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Pediatrics/ Maternity > Pediatrics- Respiratory > Flashcards

Pediatrics- Respiratory Flashcards

1
Q

What is an expected range for SaO2

A

95 to 100

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2
Q

Sao2 of less than 86 means

A

Life-threatening emergency

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3
Q

What position maximizes ventilation

A

Semi followers or Fowler’s

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4
Q

What is nebulizer aerosol therapy

A

Nebulization breaks up medication’s into minute particles that are dispersed throughout the respiratory track

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5
Q

Indications for nebulizer aerosol therapy

A

Respiratory conditions that necessitate bronchodilators corticosteroids Mucolytes lights and anabiotic’s

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6
Q

How long does a nebulizer take

A

15 minutes

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7
Q

How should a patient use A nebulizer

A

Take a slow deep breaths by mouth

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8
Q

What is a metered dose inhaler or dry powder inhaler

A

Handheld devices that allow children to self administer medication on intermittent basis

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9
Q

How do you use a MDI

A

Shake the inhaler 5 to 6 times attach spacer play say inhaler between lips take deep breath and then exhale slow deep breaths the last 3 to 5 seconds hold breath for approximately 5 to 10 seconds wait one minute between puffs

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10
Q

How do use a dpi

A

Do not shake the device exhale completely place mouthpiece switching lips hold breath 5 to 10 seconds slowly exhale through pursed lips

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11
Q

What is chest physiotherapy

A

Techniques that include manual or mechanical percussion vibration cough or forceful expiration

Gravity and positioning loosen respiratory secretions and move them to central air way

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12
Q

When would you use chest physiotherapy

A

Client presents with thick secretions with an inability to clear airway

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13
Q

Pre-procedure of chest physiotherapy

A

Schedule treatments before meals or at least one hour after meals and a bedtime decrease likelihood of vomiting or aspiration
Administer bronchial dilator

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14
Q

Positions for chest physiotherapy

Apical secretions of the upper lobes

A

Fowler’s 

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15
Q

Positions for chest physiotherapy

posterior sections of the upper lobes

A

Sitting position with child leaning forward curled over pillows

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16
Q

Position for physiotherapy

anterior segment of both upper lobes

A

Supine and rotated slightly away from side being drained

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17
Q

Position for chest physiotherapy at

superior segments of both lower lobes

A

Prone with hips elevated on pillows

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18
Q

How to perform chest physiotherapy

A

Manually percussion using cup to hand or special device to clap rhythmically on chest wall to break up secretions

electronic percussion is applied by vest device worn by child

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19
Q

How long should a child remain in a position for chest physiotherapy

A

20 to 30 minutes

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20
Q

What is hypoxemia

A

Inadequate level of oxygen in the blood

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21
Q

What is early manifestations of hypoxemia

A

Tachpnea
tachycardia 
restlessness 
pallor
use of accessory muscles
nasal flaring

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22
Q

Late manifestations of hypoxemia

A

Confusion
stupor
cyanosis
Brady piña
bradycardia
hypotension or hypertension

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23
Q

How do you discontinue oxygen

A

Gradually

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24
Q

What is oxygen toxicity

A

Result from high concentrations of oxygen

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25
Q

When do you need to use suctioning

A

To remove mucous plugs and excessive secretions

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26
Q

How much time can you suction child in an infant

A

Limit suction time to less than five seconds for infants in less than 10 seconds for children allow children to rest 30 to 60 seconds after each aspiration

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27
Q

When do you need a trach

A

When there is an obstruction of the upper airway requiring the use of artificial ventilatio

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28
Q

Where should you keep an emergency tracheotomy tube

A

At the bedside

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29
Q

How do you clean a trach

A

Soap and water

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30
Q

What happens if a trach is accidentally decannulated

A

If it is decannulated in the first 72 hours after surgery it is an emergency

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31
Q

What is an occlusion in the trach

A

Occlusion is a situation in which of the two was clogged with secretion and prevents adequate air exchange

