Final Chapter Flashcards
(14 cards)
Croup - what is it caused by and how does it present in patients?
-Respiratory infection that affects young children
- Viral infections are the most common cause of condition
- Causes swelling of voice box (larynx) and windpipe - trachea
This swelling causes the airway below their vocal cords to narrow, which makes their breathing noisy and difficult
As children get older, croup isn’t seen as often
Symptoms of croup
Croup is typically mild and lasts less than one week,but symptoms can get more severe
Symptoms normally start slowly and may begin with a runny or stuffy nose.Over the next 12 to 48 hours,symptoms can worsen the barking cough
Symptoms are usually worse at night
Symptoms - other mild croup symptoms include
Hoarseness
Fever
Rash
Eye redness - conjunctivitis
Swollen lymph nodes
Symptoms of moderate to severe croup mat include
Difficulty breathing
Restlessness and nervousness
Retractions
Cyanosis - blue tint to skin
Treatment - what if one single dose doesn’t work?
Fluids, warm bath, paracetamol and Ibuprofen
- don’t give cough meds - can make patient drowsy and stop from coughing
Mild croup - self limiting but single dose steroid - dexamethasone can be used
Moderat to severe croup - needs hospital admission, single dose steroid given whilst at hospital
If croup not better after single dose, then nebulised adrenaline/epinephrine solution given to reduce airway swelling
If child too unwell to receive oral medication, dexamethasone by intramuscular injection or budesonide by nebulisation are suitable alternatives whilst waiting for hospital admission
Antihistamines
Used for:
- Nasal allergies and seasonal allergic rhinitis (inflammation of inside the nose, caused by an allergen eg. Pollen)
- Helps rhinorrhoea
To treat urticaria - itchy rash and hives used for:
- rashes
- puritis - itching
- insect bites
- drug allergies
Sedating anti histamines, cautions and their side effects
- Alimemazine,promethazine,cyclizine
- drowsiness,dizziness,dry mouth,blurred vision,urinary retention and constipation
NON SEDATING - cautions and side effects
Cetirizine, loratadine, fexofenadine
Generally fewer sedative side effects, possible headaches, dry mouth, Gi disturbances, may interact with certain medications like ketoconazole and erythromycin
Cystic Fibrosis
Genetic disorder that affects the lungs- thick sticky mucus to build up in body
Obstructs the airway in the lungs and affects the normal function of various organs
Symptoms of cystic fibrosis
- production of thick mucus, chronic coughing,wheezing, lung infections
- digestive issues and diarrhoea
Other complications - liver disease,osteoporosis, CF related diabetes
AIM of treatment cystic fibrosis
Currently no cure, so its really about managing symptoms and improving quality of life
Airway clearance techniques
Antibiotics to treat chest infections
Enzyme replacement to aid in digestion
Preventing or treating intestinal blockage
Mucolytic treatment for CF
1) Doranse Alfa - via a nebuliser
2) mannitol dry powder if dornase alpha not suitable
PLUS
Prophylactic antibiotic for chest infection
Cough and congestion
Eucalyptus Oil
Menthol crystals in warm water
Breathe in towel over head
Cough suppressants
Codeine - evidence suggests its not effective
Dextromethorphan and pholcodine not for children under 6 years of age
Causation in 6-12 years
Expectorants - no evidence to suggest they work. Not recommended especially if children 6 years or older
Simple linctus paediatric for under 12 years old
Palliative care cough
Diamorphine and methadone can be used
Morphine is preferred
