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Peds Test 2 > Respiratory > Flashcards

Respiratory Flashcards

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0
Q

What is more prone to obstruction in children? Why?

A

Upper airway because they have a smaller airway with greater resistance

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1
Q

When are people at risk for respiratory illness?

A

Children until age 12 because of the changes

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2
Q

What does children having less alveolar surface area lead to?

A

Reduced area for gas exchange

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3
Q

Who has more diaphragmatic breathing adults or children?

A

Children because the flexible chest reduces air intake, you can see retractions easier

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4
Q

Immature infant respiratory and neurologic system offers less efficient response to what?

A

Hypoxia and elevated PCO2

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5
Q

What happens to the chest wall with age

A

It stiffens so there are less retractions with distress

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6
Q

What is wheezing

A

High pitched sound on expiration, may occur with obstruction in lower trachea or bronchioles

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7
Q

What is rales

A

Crackling sounds heard when alveoli become fluid filled, may occur with pneumonia

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8
Q

When may you see rales

A

With pneumonia because alveoli become fluid filled and you hear crackling

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9
Q

When is wheezing heard

A

On expiration

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10
Q

What may blood gases show

A

Carbon dioxide retention and hypoxemia

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11
Q

Why may you use a sputum culture for respiratory alteration

A

To determine causative bacteria in older children and adolescents

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12
Q

When may white blood cell count be elevated

A

In the case of bacterial pneumonia

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13
Q

What is a bronchoscopy? Why do we do it?

A

Scope through trachea and down to bronchial. Do it to visualize the inside of the airways, and take a biopsy of any areas that appear abnormal, to help diagnose a lung disease or lung cancer.

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14
Q

Inhalation of objects into the lungs

A

Foreign body aspiration

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15
Q

When does foreign body aspiration often happen

A

During feeding or playing

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16
Q

Who is foreign body aspiration most common in

A

6 months-4 years

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17
Q

What can foreign body be that is aspirated

A

Solid or liquid/ food or non-food

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18
Q

What foods should you avoid to prevent foreign body aspiration

A

Carrots, hot dogs, popcorn, nuts

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19
Q

Where is the most common place for foreign body to go when aspirated

A

Right lung because this side is higher up and steeper

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20
Q

Symptoms of aspiration

A

Sudden episode of coughing or gagging, dyspnea, tachypnea, retractions, stridor

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21
Q

Why is stridor a symptom of aspiration

A

Because what they swallowed may hit stuff as it went down

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22
Q

Management of foreign body aspiration

A

Clinical emergency, usually bronchoscopy or surgery, post op or post procedure risk of hemorrhage and risk of airways obstruction due to edema

