Respiratory

Question 1

Respiratory rate greater >60 make them what?

Answer 1

NPO

Question 2

use un-cuffed trach in children under 8 years old, t or f

Answer 2

true

creates functional seal

Question 3

why are kids prone to respiratory infections

Answer 3

their trachea is very short, bacteria gets into lungs

narrowness of chest

Question 4

infant airway measurement

Answer 4

smaller in diameter = 4mm

shorter in length

Question 5

adult airway measurement

Answer 5

8mm

Question 6

assess patient for signs of working breathing

Answer 6

children can only keep working for so long before respiratory arrest

Question 7

clubbing of nails equates to

Answer 7

chronic hypoxemia

Question 8

grunting is sign of*

Answer 8

impending respiratory failure

Question 9

infants can have 20 sec without breathing is called

Answer 9

periodic breathing - normal

Question 10

alte-apnea period beyond 20 seconds stands for

Answer 10

apparent life threatening event

Question 11

sweat chloride test is used for (dx test)

Answer 11

cystic fibrosis

>60 is usually positive for cystic fibrosis

Question 12

never prop a bottle, t or f

Answer 12

true

Question 13

most common location for aspiration of foreign bodies

Answer 13

right main-stem bronchus

Question 14

croup

Answer 14

acute upper airway obstruction
caused by viral infection
typically mild
seen in children from 6 mos-5 years old

Question 15

croup s/s

Answer 15

bark cough
fever may/may not
stridor on inspiration & expiration
gradual onset
retractions
hyperventilation

Question 16

croup dx

Answer 16

xray (steeple sign)

Question 17

most common type of croup requiring hospitalization

Answer 17

laryngotrachobronchitis (LTB)

usually have URI symptoms prior to croup

Question 18

croup nursing interventions

Answer 18

cool mist
nebulized epinephrine (in ER)
dexamethasone (reduces edema in airway)
heliox (in ICU) helium & oxygen decreases work of breathing
hydration

Question 19

RSV - respiratory syntactical virus

Answer 19

season = October through April
highly contagious (isolation)
transmitted by hands & resp droplets

Question 20

most common cause of bronchiolitis

Answer 20

RSV

Question 21

This population is a greatest risk for RSV

Answer 21

premature infants
congenital heart disease
BPD (broncho pulmonary dysplasia)

Question 22

most frequent cause of hospitalization in children

Answer 22

RSV

Question 23

peak incidence of RSV

Answer 23

2-7 mos

Question 24

RSV nursing interventions

Answer 24

isolation precautions
freq hand washing
assess respiration's
iv corticosteroids
encourage mom to pump & store milk
control secretions (before eating/bedtime)

Question 25

what is Ribavirin

Answer 25

Inhaled antiviral agent - approved specified therapy in children w/ RSV Expensive - Conflicting results

Question 26

what is palivizumab

Answer 26

Approved RSV drug in the US Given IV or IM q30 days during RSV season $1200 per dose

Question 27

what is asthma

Answer 27

chronic inflammatory disorder of the airway causing broncho-constriction

Question 28

asthma risk factors

Answer 28

``` boys>girls hereditary factor exposure to smoke allergies trigger/exacerbation's (environment) ```

Question 29

asthma s/s

Answer 29

wheezing/retractions | SOB

Question 30

what is status asthmaticus

Answer 30

acute asthma exacerbation w/ bronchial obstruction severe & continues to worsen despite treatment leads to respiratory failure

Question 31

s/s of status asthmaticus

Answer 31

diaphoretic (sweating) anxious use of accessory muscles respiratory failure

Question 32

mgmt of asthma

Answer 32

educate parents medication admin. asthma action plan (kids over 5)

Question 33

medications for asthma include

Answer 33

treatment for long term care & acute exacerbation's oral steroids mast cell stabilizers inhalers

Question 34

controller asthma medications

Answer 34

single inhaled corticosteroids (flovent, pulmicort, QVAR, asmanex)

Question 35

combined asthma medications

Answer 35

advair dulera symbicort

Question 36

rescue asthma medications

Answer 36

``` q4hr PRN albuterol (proair, ventilin, proventil) albuterol nebulizer levalbuterol (xopenex) levalbuterol nebulizer ```

Question 37

asthma spacer devices provide

Answer 37

better delivery for inhaled medications in children

Question 38

peak expiratory flow meter measures/use

Answer 38

max flow of air forcefully exhaled in 1 sec measured in liters/min result shown in green, yellow, red establish baseline when stable - chart (3 occurences) age 5+ required for severe patients

Question 39

what is cystic fibrosis

Answer 39

chronic multi-system condition autosomal recessive (1 in 4 births if parents carry gene) long arm of chromosome 7 screened in 50 states life expectancy (40's) may or may not display symptoms at birth - can develop

Question 40

cystic fibrosis manifestations

Answer 40

sticky mucous which blocks ducts improper salt balance, sweat has elevated Na+ and Cl abnormal ion concentration

Question 41

dx test for cystic fibrosis

Answer 41

sweat chloride test

Question 42

children with cystic fibrosis develop

Answer 42

``` chronic sinus issues nasal polyps pancreatic dysfunction malabsorption prone to infections delayed puberty in girls mild to severe symptoms ```

Question 43

mgmt of cystic fibrosis

Answer 43

``` multi-disciplinary team preventative labs auditory - hearing loss from antibiotics? test at 6+ mos brain-stem hearing test (asleep) assessments (baseline) ```

Question 44

cystic fibrosis s/s

Answer 44

gray/fatty stools (steatorrhea) digestive problems (decreased absorption) recurrent URI

Question 45

medications for cystic fibrosis

Answer 45

``` vitamins a,e,d,k inhaled antibiotics regardless of age (found beneficial) mucolytic enzymes pancreatic enzymes bronchodialators oral/iv antibiotics ```

Question 46

nursing interventions for cystic fibrosis

Answer 46

``` patient/parent education nutrition assessment percussion/postural drainage - cough - spit out mucous chest p/t q4hrs support groups supplemental feedings at night chronic - never ends ```

Question 47

child life therapist is someone who holds a

Answer 47

bachelors degree in growth and development

Question 48

bibliotherapy

Answer 48

a communication tool to help prepare a child for trt | reduces fear of the unknown

Question 49

2 huge philosophies that drive pediatric nursing practice

Answer 49

atraumatic care - avoid distressing (treatment room) | patient/family centered care - collaborate/communicate with the family