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nu 374 > Ch. 26 > Flashcards

Ch. 26 Flashcards

1
Q

what muscles should be used when breathing?

A
  • diaphragm (<7 years)
  • abdominal muscles
  • intercostals
  • thoracic muscles (>7 years)
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2
Q

what should you see and hear during a lung assessment?

A
  • sounds
    • anterior, posterior, and sides L&R
  • symmetrical expansion
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3
Q

what is increased WOB?

A

increased work of breathing
- nasal flaring
- wheezing (audible is very bad)
- tripod position
- head bobbing (younger babies)
- not talking
- retractions
- increased RR, HR

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4
Q

what is accessory muscle use?

A

anything besides the diaphragm and intercostals
- neck
- spinal cord muscles

severe distress

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5
Q

what do you hear if a child is having trouble breathing?

A
  • wheezing
  • stridor (upper airway obstruction)
  • diminished air sounds
  • crackles
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6
Q

what are the common retraction sites and names?

A
  • supraclavicular
  • suprasternum
  • subclavicular
  • substernal
  • intercostal
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7
Q

what are mild vs. moderate vs. severe (retractions)?

A

mild: barely visible

moderate: various muscle groups working, child knows that they are in distress: eating/sleeping affected, visible retractions apnea, bradycardia spells

severe: if all accessary muscles are in use, prolonged expiratory phase, changes in levels of consciousness

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8
Q

where should you auscultate for lung sounds?

A

start right about clavicles, R-L
move down about 4 points on each side

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9
Q

should you perform percussion in children?

A
  • no, not with asthma or bronchiolitis, don’t want to induce bronchospasm
  • yes with CF, anything with mucus plugs
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10
Q

supraclavicular

A

retraction above the clavicle

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11
Q

suprasternum

A

retraction above the sternum

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12
Q

substernal

A

retraction below the sternum

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13
Q

subcostal

A

retraction of the ribs

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14
Q

intercostal

A

retraction between the ribs

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15
Q

home management (medications) of respiratory illnesses includes

A
  • antipyretics (tylenol)
  • antihistamines (Benadryl)- cautious under 6years very tired and sleepy
  • cough suppressants
  • decongestants
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16
Q

other remedies (respiratory disorders)

A
  • nasal suction
  • saline solution
  • warm compress on sinus cavities
  • fluids to prevent dehydration
  • coolness vaporizers
  • elevate head when sleeping
  • shower steam
  • warm food
  • rest
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17
Q

medications for colds/respiratory infection are used for

A

just for symptomatic control

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18
Q

nursing outcomes- respiratory focus

A
  • promote comfort
  • promote hydration and nutrition
  • reduce body temperature
  • prevent spread
  • ease respiratory effort
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19
Q

moisture: hot vs. cold?

A
  • no right answer
  • heat or cold, whatever works for child
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20
Q

assessment of nursing outcomes

A

box 26.1 and 26. 2

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21
Q

promoting comfort

A
  • unclog and consider non-pharm and pharm
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22
Q

preventing spread

A

HW and isolation PRN

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23
Q

reducing body temperature

A

educate right meds for age and fluid choices

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24
Q

promoting hydration and nutrition

A
  • small frequent feeds
  • I/O
  • feeding tips ## p. 682
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25
Q

acute streptococcal pharyngitis (GABHS) s/sx

A

varying presentation:
- sore throat
- fever
- stomach ache/abdominal pain, vomiting
- headache
- dysphagia: difficulty swallowing
- anterior cervical lymphadenopathy (tender)
- inflamed tonsils and pharynx (may have exudate)

strep carrier vs. strep positive

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26
Q

scarlett fever

A
  • strep throat with sand paper rash
  • towards end of illness: massive peeling of fingers, hands, feet
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27
Q

s/sx of tonsilitis

A
  • pharyngitis (may be present)
  • enlarged tonsils (may have exudate)
  • hoarseness
  • nasal/muffled voice
  • difficulty breathing/sleep apnea
  • dysphagia
  • foul halitosis
  • mouth breathing (adenoids)
  • snoring
  • persistent cough
  • OM/difficult hearing (possible)
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28
Q