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32
Q

A nurse is teaching an adolescent a self administer a corticosteroid medication using a metered dose inhaler which of the following instruction should the nurse include (select)

Shake the device prior to use
rinse the expectIrate or after ministration
Inhale slowly with the medication administration
Exhale quickly after medication administration
wait 30 seconds between puffs

A

Shake the device prior to use
rinse the expectIrate or after ministration
Inhale slowly with the medication administration

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33
Q

A nurse is caring for a child who is receiving oxygen therapy Amazon continuous oxygen saturation monitor that is reading 89% which of the following action should the nurse take first

Increase the oxygen flow rate
encourage the child to take deep breaths ensure proper placement of the sensor probe
place a child and Fowlers position

A

Ensure the proper placement of the sensor probe

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34
Q

A nurse is in the emergency department and is assessing a newly admitted infant which of the following findings is an early indication of hypoxemia

Nonproductive cough
hyperventilation
tacky piña
nasal stuffiness

A

Tachypnea

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35
Q

A nurse is caring for a child who is receiving oxygen which of the following findings indicates oxygen toxicity

Increase blood pressure
hyperventilation
decrease PaCO2
unconsciousness

A

Unconsciou

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36
Q

A nurse is caring for a child who is receiving a bronchodilator medication by nebulized aerosol therapy which of the following action should the nurse take( select)

Instruct the child that the treatment will last 30 minutes
obtain vital signs prior to the procedure tell the child to take slow deep breaths determine if the child should use a mask attach a device to an air source

A

obtain vital signs prior to the procedure tell the child to take slow deep breaths determine if the child should use a mask attach a device to an air source

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37
Q

 What are tonsils and what do they do

A

Masses of limit type tissue found in the pharyngeal area that filter pathogenic organisms to protect the respiratory and G.I. track

Protect against infection

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38
Q

What are palatine tonsils

A

Located on both sides of the ortho pharynx tonsils removed during a tonsillectomy

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39
Q

What are pharyngeal tonsils

A

Also known as adenoids are removed during an adnoidectomy

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40
Q

What is the problem with enlarged tonsils

A

They can block the nose and throat which can interfere with breathing drainage, sleeping, swallowing, and speaking

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41
Q

Preoperative nursing actions for tonsillectomy

A

Maintain NPO status

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42
Q

Postoperative nursing actions after a tonsillectomy

A

Please patient in position to facilitate drainage elevate head of bed check for bleeding monitor for difficulty breathing offer ice chips

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43
Q

Diet after a tonsillectomy

A

Encourage clear liquids and fluids after return of the gag reflex avoid red colored liquids Citrus juice and milk base foods 

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44
Q

Instructions after a tonsillectomy

A

Discourage coughing throat clearing a nose blowing in order to protect the surgical site
avoid straws

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45
Q

Why do people get respiratory illnesses

A

Events between ages three and six short now airways short respiratory tract compromised immune system chronic medical condition asthma

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46
Q

What is nasopharyngitis 

A

The common cold usually last 4- 10 days

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47
Q

What is GABHS 

A

Infection of the upper airway strep throat

48
Q

Expected finding in testing in strep throat

A

Tonsils and pharynx covered with exudate get a throat culture to determine

49
Q

Treatment for strep throat

A

Oral penicillin for at least 10 days

50
Q

What is bronchitis

A

Associated with upper respiratory infection and inflammation of large airways

51
Q

Expected findings in bronchitis

A

Persistent dry hacking cough as a result of inflammation resolves in 5 to 10 days

52
Q

Treatment bronchitis

A

Increased humidity cough suppressant

53
Q

Bronchiolitis

A

Mostly caused by respiratory syncytial virus RSV Primarily affects the bronchi and bronchioles occurs in the bronchial level 

