Ch. 19: CF Flashcards Preview

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Flashcards in Ch. 19: CF Deck (46):
1

CF is a respiratory disorder that results from inheriting a ____

Mutated gene

2

What is CF characterized by?

-Mucus glands that secrete an increase in the quantity of thick, tenacious mucous--> Leads to mechanical obstruction of organs
-Increase in organic and enzymatic constituents in the saliva
-Increase in Na and Cl in sweat
-CNS abnormalities

3

One of the things CF is characterized by is mucus glands that recreate an increase in the quantity of thick, tenacious mucous, which leads to obstruction of organs. What organs are affected?

Pancreas
Lungs
Liver
S. Intestine
Reproductive system

4

One or both biological parents carry the recessive trait for CF?

BOTH

5

Physical assessment findings:

______ at birth manifested as distention of the abdomen, vomiting, and inability to pass stool

Meconium ileus

6

Physical assessment: Respiratory

What are the early signs?

Wheezing
Dry, non-productive cough

7

Physical assessment: Respiratory

What are the increased involvement signs?

Dyspnea
Paroxysmal cough
Mucus plugs and atelectasis on xray

8

Physical assessment: Respiratory

What are the advanced involvement signs?

Cyanosis
Barrel-shaped chest
Clubbing of fingers and toes
Multiple episodes of bronchitis or bronchopneumonia

9

Physical assessment: GI

What kind of stools?

Large, loose, fatty, sticky, foul-smelling

10

Physical assessment: GI

What are the early signs for appetite? late?

Early: Voracious appetite
Late: Loss of appetite

11

Physical assessment: GI

Do they gain weight easily?

No--failure to gain weight; weight loss

12

Physical assessment: GI

How are their growth patterns? What type of abdomen, arms, and legs?

Growth pattern= delayed

Arms and legs= thin

13

Physical assessment: GI

Deficiency of what?

Fat soluble vitamins

14

Physical assessment: GI

What kind of blood problems?

Anemia

15

Physical assessment: Integumentary

How are the sweat, tears, and saliva?

Abnormally salty

16

Physical assessment: Endocrine and reproductive

What goes on here?

-Viscous cervical mucus
-Decreased/absent sperm

17

How is CF diagnosed?

Sweat chloride test

18

What is a sweat chloride test?

A special device that stimulates sweat production

19

How many sites need to have sweat collected for it to be an adequate sample for the sweat test?

Sweat from 2 different sites

20

Sweat chloride test: Expected reference range is the presence of chloride less than ____

40 mEq/L

21

**Sweat chloride test: What is the diagnostic confirmation for CF?

Normal= 40 mEq/L

CF= Chloride greater than 60 mEq/L for infants less than 3 months of age & greater than 40 mEq/L for all others

22

Why would a chest x ray be done?

May indicate atelectasis and obstructive emphysema

23

Why would an abdominal x ray be done?

Detect meconium ileus

24

Lab tests: What are we testing for detection of infection?

-Pseudomonas aeruginosa
-Haem influenzae
-Burkholderia cepacia
-S. aureus
-E. Coli
-Klebsiella pneumonia

25

What 2 types of infection need contact isolation?

B. cepacia and P. aeruginosa

26

For pulmonary management for CF, one nurse care is to perform chest physiotherapy (CPT) with postural drainage as prescribed. When should we avoid doing CPT?

Before and after meals

27

For pulmonary management for CF. one nurse care is to perform airway clearance therapy. What do we use to do this and how many times a day do we do this?

Use flutter mucus clearance device
Twice daily

28

Pulmonary management. We should encourage physical exercise. Ex?

Stationary bike

29

GI management. What kind of diet? How many meals a day?

Diet: well balanced, high in PROTEIN and CALORIES
3 meals a day with snacks

30

GI management. What do we administer as prescribed 30 min within eating?

Pancreatic enzymes

31

GI management: What vitamins may we give (as prescribed)?

Multivitamins; vit. A, D, E and K

32

GI management. What if the child is constipated?

Give GoLYTELY (polythylene-glycol electrolyte solution)

33

Medications. What med decreases the viscosity of mucus and improves lung function?

Dornase alfa

34

Dornase alfa is administered ____

1x a day

35

If a client is taking ipratropium bromide (cholinergic antagonists), what should we observe for and what should we do with client education?

Observe: Dry mouth
Client education: Wait 5 min between ipratropium bromide and other inhaled meds

36

If the client is taking albuterol, what do we monitor the child for?

Tremors and tachycardia

37

What should we teach the client about fluticasone propionate/salmeterol?

Rinse mouth after taking that

38

What are some common antibiotics given? How are they administered?

Tobramycin
Ticarcillin
Gentamicin

Administered through IV or aerosol

39

If we are giving the child with CF pancreatic enzymes, what should we be monitoring? Explain.

Adequate dosing

Loose, fatty stool= increase dose
Constipated= decrease dose

40

How do we give the pancreatic enzymes?

In a capsule with all meals and snacks (remember earlier, give within 30 min of eating)

41

Pancreatic enzymes--is it okay if the client swallows capsule whole? Is it okay if they sprinkle capsules on food?

Yes to both

42

Care after discharge. What should we emphasize?

Need for up-to-date immunizations and a yearly influenza vaccine

43

A nurse is caring for a child who is suspected of having CF. Which of the following tests should the nurse prepare to administer to confirm the diagnosis?

A. Sweat chloride
B. Pulmonary function test
C. Arterial blood gases
D. Chest percussion

A

44

A nurse is admitting a child who has CF. Which of the following meds should the nurse anticipate including in the plan of care? (SATA)

A. Tobramycin
B. Solu-medrom
C. Fat-soluble vitamins
D. Albuterol
E. Dornase alfa

A, C, D, E

45

A nurse is caring for a child who has CF. Which of the following are expected findings? (SATA)

A. Wheezing
B. Clubbing of fingers and toes
C. Barrel-shaped chest
D. Thin, watery mucus
E. Rapid growth spurts

A, B, C

46

A nurse is planning care of child who has CF. Which of the following interventions should she include in plan of care?

A. Provide a low calorie, low protein diet
B. Administer pancreatic enzymes with meals and snacks
C. Promote an increase in fluids after 1800
D. Restrict physical activity

B