Alteration in gas exchange

Question 1

why are infants belly breathers

Answer 1

because their intercostal muscles are still week

Question 2

why dont infants have productive coughs

Answer 2

because they dont produce alot of mucus

Question 3

how many alveoli does an infant have compared to a 7-8 year old

Answer 3

50million, 7-8 year old have 300 million

Question 4

what is tidal volume

Answer 4

the amount of air moved in and out of the lungs

Question 5

how many L of oxygen do babies consume compared to adults

Answer 5

infants 6-8L/min, adults 3-4L/min

Question 6

what is the RR of a preterm infant

Answer 6

40-60

Question 7

what is the RR of newborn- 1 year

Answer 7

30-35

Question 8

what is the RR of a 2-6 year old

Answer 8

21-25

Question 9

what is the RR of a 6-12 year old

Answer 9

19-21

Question 10

what sound would you hear when percussing someone with pneumonia

Answer 10

dull

Question 11

what are antihistamines for

Answer 11

allergic rhinitis, asthma

Question 12

what are anticholinergic for

Answer 12

acute or chronic wheezing - by bronchodilation

Question 13

what do B2 agonist do

Answer 13

smooth muscle relaxer results in bronchdilation

Question 14

what are the organisms that cause upper respiratory infections

Answer 14

Most common: rhinovirus, parainfluenza, adenovirus
Others: parainfluenza, adenovirus, human metapneumovirus

Question 15

how many colds to children have a year

Answer 15

6-9 colds per year

Question 16

how long do respiratory infections last

Answer 16

7-10 days

Question 17

a cold past 7-10 days is what

Answer 17

sinuisitis rhinosinusitis

Question 18

acute sinusitis is less then how many days

Answer 18

30 days

Question 19

chronic sinusitis is between _ and _ week

Answer 19

4 and 6

Question 20

what is bronchiolitis

Answer 20

acute inflammatory process of the bronchioles and small bronchi

Question 21

what are some organisms that cause bronchiolitis

Answer 21

RSV, adenovirus, parainfluenza, metapneumovirus

Question 22

how does RSV infect someone

Answer 22

invades nasopharynx into lower airway - aspiration of secretions - spreads from adults to children

Question 23

what does RSV do to the lungs

Answer 23

Air trapping occurs as a result of the inability to achieve full expiration
Hyperinflation and atelectasis occur
Pulmonary ventilation and perfusion are mismatched
Hypoventilation r/t increased work of breathing

Question 24

what are some ss of Bronchiolitis (RSV)

Answer 24

fever, cough, wheezing, paryingitis, mucus, elevated ESR

Question 25

what are some ss of sudden onset of respiratory distress

Answer 25

Increased respiratory rate, Nasal flaring, Retractions on inspiration, Tachycardia and cyanosis (r/t hypoxia), Low oxygen saturation

Question 26

what are some labs and tests that should be done for Bronchiolitis (RSV)

Answer 26

pulse ox, chest radiography (for hyperinfiltration), ABGs, nasal-pharyngeal wash

Question 27

how is RSV confirmed

Answer 27

RSV via (ELISA) or (IFA) testing- confirmed

Question 28

what kind of precautions should be placed from someone with RSV

Answer 28

droplet

Question 29

what is the med to prevent RSV and how does it work

Answer 29

Palivizumab (Synagis) – monoclonal antibody immunoprophylaxis For high-risk infants/toddlers < 24-months-old Intramuscular IM injection every 28-30 days 1st dose before RSV season

Question 30

what is Laryngotracheobronchitis (Croup)

Answer 30

inflammation and edema of the larynx, trachea, and bronchi Viral: Parainfluenza is most common cause

Question 31

what are some ss of Laryngotracheobronchitis (Croup)

Answer 31

worse at night, inspiratory stridor, barking cough, last 3-5 days

Question 32

what are some complications that can occur with Laryngotracheobronchitis (Croup)

Answer 32

worsening respiratory distress, hypoxia, bacterial superinfection, epiglottits

Question 33

what is the treatment for Laryngotracheobronchitis (Croup)

Answer 33

corticosteriods (dexamethasone 0.15-0.6), racemic epinephrine nebulizer

Question 34

what is Epiglottitis

Answer 34

Inflammation and swelling of the epiglottis most often caused by Haemophilus Influenza type b, affects 1-8 years old

Question 35

what are some ss of Epiglottitis

Answer 35

high fever, dysphagia, toxic apperance

Question 36

what are some complications of Epiglottitis

Answer 36

respiratory arrest, pneumothorax, pulmonary edema

Question 37

what is Epiglottitis diagnosed

Answer 37

soft tissue imaging of neck and chest, blood cultures, history

Question 38

how is Epiglottitis treated

Answer 38

corticosteriods, antibiotics (ampicillin and sulbactam

Question 39

what are the dos and dont of Epiglottitis

Answer 39

do not attempt to visualize the throat, place in supine do provide 100% o2, ensure tracheostomy tray and emergency equipment are readily available

Question 40

what is tonsillitis and pharyngitis

Answer 40

Inflammation of the tonsils Bacterial or viral Group A beta-hemolytic Streptococci 20-30% of cases

Question 41

what are some complications of tonsillitis and pharyngitis

Answer 41

airway obstruction, shifting of uvula, peritonitis abscess, increased risk for rheumatic fever, glomelular nephritis

Question 42

what are the meds used to treat tonsillitis and pharyngitis

Answer 42

Antibiotics: penicillin PCN allergic: ocephalsoprin, microline

Question 43

what are some ss of tonsillitis and pharyngitis

Answer 43

drooling, fever, exudate, throat pain, mouth breathing, nasal sounding voice

Question 44

what is post op care from someone who had tonsillectomy

Answer 44

side lying or prone, dont cough, avoid citrus and brown red fluids, ice collar, avoid highly seasoned and sharp foods, watch for frequent swallowing as it can be a sign of bleeding

Question 45

what are some ss of cystic fibrosis

Answer 45

Salty tasting skin, Chronic Respiratory symptoms, Frequent lung infections, Poor growth, Constipation, Greasy, bulky stools, malnutrition,

Question 46

what are some early signs of respiratory distress

Answer 46

Restlessness | anxiety Tachycardia Tachypnea

Question 47

what are some late signs of respiratory distress

Answer 47

Bradycardia Extreme restlessness Severe dyspnea