54
Q

Expected finding in bronchiolitis

A

Rhinorrhea wheezing possible ear infection increase coughing retractions refusal to feed tacky piña poor air exchange cyanosis

55
Q

What is allergic rhinitis

A

Caused by seasonal reaction to allergens most common in autumn or spring

56
Q

Expected findings in allergic rhinitis

A

Watery rhinorrhea nasal obstruction itchiness of the nose conjunctivitis snoring Molise headache

57
Q

Treatment of allergic rhinitis

A

Give nasal corticosteroids

58
Q

What is bacterial pneumonia findings

A

High fever cough with whites beautiful retraction nasal flaring don’t mess with percussion advantageous breath sounds pale color

59
Q

How to determine you have bacterial pneumonia

A

Gram stain and culture of sputum an older children

60
Q

Treatmentof viral pneumonia

A

Oxygen with cool mist

61
Q

Treatment for bacterial pneumonia

A

Encourage rest IV antibiotics fluids

62
Q

What is a pneumothorax

A

Accumulation of air in the pleural space

63
Q

Manifestations of pneumothorax

A

Chest pain back pain labored breathing decreased oxygen saturations

64
Q

Plural effusion

A

Accumulation of fluid in the pleural space

65
Q

Manifestations of plural effusion

A

Chest pain back pain labored respirations decrease oxygen saturations tachycardia

66
Q

Bacterial epiglottis is

A

Medical emergency usually caused by HIP 

67
Q

Expected findings in bacterial epiglottitis

A

Absence cough
drooling
agitation
sitting upright with chin pointed out in mouth open
thick muffled voice like the frog life croaking sound
dysphasia
stridor

68
Q

Nursing care of bacterial Epiglottitis

A

Avoid throat culture or using tongue blade
prepare for intubation
provide humidified air
droplet isolation precautions for first 24 hours

69
Q

What causes Acute laryngotracheobronchitis

A

Causative agent including RSV influenza a and B and pneumonia

70
Q

Another name for Laryngotracheobronchitis

A

Croup

71
Q

Expected findings in croup

A

Restlessness
hoarseness
barky cough
dyspnea
strider
retractions
nasal flaring
night time episodes of obstructions

72
Q

Nursing care for croup

A

Provide humidified oxygen with coolmist nebulize Eppinette friend as prescribed administer corticosteroids dexamethasone

73
Q

Influenza a and B expected findings

A

Fever and chills dry throat dry cough flushed face photophobia myalgia(pain in muscles) fatigue

74
Q

A nurse is caring for a child who has bronchiolitis which of the following action should the nurse take (select) 

Administer oral prednisone
Initiate chess percussions and posterior drainage
administer humidified oxygen
suction the nasopharynx as needed administer oral penicillin

A

administer humidified oxygen
suction the nasopharynx as needed

75
Q

A nurse is caring for a child who is postoperative period following a tonsillectomy which of the following is a clinical finding of postoperative bleeding

HGB 11.6 and HCT 37%
inflamed and red in throat frequent swallowing and clearing of the throat
Blood tinged mucus

A

Swallowing and clearing of the throat

76
Q

A nurse is caring for a child in the postoperative period following a tonsillectomy which of the actions should the nurse take

Encourage the child to blow their nose gently administer analgesics on a schedule
offer orange juice
position the child supine 

A

Administer analgesics on the schedule

77
Q

A nurse is assessing a child who has epiglottitis which of the following findings should the nurse expect (select)

Hoarseness in difficulty speaking
difficulty swallowing
low-grade fever
drooling
dry barking cough
stridor 

A

Hoarseness in difficulty speaking
difficulty swallowing
drooling
stridor

78
Q

What is asthma

A

A chronic childhood inflammatory disorder of the airways that result in intermittent and reversible airflow obstruction of the bronchioles 

79
Q

What is the leading cause of hospitalizations among children

A

Asthma

80
Q

Risk factors for asthma

A

Family history of asthma + allergies
sex- boys are affected more than girls in adolescence than greater in girls
tobacco smoke
low birthweight
being overweight