pharyngitis: diagnostic

A
  • rapid strep
  • if negative, send out for culture
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29
Q

tonsilitis: diagnostic

A
  • rapid strep culture
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30
Q

pharyngitis: therapautic management

A
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31
Q

pharyngitis: nursing care

A
  • ice pops, ice color around the throat
  • hot liquids
  • fluids/hydration
  • salt water gargle
  • fever: Tylenol
  • antibiotic: cephalosporin
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32
Q

tonsilitis: nursing management

A
  • ice pops, ice color around the throat
  • hot liquids
  • fluids/hydration
  • salt water gargle
  • fever: tylenol
    *no antibiotic unless bacterial
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33
Q

grade 0 tonsil

A

absent

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34
Q

grade 1 tonsil

A

subtle
see a little

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35
Q

grade 2 tonsils

A

tonsils are half way to uvula

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36
Q

grade 3 tonsils

A

tonsils covering 3/4 back of throat

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37
Q

grade 4 tonsils

A

kissing tonsils

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38
Q

diagnostic criteria to have tonsils removed

A

7 episodes in 1 year
5 episodes in 2 years
3 episodes in 3 years

*episode: tonsilitis or pharyngitis (strep throat)

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39
Q

s/p tonsil removal: #1 complication (and what to monitor for)

A

hemorrhage
- HR increases
- RR increases
- BP increases initially, then drops
- pale skin
- frequent swallowing
- bright red blood

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40
Q

post-op management: tonsil removal

A
  • monitor for hemorrhage
  • facilitate drainage of secretions/promote airway clearance
  • reduce discomfort
  • maintain fluid volume
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41
Q

post-op mngmnt: tonsil removal- hemorrhage

A

intervention:
- assess risk for bleeding
- baseline VS

examples:
- Discourage frequent coughing, throat clearing, gargling, or nose blowing, straws, sippy cup, no PO objects

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42
Q

s/p tonsil removal: scabs

A

nothing that will irritate the surgical site
- nose gargling
- straws
- nothing in the throat to irritate it

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43
Q

nutrition after tonsil surgery

A
  • popsicles: no purple or red color (too much like blood)
  • bland diet, easy to swallow
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44
Q

child eustachian tube

A
  • very short
  • straight
  • thin
  • this contributes to a higher rate of ear infections
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45
Q

OME

A

otitis media with effusion (fluid behind the eardrum)

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46
Q

AOM

A

acute otitis media

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47
Q

OME and AOM are caused by

A

dysfunctional eustachian tube

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48
Q

AOM: s/sx

A
  • impaired hearing: mild to moderate
  • otalgia: ear pain
  • otorrhea if tympanic membrane is perforated
  • infection: viral or bacterial
  • systemic s/sx: fever, malaise
  • behavior: crying/irritable, ear batting, poor PO and sleep
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49
Q

AOM: examination

A
  • bulging TM
  • redness
  • displaced light reflex
  • immobile
  • use otoscopy
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50
Q

OME: s/sx

A
  • impaired hearing: mild to moderate
  • behavior: difficulty hearing or responding to sounds
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51
Q

OME: examination

A
  • TM retracted
  • immobile
  • yellow or opaque
  • use pneumatic otoscopy
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52
Q

otalgia is __

A

ear pain

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53
Q

chronic AOM is not getting better: child is at risk for

A
  • loss of hearing
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54
Q

chronic OME is not getting better: child is at risk for

A
  • impaired speech development
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55
Q

AOM: treatment

A

Non-severe unilateral involvement:
- Observation-wait 48-72 hrs.
- If improved = no treatment
- If same/worse = treatment

Severe or bilateral disease:
- Antimicrobial therapy
- Antipyretics for fever & pain

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56
Q

OME: treatment

A
  • Watchful waiting x 3 mos.
  • No decongestants
  • No antihistamines
  • ABT if persistent OME (> 3 mos.)
  • No corticosteroids
  • No recommendation for an allergist (by AAP)
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57
Q

diagnostic criteria for getting (ear) tubes put in

A

3 AOM in 6 months
4 AOM in 1 year
OR
OME is not getting better and failed with medications

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58
Q

why is bottle propping not condoned?

