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Pathology 2 > Pediatric Respiratory > Flashcards

Pediatric Respiratory Flashcards

(47 cards)

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1
Q

What is respiratory distress

A

Increased work of breathing to maintain oxygenation and/or ventilation.
-Compensated state in which increased work of breathing results in adequate pulmonary gas exchange

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2
Q

What are the three classifications of respiratory distress

A

-mild
-moderate
-severe

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3
Q

What are the hallmarks of respiratory distress

A

-Retractions
-Abdominal breathing
-Nasal flaring
-Grunting

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4
Q

What is respiratory failure

A

Patient can no longer compensate for underlying pathologic or anatomical problem by increased work of breathing
-Hypoxia and/or carbon dioxide retention may occur

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5
Q

Signs of respiratory failure

A

Decreased or absent retractions due to chest wall retractions due to chest wall fatigue
Altered mental status due to inadequate oxygenation and ventilation of the brain
Abnormally low RR

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6
Q

Respiratory Arrest

A

Pt not breathing spontaneously
BVM immediately
Resuscitation is often successful

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7
Q

How to assess work of breathing

A

Patients position of comfort
Presence or absence or retractions
Grunting or flaring

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8
Q

How to assess the airway

A

Listen for stridor
Check for obstructions

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9
Q

How to assess breathing

A

Determine the RR
Listen to the lungs for adequacy of air entry and abnormal breath sounds
Check SPO2

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10
Q

Management of foreign body aspiration or obstruction

A

-position of comfort
-providing supplemental O2
-Avoid agitation
-Transport

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11
Q

Severe airway obstruction management

A

Five back slaps and five chest thrusts

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12
Q

If the child is still apneic after the obstruction is removed

A

Assess for a pulse and preform CPR if needed

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13
Q

What is the dose for IM epi

A

0.01mg/kg of 1:1000 up to a max dose of 0.5mg

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14
Q

Treatment for anaphylaxis

A

-IM epi
-supplemental O2
-fluid resuscitation for shock
-Diphenhydramine (1mg/kg)
-Bronchodilators for wheezing

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15
Q

Croup (laryngotracheabronchitis)

A

Viral infection of the upper airway
Most common cause of upper airway emergencies in children under five
Transmitted through respiratory secretions

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16
Q

What is the hallmark sign of croup

A

Stridor

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17
Q

What does the sample history for croup usually reveal?

A

-several days of cold symptoms and low-grade fever, followed by barky cough, stridor, and trouble breathing

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18
Q

PAT of a child with croup

A

-Audible stridor
-Barky cough
-increased WOB
-Normal skin colour

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19
Q

Treatment of croup

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A

Position of comfort

20
Q

When is the use of nebulized epinephrine indicated

Study These Flashcards
A

Stridor at rest
Moderate to severe respiratory distress
Poor air exchange
Hypoxia
Altered appearance

21
Q

Dose for racemic epinephrine (2.25%)

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A

0.5ml in 3ml of saline

22
Q

Epiglottitis

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A

Life-threatening inflammation of the supraglottic structures, usually due to bacterial infection

23
Q

Why is epiglottitis rare now

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A

The vaccine against Haemophilus influenzae type B

24
Q

Epiglottitis PAT

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A

-Child will look sick and anxious
-sniffing position
-drooling due to inability to swallow
Increased work of breathing
Pallor or cyanosis

25
Signs of epiglottitis
Stridor upon auscultation of the neck Muffled voice Decreased or absent breath sounds Hypoxia Sudden onset of high fever or sore throat in preschool or school-age children
26
Epiglottitis management
-do not look in the mouth -do not put in an IV -be prepared with a BVM and an ET tube one or two sizes smaller than normal
27
Bacterial Tracheitis
Invasive exudative bacterial infection of the soft tissues of the trachea Typically presents with cough, stridor and respiratory distress of varying degree with a history of preceding viral infection Toddlers are at an increased risk of complications due to their relatively narrow airway diameter and may present in extremis Pts are often febrile and prefer the sniffing position
28
Bacterial tracheitis treatment
POC Do not look in the mouth Do not insert IV Try to keep pt calm and quiet Have a BVM and ET tube one to two sizes smaller than required ready
29
What is an upper airway emergency
Restriction of airflow into the lungs
30
What is a lower airway obstruction
Respiratory emergencies that involve restriction of air flow out of the lungs
31
What are the three components of asthma that lead to poor gas exchange
-Bronchospasm -Mucus production -Airway inflammation
32
Why does asthma cause hypoxia
Ventilation - perfusion mismatch Blood flowing to parts of the lung is poorly oxygenated
33
What are some triggers for an asthma attack
-Upper respiratory infections -Environmental allergies -exposure to cold -changes in weather -second hand smoke
34
Clinical signs of asthma
-wheezing -frequent cough Respiratory distress
35
Mild to moderate respiratory caused by asthma (presentation)
-child will be awake and alert, sometimes preferring a seated posture Increased work of breathing may be evident by retractions and nasal flaring, circulation will be normal
36
Signs of severe respiratory distress and impending respiratory failure
-Decreasing -Tripod position -Deep retractions -Cyanosis
37
Primary assessment findings for asthma
-inability to speak in full sentences -increased RR Prolonged expiration phase Wheezes noted on auscultation Expiratory wheezes may be audible in moderate to mild attacks Inspiratory and Expiratory wheezes in severe cases
38
Dose of salbutamol
2.5mg of salbutamol premixed with 3ml of normal saline 4 puffs MDI
39
Treatment for asthma
Salbutamol Atrovent (ACP) Supplemental O2 Epi 1:1000 (SEVERE CASES ONLY)
40
Bronchiolitis
Inflammation or swelling of the small airways (bronchioles) in the lower resp tract Common in winter Usually occurs in children under 2 Highly contagious
41
Symptoms of bronchiolitis
Similar to asthma Retractions Tachypnea Diffuse wheezing Diffuse crackles Mild hypoxia
42
Severe bronchiolitis signs
-sleepy or obtunded -severe retractions -diminished breath sounds -moderate to severe hypoxia (SpO2 less than 90)
43
Management of bronchiolitis
Position of comfort Supplemental oxygen
44
Signs of pneumonia
-Nasal flaring -tachypnea -crackles -chest pain -hypothermia /fever
45
Pertussis - Whooping cough
Highly contagious, potentially deadly Caused by bacteria Presents as a common cold
46
Whooping cough
The distinctive whoop sound heard during the Inspiratory phase -the cough can be so severe that it can cause post cough vomiting, conjunctival hemorrhage, and cyanotic
47
BVM rate for children
12 to 20bpm One breath every 3 to 5 secs Only squeeze the bag until chest rise is seen

Pathology 2 (13 decks)

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