoxemia, clubbing
A

Tricuspid Atresia

66
Q
  • Failure of septum formation
  • Results in single vessel coming off of ventricles
A

Truncus Arteriosis

67
Q

Symptoms:

  • Murmur
  • Heart failure
  • Variable cyanosis
  • Delayed growth
  • Fatigue
  • Poor feeding to FTT
A

Truncus Arteriosis

68
Q
  • L side of heart is underdeveloped
  • An ASD or PFO allows for oxygenation of blood
A

Hypoplastic Left Heart Syndrome

69
Q

Symptoms:

  • Cyanosis (mild)
  • Heart failure
  • Lethargy
  • Cool extremities
  • Demise once PDA closes
  • Needs surgery quickly
A

Hypoplastic Left Heart Syndrome

70
Q
  • Inflammatory disease resulting from a GABHS infection in throat
  • Occurs 2-6 weeks following an untreated or partially treated GABHS infection
A

Rheumatic Fever

71
Q

Symptoms: macular rash on trunk (erythema marginatum), polyarthritis, cardiac involvement, CNS involvement

A

Rheumatic Fever

72
Q

Treatment for Rheumatic Fever

A

long term antibiotic therapy

73
Q
  • Acute systemic vasculitis – especially cardiac (think aneurysms!)
  • Acute phase: onset of high fever that is unresponsive to antipyretics along with other symptoms (rash, strawberry tongue, hand/feet swelling, joint pain)
  • Subacute phase: fever resolves, irritability, peeling skin around nails, palms and soles
  • Convalescent: no clinical manifestations
  • Resolves in 6-8 weeks from onset
A

Kawasaki Disease

74
Q
A

Kawasaki’s Disease

Nur 4410 Peds Exam #1 (4 decks)

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