RESPIRATORY

Question 1

what medication is given for acute tonsillitis?

Answer 1

Penicillin/amoxicillin

Question 2

what medicine is given for chronic tonsillitis? (hx of bad smelling material)

Answer 2

Clindamycin

Question 3

what would you see with increased work of breathing?

Answer 3

retractions

Question 4

if a chest is larger on the L side, it can be a sign of what with the heart/lungs

Answer 4

enlarged heart
collapsed R lung

Question 5

what position are childrens lung sound best heard?

Answer 5

child sitting down

begin at apices then go side to side

Question 6

what would a tachy HR be?

Answer 6

80-120

Question 7

dominate way infants/newborns breath

Answer 7

thru nose

Question 8

what is a primary intervention for stridor? & why?

Answer 8

humidified air to lubricate airway

Question 9

s/sx of respiratory distress?

Answer 9

Grunting
Nasal flaring
Retractions
Cyanosis
Tachypnea

Question 10

what is the first sign of hypoxia?

Answer 10

altered LOC

Question 11

what sound/symptoms would indicate impending respiratory failure?

Answer 11

grunting

Question 12

trt for impending respiratory failure?

Answer 12

PEEP
Positive pressure to keep lungs open

Question 13

what does HR do in progression of respiratory distress?

Answer 13

tachy –> brady

Question 14

tx of resp distress?

Answer 14

Chest percussion to loosen secretions
Stimulate (activity/crying) to mobilize secretions
Older child sit up & cough

Question 15

on resp assessment, what would be a normal finding about inhale/exhale?

Answer 15

inspiratory phase slightly longer/= to expiratory phase

Question 16

what resp phase is prolonged with asthma?

Answer 16

expiratory

Question 17

which resp phase is prolonged with an upper air way obstruction? & ex’s of UAO

Answer 17

inspiratory
Croup/foreign body

Question 18

Croup cough sounds like?

Answer 18

Hoarse, “barking” / “brassy” cough

Question 19

s/sx of Croup?

Answer 19

Barking cough
Inspiratory stridor
Drooling

Question 20

most severe variation of croup?

Answer 20

epiglottitis

Question 21

Home treatment for Croup?

Answer 21

Cool mist
Fluids

Question 22

Hospital care for croup?

Answer 22

Neb w/ epinephrine/steroid inhale
IV fluids if no PO fluids

Question 23

how does a child progress with acute epiglottitis?

Answer 23

Goes to bed asymptomatic then wakes with sore throat & 103-105 fever

Question 24

what position will a child likely assume with epiglot?

Answer 24

tripod (airway obstruct = immediate attention)

Question 25

how does epiglot sound on inspiration?

Answer 25

Frog like croaking sound

Question 26

Treatment for Epiglott?

Answer 26

Abx (amox) IV fluids (NPO) O2 Cool mist

Question 27

what do you never do in treating epiglot? & why?

Answer 27

examine the throat/put anything in throat increased risk of laryngospasm

Question 28

acute epiglot is often caused by what virus

Answer 28

HiB (haem influ B)

Question 29

what is laryngotracheobronchitis (LTB)?

Answer 29

viral inflammation of mucosa of larynx & trachea = narrow passageway DOESNT involve epiflot

Question 30

what does laryngotracheobronchitis (LTB) cough sound like?

Answer 30

seal like/ crowing

Question 31

s/sx of laryngotracheobronchitis

Answer 31

purulent sputum (?) inspiratory stridor suprasternal retractions low grade fever

Question 32

laryngotracheobronchitis is often developed after what infection?

Answer 32

upper respiratory infection

Question 33

what is most common cause of bronchiolitis?

Answer 33

RSV (droplet + standard precautions)

Question 34

initial s/sx of bronchiolitis?

Answer 34

lots of thick secretions rhinorrhea wheezing intermittent fever

Question 35

severe s/sx of bronchiolitis

Answer 35

tachypnea (>70) decreased breath sounds apneic episodes

Question 36

tx of bronchiolitis

Answer 36

oxygen/humidified Suctioning (30/40 degree angle) ribavirin

Question 37

in asthma w/ severe distress what may be heard?

Answer 37

Inspiratory wheeze

Question 38

what part of the airway is obstructed in asthma

Answer 38

lower airway (air trapped) bronchial hyperresponsive

Question 39

s/sx of recurrent asthma episodes?

Answer 39

wheezing chest tightness non productive "hacking" cough diaphoresis

Question 40

what is an early s/sx of an asthma attack?

Answer 40

Decreased pCO2

Question 41

complication of asthma?

Answer 41

hypoxemia r/t collapsed alveoli

Question 42

what is normal PEFR for asthma action plan?

Answer 42

80-100

Question 43

edu about asthma action plan?

Answer 43

Record PEFR 2x/day estab personal best PEFR during 2-3 wk period when asthma is stable = baseline monitor peak flow, if low = assess

Question 44

medical emergency complication of asthma?

Answer 44

status asthmaticus treat with epi 0.01 subQ

Question 45

primary intervention for asthma?

Answer 45

Neb albuterol (B2 agonist - bronchodilator)

Question 46

2ndary med intervention for asthma?

Answer 46

Methylprednisolone (Solu-medrol) IV (cortico - bronchodilator)

Question 47

what position is best for child to be placed in with asthma?

Answer 47

high fowlers

Question 48

heliox does what in/for asthma?

Answer 48

loosen secretions

Question 49

edu about inhalers?

Answer 49

oral care to prevent thrush

Question 50

how to do peak flow meter?

Answer 50

Tight seal around mouth, standing straight then Take 1 deep breath & blow as hard/fast as possible

Question 51

edu about PFM (peak flow meter)?

