Care of Child With Respiratory Problems Flashcards
(67 cards)
1
Q
BREATHING SEQUENCE
A
- Phrenic nerve stimulation
- diaphragm and muscles contract; thorax expands
- Intrathoracic and intrapulmonic pressures decrease
- INSPIRATION : air moves from (+) pressure outside to (-)
pressure in alveoli; stretch receptors are stimulated - EXPIRATION : passive expulsion of air as elastic tissue
recoils
2
Q
air moves from (+) pressure outside to (-)
pressure in alveoli; stretch receptors are stimulated
A
INSPIRATION
3
Q
passive expulsion of air as elastic tissue recoils
A
EXPIRATION
4
Q
inspiration stimulates alveolar stretch receptors, which send inhibitory impulses to brainstem to prevent overdistention
A
Hering-Breuer reflex
5
Q
stimulate respiration in response to lowered pH, increased PCO2 and decreased PO2
A
Chemoreceptors
6
Q
control respiration rate and depth
A
Medulla oblongata and pons
7
Q
capacity of chest wall and lung to distend
A
Compliance
8
Q
mostly dependent on airway size, as well as tissue resistance
A
Resistance
9
Q
rapid RR (high metabolism); rate steadily decreases with growth and maturity
A
Neonate
10
Q
hydrogen ion concentration in solution
A
pH
11
Q
measure of acidity and alkalosis
A
pH
12
Q
homeostasis; balance between acidosis and alkalosis
A
Steady pH concentration in the body
13
Q
when pH drops, respirations _______________ to exhale more ________________
A
increase; carbon dioxide
14
Q
when pH rises, respiratory center ________________ rate of respiration
A
decreases
15
Q
excess presence of H+ ions
A
Acidosis
16
Q
deficiency of H+ ions
A
Alkalosis
17
Q
In many disorders, symptoms like ________________________________________________, cause acid-base disturbances that are more hazardous to a child than the primary disorder
A
fever, vomiting or diarrhea
18
Q
RESPIRATION-VENTILATION
Physical Observations
A
- Chest rise-and-fall (child 7 and up)
- Abdominal rise-and-fall (infant and young child)
- Nasal Flaring : indicates respiratory distress
- Skin: mottled, pallor, cyanosis
- Clubbing at fingertips, usually with chronic hypoxia
19
Q
Chest rise-and-fall
A
child 7 and up
20
Q
Abdominal rise-and-fall
A
infant and young child
21
Q
indicates respiratory distress
A
Nasal Flaring
22
Q
Counting Respirations
A
- Abdominal movements in infant to age 7
- Chest movements in age 7 and up
- Count when child is restful and unaware
- Tachypnea
23
Q
rapid respiration often due to awareness, excitement, anxiety, fever, other disorders
A
Tachypnea
24
Q
excessively deep breathing; seen in fever, anemia, etc.
A
Hyperpnea
25
shallow breathing
Hypopnea
26
difficulty breathing
Dyspnea
27
too-shallow, too-slow breathing that fails to meet the body’s needs.
Hypoventilation
28
seen in preterm infants and children with neuromuscular disorders
Hypoventilation
29
musical breathing, usually on expiration from narrowed airway or foreign body obstruction
Wheezing
30
Auscultation
1.Airway patency
2.Wheezing
3. Stridor
4. Cough
5. Whoop
31
loud, high-pitched breathing; inspiratory or expiratory; usually from narrowed upper airway or foreign body obstruction
Stridor
32
inspiratory sound with cough associated with pertussis in small children
Whoop
33
voice sounds while breathing
Fremitus
34
voice sounds while breathing
Fremitus
35
can be used to loosen secretions
Percussion
36
DIAGNOSTIC TESTS
Chest Radiograph
Computed Tomography (CT Scan)
Bronchoscopy
Pulmonary Function Tests
Sputum Culture
Pulse Oximetry
Arterial Blood Gases
37
Use of x-rays passed through the body to record internal structures
Chest Radiograph
38
Protect gonads and thyroid with lead shield
Chest Radiograph
39
Use of x-ray sequences to demonstrate cross-sections of the lung to detect lesions, masses, other abnormalities
Computed Tomography (CT Scan)
40
Use of bronchoscope to directly inspect trachea and bronchi under sedation
Bronchoscopy
41
Use of spirometry or pneumotachography to evaluate treatment and course of a disease
Pulmonary Function Tests
42
less useful diagnostically
Pulmonary Function Tests
43
spirometer measures lung volume and inhalation capacity to ascertain amount of air exchanged in breathing
Pulmonary Function Tests
44
Laboratory analysis to assess consistency, color and pathogens in secretions
Sputum Culture
45
