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Exam 3 (Resp) Flashcards

(102 cards)

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1
Q

Acute Viral Nasopharyngitis (Common Cold) — Etiology/Risk

A

Numerous respiratory viruses (rhinovirus, RSV, coronavirus); spread by droplets & contact; ↑risk in infants due to small nasal passages & limited mucus.

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2
Q

Acute Viral Nasopharyngitis (Common Cold) — S/S

A

Nasal congestion & discharge, mild fever, cough, sore throat, sneezing, feeding difficulty in infants.

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3
Q

Acute Viral Nasopharyngitis (Common Cold) — Diagnosis

A

Clinical; rule‑out streptococcal infection if severe sore throat or high fever.

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4
Q

Acute Viral Nasopharyngitis (Common Cold) — Treatment

A

Supportive: saline drops + bulb suction, humidified air, antipyretics, hydration.

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5
Q

Acute Viral Nasopharyngitis (Common Cold) — Nursing Interventions

A

Teach bulb‑suction before feeds; monitor temp/ear pain; hand‑hygiene education; head‑elevate crib mattress.

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6
Q

Acute Viral Nasopharyngitis (Common Cold) — Complications/Prevention

A

Can progress to otitis media or sinusitis; prevent with handwashing and avoiding sick contacts.

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7
Q

Acute Streptococcal Pharyngitis (GABHS) — S/S

A

Sudden severe sore throat, fever > 101.3 °F, abdominal pain/headache, inflamed tonsils with exudate; possible fine rash.

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8
Q

Acute Streptococcal Pharyngitis (GABHS) — Etiology/Risk

A

Group A β‑hemolytic Streptococcus; more common in school‑age children & winter.

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9
Q

Acute Streptococcal Pharyngitis (GABHS) — Diagnosis

A

Rapid strep antigen test and throat culture (gold standard).

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10
Q

Acute Streptococcal Pharyngitis (GABHS) — Treatment

A

Penicillin or amoxicillin x 10 days (macrolide if allergic); analgesics/antipyretics.

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11
Q

Acute Streptococcal Pharyngitis (GABHS) — Nursing Interventions

A

Warm saline gargles, cool fluids, med teaching; contagious until 24 h after first antibiotic dose.

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12
Q

Acute Streptococcal Pharyngitis (GABHS) — Complications/Prevention

A

Acute rheumatic fever (>10 d), acute glomerulonephritis (>18 d); early treatment prevents.

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13
Q

Tonsillitis — Etiology/Risk

A

Usually viral; can be bacterial; often accompanies pharyngitis.

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14
Q

Tonsillitis — S/S

A

Tonsillar inflammation, dysphagia, mouth breathing, muffled voice, ±fever.

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15
Q

Tonsillitis — Diagnosis

A

Clinical (+ throat culture if bacterial suspected).

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16
Q

Tonsillitis — Treatment

A

Supportive if viral; antibiotics if streptococcal; tonsillectomy if recurrent obstructive.

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17
Q

Tonsillitis — Nursing Interventions

A

Monitor airway, encourage fluids/popsicles, antipyretics, educate on infection signs.

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18
Q

Tonsillitis — Complications

A

Airway obstruction, abscess; post‑op hemorrhage (see tonsillectomy care).

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19
Q

Tonsillectomy — Post‑op Care — Diet

A

Start with clear, non‑red liquids → advance to soft; avoid citrus & dairy that trigger throat clearing.

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20
Q

Tonsillectomy — Post‑op Care — Bleeding Signs

A

Frequent swallowing, throat clearing, restlessness, bright‑red emesis, tachycardia.

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21
Q

Tonsillectomy — Post‑op Care — Interventions

A

Side‑lying position, ice collar, cool‑mist vaporizer, analgesics ATC, discourage coughing/blowing nose.