81
Q

Triggers to asthma

A

Mold dust grass pollen trees smokes exercise cold air animal hair medication allergies

82
Q

Expected findings in asthma

A

Chest tightness audible wheezing crackles mucus production use of accessory muscles decreased O2 in audible breath sounds

83
Q

Intermittent asthma

A

Findings 0 to 2 times a week
nighttime findings - from 0 to 4 none
from 5 to 11 two times a month
no activity limitations
use of short acting beta agonist is less than twice a week

84
Q

Mild persistent asthma

A

Findings more than twice a week but not daily
nighttime findings from 0 to 4- 1 to 2 times a month from 5 to 11 - 3 to 4 times a month
minor activity limitations
use of short acting beta agonist more than two days a week but not daily

85
Q

Moderate persistent asthma

A

Frequency daily
nighttime findings 0 to 4 - 3 to 4 times a month 5 to 11 more than once a week but not daily
some activity limitations
daily use of short acting beta agonist

86
Q

Severe persistent asthma

A

Frequency continual
nighttimes findings frequent
extreme activity limitations
several times a day use of short acting beta agonist

87
Q

Pulmonary function test

A

The most accurate test for diagnosing asthma and its severity
test every 1 to 2 years

88
Q

Nursing care for asthma

A

Assess airway patency 
respiratory rate
use of accessory muscles
breath sounds
SOB
dyspnea
audible wheezing
absence of wheezing can indicate severe constriction of alveoli

89
Q

Medication for asthma That prevents exercise-induced asthma

A

Short acting beta agonist albuterol

90
Q

Medication for asthma especially used at night

A

Long lasting beta agonist formoterol 

91
Q

What is a peak flow meter and how does it work

A

Use at the same time each day
ensure the mark is zero
have child stand up straight
close lips around mouthpiece
blow out as hard as quickly as possible read number
repeat 2 to 3 times record highest number

92
Q

What is status asthmaticus

A

A life-threatening episode of airway obstruction that is often unresponsive to common treatment it is considered a prolonged severe asthma attack

93
Q

Manifestations of status asthmaticus

A

Wheezing labored breathing nasal flaring lack of movement in lungs use of accessory muscles hypoxia diaphoresis

94
Q

What is respiratory failure

A

Persistent hypoxemia related to asthma can lead to respiratory failure

95
Q

The nurse is assessing a child who has asthma which of the following indications of deterioration in the child’s respiratory status (select)

Oxygen saturation is 95%
wheezing
retractions of sternal muscles
warm extremities
nasal flaring

A

Wheezing
retraction of sternal muscles
nasal flaring

96
Q

The nurse is teaching an adolescent about the appropriate use of his asthma medication which of the following medication should the nurse instruct the client to use as needed before exercise

fluticasone/ salmeterol
Montelukast
Prednisone
Albuterol

A

Albuterol

97
Q

A nurse is planning for a care for a child who has asthma which of the following intervention should the nurse include in the plan of care( select)

Perform chest percussions
place the child in an upright position
monitor oxygen saturation
administer bronchodilators
administer dornase Alfa daily

A

Place patient in upright position
monitor oxygen saturation
administer bronchodilators

98
Q

A nurse is teaching a client who has asthma how to use a peak flow meter which of the following information should the nurse include in the teaching (select)

Zero to meter before each use
record the average of attempts
perform three times
deliver a long slow breath into the meter
sit in the chair with feet on the floor

A

Zero to meet her before each use perform three times

99
Q

A nurse is discussing risk factors for asthma with a group of newly licensed nurses which of the following condition should the nurse include in the teaching (select)

Family history of asthma
family history of allergies
exposure to smoke
low birthweight
being underweight

A

Family history of asthma
family history of allergies
exposure to smoke
low birthweight

