week 2 : gas exchange pediatrics: resp disorders

Question 1

nursing care for any respiratory disorder:
easing respiratory efforts: what undergoes this

Answer 1

can usually be managed at home
running a steamy shower ( 10-15 mins )

Question 2

true or false. hot steam or cool mist vaporizers are recommended for easing respiratory efforts

Answer 2

false, it is not.

Question 3

true or false. encourage quiet play, rest is something to do.

Answer 3

yes this is true

Question 4

what undergoes promoting cofort for a ped pt who happens to have a resp disorder ?

Answer 4

clear nasal secretions with saline drops, bulb suction
bulb suction
medicated drops not if < 6 years
if >6 years no more that 2-3 days

Question 5

reducing temperature is also a must, what undergoes this category?

Answer 5

monitor temp
acetaminophen or ibuprofen as directed ( do not ever give aspirin )
cool liquids to prevent dehydration ( losing a lot due to diaphoresis )

Question 6

what undergoes dehydration

Answer 6

asses s & s
observe frequency and color of voids
count diapers ( home, ) weigh diapers ( hospital )
continue breastfeeding if pssible
oral rehydration fluids- pedialyte

Question 7

true or false. it is important to not force food , only give what they can eat. ( popsicles, pudding, soup )

Answer 7

true

Question 8

what are signs of a dehydrated baby

Answer 8

rapid breathing
increased heart rate
restlessness and or irritability
lethargy/weakness
poor skin turgor ( pinching a fold of skin at the abdomen results in it returning slowly to normal )

Question 9

define if these are a sign of a dehydrated baby
sunken fontanelle
sunken eyes
lack of tears when crying
wants to drink a lot of water ( but may vomit )
excessive thrist
decreased urine output

Answer 9

all

Question 10

infants/babies- indicated by no wet diapers in 6-8 hrs eriof or diapers with a little dark - yellow urine
toddlers/older children very little-dark yellow urine
is typically what we see in a dehydrated baby.

Answer 10

true

Question 11

what is a bronciolitis

Answer 11

a common vital illness most often caused by respiratory synctial virus

Question 12

how are broncholiotis transmitted ?

Answer 12

by exposure to contaminated secretions. can live on fomitesseveral hrs and hands for 30 mins

Question 13

where does broncholiotis start?

Answer 13

starts with upper airway and moves to lower airway

Question 14

how are bronchiolitis characterized by

Answer 14

acute inflammation of airways, bronchospasm, and increased mucus production

Question 15

when does bronchiolitis usually occurs?

Answer 15

typically occurs during late fall and winter months ( rsv season )

Question 16

when does incubation occur for bronchiolitis infant pts?

Answer 16

5-8 days after contact

Question 17

what is a fomite?

Answer 17

a surface that carries bacteria

Question 18

what causes destruction?

Answer 18

the mucous is causing some destruction,preventing from normal breathing, this is contagious by contaminated excretion

Question 19

what are some initial signs and symptoms of bronchiolitis

Answer 19

rhinorrhea
pharyngitis
coughing/sneezing
wheezing
possible ear or eye drainage
intermittent fever

Question 20

what is rhinorrhea

Answer 20

runny nose

Question 21

what is pharyngitis

Answer 21

inflammation of the pharynx ( throat )

Question 22

true or false. the more coughing and more wheezing the more complex it gets

Answer 22

true

Question 23

with progression of illness of bronchiliotis what happens?

Answer 23

increased coughing and wheezing
tatchypnea and restractions
cyanosis

Question 24

what happens during severe illness of broncholiotis

Answer 24

tatchypnea greater tan 70/min
listlessnes ( lethargic & lazy ) not wanting to participate
apneic cells –> periods of not breathing
poor air exchange, decreased breath sounds

Question 25

what are the ped resp rate that are considered normals premature 0-3 months 3-6 months 6-12 months

Answer 25

1) 40-70 2)30-60 3)30-45 4)25-40

Question 26

what are the ped resp rate that are considered normals 1-3 year 3-6 year 6-12 year 12+ year

Answer 26

1) 20-30 2)20-25 3)14-22 4)12-18

Question 27

how do they distinguish that a baby has a rsv

Answer 27

they swab nasal secretion- thats how they distinguish that a baby has rsv

Question 28

rsv - nursing care what undergoes this

Answer 28

* If resp distress or poor hydration will be hospitalized * Assign to separate rooms or grouped with other RSV patients * Droplet, contact and routine precautions (gloves, mask, gown)

Question 29

true or false. these are important when it comes to rsv- nursing care * O2 to keep sats >90 (Humidified via N/C, mask, hood) * Clear secretions * Superficial suctioning in (hosp) * Bulb suction (at home) Oxygen

Answer 29

true

Question 30

true or false. a lot of nasal secretion may benefit from this - superficially into the nare to get rid of some of that secretion before feeding is best

Answer 30

true

Question 31

rsv- nursing care, what type of medications are we giving?

