109 LECTURE

Question 1

is a chronic, inflammatory lung disease involving recurrent breathing problems.

Answer 1

Asthma

Question 2

Asthma is caused by complex, multicellular reaction in the airway characterized by:

Answer 2

Airway inflammation
Airway hyper-responsiveness to a variety of triggers
most common chronic health problem among children

Question 3

Symptoms of Asthma

Answer 3

Wheezing
Cough
Tightness of Chest 
Prolonged expiratory phase 
Hypoxemia 
X-ray- hyper-expansion of the lungs

Question 4

Medical Management of Asthma

Answer 4

High fowler's position/ bed rest
Pulse Oximetry
Nebulized Albuterol 
CPT (chest physical therapy)
Methylprednisolone/ Solu-medrol IV
IV FLUIDS 
OXYGEN TO KEEP OXYGEN > 95%

Question 5

Home Management of Asthma

Answer 5

Peak flow spirometer
Identify Triggers
Maximize lung expansion
Optimal physical growth
Optimal psycho-social state
Maximum participation

Question 6

measures how much and how fast air is forcefully expelled from fully inflated lungs

Answer 6

Spirometry

Question 7

Rescue Drugs for Asthma

Answer 7

short acting albuterol beta 2 agonist- used as a quick relief agent for acute bronchospasm and for prevention of exercise- induced bronchospasm

Question 8

Anti-inflammatory or preventive for Asthma

Answer 8

low-dose inhaled corticosteroid: inhaled or oral prednisone

Question 9

Allergy for asthma

Answer 9

Singulair

Question 10

rapidly relax the airway smooth muscle cells, thus reversing the bronchospasm until anti-inflammatory effects of steroids is attained

Answer 10

Bronchodilators

Question 11

Aerosols

Answer 11

Mouth piece- 3 years and older

Facial Mask - less than 3 years

Question 12

reduce the inflammatory component of bronchial obstruction, decrease mucus production, and mediator release as well as the late phase inflammatory process.

Answer 12

Corticosteroids

Question 13

Corticosteroid for severe cases

Answer 13

Methylprednisolone Iv

Question 14

Corticosteroids for experiencing GI upset

Answer 14

Reglan

Question 15

always give with food to decrease GI upset

Answer 15

Oral Prednisone

Question 16

recommended for short course in moderate or severe exacerbation

Answer 16

Oral Prednisone

Question 17

Family Teaching for Asthma

Answer 17

Teach how to use medication
When to use and how often
No to OTC drugs
Increase fluid intake 
Sign and symptoms of respiratory distress

Question 18

has decrease dramatically since introduction of the Haemophilus influenzae type b or HIB vaccine in 1985

Answer 18

Epiglottitis

Question 19

Epiglottitis Symptoms

Answer 19

Acute inflammation of supra-glottic structures
Medical emergency 
Sudden onset 
High fever 
Dysphasia and drooling 
Epiglottis is cherry red and swollen

Question 20

Management of Epiglottitis

Answer 20

Diagnosis made on presenting symptoms
Ceftriaxone- 3rd gen cephalosporin
no tongue blade in mouth 
emergency tracheostomy set 
no procedure until in the operating room 
keep in quiet room

Question 21

inflammation of the tonsils

Answer 21

Tonsilitis

Question 22

occurs when the tonsils are so enlarged they touch each other

Answer 22

“Kissing Tonsils”

Question 23

Signs and Symptoms of Tonsilitis

Answer 23

Children may refuse to drink
Night snoring = enlarged tonsils or adenoids
size of the tonsils are obstructing the airway
high grade fever

Question 24

Treatment for Tonsilitis

Answer 24

Antibiotic X ten days if positive for beta strep
Acetaminophen for pain
Cold fluids
saline gargles
Antiseptic sprays
Viral throat infections will not get better faster with antibiotics

Question 25

Acute obstruction and inflammation of the bronchioles `

Answer 25

Bronchiolitis

Question 26

Causative agent of Bronchiolitis

Answer 26

RSV (Respiratory syncytial virus)

Question 27

Symptoms of Bronchiolitis

Answer 27

``` Harsh dry cough Low grade fever feeding difficulties Respiratory Distress with apnea t ```

Question 27

Symptoms of Bronchiolitis

Answer 27

``` Harsh dry cough Low grade fever feeding difficulties Respiratory Distress with apnea Thick mucus Wheezing ```

Question 28

Management of Bronchiolitis

Answer 28

Oxygen saturation of > than 95% Pulse oximetry Normal saline nose drop before suctioning deep suction especially before feeding CPT (chest pulmonary physiotherapy) to mobilize secretion Inhalation therapy Mechanical ventilation

Question 29

inflammatory condition of the lungs in which alveoli fill with fluid or blood resulting in poor oxygenation and air exchange

Answer 29

Pneumonia

Question 30

Symptoms of pneumonia

Answer 30

High fever Thick green, yellow or blood tinged secretion Grunting respiration Rales, crackles diminished breath sounds Cough and cyanosis Infiltrates seen on x-ray

Question 31

Symptoms of pneumonia

Answer 31

High fever Thick green, yellow or blood tinged secretion Grunting respiration Rales, crackles diminished breath sounds Cough and cyanosis Infiltrates seen on x-ray

Question 32

Management for pneumonia

Answer 32

``` Assess respiratory distress NPO (RR > 60 - high risk for aspiration) IV fluids Oxygen saturation above 95% CPT (chest pulmonary physiotherapy) Deep suctioning Acetaminophen fo fever Antibiotics ```

Question 33

Pneumonia Isolation

Answer 33

Respiratory Isolation

Question 34

inherited autosomal recessive disorder of the exocrine glands

Answer 34

Cystic Fibrosis

Question 35

a chronic, progressive, genetic illness involving the digestive system and lungs

Answer 35

Cystic Fibrosis

Question 36

Mucous secretion are thick and tenacious > Dysfunction of mucous producing glands leads to multiple gastrointestinal absorption problems > blocked pancreatic ducts no secretion of digestive enzymes

Answer 36

Exocrine gland dysfunction

Question 37

Symptoms of cyctic Fibrosis

Answer 37

``` meconium ileus at birth failure to thrive steatorrhea stools/ constipation voracious appetite with poor weight gain recurrent respiratory infections chronic cough malabsorption of intestines ```

Question 38

Diagnosis of Cystic Fibrosis

Answer 38

``` Positive Sweat test genetic marker lifelong management includes: - enzyme replacement with eating - daily CPT postural drainage ```