100
Q

What is cystic fibrosis

A

Cystic fibrosis is a respiratory disorder that results from inheriting a mutated gene it is characterized by mucous glands that secrete an increase in the quantity of thick tenuous mucus which leads to mechanical obstruction of organs

101
Q

What organs does cystic fibrosis affect

A

Pancreas lungs liver small intestine and reproductive system

102
Q

What are two common findings of cystic fibrosis

A

Increased sodium in sweat salty sweat and fatty stools

103
Q

What is a risk factor for cystic fibrosis

A

Both biological parents carry the recessive trait for cystic fibrosis

104
Q

What is meconium ileus

A

Distention of the abdomen vomiting and inability to pass stool

105
Q

What is the earliest indication of cystic fibrosis in newborn

A

Meconium ileus

106
Q

Respiration findings in cystic fibrosis

A

Wheezing
rhonci
cough
obstructive emphysema
actelectasis on x-ray cyanosis
barrel shaped chest
clubbing a fingers and toes

107
Q

G.I. expected findings in cystic fibrosis

A

Large frothy bulky Gracie foul smelling stools (steatorrhea-fatty stools)
Failure to gain weight or weight loss
delayed growth patterns
distended abdomen- infants
Thing arms and legs - infants
deficiency of fat soluble vitamins
prolapse rectum-infants 

108
Q

Integumentary expected findings in cystic fibrosis

A

Sweat tears and saliva have excessively high content of sodium

109
Q

Diagnostic procedures for cystic fibrosis

A

DNA testing to isolate the mutation
stool analysis for presents a fat collection of sweat from two different sites for adequate sample

110
Q

Diagnosis confirmation of cystic fibrosis

A

Chloride greater than 40 for infants less than three months of age and greater than 60 for all of us sodium greater than 90

111
Q

Management in cystic fibrosis

A

Airway clearance therapy
avoid ACT immediately before and after meals
high in protein and calories diet
have three meals a day
administer pancreatic enzymes within 30 minutes of eating
encourage add salt
related to diabetes monitor glucose levels

112
Q

Medication‘s that help treat pancreatic insufficiency
associate with cystic fibrosis

A

Pancreatic enzymes 
monitor stools while taking

113
Q

A nurse is reviewing a diagnostic signing for preschool age child who is suspected of having cystic fibrosis which of the following findings should the nurse identify as an indication of cystic fibrosis

Sweat chloride Contant 85
increase blood levels of fat soluble vitamins
72 hours to analysis sample indicated hard packed stools
chest x-ray negative for atelectasis 

A

Sweat chloride Contant 85

114
Q

A nurse is admitting a child who is cystic fibrosis which is the following medication should the nurse expect to include in the plan of care (select)
Tobramycin
Loperamide
Fat-solvable vitamins
Albuterol
Dornase Alfa

A

 Tobramycin
Fat-solvable vitamins
Albuterol
Dornase Alfa

115
Q

A nurse is performing in administration assessment for a clock child who is cystic fibrosis which of the following findings should the nurse expect (select)

Wheezing
clubbing of the fingers and toes
barrel shaped chest
thin watery mucus 
rapid growth spurts

A

Wheezing
clubbing of the fingers and toes
barrel shaped chest

116
Q

A nurse is providing discharge teaching for a child who has cystic fibrosis which of the following instruction should the nurse include

Provide a low calorie low protein diet administer pancreatic enzymes with meals and snacks
implement a fluid restriction during times of infection
restrict physical activity

A

Administer pancreatic enzymes with meals and snacks

117
Q

A nurse is teaching a group of guardians about influenza which of the following information should the nurse include in the teaching

Amantadine will prevent the illness
Roma ya done is administered intrmuscularly
Zanamirvir can be given to children 1 year and older
Oseltamivir shoild be given within 48 hours of onset of Manifestations

A

Oseltamivir shoild be given within 48 hours of onset of Manifestations

Pediatrics/ Maternity (15 decks)

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