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NUR259 - 2016 > Week 10 > Flashcards

Week 10 Flashcards

1
Q

What are some signs of respiratory obstruction?

A
  • inspiration stridor (upper respiratory)
  • hoarse voice
  • expiratory wheeze (lower respiratory)
  • drooling
  • restlessness
  • mottled colour (cool and blueish)
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2
Q

What is Obstructive Sleep Apnoea (OSA)?

A
  • it is a significant upper airway obstruction resulting in oxygen desaturation &/or sleep fragmentation.
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3
Q

What are signs of respiratory distress?

A
  • nasal flaring
  • head bobbing
  • tachycardia
  • grunting
  • tripod position
  • tracheal tug
  • accessory muscle use
  • tachyponea
  • intercostal, subcostal or sternal recessions
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4
Q

In a Pediatric respiratory Assessment what are we assessing?

A
  • ABCD
  • airway
  • breathing
  • circulation
  • disability
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5
Q

What is asthma?

A

Asthma is a chronic disorder characterised by bronchial constriction, hyper-responsive airways and airway inflammation

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6
Q

List some triggers for asthma

A
  • allergy
  • food additives
  • viral upper and lower respiratory infection
  • drugs(NSAID)
  • exercise
  • environmental (pollution, smoking…)
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7
Q

What are some clinical manifestations for asthma?

A

-rapid laboured respiration so
-nasal flaring
-intercostal recessions
-accessory muscle use
-productive cough
-decreased air movement
-respiratory wheeze
-child may complain of chest tightness
-anxiety
-prolonged expiratory phase
-

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8
Q

What focused assessments would we be conducting on a child with asthma?

A
  • checking vital signs
  • working of breathing
  • ability to talk - sentences, phrases, single words
  • chest examination
  • chest auscultation
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9
Q

What is hypoxia and how would it present in a child?

A
  • Hypoxia is a lower than normal amount of oxygen in the tissues.
  • Can present as behaviours from wide eyed agitation to lethargic irritability in a child.
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10
Q

What does an Asthma Management Plan outline?

A
  • what medication to take every day (even if pt is feeling well)
  • how to tell if their asthma is getting worse
  • what the pt should do if their symptoms are getting worse
  • what to do if the pt has an asthma attack.
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11
Q

What is Cystic Fibrosis and what changes can occur to the body systems?

A
  • CF is a common inherited autosomal recessive disorder of the endocrine glands
  • it can lead to changes in the respiratory, GI and reproductive systems.
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12
Q

What is the treatment for Cystic Fibrosis?

A
  • chest physiotherapy 1-3 times a daily to facilitate the removal of secretions from the lungs
  • frequent prolonged courses of antibiotics for infections may be prescribed to improve pulmonary function, exercise tolerance and “quality of life”
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13
Q

What are some differences of a paediatric airway?

A
  • large head and short neck
  • large tongue
  • narrow nostrils- compressible floor of mouth
  • horse-shoe shaped epiglottis
  • high anterior larynx
  • short soft trachea
  • loose teeth
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14
Q

What is the paediatric airway position for an infant below 12 months of age?

A

The neutral head position.

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15
Q

What is the paediatric airway position for a small child 1-8 years of age?

A

The sniffing position

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16
Q

What is the paediatric airway position for a larger child that is 9 years and above?

A

The backwards head tilt with pistol grip

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17
Q

What are you look, listening and feeling for in relation to breathing?

A 
Look= at the rise and fall of the chest; Symmetry
Listen = for breath sounds
Feel = breath on your cheek
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18
Q

What is the choking management plan for a conscious child that is NOT coughing?

A
  • 5 back blows between the shoulder blades
  • assess for foreign body
  • 5 chest thrusts
  • assess for foreign bodies
19
Q

What is the choking management for a child that is not coughing and is unconscious?

A
  • open airway
  • 2 rescue breaths
  • CPR 15:2
20
Q

What is the choking management for a child that is coughing?

