Ch 25 resp-2

Question 1

bronchitis s/s

Answer 1

dry hacking cough that worsens at night

Question 2

bronchiolitis/RSV s/s severe-8

Answer 2

1. tachyP 70+
2. grunting
3. wheeze
4. retractions
5. nasal flare
6. irritability
7. distended abdo
   * noisier the lungs the better

Question 3

RSV tx-4

Answer 3

IM palivizumab

• isolation w airborne precautions
• elevate HOB
• withhold oral feed w tachyP

Question 4

TB-3

Answer 4

• under 10yr rarely contagious
• airborne if active
• directly observed drug tx

Question 5

asthma s/s-4

Answer 5

• frequent cough at night (silent s/s)
• barrel chest
• pulsus paradoxus
• head bob

Question 6

short acting beta agonists (SABA)-5

Answer 6

• rescue before steroid
• rinse mouth
• spacer
• exercised induced
• albuterol, levalbuterol, pirbuterol

Question 7

corticosteroids-2

Answer 7

• give w food in morning

- methylprednisolone, prednisone, prednisolone

Question 8

inhaled corticosteroids-2

Answer 8

-need spacer, rinse mouth

Question 9

peak expiratory flow meter-5

Answer 9

1. set to 0
2. stand and take deep breath
3. blow hard and fast 1-2sec
4. repeat x2 and record highest
5. 2x day for 2-3wk for best

Question 10

peak expiratory flow readings-3

Answer 10

green-80-100%
yellow 50-80% call dr
red -50%- use bronchodilator and call dr

Question 11

bronchopulmonary dysplasia

Answer 11

the need for supplemental O2 28days+ after premature birth

Question 12

bronchopulmonary dysplasia tx-4

Answer 12

• surfactant instillation
• continuous PEEP
• parenteral/enteral feed
• carefull fl balance

Question 13

cystic fibrosis s/s-5

Answer 13

• salty skin, clubbing
  1. newborn meconium ilieus
  2. malabsorption or fail to thrive
  3. chronic resp inf
  4. fecal impaction

Question 14

cystic fibrosis dx-2

Answer 14

sweat chloride test, immunoreactive trypsinogen (IRT)

Question 15

cystic fibrosis tx-4

Answer 15

• enzymes before eating
• chest physiotherapy
• aerosol tx w DNase before CPT
• increase salt, fat, calories

Question 16

salt depletion s/s-4

Answer 16

fatigue, weak, abdo pain, vomit

Question 17

smoke inhale-2

Answer 17

• rapid edema

- 100% O2 w nonrebreather

Question 18

pulmonary contusion s/s

Answer 18

-initial asymptomatic w resp distress, fever, wheeze, hemoptysis, and crackles over several hours

Question 19

pulmonary contusion tx-5

Answer 19

fl restriction, O2, pain control, incentive spirometry, avoid prolonged immobilization

Question 20

open pneumothorax

Answer 20

penetrating injury

Question 21

closed pneumothorax

Answer 21

blunt chest trauma

Question 22

tension pneumothorax

Answer 22

air leaks into chest w inspiration but can’t escape w expiration-collapsed lung

Question 23

pneumothorax tx-2

Answer 23

• cover wound w airtight seal

- needle thoracostomy/thoracentesis