Uses a photodetecting sensor clipped to a finger, toe or other small appendage to continuously monitor oxyhemoglobin saturation
Pulse Oximetry
46
helps determine child’s need for O2 administration
Pulse Oximetry
47
Used to assess levels of oxygenation and gas exchange by analyzing blood from an artery or capillary
Arterial Blood Gases
48
Infection and inflammation of the throat
PHARYNGITIS
49
signs and symptoms of Viral Pharyngitis
sore throat, fever & general malaise; enlarged regional lymph nodes; erythema at the back of the pharynx & palatine arch
50
Management of Viral Pharyngitis:
- acetaminophen, ibuprofen
- warm heat to the external neck area for comfort
- gargle with warm water
51
signs and symptoms of Streptococcal- caused by GABHS Pharyngitis
erythema at the back of the throat & palatine tonsils, enlarged tonsils, white exudates in tonsillar crypts, petechiae on palate, high fever, extreme sore throat, difficulty swallowing, overall lethargy, headache
52
Management of Viral Streptococcal- caused by GABHS Pharyngitis
- antibiotic treatment for 10 days (Pen G or clindamycin)
- dvise parents to strictly follow course of treatment to prevent hypersensitivity or autoimmune reaction to group A strep causing Rheumatic fever or glumerulonephritis
53
Infection and inflammation of the palatine tonsils
TONSILLITIS
54
cause of Tonsillitis in < 3 y.o is?
viral
55
cause of Tonsillitis in school age is
GABHS
56
Signs and Symptoms of Tonsillitis:
● drooling
● difficulty swallowing
● high fever
● lethargy
● increased ASO titer
● enlarged, bright red palatine tonsils
57
Management of Tonsillitis:
● Antipyretic, analgesic
● Full 10 days antibiotic treatment (Pen G or Amoxicillin)
● Tonsillectomy for chronic tonsillitis; done when organs aren’t infected
58
Tonsillectomy Management
- Avoid red fluids
- Bleeding signs check: increased pulse & RR, frequent
swallowing (cardinal sign of bleeding post tonsillectomy), throat clearing, feeling of anxiety
- Restrict child’s activity until after 7th day
- Offer sips of clear liquid, popsicles or ice chips
- Avoid acid & carbonated drinks
- Do position in prone or side lying position with head lower than the chest
59
Upper respiratory infection (type of croup) usually affecting children under age 5 years; with slow progressive onset
ACUTE LARYNGOTRACHEOBRONCHITIS (LTB)
60
ACUTE LARYNGOTRACHEOBRONCHITIS (LTB) is an ______________ respiratory infection (type of croup) usually affecting children under age ______________; with __________________ onset
upper; 5 years; slow progressive
61
An inflammation of the mucosa lining the larynx and trachea causing a narrowing the airway
ACUTE LARYNGOTRACHEOBRONCHITIS (LTB)
62
Typical patient of ACUTE LARYNGOTRACHEOBRONCHITIS (LTB) is a __________ who develops the classic ______________ and _______________ after several days of _________
toddler; “barking” cough; acute stridor; coryza
63
Causes of ACUTE LARYNGOTRACHEOBRONCHITIS (LTB):
parainfluenza virus types 1,2,3, RSV (Respiratory Syncytial Virus), Influenza type A &B, measles, Mycoplasma pneumoniae
64
Signs & Symptoms of ACUTE LARYNGOTRACHEOBRONCHITIS (LTB):
- barking (brassy) cough that usually happens at night
- dyspnea
- hoarseness
- inspiratory stridor (produced by the struggle to inhale air past obstruction and into the lungs)
- low-grade fever (gradual onset)
- moderate respiratory distress with mild wheezing
- persistent laryngospasm
- Retractions
- respiratory acidosis and respiratory failure due to
hypoxia and airway obstruction
65
Major objective for the therapeutic management of ACUTE LARYNGOTRACHEOBRONCHITIS (LTB)
medical management of infectious process and maintaining an airway for adequate respiratory exchange
66
Therapeutic Management of ACUTE LARYNGOTRACHEOBRONCHITIS (LTB)
1. mild croup without stridor are managed at home
2. cool mist with dexamethasone or racemic epinephrine
3. fluids (oral and intravenous)
4. run shower or hot water tap in bathroom; keep child in warm, moist environment
5. monitoring for signs of respiratory distress
67
Assessment of ACUTE LARYNGOTRACHEOBRONCHITIS (LTB)
✔ vigilant and accurate assessment of respiratory status:
difficulty breathing, low-grade fever, inadequate ventilation,
fatigue from persistent cough
✔ Noninvasive cardiac, respiratory and blood gas monitoring