A

some of the bottle will get into nasal passage, into eustachian tube, cause an infection

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59
Q

AOM: when to assess (recheck)

A

Ear recheck after 48-72 hrs. if watchful waiting
Ear recheck after ABT completed

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60
Q

OME: when to reassess

A

Reassess q 3-6 months and continue to watch unless hearing loss or structural issues develop

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61
Q

AOM referrals

A

Hearing testing (if loss suspected)
Language evaluation (delayed speech)

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62
Q

OME referral

A

If OME follows (see OME guidelines)

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63
Q

AOM: if conjuncitivitis is present,(type of antibiotic used)

A

use 2nd line ABT

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64
Q

OME surgeries

A
  • consider tymanoplastomy tubes if warranted
  • myringotomy (with or without tubes)
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65
Q

AOM and OME prevention

A

Breastfeeding for at least 6 mos.
- Pacifier discontinuance around 6 mos.
- No bottle propping
- avoid URI exposure
- avoid 2nd and 3rd hand smoke
- UTD immunizations (Prevnar 13 and influenza)
- minimal daycare
- upright feeding position

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66
Q

which seasons are a higher risk for croup?

A

fall winter spring
- mostly in little kids, under 6

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67
Q

croup is

A

inflammation and edema of the epiglottis and larynx
- may involve trachea and bronchi
- airway narrowing from trachea swelling against the cricoid cartilage

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68
Q

croup: symtoms

A
  • stridor
  • barking cough (seal)
  • hoarseness
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69
Q

croup: viral or bacterial?

A

viral
- spread by droplet and contact, kids cough and the drops fall onto surfaces for several hours
- highly contagious

70
Q

acute epiglottis: age group affected

A
  • toddlers
  • preschoolers
71
Q

acute epiglottis: tiologic agent

A

bacterial

72
Q

acute epiglottis: onset

A

rapid progression (hours)

73
Q

acute epiglottis: major symptoms

A
  • high fever (>102.2)
  • URI
  • intense sore throat
  • dysphagia, drooling
  • tachycardia and tachypnea
  • prefers tripoding position with neck extension
  • cherry red epiglottis
  • absent barking cough
74
Q

acute epiglottis: treatment

A

Immediate airway protection, Intubation, or tracheotomy
Supplemental oxygen
Blood cx and epiglottis cx
IVF
Gram + ABT until C&S known
Reassurance
HIB vaccination if needed

75
Q

acute LTB laryngotrachelitis: age-group affected

A
  • infant
  • young children
76
Q

acute LTB laryngotrachelitis: tiologic agent

A

viral

77
Q

acute LTB laryngotrachelitis: onset

A

slow progression over 24-48 hours

78
Q

acute LTB laryngotrachelitis: major symptoms

A

Early: mild fever (less than 102.2)
Barking-seal, brassy, croupy cough
Rhinorrhea
Sore throat
Inspiratory stridor
Apprehension
Listless or irritable
Can progress to retractions & cyanosis

79
Q

acute LTB laryngotrachelitis: treatment

A

Oral dexamethasone
Nebulized epinephrine if severe
Supplemental O2 if hypoxic
Monitor for airway obstruction

80
Q

acute spasmodic laryngitis: age group affected

A

toddlers

81
Q

acute spasmodic laryngitis:tiologic agent

A

viral with allergic component

82
Q

acute spasmodic laryngitis: onset

A
  • sudden, nocturnal
  • resolves in 24-48 hours
83
Q

acute spasmodic laryngitis: major symptoms

A

Afebrile (no fever)
Mild respiratory distress
Barking, seal-like cough
No signs of respiratory infection