Answer 51

Must repeat steps 3x good TOD is 7-9am & 6-8pm

Question 52

what is cystic fibrosis?

Answer 52

exocrine gland dysfunction, causes thick sticky mucus mechanical obstruction

Question 53

what organs are affected by CF?

Answer 53

Pancreas & respiratory tract

Question 54

edu about pancreas in CF?

Answer 54

will have to consume pancreatic enzymes before every meal (even a snack)

Question 55

diagnosis of CF? & + result?

Answer 55

Swear chloride test +: =/> 75 mmol/L

Question 56

what type of questions should you ask regarding future with CF

Answer 56

are they planning on having kids - genetic counseling

Question 57

what electrolytes will be low in CF labs? & edu about them

Answer 57

sodium & chloride unrestricted salt intake

Question 58

what should the nurse do before physiotherapy for a CF patient? & why?

Answer 58

admin bronchodilator via neb cant cough up secretions - too thick/too weak

Question 59

edu about diet & CF?

Answer 59

Increased calories & protein (150%)

Question 60

which vitamins are recommended for CF?

Answer 60

water soluble (ADE&K)

Question 61

how do children with CF physically appear?

Answer 61

short w/ thin skin (short from lack of O2)

Question 62

GI issue/presentation with CF?

Answer 62

Steatorrhea (fatty/smelly stool) from undigested fat - lack enzyme

Question 63

what disease process can result from blocked pancreatic ducts?

Answer 63

T1 diabetes

Question 64

best tx for a patient using accessory muscles with an RR of 40 & O2 of 88?

Answer 64

Oxygen with non rebreather

Question 65

a pt presents with drooling, leaning forward and a high pitched crowing sound. what do they have & what is tx?

Answer 65

Stridor from croup & admin humid O2

Question 66

with a foreign body obstruction, wheezing & diminished breath sounds, what is the priority intervention?

Answer 66

high flow O2

Question 67

what is esophageal atresia?

Answer 67

esophagus ends in blind pouch

Question 68

what normal function is complicated by esophageal atresia?

Answer 68

Swallowing normally

Question 69

s/sx of esophageal atresia

Answer 69

excessive drooling resp distress/coughing choking w/ attempted feedings inability to pass NG/OG tube

Question 70

management of esophageal atresia?

Answer 70

Suction Monitor for patency (don't irrigate) NPO (high aspiration risk) Positioning

Question 71

what is proper positioning for esophageal atresia?

Answer 71

30-45 degree HOB elevation Head turned side to prevent aspiration or lat side lying

Question 72

how to administer ear medication?

Answer 72

Place dropper above ear canal Gently pull outer flap down & back to straighten ear canal

Question 73

what type of babys are at lower risk of otitis media?

Answer 73

breast fed babies

Question 74

s/sx of otitis media?

Answer 74

Very irritable pulling on ear purulent effusion/bulging red membrane doesnt want to eat (swallow hurts) fever

Question 75

management for otitis media?

Answer 75

Abx hold upright when feeding Tympanostomy

Question 76

edu about tympanostomy

Answer 76

may have temp hearing loss keep water out of ear/no swimming 2 weeks (use earplugs or cotton ball) No blowing nose for 7-10 days

Question 77

what is criteria for tonsillectomy?

Answer 77

3+ treated infections a year done 6wk after acute infection is resolved

Question 78

what liquids shouldnt be consumed after tonsillectomy?

Answer 78

no mouthwash/citrus juice red/brown colored dairy

Question 79

what would be indicative of post op bleeding of a tonsillectomy?

Answer 79

frequent swallowing restlessness Rapid HR bright red blood in vomit (emergency!)

Question 80

how should a pt sleep after a tonsilectomy?

Answer 80

lateral/side facilitate drainage

Question 81

chronic pharyngitis can lead to what?

Answer 81

rheumatic fever/scarlet fever

Question 82

management of pharyngitis?

Answer 82

Penicillin (2xday/10day) no 2nd hand smoke

Question 83

s/sx of pharyng?

Answer 83

halitosis (bad breath) enlarged tonsils petechiae on palate fine red sandpaper rash on trunk

Question 84

staple s/sx of Bronchilotis/RSV?

Answer 84

Intercostal retractions

Question 85

other s/sx of bronchiloitis/RSV?

Answer 85

apnea non productive cough fever up to 102 rhinorrhea for 3-7days

Question 86

management for BRONCHILOITIS & RSV?

Answer 86

bulb syringe & saline drop to nares (prior to all feeds) suction first!!! contact precautions

Question 87

what causes bronchopulmonary dysplasia?

Answer 87

Long term O2 = dependence

Question 88

how to prevent bronchopulmonary dysplasia?

Answer 88

Keep o2 low as possible in newborn wean off asap

Question 89

meds for BPD (bronchpulm dys)

Answer 89

bronchodilators (albuterol) anticholingergic (ipratropium)

Question 90

lower resp infections affect what structures?

Answer 90

alveoli bronchi lungs

Question 91

how does air move thru resp system?

Answer 91

Pharynx --> Larynx Larynx --> trachea trachea --> bronchi (L/R) passes thru the trachea into bronchus

Question 92

how long are infants obligate nose breathers?

Answer 92

4wk

Question 93

which anatomical diff in younger children puts them at higher risk for aspiration?

Answer 93

Larynx & glottis are higher in neck

Question 94

giving corticosteroids for pertussis can mask what?

Answer 94

s/sx of infection

Question 95

if a child with pertussis is given prednisone & is sleeping more than usual/not eating well, what should be recommended?

Answer 95

go to ED for infection workup

Question 96

what lung sounds would be heard in foreign body aspiration?

Answer 96

Unilateral wheezing

Question 97

what lung sounds does asthma present with?

Answer 97

BIlateral wheezing