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23
Q

Inflammation of the tissue that covers the trachea

A

Epiglottis

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24
Bacterial infection of the trachea often following a viral URI
Tracheitis
25
Viral infection of the upper respiratory tract that causes varying degrees of airway obstruction
Laryngottracheo-bronchitis
26
Most life threatening Croup syndrome
Epiglottis
27
Most common Croup syndrome
Laryngotracheo-bronchitis
28
Symptoms of epiglottis
High fever, sore throat, drooling(dysphagia), Dysphonia Tripod
29
Symptoms of tracheitis
Early mild fever, URI, stridor
30
Symptoms of laryngotracheo-bronchitis
Early afebrile, barking cough, sore throat, stridor, tachypnea
31
3 things in Croup syndrome
Laryngotracheo-bronchitis, tracheitis, epiglottis
32
Non-pharmacological management of Croup
``` Mild- treated in ER Severe- treated in PICU humidification Supplemental oxygen Fluids (IV or po) ```
33
Pharmacological management of Croup
Antibiotics-bacterial Anti-viral meds- only if very severe Beta agonists (albuterol, epinephrine)- w/ continued wheezing Steroids (dexamethasone) - if swelling of upper airway
34
Nursing management of epiglottis
Do not attempt to visualize the throat Do not leave the child unattended Do not place the child in supine position Provide 100% oxygen in least invasive manner If complete airway obstruction occurs, tracheostomy may be necessary Ensure emergency equipment is available
35
What should you do if complete airway obstruction occurs with epiglottis
tracheostomy may be necessary
36
What types of disorders are bronchitis and bronchiolitis?
Lower airway disorders
37
Inflammation of the trachea and bronchi
Bronchitis
38
What kind of cough will you hear with bronchitis
Coarse, hacking cough
39
What is treatment of bronchitis
Symptom management
40
Peak occurrence of bronchiolitis
2-6 months
41
How do you diagnosis bronchiolitis
Nasal culture
42
What type of isolation with somebody with bronchiolitis be on
Droplet
43
Types of bronchiolitis
Viral-RSV (common) or bacterial
44
Initial symptoms of bronchiolitis
URI with mild fever then wheezing
45
What do symptoms if bacterial pneumonia include? How do they usually develop?
Usually develop very quickly. Include: a dingle episode of shaking chills, chest pain on the side of the affected lung, severe abdominal pain sometimes occurs if the pneumonia is in the lower lobes, cough which may be dry at first but eventually produces phlegm, N/V and muscle aches, rapid breathing and heartbeat, sob
46
CPAP and PEEP are ______ pressure
Positive
47
What is Synargis? When is it used?
IM. Used prophylactic to try and decrease viral URI that lead to bacterial after you have had URI
48
When do symptoms of pneumonia usually improve
In 24-72 hours
49
Characteristics of asthma
Inflammation, mucous formation (bronchospasm), airway remodeling, anxiety
50
Asthma symptoms
Cough, wheeze, dyspnea
51
Causative factors of asthma
Environmental exposures, viral illnesses, allergens, genetic pre-disposition
52
How old does somebody have to be to do spirometry testing
4-5 years old
53
What is spirometry testing
Measuring volume of air child can expel from lungs after a maximal inspiration need 3 readings
54
How old does a child have to be to diagnose them with asthma
Over 2
55
Diagnostic testing for asthma
Physical s/Sx- episodic airflow obstruction Reversibility of bronchospasms Exclusion of alternate diagnosis- sick w/ something else? Spirometry testing
56
Do you treat asthma at the highest or lowest level needed at that time
Highest
57
Nursing interventions with asthma
Maintain airway patency, meet fluid requirements/needs, promote rest, support family participation, discharge planning, patient and family education
58
What is SIDS
Sudden death on an infant under 1 year of age that remains unexplained after a complete autopsy, a death scene investigation, and review of the history
59
Highest incidence of SIDS occurs when
2 to 4 months
60
____% of SIDS cases occur before 6 months
90%
61
Symptoms of SIDS
Cardiopulmonary arrest, more often in fall and winter, evidence in change in position with frothy blood tinged secretions from mouth and nares when found, during a unobserved time period
62
When is SIDS more likely to occur
During fall and winter
63
What can respiratory distress lead to
Respiratory failure-early recognition and intervention is vital
64
Symptoms of mild respiratory distress
Tachypnea, tachycardia, diaphoresis, restlessness
65
Symptoms of moderate respiratory distress
Flaring, retractions, grunting, wheezing, anxiety, irritability, confusion, mood changes, headaches, hypertension
66
Symptoms of severe respiratory distress
Dyspnea, bradycardia, stupor, coma, cyanosis=late signs
67
Respiratory distress treatment
Oxygenation, positioning, fluid | Medications: bronchodilators, anti-inflammatory, corticosteroid
68
Symptoms to watch for in UPPER airway disorders
Inspiratory stridor, barking cough, hoarseness
69
Treatment goals for upper airway disorders
Keep airway open, maintain oxygenation, reduce anxiety
70
Signs to watch for in a LOWER airway disorder
Wheezes, crackles, high pitched or absent sounds
71
Treatment goals of a LOWER airway disorder
Maintain oxygenation, remove secretions, curtail infection
72
If you give a treatment when should you assess
Before and after treatment
73
Goals with chronic conditions
Cope with lifestyle changes, avoid triggers that worsen condition, manage medications and side effects
74
Side effects of albuterol
Can be what you are trying to prevent from happening. Rapid heart rate, increased anxiety, stressed
75
Why is careful monitoring needed with smoke inhalation, blunt force trauma, pulmonary contusion, and pneumothorax
Child may appear at first so careful monitoring is needed
76
What should you use with smoke inhalation, blunt force trauma, pulmonary contusion, pneumothorax?
Pulse oxygen, arterial blood gas, level of consciousness indications of respiratory failure
77
What causes bronchiolitis most of the time
Respiratory syncytial virus (RSV)

Peds Test 2 (4 decks)

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