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22
Q

Influenza (A or B) — Etiology/Risk

A

Influenza viruses spread via droplets; contagious 1–2 days pre‑symptom. High‑risk: cardiac, pulmonary, immunocompromised, diabetes, <2 yrs.

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23
Q

Influenza (A or B) — S/S

A

Abrupt high fever > 103 °F, chills, myalgia, malaise, facial flushing, dry cough, sore throat, coryza; may cause wheeze, GI upset, photophobia.

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24
Q

Influenza (A or B) — Diagnosis

A

Rapid influenza antigen or PCR swab.

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25
Influenza (A or B) — Nursing Interventions
Droplet precautions, encourage rest/fluids, monitor for secondary infection.
25
Influenza (A or B) — Treatment
Supportive (fluids, antipyretics); oseltamivir within 24–48 h for high‑risk or severe cases.
26
Influenza (A or B) — Complications/Prevention
Otitis media, pneumonia, Reye syndrome (aspirin use); annual vaccine ≥6 months.
27
Acute Otitis Media (AOM) — Etiology/Risk
Bacterial (S. pneumoniae, H. influenzae); risk: short eustachian tubes, smoke exposure, bottle‑propping.
28
Acute Otitis Media (AOM) — S/S
Ear pain (tugging), fussiness, fever, bulging erythematous tympanic membrane.
29
Acute Otitis Media (AOM) — Diagnosis
Otoscopic exam shows immobile, bulging TM; pneumatic otoscopy.
30
Acute Otitis Media (AOM) — Treatment
High‑dose amoxicillin 80–90 mg/kg/day x 10 days if <2 yrs or severe; may observe 48 h if mild.
31
Acute Otitis Media (AOM) — Nursing Interventions
Pain control (acetaminophen/ibuprofen), warm compress, educate on complete antibiotic course.
32
Acute Otitis Media (AOM) — Complications/Prevention
Temporary hearing loss, TM rupture; prevent with breastfeeding, pneumococcal/influenza vaccines.
33
Infectious Mononucleosis (EBV) — Etiology/Risk
Epstein‑Barr virus via saliva ('kissing disease'), common in adolescents.
34
Infectious Mononucleosis (EBV) — S/S
Fever, severe sore throat, lymphadenopathy (posterior cervical), fatigue, splenomegaly, ±hepatomegaly, palatal petechiae.
35
Infectious Mononucleosis (EBV) — Diagnosis
Monospot (positive after day 7–10) or EBV titers.
36
Infectious Mononucleosis (EBV) — Treatment
Supportive: hydration, antipyretics, corticosteroid if airway obstruction.
37
Infectious Mononucleosis (EBV) — Nursing Interventions
Educate on rest, no contact sports ≥3–4 wks if splenomegaly; monitor airway.
38
Infectious Mononucleosis (EBV) — Complications
Splenic rupture, Guillain‑Barré, aseptic meningitis.
39
Acute Epiglottitis — Etiology/Risk
Haemophilus influenzae type b (bacterial); age 2–8 yrs; ↓incidence with Hib vaccine.
40
Acute Epiglottitis — S/S
High fever, severe sore throat, drooling, dysphonia, inspiratory stridor, tripod position, anxiety.
41
Acute Epiglottitis — Diagnosis
Lateral neck X‑ray shows 'thumb sign'; diagnosis often clinical—do not examine throat blindly.
42
Acute Epiglottitis — Treatment
Controlled airway (intubation), IV ceftriaxone, corticosteroids.
43
Acute Epiglottitis — Nursing Interventions
Keep child calm, avoid throat culture; emergency trach set available.
44
Acute Epiglottitis — Complications/Prevention
Sudden airway obstruction; prevent with Hib vaccination.
45
Acute LTB (Viral Croup) — Etiology/Risk
Parainfluenza, RSV, influenza viruses; peak 6 mo–3 yrs.
