Flashcards in Module 2 - Pediatric Respiratory Disorders Deck (128)
What are the critical differences between adults and children in regard to repsiration?
1. Nares (infant take 4-6 weeks before breathing via the mouth)
2. Mouth (smaller mouth and larger tongue/tonsils - so a smaller oral cavity proportion makes it more difficult to swallow)
3. Faster Respiratory Rate
4. Bronchioles and Intercoastal Muscles are Immature (Upper airway shorter and narrower in diameter)
5. Short, Horizontal Eustachian Tubes (so if there is a sinus issue some infection can move and cause ear infection)
Why is ear infection so common in PEDS?
their shorter an horizontal eustachian tube makes it easier for infection to move into the ear
Pediatric Assessment Triangle (P.A.T.)
A doorway assessment that can be done before even touching the patient w/ 3 things
3. Work of Breathing
What things for Appearance need to be looked at in the PAT?
What things for Work of Breathing (WoB) need to be looked at in PAT?
Rate of Breathing
Position (are they tripoding?)
Retractions (intercostals, etc)
What things for Circulation need to be looked at in PAT
Color (pale cyanosis, ashen, modeled)
What things can we look for (Assess) in a Pediatric Respiratory Assessment?
Irregular or Difficulty Breathing
Cough/Stridor (Insp pull/gasp)
Is the cough wet, productive, dry, etc
Tests that can be done for a Pediatric Respiratory Assessment?
Example Nursing Diagnosis for Pediatric Respiratory Assessments?
Ineffective Breathing Pattern
Ineffective Airway Clearance
Fear and Anxiety
Knowledge Deficit (Re: Condition, Treatment Plan, Self Care, and Discharge Plan)
Nursing Management for Potential Respiratory Distress?
*If O2 Sats are less than 94%...
1. Confirm if the reading is believable (it correlates to heart beat)
2. Make sure O2 Sat Probe is Fxning (if anxious and moving could get a false reading)
3. Raise HOB or sit child up --> Open Airway (i.e suctioning if needed and ordered) --> Administer O2 (blow by, n/c or face mask) - [This is the order of stuff IF NEEDED]
4. Assess for changes in tone, color, VS, etc
5. Alert to the appropriate person to communicate changes in O2 and responses to treatment, obtain order for O2 and further actions
Signs of Respiratory Distress needs ...
action and reporting to instructor, RN and MD!
Can we administer O2 on our own?
We can, BUT we will eventually need an order on what we had to do and what may need to be done further
What changes should we assess for in children if there is Respiratory Distress?
VS - Especially HR, RR, BP
Who is at risk for Foreign Body Aspiration?
Infants, Toddlers, Preschoolers - d/t exploration and imitation (check for them putting things in their mouth)
Older Children and Teens - d/t activities while eating like laughing, going to fast, eating too much, high risk activities (esp if intoxicated)
Severity of Foreign Body Aspiration depends on...
Location and Type of Object (ex: popcorn, peanuts, carrots, peanut butter, coins, nails, toys)
Clinical Presentations and Diagnostic Findings of Foreign Body Aspiration
Clinical: Chocking, Cough, Gagging, Hoarseness, Wheezing, Stridor, Drooling and/or Asymmetric Breath Sounds
Diagnostic: CXR, Bronchoscopy
Main methods of Clinical Management for Foreign Body Aspiration
Assessing S/S, Location and Degree of Obstruction
Chest Thrusts and Back Blows for Infants, Abdominal Thrusts, etc
Passage through the GI Tract
Sedation/surgery to remove a foreign body obstruction object
Make sure to monitor vitals after and check gag reflex after they wake up
What should be done for object passage through the GI tract for a foreign object?
Just giving a normal diet with no laxatives for speeding it up
Abdominal Thrusts are often done on choking adults, what should be done though for infants?
Chest thrusts and Back Blows
What is the best clinical management for foreign body aspiration?
ex: clean up small objects/toys, use Mylar Balloons not latex, positive role model, supervised meals, appropriate size bites ....
cessation of respiration for longer than 10 seconds
*not always about color changes or limpness or choking*
What may be the first sign of resp distress in infants (ex: for respi. dysfunction, illness, sepsis, etc)?
What may OR MAY NOT be accompanying Apnea?
Apnea of Prematurity
occurs in preterm infants d/t lack of maturity of neuro/respiratory systems
Apparent Life Threatening Event (ATLE)
Episode of apnea accompanied by color change, hypotonia, choking, gagging in infants born >37 weeks and aged >60 days
Occurs more so in full term babies rather than preme
When May ATLE occur?
During sleep, wakefulness, feeding - many different times
What is important to do when an ATLE occurs?
You NEED TO FIND OUT WHAT HAPPENED
Find the situation it occurred and try to watch a recreation of the moment so we can monitor for later episodes
After admission and monitoring, what do parents often go home with for ATLE?
Home Apnea Monitor