Can reoccur due to allergies, another viral infection & GERD

84
Q

acute spasmodic laryngitis: treatment

A

Cool mist
Reassurance
Oral dexamethasone

85
Q

acute tracheitis: age-group affected

A
  • infancy through preschool
86
Q

acute tracheitis: tiologic agent

A

viral or bacterial with allergic component

87
Q

acute tracheitis: onset

A

moderate progression over 2-5 days

88
Q

acute tracheitis: major symptoms

A

High fever (>102.2F)
URI
Initially presents like spasmodic croup
Purulent secretions
Prefers supine
No drooling
No dysphagia

89
Q

acute tracheitis: treatment

A

Initially same as LTB then
Blood cultures
IV Antibiotics
Fluids
Possible intubation

90
Q

westley croup score: <2

A

mild

91
Q

westley croup score: 3-7

A

moderate

92
Q

westley croup score: 8-11

A

severe

93
Q

westley croup score: >/= 12

A

failure

94
Q

RSV is

A

respiratory syncytial virus

95
Q

bronchiolitis

A

Most commonly from RSV but also Adenovirus, Parainfluenza Human metapneumovirus

May be accompanied by other viruses & bacteria

96
Q

RSV etiology

A
  • incubation period: 2-8 days
  • viral shedding: 3-8 days
  • fall through spring months
  • spread through direct and indirect contact, contact and droplet precautions
  • increases in severity before resolving
97
Q

RSV: mild s/sx

A

rhinitis, cough, low-grade fever, wheezing, tachypnea, poor feeding, emesis, diarrhea

@home

98
Q

RSV: severe s/sx

A

RR>70, grunting, wheezing, crackles, retractions, nasal flaring, irritability, lethargy, poor PO, distended abdomen, cyanosis

@hospital

99
Q

RSV: diagnostic and lab evaluation

A
  • CXR
  • viral swab or wash
100
Q

RSV: nursing care and management

A
  • contact and droplet precautions
  • hydration PO/IV (FMR)
  • nasal suctioning, saline
  • positioning for feeds/sleep: 30* elevation to help with post-nasal drip
  • fever: tylenol
  • if destating: O2
  • cardiopulmonary monitoring (A&B)
  • VS, I&O, USG, focused assessments
101
Q

RSV medications

A
  • humidified oxygen
  • antipyretics
  • nebulized saline
  • antibiotics ONLY if bacterial (UTI, meningitis, OM, PNA)
  • prevention: palivizumab (synagis)
102
Q

who is at risk for RSV?

A
  • premature or PT infant
  • congenital heart disease
  • exposed to smoke
  • compromised immunity
  • daycare, siblings (exposure to germs)
103
Q

prevention medication for RSV

A

palivizumab (synagis)

104
Q

palivizumab (synagis)

A

short-acting monoclonal antibody vaccine for RSV that is given 1x/month (q30 days) from November-March (RSV season), 5 doses total

for:
- high-risk infants (CHD, CLD w/ prematurity)
- infants born before 29 weeks gestation
- infants in the first year of life with hemodynamically significant heart disease
- infants in the first year of life for preterm infants (<32 weeks) with chronic lung disease who require continued medical intervention
- immunocompromised children under 24 months of age
- children with anatomic lung abnormalities or a neuromuscular disorder
- possible second year of life dosing

105
Q

nirsevimab

A

long-acting monoclonal antibody vaccine for RSV, single dose

for:
- full-term or late-term babies
- All infants < 8 months born during or entering their first RSV season, including those recommended by the American Academy of Pediatrics (AAP) to receive palivizumab
- Infants and children aged 8-19 months at increased risk of severe RSV disease and entering their second RSV season, including those recommended by the AAP to receive palivizumab

106
Q

when do you begin using palivizumab if the baby was born in january?

A

start in january, end in march

107
Q

would you recommend palivizumab for children with Trisomy 21 or CF?

A

no research to support it

108
Q

should children continue to finish the series if they get RSV?