45
Acute LTB (Viral Croup) — Diagnosis
Clinical; neck X‑ray may show subglottic narrowing ('steeple sign').
46
Acute LTB (Viral Croup) — S/S
Barky cough, inspiratory stridor, hoarseness, low‑grade fever, retractions.
47
Acute LTB (Viral Croup) — Treatment
Systemic dexamethasone; racemic epinephrine for stridor; cool mist, fluids.
48
Acute LTB (Viral Croup) — Nursing Interventions
Monitor airway, keep calm; teach parents cool night air/steam for mild cases.
48
Acute LTB (Viral Croup) — Complications
Respiratory failure if progressive obstruction.
49
Spasmodic (Paroxysmal) Croup — Etiology/Risk
Likely viral/allergic; sudden nighttime onset in toddlers.
50
Spasmodic (Paroxysmal) Croup — S/S
Barky cough, stridor at night, afebrile, resolves quickly.
51
Spasmodic (Paroxysmal) Croup — Treatment/Nursing
Calm child, expose to cool air or steam; may give oral dexamethasone.
52
Bronchiolitis (RSV) — Etiology/Risk
RSV spreads via secretions; peak winter‑spring; high‑risk: <6 mo, prematurity, CHD, CLD.
53
Bronchiolitis (RSV) — S/S
Initial URI symptoms → wheeze, cough, tachypnea, retractions; severe: SpO₂↓, apnea, quiet chest.
54
Bronchiolitis (RSV) — Diagnosis
Nasopharyngeal RSV antigen (ELISA/IFA); CXR: hyperinflation, patchy atelectasis.
55
Bronchiolitis (RSV) — Treatment
Supportive O₂, suction, hydration; bronchodilator trial; hospitalization if severe.
56
Bronchiolitis (RSV) — Nursing Interventions
Contact & droplet isolation, elevate HOB, frequent suction, monitor apnea.
57
Bronchiolitis (RSV) — Prevention/Complications
Monthly palivizumab for high‑risk infants; possible recurrent wheeze/asthma later.
58
Pneumonia — Etiology/Risk
Viral most common <5 yrs; bacterial (Strep pneumoniae, Mycoplasma), aspiration, fungal.
59
Pneumonia — S/S
Fever, cough, tachypnea, retractions, crackles ±wheeze, abdominal pain in older child.
60
Pneumonia — Diagnosis
Chest X‑ray: viral—diffuse infiltrates; bacterial—lobar; WBC↑ bacterial; sputum culture (older).
60
Pneumonia — Treatment
Viral: supportive; Bacterial: high‑dose amoxicillin/ampicillin or macrolide (atypical).
61
Pneumonia — Nursing Interventions
O₂ if hypoxic, hydration, antipyretics, cluster care for rest, teach deep‑breathing/IS.
62
Pneumonia — Complications
Effusion, empyema, pneumothorax, sepsis.
63
Bronchitis — Etiology/Risk
Usually viral; M. pneumoniae in older kids; follows URI.
64
Bronchitis — S/S
Dry hacking cough progressing to productive; coarse rales; fever low‑grade.
65
Bronchitis — Diagnosis
Clinical; CXR may show perihilar markings.
66
Bronchitis — Treatment
Supportive: expectorants, hydration, antipyretics; antibiotics only if bacterial.
67
Bronchitis — Nursing Interventions
Teach parents to avoid cough suppressants; use honey >1 yr.
67
Asthma — Pathophysiology
Chronic airway inflammation, hyper‑responsiveness, mucus; triggers: allergens, exercise, cold air.
68
Asthma — S/S
Recurrent wheeze, nighttime cough, dyspnea, chest tightness; prolonged expiratory phase.
69
Asthma — Diagnosis
Pulmonary function test (≥5 yrs), peak expiratory flow monitoring, allergy testing.
69
Asthma — Treatment
Rescue: SABA (albuterol), ipratropium, systemic steroids. Controller: inhaled corticosteroid, LABA ≥12 yrs, leukotriene modifiers.
70
Asthma — Nursing Interventions
Asthma action plan, spacer/neb education, trigger avoidance, peak‑flow monitoring daily.
71