A

Encourage coughing until clear foreign body

21
Q

The four main symptoms of asthma are?

A

1) wheeze
2) SOB
3) cough
4) chest tightness

22
Q

The narrowing of the airways in an asthma attack is caused by?

A
  1. smooth muscle contraction of the airways
  2. mucosal oedema
  3. increased mucus secretions
23
Q

List the 3 changes that take place in the airways during an asthma attack:

A
  • bronchospasm
  • inflammation of the bronchial mucosa
  • increased bronchial secretions
24
Q

A child presents with an acute episode of asthma. Describe the signs and symptoms of an acute asthma attack?

A
  • pale with flushed cheeks and ears
  • tripod stance
  • mouth breathing
  • nasal flaring
  • use of accessory muscles
  • recession
  • cycanosis
  • anxious facial expression
25
Which of the above signs would alert you to impending respiratory failure in a child with an acute asthma attack?
cyanosis pale flushed cheeks recession accessory muscle use
26
Name 2 common pathogens that cause respiratory illness in infants and children?
- adenovirus influenza | - respiratory syncytial virus human metapneumovirus
27
List two different methods of supplying an infant with oxygen
- nasal prongs | - headbox
28
What four signs are you observing for when assessing respiratory status?
- oxygen saturation - respiratory rate - HR - degree of respiratory effort
29
4. What is the normal range of oxygen saturation in an infant or child?
92-100%
30
Name three tests which may diagnose a respiratory illness
- Post Nasal Aspirate (PNA) - chest xray (CXR) - sputum sample
31
What is the difference between aerosol and droplet transmission?
Aerosols are much smaller than droplets, therefore are more easily spread and may be suspended in the air for much longer.
32
Name four differences between children’s and adults respiratory tracts.
- smaller in size - narrower airways - have shorter necks - have larger tonsils in proportion to their mouths
33
What infection control precautions would you take with a child with a respiratory illness?
Isolate in single room, send samples in sealed containers with sealed biohazard bag
34
Nasal prongs are used to deliver oxygen for infants, children, adolescents and adults. List the oxygen you would administer to each.
Infants- up to 2.5L children- up to 3L adolescents- up to 4L adults- up to 6L
35
what is a headbox used for?
a headbox is used to provide high concentrations of oxygen for infants under the age of 12 months who require more than 2.5L of oxygen.
36
Headbox sizes come in neonatal, small and large. How much flow of gas would be required for each size?
Neonatal=8L Small=12L Large=15L
37
What type of lung sounds would you expect to hear in a child with bronchiolitis?
Expiratory wheeze and occasionally crackles
38
When inspecting respiratory effort what are you observing for?
- recession - tracheal tug - abdominal breathing - use of accessory muscles - nasal flaring - colour - degree of restlessness - conscious state - ability to speak ie in words or sentences
39
What are the signs of severe respiratory effort?
- unable to feed - severe respiratory distress with marked chest retractions, nasal flaring and grunting - RR >60 - may appear tired - may hypoxaemia which may not be corrected with oxygen
40
How often should an oxygen analyser be calibrated and what is the oxygen percentage of room air?
once a shift | RA is 21% oxygen
41
List the equipment required for a headbox
- appropriate size headbox - greeb oxygen tubing - red air tubing - Y connector for tubing
42
What is the minimum frequency of observations whilst a child is receiving oxygen therapy
minimum of hourly observations but may be more frequent if required
43
Describe the signs that would lead you to consider ceasing oral feeds in an infant with respiratory distress?
- unable to maintain 2/3 of usual oral intake - decreased urine output - fatigue - excessive cough - vomiting - tachypnoea - increased respiratory effort
44
when would you make a MET call and how would you do this?
when your child needs an urgent review and the consulting medical team is unable to be reached. Press button, dial number and state MET call ward___ phone___

NUR259 - 2016 (13 decks)

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