Answer 31

medication ◦ Nebulized Epinepherine ? ◦ Tylenol ◦ No abx - viral ◦ No OTC decongestants, cough/cold meds, etc. ◦ nosteroids

Question 32

is it important for an rsv to be hydrated? if so what do we check or do ?

Answer 32

yes Hydration ◦ Hydration!!! Check skin turgor, U/O ◦ Encourage Breastfeeding if tolerated ◦ Suction before feedings ◦ Small frequent as tolerated ◦ IV fluids or NG feeds

Question 33

signs of dehydration what do we do?

Answer 33

always encourage feeding ( may go iv or ng tube )

Question 34

prevention of rsv

Answer 34

monoclonal antibody : palivizumab

Question 35

is monoclonal antibody palivizumab an actual vaccine?

Answer 35

not a rue vaccine offers passive protection antibody activates the immune system

Question 36

monoclonal antibody is a annual injection

Answer 36

no monthly

Question 37

which type of babies are monoclonal antibody given to

Answer 37

given to high risk babies ( underlying medical conditions that weaken immune system )

Question 38

potential complications of rsv ( otitis media what is it?

Answer 38

fluid/inflammation of middle ear common to children < 2 years majority of OM infectios preceded by rsv

Question 39

true or false. chronic OM can cause hearing impairment. difficulties communicating

Answer 39

true

Question 40

potential complications of rsv: otis media S & S

Answer 40

abrupt onset - earache -fever -purulent discharge if becomes chronic can cause hearing impairment

Question 41

is this true : this is painful - babies are more cranky children are more common, inflammation of the middle ear with fluid there ( so much pressure it could rupture )

Answer 41

true

Question 42

Om- treatment and nursing care what are our goals?

Answer 42

relieving pain, facilitating drainage of fluid, preventing complications or recurrence, provide support to child and family

Question 43

what are the treatment for most om: are abx required

Answer 43

no abx are not required, for severe OM the abx required is amocillin

Question 44

how do we manage pain and fever for om

Answer 44

analgesics/antipyretics ( ibu or acetaminophen )

Question 45

how do we facilitate drainage for om?

Answer 45

cotton balls, sterile cotton swabs

Question 46

om- tx and nursing care surgical intervention to drain fluid decrease pain

Answer 46

myringotomy- surgical of eardrum - decrease pain pressure equalizer tubes. tympanoplasty tubes - allows continous drainage

Question 47

how do we prevent om?

Answer 47

prevention - rpoutine immunization with pneumococcal vaccine ( the bug can cause om so it is suggested to get this vaccine )

Question 48

why do we not want to prescribe to antibiotics ?

Answer 48

doesnt want children to be immune to abx

Question 49

potential complications of rsv: laryngobronchitis what is it "?

Answer 49

inflammation of larynx and tranchea and bronchi viral ( most ) can be bacterial ( tissue is inflated )

Question 50

what are the signs and symptoms of laryngobronchitis ( croup )

Answer 50

hoarse voice, milf fever, restless, irritable cough ( barking seal ) stridor " darth vader: inhaaltion sound ( harsh and raspy = inspiratory wheeze )

Question 51

are these true about laryngobronchitis ( croup ) progressive breathing difficulty as the air passages narrow- risk for obstruction - increased rr, nasal flaring, restrations cyanosis

Answer 51

true

Question 52

what would you do if you start hearing stridor ?

Answer 52

take the patient to the hospital

Question 53

If mild croup ( no stridor on inhalation ) , what does this mean ?

Answer 53

this can be managed at home - teach parents to closely monitor breathing ( esp at night ) and seek medical attention if labored respirations or stridor, night air seems to behelpful

Question 54

if more severe will be hospitalized, vigilant assesment/observation by nurse for worsening symptoms such as

Answer 54

02, pulse oximetry, oral fluids, iv oral steroids ( dexamethasone ) im or iv if cant be tolerate po nebulized epinephrine

Question 55

true or false. giving abx is rare when a baby has a corup?

Answer 55

yes this si true

Question 56

true or false. parent should remain with child as much as possible, hold on lap during tx.