Asthma — Complications
Status asthmaticus, airway remodeling.
72
Status Asthmaticus — Definition
Severe asthma attack unresponsive to initial bronchodilators; medical emergency.
73
Status Asthmaticus — Management
Continuous neb albuterol, IV corticosteroids, O₂, possible magnesium sulfate/intubation.
74
Status Asthmaticus — Nursing Interventions
Monitor VS, SpO₂, ABGs; prepare for ICU transfer.
75
Cystic Fibrosis — Etiology/Genetics
Autosomal recessive CFTR mutation (chromosome 7); defective chloride transport → thick secretions.
76
Cystic Fibrosis — S/S
Salty skin, meconium ileus, chronic cough with sputum, recurrent infections, bulky greasy stools, poor weight gain.
77
Cystic Fibrosis — Diagnosis
Positive sweat chloride >60 mEq/L, newborn screen, genetic testing.
78
Cystic Fibrosis — Pulmonary Treatment
Daily airway clearance (CPT/vest), dornase alfa, inhaled bronchodilators & antibiotics, exercise.
78
Cystic Fibrosis — GI/Nutrition
Pancreatic enzymes with all meals, high‑calorie/high‑protein diet, ADEK vitamins, salt supplements.
79
Cystic Fibrosis — Nursing Interventions
Teach CPT techniques, infection control, psychosocial support, transition planning.
80
Cystic Fibrosis — Complications
Bronchiectasis, pneumothorax, cor pulmonale, CF‑related diabetes, infertility.
81
Pediatric Airway/Respiratory Differences — Obligate Nose Breathing
Infants <4 weeks are obligate nose‑breathers, so nasal patency is critical during feeding.
82
Respiratory Distress Signs — Early vs Late Signs
Early: tachypnea, retractions, nasal flaring. Late: grunting, head bobbing, cyanosis, clubbing.
83
Respiratory Distress Signs — Stridor vs Wheeze
Stridor = upper airway obstruction (inspiration). Wheeze = lower airway narrowing (expiration).
84
Respiratory Distress Signs — Grunting Purpose
Grunting creates PEEP to keep alveoli open—sign of impending failure.
85
Respiratory Distress Signs — Apnea Definition
Respiratory pause >20 seconds or any pause with bradycardia or desaturation.
86
Respiratory Distress Signs — Pulse Oximetry Goal
Maintain SpO₂ ≥ 95 % in infants/children unless otherwise ordered.
87
Respiratory Distress Signs — Clubbing Cause
Chronic hypoxemia stimulates soft‑tissue proliferation at nail beds.
88
Respiratory Distress Signs — Tripod Position
Leaning forward with chin thrust helps maximize airway diameter in severe obstruction.
89
Respiratory Distress Signs — Seesaw Breathing
Chest sinks as abdomen rises—diaphragm fatigue and very late distress sign.
90
Suctioning & Nasal Wash — RSV Viral Testing
Collect nasal wash/aspirate for ELISA or IFA to detect RSV antigen.
91
Suctioning & Nasal Wash — Bulb Syringe Order
Tilt head slightly back, saline drops, squeeze bulb, insert, release, repeat other nostril before feeds.
92
Chest Physiotherapy (CPT) — Indications
Bronchiolitis, pneumonia, cystic fibrosis—NOT for acute inflammatory airway diseases like asthma alone.
93
Chest Physiotherapy (CPT) — Percussion Technique
Cup hand or use device; percuss each lung segment 1–2 min, producing hollow sound.
94
Chest Physiotherapy (CPT) — Postural Drainage
Position child so gravity aids mucus drainage; schedule before meals or >1 h after.
95
Chest Physiotherapy (CPT) — Flutter Valve / PEP
Creates back‑pressure during exhalation to splint airways and mobilize secretions.

Pediatrics (3 decks)

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