Week 3 - Respiratory and Cardiology Flashcards
Layngotracheobronchitis patho
Viral - RSV, Influenza
What kind of precautions are needed for Laryngotracheobronchitis?
Droplet
Laryngotracheobronchitis s/s (5)
- croup
- stridor
- suprasternal retractions
- nasal flaring
- decreased pulse ox
An easy nursing intervention for Laryngotracheobronchitis parents could do at home
Provide cool mist humidified O2 - take the child outside for a walk
Epiglottitis triage
Emergency
Which upper airway disorder is caused by Hib
Epiglottitis
Which upper airway disorder presents through the Tripod + 4 D’s
Epiglottitis
4 D’s of Epiglottitis
- Dyspnea
- Dysphagia
- Dysphonia
- Drooling
Epiglottitis Interventions (7)
- Vaccination
- NPO
- Reduce stimuli
- Antibiotics + fluids
- Airway tray ready
- Continuous pulse ox
- Calm the child
Broncholitis patho
RSV
- Tachypena
- Wheezing
- Cough
- Rinorrhea
- Sneezing
- Retractions
- Nasal flaring
Broncholitis
When do you suction for Broncholitis?
Pre-feed and before sleep
For which condition do you avoid antibiotics and cough suppressants?
Broncholitis
Short acting beta-2 agonist for Asthma
Albuterol
When should Asthmatic children take their medicine?
With symptoms or before exercise
Cystic Fibrosis description
Multisystem autosomal recessive trait disorder
Cystic Fibrosis patho
Over production of thick mucous results in insult to the
- Respiratory
- GI
- Reproductive system
How do you confirm cystic fibrosis?
Positive newborn screening
- Sweat Chloride Test
With cystic fibrosis, you have chronic ________
Chronic Hypoxemia
- Barrel Chest
- Clubbing
- Coughing
- Cyanosis
How does cystic fibrosis affect the stomach?
- Intestinal obstruction
- Foul stool
- Malabsorption issues
What kind of diet do you need for cystic fibrosis?
High calorie, high protein
Cystic Fibrosis intervention for the mucous
Chest PT
Foreign Body Obstruction
Prevention and teaching: danger of certain foods, toy age requirements, Heimlich maneuver - DO NOT finger swipe
Pneumonia interventions (6)
- Chest PT (splinting with cough)
- Monitor pulse ox
- Antipyretics - Tylenol, Motrin
- Antibiotics if it’s bacterial
- Lay on the AFFECTED side
- Monitor for dehydration
In ASD, which way does the blood shunt?
Left to right
S/Sx of ASD
Dyspnea, easily fatigued, systolic murmur at pulmonic region
In VSD, which way does the blood shunt?
Left to right
S/Sx of VSD
- Dyspnea
- Easily fatigued
- Systolic murmur at lower left sternal border
- Can lead to CHF
For ASD and VSD, what would you find on the echocardiogram?
Right Ventricular hypertrophy
Coarction of the Aorta patho
- Narrowing along the descending aorta past the subclavian artery
- Decreased blood flow to the periphery, especially the lower body
- Increased pressure in the left ventricle
- Left sided heart failure
Coarction of the Aorta S/sx
- Cold feet
- Cramping of the lower extremities
- BP differences (upper > lower)
- Pulse differences (upper - full, lower - diminished/absent)
- Exercise intolerance
- Dyspnea
What are children with cardiac disorders at higher risk for?
Bacterial Endocarditis
What do children with cardiac disorders need before dental procedures or dental cleaning?
Antibiotic prophylaxis
Tetraology of Fallot definition
4 defects create RIGHT to LEFT shunting
4 defects of TEF
- Right ventricular hypertrophy
- VSD
- Overriding aorta
- Pulmonic stenosis
What is TET Spells?
acute episodes of cyanosis that occur when infant’s O2 requirements exceed blood supply - crying, feeding, defecating
How do you keep the PDA open?
Prostaglandins
How can you relieve TET spell ?
Infants: knees to chest
Older: squatting
Can children with TEF have tantrums often?
No, want to avoid TET spells
Transposition of the Great Vessels (TGA) description
Aorta emerges from right ventricle and pulmonary artery leaves the left ventricle
TGA patho
Closed circulation pathways, thus need another anomaly to survive - ASD, VSD, PDA
Hypopalstic Left Heart Syndrome description
Small and thick left ventricle
Hypopalstic Left Heart Syndrome - patho
Almost no blood can enter left ventricle so it backs into the left atrium and through the ASD, flowing to the right side
Hypopalstic Left Heart Syndrome anomalies (5)
- ASD
- Stenotic Mitral valve
- Stenotic Aortic valve
- Hypoplastic left ventricle
- Hypoplastic ascending aorta
Rheumatic Fever description
Systemic inflammatory disease that involves the heart and joints - needs 2 major or 1 major + 2 minor criteria
Main cause of Rheumatic Fever
Strep throat (group A beta-hemolytic streptococcus)
Acute phase of Rheumatic Fever
Inflammation of connective tissue in heart, joints, skin
Proliferative phase of Rheumatic Fever
Cardiac valve stenosis/scar
Rheumatic Fever diagnosis
Positive rapid strep test and culture - anti-stroptolysin O titer, antideoxyribonuclease
Rheumatic Fever - Major criteria (5)
- Multi large joint involvement
- Carditis (new murmur, pericardial friction rub)
- Chorea
- Erythema marginatum (macular rash)
- Subcutaneous nodules on flexor surfaces
Rheumatic Fever - Minor critera (4)
- Fever
- Arthralgia
- Elevated ESR, CRP, and decreased RBC
- Prolonged PR and or QT intervals
Main meds for Rheumatic Fever
- Aspirin
- Prednisone
What kind of rest should kids with Rheumatic Fever be on?
Bed rest
Kawasaki’s Disease definition
Vasculitis (inflammatory process of the arteries) affecting many systems
When should you be concerned for Kawasaki’s Disease?
If a fever has lasted longer than 5 days
Stage 1 of Kawasaki’s
- Fever longer than 5 days
- Conjunctivitis (redness of the eyes)
- Dried lips and mucous membranes - strawberry tongue
- Swelling to hands and feet
- Lymphadenopathy (abnormal nodes)
Stage 2 of Kawasaki’s
- Fever resolves
- Irritable (not calmed by mom)
- Anorexia
- Desquamation (skin peeling) of hands and feet
- Arthritis / arthralgia
- Cardiovascular issues
Stage 3 of Kawasaki’s
- ESR decreases, illness appears to resolve
Interventions for Kawasaki’s
- IVIG
- Aspirin
- Passive ROM
- Monitor for aneurysm, bleeding, myocarditis