A

no, we don’t have to
- unlikely that children would get RSV twice in same season

109
Q

pertussis is also known as

A

whooping cough

110
Q

pertussis: caused by

A

bordetella pertussis

*in US occurs most often in children who are not immunized
*highest incidence in spring and summer months

111
Q

pertussis: predominant symptom

A

highly contagious
- persistent cough x 6-10 weeks
*risk of death in young infants

112
Q

pertussis: lifelong immunity

A

with a single episode

113
Q

pertussis vaccines

A
  • DTaP x5 in childhood
  • booster x1 with TDaP between ages of 11-64 years
114
Q

pertussis: incubation period

A

5-10 days

115
Q

pertussis: catarrhal stage

A

*1st stage of s/sx
cold s/sx x 1-2 weeks

116
Q

pertussis: paroxysmal stage

A

nasal swab confirmation

117
Q

pertussis episode:

A

series of rapid coughs f/b a forceful inhalation through a narrowed glottis (whoop)

118
Q

pertussis: infant episode s/sx

A
  • gagging
  • gasping
  • apnea
  • absence of whoop
  • can be triggered by feeds
  • risk for complications from the forcefulness of cough
119
Q

pertussis: child episode s/sx

A
  • cyanosis
  • post-tussis emesis
  • exhaustion
  • whoop may be absent
  • risk for complications from the forcefulness of cough
120
Q

pertussis precautions

A

droplet precautions x 5 days

121
Q

pertussis: nursing care and management

A
  • small frequent PO feeds
  • oxygenation during paroxysms (side-lying position until passes)
  • suctioning PRN
  • observe for s/sx of airway obstruction (restlessness, increased WOB, cyanosis, A’s and B’s)
  • encourage ABT compliance
  • encourage immunizations/boosters (include close contacts)
  • many complications (PNA= death in infants) may result in pICU with advanced airway management
  • observe for s/sx of hemorrhage (pulmonary, nasal, sclera, conjunctiva)
  • assess for hernia, prolapsed rectum, syncope, rib fracture, incontinence, weight loss, dehydration, seizures, OM, anorexia, dehydration, PNA or atelectasis
  • may need mechanical ventilation
  • antipyretics PRN
122
Q

asthma

A
  • IgE mediated response, reaction within the lung itself
  • hereditary
123
Q

risk factors of asthma

A

prematurity or LBW, exposure to second-hand smoke

124
Q

asthma triggers

A
  • environmental factors: allergens: pollen/mold/pet dander/grass, smoke, humidity/cold
  • exercise
  • infections (respiratory), flu, cold, sinus infection
125
Q

drug therapy for asthma can be

A
  • quick relief
  • long-term control
126
Q

asthma: quick relief medications

A
  • short-acting beta agonisits
  • anticholinergics
  • systemic corticosteroids

*rescue meds

127
Q

asthma: long-term control medications

A
  • inhaled corticosteroids
  • cromolyn sodium and nedocromil
  • long-acting beta agonists
  • methylxanthines
128
Q

PEFM

A

peak flow meter
- used in children with asthma to measure how open the airways in the lungs are functioning/opening
- done when child is well (baseline), to compare numbers when sick

129
Q

family-centered care: how to use a peak flow meter

A
  1. before use, make sure the sliding marker/arrow on the peak flow meter is at the bottom of the numbered scale
  2. stand up straight
  3. remove gum or food from mouth
  4. close lips tightly around the mouthpiece. be sure to keep tongue away from mouthpiece
  5. blow out as hard and as fast as you can, a “fast, hard puff”
  6. note the number by the marker on the numbered scale
  7. repeat entire routine 2 more times but wait at least 30 seconds between each routine
  8. record the highest of the three readings, not the average
  9. measure your peak expiratory flow rate (PEFR) close to the same time and same way every day (ie morning and evening; before and 15 minutes after taking medication)
  10. keep record of your PEFRs
130
Q

asthma severity: green zone

A

80-100% function, intermittent- persistent

s/sx occur:
(intermittent green)
- day: 0-1 day/week
- night: 0-1x/month
(persistent green)
day: >2 days/week; not QD
night: 1-4x/month

going to school
eating & sleeping well
participating in sports, parties
no limitations (intermittent); minor limitations to activity (persistent)