Answer 56

true

Question 57

what could possible happen when an infant has a croup?

Answer 57

possible intubation, be ready for emergencies as this can lead to destruction so intubation is a must

Question 58

where does the intubation goes ?

Answer 58

go in through the mouth and then through the larynx , tranchea, and then ventilate and regulate

Question 59

what is this describing : requiring of symptom and constriction of bronchioles

Answer 59

asthma

Question 60

what is asthma, ( explain )

Answer 60

chronic pulmonary disorder causes inflammation bronchiole constriction mucus hyper secretion OBSTRUCTION

Question 61

what age is common for asthma to be hospitalized

Answer 61

hospitalized common < 5 years

Question 62

true or false. asthma is life threatening if not controlled.

Answer 62

true

Question 63

what are the classic s&s for asthma

Answer 63

recurrent episodes of wheezing, breathlessness, chest tightness, and cough, especially at night or in the early morning

Question 64

recall that recurrent episodes of wheezing, breathlessness, chest tightness, and cough, especially at night or in the early morning are a part of the classic s & s of asthma what else?

Answer 64

restlessness, agitation common, may experience itching ( on front og the neck and chest ) prior to attack

Question 65

what would be a warning sign of asthma ?

Answer 65

if they become hypoxic- restless and agitated ( itchiness prior to having an attack )

Question 66

asthma therapeutic management ( long term ) what are out goals ?

Answer 66

maintian normla activity, normal pulmonary function, prevent symtoms and reccurent exacerbations

Question 67

true or false. we do not want kids to participate in family school activities and sports as this can cause exhaustion

Answer 67

false, we still want them to be involved.

Question 68

how will our goals with asthma therapeutic management ( long term ) be accomplished ?

Answer 68

*Regular HCP visits (1-6 mths), Prevent exacerbations (avoid triggers), use meds as prescribed and adjust when needed * Pulmonary Function tests done to assess for changes *Encourage activity and exercise and teach how to manage

Question 69

these are encouraged for out goals to be accomplished when it comes to asthma therapeutic management : *Optimum medication therapy that is individualized for the child *Long Term Asthma Good teaching to child and parents with child being part of the plan

Answer 69

true

Question 70

medication therapy ( for long term ) medications will prevent , what are the the 2 main categories?

Answer 70

1) controllers or preventers - decrease inflammation and prevent episodes 2) relievers - treat symptoms quickly

Question 71

what would help for accuracy when it comes to inhalers?

Answer 71

spacers

Question 72

if coming to er with severe symptoms of asthma will step up therapy until under control. true or false?

Answer 72

true

Question 73

what are some examples of controllers or preventers inhalers?

Answer 73

corticosteroids or long term treatments

Question 74

what are example of releivers?

Answer 74

bronchodialator ( resuce drug ) very quick acting

Question 75

what are some examples of triggers that precipitate/aggravate asthma exacerbations

Answer 75

smoke colds animals pollens molf dust strong smells weather changes string emotions

Question 76

allegy proofing the home and community to avoid asthma exacerbations

Answer 76

air quiality cleaning .....

Question 77

acute asthma - nursing care exercise induced bronchospasm is what ?

Answer 77

is acute and reversible cough, sob, chest pain, tightness, wheezing that develops during activity or after

Question 78

what can u tak before exercise for prevnetion of asthma

Answer 78

sabas ( salbutamel )

Question 79

what is staus asthmaticus?

Answer 79

med emerg, comes to er and then most often go to peds icu

Question 80

what are the sympotoms of resp distress ( status asthmaticus )

Answer 80

may developgradullay or suddenly severe sob, 02 sats is <94 , profuse diaphoresis, sitting upright, refusing to lie down

Question 81

what are the most severe of status asthmaticus symptoms

Answer 81

changes in loc, wheezes that become absent ( silent chest )

Question 82

what is a sign of distress in status asthamaticus?

Answer 82

silent chest ( concern if cannot hear the wheezes anymore= tired and just not breathing )

Question 83

true or false. we must keep sats > 94% . ventilator if resp stress worsens on a pt who has status asthmaticus

Answer 83

true

Question 84

true or false. will increase inhaled drugs ( step up ) if continue on someone who has staus asthmaticus

Answer 84

true

Question 85

what can we add for someone who has status asthmaticus

Answer 85

will add oral/iv steroids and muscle relexants to decrease increase pulmonary function

Question 86

what will we monitor for someone who has status asthmaticus

Answer 86

will monitor and correct deydation, hypoxia, acidosis ( ventilation is necessary )