Chapter 18

Question 1

Where is the airway smaller in children (infants’ trachea is 4mm wide compared to adults that is 20mm)

Answer 1

trachea

Question 2

effort or labor associated with respiration

Answer 2

working of breathing (WOB)

Question 3

genetic tendency toward asthma, allergic, rhinitis atopic dermatitis

Answer 3

atopy

Question 4

a bluish tinge to the skin and mucous membranes

Answer 4

cyanosis

Question 5

increased respiratory rate for age

Answer 5

tachpnea

Question 6

a collapsed or airless portion of the lung

Answer 6

atelectasis

Question 7

the inward pulling of soft tissues with respiration

Answer 7

retractions

Question 8

gas exchange

Answer 8

ventilation

Question 9

binding of oxygen

Answer 9

oxygenation

Question 10

an enlargement of the terminal phalanx of the fingertip

Answer 10

clubbing

Question 11

noninvasive method of continuous (or intermittent) measuring of oxygen saturation

Answer 11

pulse oximetry

Question 12

low oxygen concentration in the blood

Answer 12

hypoxemia

Question 13

low oxygen concentration in the tissues

Answer 13

hypoxia

Question 14

may occur in asthma or viral infections

Answer 14

wheezing

Question 15

may occur with pneumonia

Answer 15

rales

Question 16

may occur in croup

Answer 16

stridor

Question 17

what are the risk factors for respiratory disorders?

Answer 17

Prematurity
chronic illness (diabetes, sickle cell anemia, cystic fibrosis..)
developmental disorders (cerebral palsy)
passive exposure to cigarette smoke
immune deficiency
crowded living conditions or lower socioeconomic status
daycare attendance

Question 18

Also called rhinosinusitis and a symptom is halitosis (bad breath)

Answer 18

sinusitis

Question 19

nasopharyngitis and THE COLOR OF NASAL DISCHARGE IS NOT AN ACCURATE INDICATOR OF VIRAL VS BACTERIAL INFECTION

Answer 19

Common cold

Question 20

Viral infection
spread through inhalation of droplets or contact with fine-particle aerosols
children with co-morbidities are at greater risk
primarily affects the upper respiratory epithelium but can be systemic

Answer 20

influenza

Question 21

-Exudate may be present, inflammation, petechiae, strawberry tongue, cervical nodes enlargement and tenderness, skin may have fine, red sandpaper rash (scarlatiniform) on trunk or abdomen (common in step A infection)
-Education point: throw away toothbrush after starting antibiotics (24 hrs in)
-No longer contagious after 24 hours of antibiotics

Answer 21

Pharyngitis

Question 22

• “grade” the tonsil enlargement (1+ - 4+ kissing tonsils)

Answer 22

tonisillitis

Question 23

No interventions but voice rest for at least 24 hours

Answer 23

laryngitis

Question 24

What is a nursing care for post tonsillectomy?

Answer 24

frequent swallowing may indicate bleeding

Question 25

-inflammation and swelling of the epiglottis- from Hib
-respiratory arrest and death can occur if the airway becomes completely occluded
-airway maintenance and antibiotic therapy (PICU admission)
-sudden onset of symptoms: high fever, toxic appearance, may refuse to speak, sitting forward with neck extended, may refuse to lay down, drooling, anxiety, irritability, significant respiratory distress, dysphagia
-DO NOT TRY TO VISUALIZE THROAT- may cause reflex laryngospasm causing immediate airway obstruction
-do not leave child unattended, no not place in supine position, provide 100% oxygen
- if complete airway occlusion occurs- emergency tracheostomy (always have emergency equipment at the bedside)

Answer 25

epiglottitis

Question 26

-mostly always viral- and mostly from respiratory syncytial virus (RSV)
- highly contagious virus
-allows for adequate inspiration but prevents full expiration = this leads to hyperinflation and atelectasis
-serious alterations in gas exchange
-increased WOB and carbon dioxide retention
- supportive management- supplemental oxygen suctioning, hydration, bronchodilator therapy (racemic epi or albuterol)
-tachypnea, significant retractions, poor oral intake, lethargy

Answer 26

bronchiolitis

Question 27

What are the symptoms of bronchiolitis?

Answer 27

-onset of illness with a clear runny nose (sometimes profuse)
-pharyngitis
-low grade fever
-development of cough 1-3 days into illness, followed by a wheeze shortly thereafter
-poor feeding

Question 28

bacterial - looks more “toxic appearance” but can recover quickly with antibiotics

Answer 28

pneumonia

Question 29

-inflammation of the trachea and major bronchi often associated with URI
-mostly viral in nature supportive care adequate hydration, antipyretics, and OTC expectorants (if bacterial- antibiotics)
-dry hacking cough, fever, coarse rales

Answer 29

bronchitis

Question 30

-children with latent TB are treated with isoniazid for 9 months to prevent progression of the disease
-children with active TB will get 2 months of isoniazid, rifampin, and pyrazinamide daily then twice weekly. isoniazid, and rifampin

Answer 30

tuberculosis

Question 31

what is epistaxis?

Answer 31

nose bleed

Question 32

What does stridor suggest upper airway

Answer 32

foreign body aspiration

Question 33

trapped air consumes the space within the pleural cavity- the affected lung has a partial or full collapse

Answer 33

pneumothorax

Question 34

• generalized dysfunction of the exocrine glands
  -thickened tenacious secretions in the sweat glands, GI trac, pancreas, and respiratory tract (the increased viscosity of these glands make them very difficult to clear)
  -sweat glands produce large amounts of chloride = salty taste of the skin and alterations in electrolyte balance and dehydration
  -considered suspicious if the level of chloride is collected sweat is above 50 mEq/L and diagnostic if the level is above 60 mEq/L
  -Treatment: chest physiotherapy (multiple times daily)

Answer 34

cystic fibrosis

Question 35

-chronic inflammation airway disorder- airway hyperresponsiveness, airway edema & mucus production
REVIEWWWWW

Answer 35

asthma