Week 4: CH 20 Respiratory Flashcards
upper airway differences in pediatric vs adults
airway is much smaller
why is the respiratory rate higher in younger children
smaller the airway the quicker the air moves
ET tube in children
easier to put in right stem due to it being smaller
alveoli in kids
- 36 weeks alveoli begin to differentiate
- sized normally by 8 years old
diaphragm in children
- use diaphragm to breathe for the first 6 years of life due to the intercostal muscles being immature
why do retractions happen
the ribs are made of a flexible cartilage and respiratory distress causes the chest wall to be drawn in
upper airway conditions
- croup
- epiglottitis
croup
- broad class of airway illnesses
- results in inflammation and swelling of the epiglottis and larynx
laryngotracheobronchitis
viral infection that causes the swelling
radiology of croup
steeples sign
treatment of croup
- oral dexamethasone
- nebulized racemic
- epi
- fever reducer
epiglottitis
- bacterial infection
- caused by flu
- inflammation and swelling of the epiglottis and larynx
is epiglottitis life threatening
- yes
- progresses rapidly and causes complete airway obstruction
s/s of epiglottitis
expected symptoms but there is NOT a barky cough
radiology of epiglottitis
thumb sign
treatment of epiglottitis
- antibiotics
DO NOT UPSET be prepared to
put in IV dexamethasone - nebulize
lower airway conditions
- bronchiolitis
- pneumonia
bronchiolitis
lower respiratory tract infection which occurs when a viral or bacterial organism causes inflammation/obstruction of the bronchioles
common months of RSV
october to march
s/s of bronchiolitis
- cough
- runny nose
- congestion
- fever
- wheezing
- tachypnea
nursing considerations for bronchiolitis/pneumonia
- obtain nasal swabs
- administer humidified O2
- nasal suctioning
high flow nasal cannula
provides oxygen and “flow” to keep positive pressure and help keep alveoli open for gas exchange
pneumonia
inflammation of bronchioles AND alveoli
types of pnemonia
-viral (common under 5yr)
- bacterial
- mycoplasmal (common over 5yr)
s/s of pneumonia
- cough
- congestion
- fever
- poor appetite
auscultating bronchiolitis vs pneumonia
- bronchiolitis is wheezing/crackles
- pneumonia is rhonchi/crackles
antibiotics for pneumonia
- amp for inpatient
- high dose amp for outpatient
- azithromycin for mycoplasmal
- ceftriaxone for high risk/unvaxxed children
chronic airway conditions
- asthma
- cystic fibrosis
asthma
- persistent inflammation of the airway
- causes excess mucous formation, swelling and airway muscle contraction
s/s of asthma
- wheezing
- cough
- decreased air movement
treatment for asthma
- short acting beta 2 agonist relax smooth muscles by bronchodilation
- corticosteroids decrease airway inflammation through bronchodilation
- anticholinergics stop bronchoconstriction and decrease mucous production
rule of 2
- use rescue inhaler 2x per week?
- awake due to asthma 2x per month?
- refill rescue inhaler more than 2x per year?
- if yes to any of these the asthma is out of control
using a spacer
- shake
- head back and breathe in for 5sec
- hold for 10sec
- exhale for 5sec
cystic fibrosis
- inherited disorder that causes sever damage to the lungs and other organs
- autosomal recessive disorder
patho of cystic fibrosis
- caused by mutated gene called CFTR
- chloride ion transport is impaired which causes reduced water movement across cell membranes
- reduced water movement causes thickened secretions
dx of cystic fibrosis
- sweat test
- chloride concentration