131
Q

asthma severity: yellow zone

A

50-80% function, moderate persistent

s/sx occur:
day: daily
night: >1x/week, but not nightly

compromised, head cold
some limitations to activity
bronchodialotor

132
Q

asthma severity: red zone

A

<50% function, severe persistent
if adding steroid is not helping, going to hospital

s/sx occur:
- day: continuous
- night: frequently

extremely limited activity

133
Q

asthma scale

A

lower number- milder symptoms
higher number- more severe symptoms

134
Q

asthma action plan: green zone

A
  • no cough, wheeze, chest tightness, trouble breathing at any time
  • can do all things usually done (acitivities)
  • when using peak flow meter, peak flow is >80%

action: continue taking long-term control medicine

135
Q

asthma action plan: yellow zone

A
  • some cough, wheezing, chest tightness, trouble breathing
  • waking up at night because of asthma
  • can’t do some of the things usually done (acitivities)
  • when using peak flow meter, peak flow is 1/2 to 3/4 of best peak flow

control: add quick-relief medicine and continue long-term control medicine
- if sx get better after an hour, keep checking them and continue long-term control medicine

136
Q

asthma action plan: red zone

A
  • have a lot of trouble breathing
  • quick-relief meds aren’t helping
  • can’t do any of the things usually done (activities)
  • was in yellow zone for 24 hours and did not get better
  • when using peak flow meter, peak flow is less than 1/2 best peak flow

action: add other medicines MD prescribed and call MD
- if symptoms don’t get better and can’t reach MD, go to the hospital

137
Q

asthma score: mild

A

peak expiratory flow rate %: >70%
scale score: 5-7

138
Q

asthma score: moderate

A

peak expiratory flow rate %: 50-70%
scale score: 8-11

139
Q

asthma score: severe

A

peak expiratory flow rate %: <50%
scale score: 12-15

140
Q

management of asthmaticus status

A
  • maintain airway patency
  • fluid maintenance/hydration
  • promote rest and stress reduction
  • family support
141
Q

asthmaticus management: maintaining airway patency

A
  • NPO
  • oxygen (high flow)
  • positioning
  • cardiopulmonary monitoring and VS
  • systemic medications
142
Q

asthmaticus management: fluid maintenance/hydration

A
  • IVF at FMR
  • I&O and USG
  • possible nutritional support
  • monitor for overhydration
143
Q

asthmaticus management: promote rest and stress reduction

A
  • quiet room
  • cluster care
144
Q

asthmaticus management: family support

A
  • frequent updates on the child’s condition
  • participation at will
  • respite breaks PRN
  • cultural and spiritual assessments
  • discharge planning when appropriate
145
Q

cystic fibrosis

A
  • more common in caucasians, no gender dominance
  • survival rate: late 30s/early 40s
  • hereditary, inherited autosomal recessive disorder: both parents have to be carriers for child to get the disease
  • endocrine and exocrine glands disorder
  • causes physiological alterations to body systems: Resp, GI, Reproductive
146
Q

endocrine glands

A

pancreas
pituitary gland
thyroid
parathyroid
hypothalamus

147
Q

exocrine gland

A

any secreting gland

148
Q

concerns/sx warranting testing for CF

A
  • baby fails to pass meconium stool
  • salty-tasting babies
  • s/sx associated with thick mucus
  • growth failure
149
Q

what tests are used for CF screening

A

PKU
newborn screening: IRT (elevated pancreatic enzymes)
DNA test (gene for CF: CFTR)
- sweat chloride test (quantitative: >40 suggests, >60 indicates)

150
Q

IRT test

A

IRT is tested in the newborn screening blood sample. If +, it is repeated 1-2 weeks later. If elevated again, DNA testing is performed. The newborn screening is positive if the birth sample and the repeat test are positive AND the DNA test identifies one or more CFTR mutations are present.

