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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
Q

Which of the above signs would alert you to impending respiratory failure in a child with an acute asthma attack?

A

cyanosis
pale flushed cheeks
recession
accessory muscle use

26
Q

Name 2 common pathogens that cause respiratory illness in infants and children?

A
  • adenovirus influenza

- respiratory syncytial virus human metapneumovirus

27
Q

List two different methods of supplying an infant with oxygen

A
  • nasal prongs

- headbox

28
Q

What four signs are you observing for when assessing respiratory status?

A
  • oxygen saturation
  • respiratory rate
  • HR
  • degree of respiratory effort
29
Q
  1. What is the normal range of oxygen saturation in an infant or child?
A

92-100%

30
Q

Name three tests which may diagnose a respiratory illness

A
  • Post Nasal Aspirate (PNA)
  • chest xray (CXR)
  • sputum sample
31
Q

What is the difference between aerosol and droplet transmission?

A

Aerosols are much smaller than droplets, therefore are more easily spread and may be suspended in the air for much longer.

32
Q

Name four differences between children’s and adults respiratory tracts.

A
  • smaller in size
  • narrower airways
  • have shorter necks
  • have larger tonsils in proportion to their mouths
33
Q

What infection control precautions would you take with a child with a respiratory illness?

A

Isolate in single room, send samples in sealed containers with sealed biohazard bag

34
Q

Nasal prongs are used to deliver oxygen for infants, children, adolescents and adults. List the oxygen you would administer to each.

A

Infants- up to 2.5L
children- up to 3L
adolescents- up to 4L
adults- up to 6L

35
Q

what is a headbox used for?

A

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
Q

Headbox sizes come in neonatal, small and large. How much flow of gas would be required for each size?

A

Neonatal=8L
Small=12L
Large=15L

37
Q

What type of lung sounds would you expect to hear in a child with bronchiolitis?

A

Expiratory wheeze and occasionally crackles

38
Q

When inspecting respiratory effort what are you observing for?

A
  • 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
Q

What are the signs of severe respiratory effort?

A
  • 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
Q

How often should an oxygen analyser be calibrated and what is the oxygen percentage of room air?

A

once a shift

RA is 21% oxygen

41
Q

List the equipment required for a headbox

A
  • appropriate size headbox
  • greeb oxygen tubing
  • red air tubing
  • Y connector for tubing
42
Q

What is the minimum frequency of observations whilst a child is receiving oxygen therapy

A

minimum of hourly observations but may be more frequent if required

43
Q

Describe the signs that would lead you to consider ceasing oral feeds in an infant with respiratory distress?

A
  • unable to maintain 2/3 of usual oral intake
  • decreased urine output
  • fatigue
  • excessive cough
  • vomiting
  • tachypnoea
  • increased respiratory effort
44
Q

when would you make a MET call and how would you do this?

A

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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