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Pediatrics Exam 2 > Week 5 - Respiratory > Flashcards

Week 5 - Respiratory Flashcards

1
Q

Airway diameter of a newborn vs. adult

A

Newborn: 4 mm

Adult: 20 mm

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2
Q

Airway Diameter of a Newborn

KNOW THIS!!!!!

A

4 mm

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3
Q

Airway Diameter of an Adult

A

20 mm

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4
Q

When do alveoli grow & mature in children?

KNOW THIS!!!!!

A
  • Grow by week 36 gestation
  • Mature by 5-8 years
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5
Q

S/S of Mild Respiratory Distress

KNOW THIS!!!!!

A

Restlessness, tachypnea, tachycardia, diaphoresis

  • Child is trying to compensate for 0-2 deficits & airway blockages
  • Vital signs reflect compensation & beginning hypoxia
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6
Q

Signs & Symptoms Moderate Respiratory Distress with Early Decompensation

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A
  • Nasal flaring
  • Retractions
  • Grunting, wheezing
  • Anxiety, irritability, mood changes, confusion
  • Hypertension
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7
Q

Signs & Symptoms of Severe Respiratory Distress: Respiratory Failure / Imminent Arrest

KNOW THIS!!!!!

A
  • Dyspnea
  • Bradycardia
  • Cyanosis (LATE sign)
  • Stupor, coma

Children with severe respiratory distress & a narrowed airway often sit in tripod position, leaning forward with arms on the legs. The head & neck are extended with the jaw thrust forward to help keep the airway open.

  • this position may also be seen in a child with an acute asthma flare.
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8
Q

Croup

KNOW THIS!!!!!

A

Broad class of upper airway illnesses that result in inflammation & swelling of the epiglottis & larynx, swelling extends into the trachea & larynx

Cause: can be viral or bacterial

  • Common among 3 months - 3 year olds

Dx: CXR with steeple sign

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9
Q

Signs & Symptoms of Croup (Laryngotracheitbronchitis / LTB)

KNOW THIS!!!!!

A
  • Fever
  • Barking / croupy cough
  • Inspiratory stridor
  • Retractions
  • Hoarse cry
  • Cyanosis
  • Decreased level of consciousness (LOC)
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10
Q

Treatment / Clinical Therapy for Croup (Laryngotracheitbronchitis / LTB)

KNOW THIS!!!!!

A
  • Oral dexamethasone
  • Nebulized epinephrine
  • Supplemental O2 (if hypoxic)
  • Antipyretics PRN
  • Hydration
  • Continuous observation of respiratory status
  • Administer medications
  • Quiet environment to promote rest
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11
Q

Stridor

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A

High-pitched sound generated from partially obstructed air flow in the upper airway

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12
Q

Epiglottitis

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A

Inflammation & swelling of the epiglottis & larynx

Cause: bacterial infection often caused by haemophilis influenza

Dx: CXR = thumb sign

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13
Q

S/S of Epiglottitis

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A
  • High fever
  • Sore throat
  • Drooling dysphagia
  • Tachycardia
  • Tachypnea
  • Tripod position
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14
Q

Nursing Management of Epiglottitis

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A
  • do NOT upset child
  • do NOT put anything in their mouth
  • Prep for intubation THEN IV access / labs
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15
Q

Tx of Epiglottitis

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A
  • IV antibiotics
  • IV dexamethasone
  • Nebulized epinephrine
  • Antipyretics
  • O2
  • Intubation
  • Hib vaccine (influenza type B)
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16
Q

Bronchiolitis

KNOW THIS!!!!!

A

Inflammation & obstruction of the bronchioles

  • lower respiratory infection (viral or bacterial)
  • leading cause of hospitalizations in ages 1 year
  • RSV = #1 cause

Dx: CXR = reactive airway disease

17
Q

Respiratory Syncytial Virus (RSV)

KNOW THIS!!!!!