151
Q

s/sx of CF: upper respiratory

A

clogged sinuses
- nasal polyps
- chronic sinustis, frontal HA, rhinitis, post-nasal drip

152
Q

s/sx of CF: lower respiratory

A

decreased ciliary clearance, obstructed airways, air trapping and hyperinflation, bacterial colonization, chronic fibrotic lung changes
- Chronic moist productive cough
- wheezing
- course crackles
- frequent infections
- SOB
- ↓ exercise tolerance
- barrel chest
- digit clubbing

153
Q

s/sx of CF: pancreas

A

damaged pancreatic ducts obstruct digestive enzynmes; enzymes damage the pancreas leading to inadequate insulin secretion
- Poorly digested food
- Vitamin ADEK deficiencies
- poor wt. gain
- FTT
- delayed puberty
- CF-IDDM

154
Q

s/sx of CF: GI

A

thickened intestinal secretions and decreased motility obstructed bile ducts
- Meconium ileus
- abdominal distention
- steatorrhea (frothy, foul, floating)
- constipation
- obstruction
- prolapse
- cirrhosis

155
Q

s/sx of CF: reproductive

A

male: absence of vas deferens, decreased sperm count
- infertility

female: thick vaginal discharge, decreased cervical secretions
- difficulty conceiving

156
Q

s/sx of CF: sweat glands

A

excessive CL and NA electrolyte loss in sweat
- salty sweat
- salt depletion, hyponatremia

157
Q

CF: nursing management

A

Focused respiratory and GI assessments
Anthropometric measurements
Respiratory therapy
- VS and spirometry
- CPT/pulmonary toilet
- Airway clearance techniques (video)
- Meds
Nutrition
Meds
High fat, high protein, high calories, unrestricted salt
Psychosocial support
Home care mgmt.

158
Q

CF medications: SABA meds

A
  • bronchospasm prevention
159
Q

CF medications: dornase alpha nebulizer

A
  • loosens and thins secretions
160
Q

CF medications: hypertonic saline nebulizer

A
  • hydrates airway mucus and stimulates cough
161
Q

CF medications: ibuprofen PO

A
  • slow progression of pulmonary function decline
162
Q

CF medications: antibiotics nebulizer, oral, or IV

A
  • treat or prevent infection
163
Q

CF medications: pancreatic enzyme supplements

A
  • with every meal!
  • assists in digestion of nutrients
164
Q

CF medications: vitamins ADEK and antioxidants (zinc, selenium, ascorbate)

A
  • supplements and vitamins not produced
165
Q

CF: treatments to promote airway clearance

A
  • high frequency chest wall oscillation vest (usually paired with with nebulized medication)
  • flutter mucus clearance device
166
Q

can expectorants be used on children to aid in respiratory illness relief?

A

no, don’t use with children

167
Q

tonsilitis: therapeutic management

A
  • treatment is symptomatic b/c viral
  • tonsillectomy: surgical removal of tonsils
  • adenoidectomy: surgical removal of adenoids
168
Q

post-op mngmnt: tonsil removal- drainage of secretions/promote airway clearance

A

Interventions:
- positioning
- suctioning PRN

Examples:
- side lying position/prone then sitting

169
Q

post-op mngmnt: tonsil removal- reducing discomfort

A

Interventions:
- Pain assessment
- Pharm vs. non-pharm
- Cluster care

Examples:
- ATC med dosing
- Consider IV, IM, PO
- Ice collar
- Local anesthetics
- antiemetics

170
Q

post-op mngmnt: tonsil removal- maintain fluid volume

A

Interventions:
- assess I/O
- offer fluids as tolerated

Examples:
- Avoid citrus and red/brown fluids; avoid scratchy foods

171
Q

is it advisable to give both Nirsevimab and Palivizumab for RSV vaccines in the same year?

A

no it is not

172
Q

when should nirsevimab be administered to an infant?

A

moms status unknown: 1 dose before RSV season/within 1 week (if born in RSV season: October-March)

mom’s dose <14 days: 1 dose before RSV season/within 1 week (if born in RSV season: October-March)

mom’s dose >14 days: not needed

nu 374 (18 decks)

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