Acute Respiratory PT.1 (Exam 2)

Question 1

Infants rely on what to breath?

Answer 1

Diaphragmatic / abdominal breathing

Question 2

Respiratory Assessment

Answer 2

LOC

Respiratory Rate

Respiratory Effort

Skin and Mucous Membrane

Breath sounds

Question 3

Infant RR

Answer 3

30-40

Question 4

Child RR

Answer 4

20-24

Question 5

Adolescent RR

Answer 5

16-18

Question 6

Why are we concerned with lower RR

Answer 6

Child is getting tired

Question 7

Breathing levels in early respiratory distress vs later

Answer 7

Breathing is fast but as they ware our they will slow

Question 8

Signs of Respiratory Distress

Answer 8

Tachypnea

Tachycardia

Diaphoresis

Change in LOC

Cyanosis

Increased WOB

Question 9

Depth and Location associated with mild distress

Answer 9

Isolated intercostal

Question 10

Depth and location associated with moderate distress

Answer 10

Subcostal

Supresternal

Supraclavicular

Question 11

Depth and location associated with severe distress

Answer 11

subcostal

suprasternal

supraclavicular

Use of accessory muscles

Question 12

Stridor is in

Wheezing is in

Answer 12

Stridor = inspiration (upper airway)

Wheezing = expiration (lower airway)

Question 13

Brassy cough indicates

Answer 13

croup

Question 14

Pulse Oximetry

Answer 14

Placed in many places

95-100 percent is normal reading

Question 15

Nursing intervention: Ease Respiratory Effort / Promote Rest

Answer 15

-Positioning to open airway

-Warm or cool mist (No steam vaporizer)

-Mist tents

-Saline nose drops with bulb suctioning (they are nose breathers)

-Bedrest or quiet activities

Question 16

Nursing Intervention: Prevent Spread of Infection

Answer 16

-Hand Washing

-Teach people to cover mouth with tissue

-Judicious patient room assignments

-Immunizations

-Antibiotics (only bacterial)

Question 17

Nursing Intervention: Promote hydration and nutrition

Answer 17

-High calorie fluids (milkshake or anything)

-Avoid caffeine

-Allow children to self regulate the diet

-We DO NOT care about what they eat when they are sick

Question 18

Fever Management

Answer 18

Low grade fever is VERY beneficial (helps body kill bacteria or virus)

If child is uncomfortable treat with medication

Question 19

What medications do we use to treat fevers in kids?

Answer 19

Acetaminophen

Ibuprofen > 6 months of age

(Do not go back and forth)

Question 20

We do not recommend OTC cold medications for children under what age?

Answer 20

Under 3 years old

Question 21

Specific Therapies to Improve Oxygenation

Answer 21

Coughing and deep breathing
-pinwheels
-games

Suctioning

Aerosolized nebulizer medications

Chest Physiotherapy

Percussion and Postural Drainage

Question 22

Why is suctioning important for kids with respiratory issues?

Answer 22

They mucous can block oxygen from getting in

Question 23

CPAP

Answer 23

Give increase pressure to keep lung expand and from letting avolie collapse

Question 24

NHF

Answer 24

Nasal High Flow

Decrease work of breathing

Increases lung volume

Improves mucosal integrity and clear acne

Question 25

Infection in children tend to spread from one structure and the other, and

Answer 25

Frequently involve multiple areas

Question 26

Clinical Manifestations of General Respiratory Infections

Answer 26

Fever Meningismus Anorexia Vomiting and Diarrhea Abdominal Pain Nasal Blockage Respiratory sounds Sore throat

Question 27

Size of airway with kids and respiratory infections

Answer 27

Diameter of airway plays big role in respiratory illnesses Distance between structures is shorter, allowing organisms to rapidly move down Short eustachian tubes

Question 28

Sick Season

Answer 28

November - April

Question 29

Nasopharyngitis what is it? what causes it?

Answer 29

Common Cold Rhinoviruses Adenovirus Influenza Parainfluenza

Question 30

Nasopharyngitis: Young Child Manifestations

Answer 30

Fever Irritability Restlessness Sneezing Vomiting / Diarrhea

Question 30

Nasopharyngitis: Old Child Manifestations

Answer 30

Dryness / irritation of nose and throat Sneezing Chilling Muscular aches Cough Edema of mucosa

Question 31

Nasopharyngitis: How long does it last and when should they be seen?

Answer 31

10-14 days go be seen if fever last longer than 5-7 days / ear infection

Question 32

If temp is taken under the arm we add

Answer 32

1 degree

Question 33

Nasopharyngtits: Treatment

Answer 33

No OTC < 3 Antipyretics for high fever / discomfort Rest Decongestants (older chilren) Hydration (important)

Question 34

We should avoid cough suppressants with

Answer 34

Large amount of alcohol

Question 35

Why do we not recommend antihistamines with nasopharyngitis?

Answer 35

Can cause drowsiness or have paradoxical effect

Question 36

Nasopharyngitis: Pneumonic

Answer 36

C - Comfort O - Offer fluids L - Look for complications D - Decrease disease spread

Question 37

Tonsillitis

Answer 37

VIRAL infection of throat

Question 38

How do we treat tonsillitis?

Answer 38

Treat symptomatically NO antibiotics

Question 39

Strep Pharyngitits: Clinical Manifestations

Answer 39

Sudden onset Sore throat Headache Fever Vomiting / Belly pain (could be first) Lymphadenopathy BEEFY RED THROAT

Question 40

Strep Pharyngitis: Risk if untreated

Answer 40

Acute rheumatic fever (heart) Acute glomerulonephritis (kidney) Impetigo Pyoderma (leg ulcers) Scarlet fever

Question 41

Strep Pharyngitis: Treatment

Answer 41

Full 10 day course of antibiotics

Question 42

Strep: Management and Nursing Care

Answer 42

Antibiotics Throw away toothbrush after 24 hours Stay hydrated - Cool liquids No should drink or eat after them

Question 43

When can a child return to school with strep?

Answer 43

24 hours after antibiotic therapy

Question 44

Strep and orthodontic appliances

Answer 44

wash thoroughly and sterilize if possible Try to get new items We do not want to re-infect

Question 45

Tonsillectomy: Indicaitons

Answer 45

Frequent strep infection Peritonsillar abscess Sleep apnea

Question 46

Tonsillectomy: Contrainidicaitons

Answer 46

Cleft palate Acute infections Uncontrolled systemic disease Blood dyscrasias Under 4 years of age

Question 47

Tonsillectomy: Nursing Consideration

Answer 47

Observer for signs and symptoms of bleeding

Question 48

What indicates bleeding post tonsillectomy?

Answer 48

Excessive swallowing Position on side until alert (then sit up) Discourage straws - coughing - laughing - crying - blowing nose Ice Collar (cold compress) Cool mist vaporizer

Question 49

Is blood tinged mucus normal with tonsillectomy?

Answer 49

Yes

Question 50

Why do we not give to children post tonsil removal?

Answer 50

Anything that might hurt their throat or anything that is red or brown Citrus juice Milk - Ice Cream - Pudding NO HARDS FOODS

Question 51

Signs that indicate bleeding in tonsilecortmy?

Answer 51

Increase swallowing Vomiting bright blood Restlessness Decrease BP (late sign shock) Membrane discoloration

Question 52

What does stridor indicate?

Answer 52

Swelling and air compromise