A
  • Highly contagious viral respiratory infection
  • major cause of bronchiolitis
  • form syncytia or large masses of cells that clog & irritate the airway
18
Q

S/S of Bronchiolitis / RSV

KNOW THIS!!!!!

A
  • Nasal symptoms
  • Cough
  • Fever
  • Wheezing
  • Tachypnea
  • Retractions / nasal flaring / grunting
  • ↓ activity level
  • ↓ oral intake
  • Dehydration (dry lips, tachycardia, lethargy)
  • Wheezing & crackles in airways
19
Q

Nursing Management for Bronchiolitis

A
  • Nasal swabs
  • Suction
  • IV fluids
  • O2 (NC or high flow NC)
20
Q

Tx of Bronchiolitis / RSV

KNOW THIS!!!!!

A
  • Supportive care
  • Antibiotics
  • Nebulized albuterol
  • Chest physiotherapy (CPT)
  • Synagis: Immunoglobulin for high risk children less than 32 weeks old; administerd q30 days for 5 months (winter months)
21
Q

High Flow Nasal Cannula (HFNC)

KNOW THIS!!!!!

A

Continuous positive airway pressure (CPAP)

  • up to 60 L/min
22
Q

Pneumonia

KNOW THIS!!!!!

A

Inflammation of the bronchioles & alveoli

  • community or hospital acquired or from aspiration
  • TYPES: viral, bacterial, mycoplasmal (atypical)
23
Q

S/S of Pneumonia

KNOW THE BOLD!!!!!

A
  • cough
  • crackles / rhonchi
  • congestion
  • fever
  • chest pain
  • Retractions / nasal flaring / grunting / SOB / lethargy
  • abdominal pain
  • poor appetite
24
Q

Tx for Pneumonia

A

Antibiotics for Bacterial
* ampicillin or amoxicillin for outpatient
* azithromycin for atypical
* ceftriaxone for high risk or unvaxxed

Pain / fever control

25
Q

Asthma

KNOW THE BOLD!!!!!

A

Persistent inflammation of the airway causing hyper responsiveness leading to excess mucous, swelling, & muscle contraction

Triggers: environmental, exercise, viruses, or allergens, smoke, dander, feces, air pollutants

26
Q

S/S of Asthma

KNOW THE BOLD!!!!!

A
  • sudden onset of SOB
  • cough
  • inspiratory or expiratory wheezing
  • tachypnea
  • retractions
27
Q

Tx for Asthma

A

Short-acting beta agonist (SABA)
* albuterol

Corticosteroids
* decadron, prednisone, solumedrol

Anticholinergics
* ipatropium

Adjuncts
* duoneb: albuterol/ipatropium, magnesium sulfate

28
Q

Rule of Twos for Asthma

KNOW THIS!!!!!

A
  • Do you use your quick-relief inhaler more than 2 times per week?
  • Do you awaken at night due to ashtma more than 2 times per month?
  • Do you refill a quick-relief inhaler prescription more than 2 times per year?
29
Q

5-10-5 Rule (asthma)

KNOW THIS!!!!!

A

How to use a Spacer:

  • Tilt head back & breath in for 5 seconds
  • Hold breath for 10 seconds
  • breathe out for 5 seconds
30
Q

Cystic Fibrosis (CF)

KNOW THE BOLD!!!!!

A

Reduced water movement across cell membranes = blocked airways

  • Inherited disorder, CFTR gene mutation; autosomal recessive trait
  • Causes damage to the lungs, pancrease, gallbladder, & liver
  • 30,000 in the US
  • 10 million carriers

Dx: sweat test (gold standard)

31
Q

Tx for Cystic Fibrosis (CF)

A
  • Short-acting beta agonist (SABA) for airway inflammation
  • inhaled (tobramycin) & IV antibiotics (Cefepime) for flare ups
  • Hypertonic saline nebulizer tx
  • Pulmozyme (liquifies secretions)
  • pancreatic supplements
  • Vit ADEK (fat soluble)

Pediatrics Exam 2 (8 decks)

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