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Mgmt PEDS > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Respiratory rate greater >60 make them what?

A

NPO

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2
Q

use un-cuffed trach in children under 8 years old, t or f

A

true

creates functional seal

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3
Q

why are kids prone to respiratory infections

A

their trachea is very short, bacteria gets into lungs

narrowness of chest

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4
Q

infant airway measurement

A

smaller in diameter = 4mm

shorter in length

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5
Q

adult airway measurement

A

8mm

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6
Q

assess patient for signs of working breathing

A

children can only keep working for so long before respiratory arrest

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7
Q

clubbing of nails equates to

A

chronic hypoxemia

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8
Q

grunting is sign of*

A

impending respiratory failure

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9
Q

infants can have 20 sec without breathing is called

A

periodic breathing - normal

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10
Q

alte-apnea period beyond 20 seconds stands for

A

apparent life threatening event

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11
Q

sweat chloride test is used for (dx test)

A

cystic fibrosis

>60 is usually positive for cystic fibrosis

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12
Q

never prop a bottle, t or f

A

true

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13
Q

most common location for aspiration of foreign bodies

A

right main-stem bronchus

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14
Q

croup

A

acute upper airway obstruction
caused by viral infection
typically mild
seen in children from 6 mos-5 years old

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15
Q

croup s/s

A 
bark cough
fever may/may not
stridor on inspiration & expiration
gradual onset
retractions
hyperventilation
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16
Q

croup dx

A

xray (steeple sign)

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17
Q

most common type of croup requiring hospitalization

A

laryngotrachobronchitis (LTB)

usually have URI symptoms prior to croup

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18
Q

croup nursing interventions

A 
cool mist
nebulized epinephrine (in ER)
dexamethasone (reduces edema in airway)
heliox (in ICU) helium & oxygen decreases work of breathing
hydration
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19
Q

RSV - respiratory syntactical virus

A 
season = October through April
highly contagious (isolation)
transmitted by hands & resp droplets
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20
Q

most common cause of bronchiolitis

A

RSV

21
Q

This population is a greatest risk for RSV

A

premature infants
congenital heart disease
BPD (broncho pulmonary dysplasia)

22
Q

most frequent cause of hospitalization in children

A

RSV

23
Q

peak incidence of RSV

A

2-7 mos

24
Q

RSV nursing interventions

A 
isolation precautions
freq hand washing
assess respiration's
iv corticosteroids
encourage mom to pump & store milk
control secretions (before eating/bedtime)
25
Q

what is Ribavirin

A

Inhaled antiviral agent - approved specified therapy in children w/ RSV
Expensive - Conflicting results

26
Q

what is palivizumab

A

Approved RSV drug in the US
Given IV or IM q30 days during RSV season
$1200 per dose

27
Q

what is asthma

A

chronic inflammatory disorder of the airway causing broncho-constriction

28
Q

asthma risk factors

A 
boys>girls
hereditary factor
exposure to smoke
allergies
trigger/exacerbation's (environment)
29
Q

asthma s/s

A

wheezing/retractions

SOB

30
Q

what is status asthmaticus

A

acute asthma exacerbation w/ bronchial obstruction
severe & continues to worsen despite treatment
leads to respiratory failure

31
Q

s/s of status asthmaticus

A

diaphoretic (sweating)
anxious
use of accessory muscles
respiratory failure

32
Q

mgmt of asthma

A

educate parents
medication admin.
asthma action plan (kids over 5)

33
Q

medications for asthma include

A

treatment for long term care & acute exacerbation’s
oral steroids
mast cell stabilizers
inhalers

34
Q

controller asthma medications

A

single inhaled corticosteroids (flovent, pulmicort, QVAR, asmanex)

35
Q

combined asthma medications

A

advair
dulera
symbicort

36
Q

rescue asthma medications

A 
q4hr PRN
albuterol (proair, ventilin, proventil)
albuterol nebulizer 
levalbuterol (xopenex)
levalbuterol nebulizer
37
Q

asthma spacer devices provide

A

better delivery for inhaled medications in children

38
Q

peak expiratory flow meter measures/use

A

max flow of air forcefully exhaled in 1 sec
measured in liters/min
result shown in green, yellow, red
establish baseline when stable - chart (3 occurences)
age 5+
required for severe patients

39
Q

what is cystic fibrosis

A

chronic multi-system condition
autosomal recessive (1 in 4 births if parents carry gene)
long arm of chromosome 7
screened in 50 states
life expectancy (40’s)
may or may not display symptoms at birth - can develop

40
Q

cystic fibrosis manifestations

A

sticky mucous which blocks ducts
improper salt balance, sweat has elevated Na+ and Cl
abnormal ion concentration

41
Q

dx test for cystic fibrosis

A

sweat chloride test

42
Q

children with cystic fibrosis develop

A 
chronic sinus issues
nasal polyps
pancreatic dysfunction
malabsorption 
prone to infections
delayed puberty in girls
mild to severe symptoms
43
Q

mgmt of cystic fibrosis

A 
multi-disciplinary team
preventative
labs 
auditory - hearing loss from antibiotics? test at 6+ mos
brain-stem hearing test (asleep)
assessments (baseline)
44
Q

cystic fibrosis s/s

A

gray/fatty stools (steatorrhea)
digestive problems (decreased absorption)
recurrent URI

45
Q

medications for cystic fibrosis

A 
vitamins a,e,d,k
inhaled antibiotics regardless of age (found beneficial)
mucolytic enzymes
pancreatic enzymes
bronchodialators
oral/iv antibiotics
46
Q

nursing interventions for cystic fibrosis

A 
patient/parent education
nutrition assessment 
percussion/postural drainage - cough - spit out mucous
chest p/t q4hrs
support groups
supplemental feedings at night
chronic - never ends
47
Q

child life therapist is someone who holds a

A

bachelors degree in growth and development

48
Q

bibliotherapy

A

a communication tool to help prepare a child for trt

reduces fear of the unknown

49
Q

2 huge philosophies that drive pediatric nursing practice

A

atraumatic care - avoid distressing (treatment room)

patient/family centered care - collaborate/communicate with the family

Mgmt PEDS (21 decks)

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