respiratory assessment (1)

Question 1

what do most respiratory problems in children look like?

Answer 1

mild, short, managed at home

Question 2

what kind of problems involve alterations in the size and shape of parts of the respiratory tract

Answer 2

structural problems

Question 3

what kind of problems involve alterations in gas exchange and threats to gas exchange (irritants and invaders)

Answer 3

functional problems

Question 4

what is the infection rate like in kids less than 3 months old?

Answer 4

lower infection rate due to protective function of maternal antibodies (do a full work up)

Question 5

what is a “full work up”

Answer 5

CBC, electrolytes, blood cultures, lumbar puncture (meningitis), urinalysis

Question 6

describe resp infection rate at 3-6 months

Answer 6

infection rate increases due to disappearance of maternal antibodies and initiation of the production of the infants’ own antibodies (full work up)

Question 7

describe resp infection rates at toddler/school age years

Answer 7

viral infection rate high (cough and touch)

Question 8

why are peds at greater risk for airway obstruction?

Answer 8

shorter/narrow airway

Question 9

what is the approximate size of an infant airway

Answer 9

4mm, size of a drinking straw

Question 10

how big is the adult airway

Answer 10

20mm

Question 11

how does the trachea grow during the first 5 years

Answer 11

in length rather than diameter (4mm)

Question 12

newborns are obligatory nose breathers until how old

Answer 12

4 months

Question 13

do infants 2-3 months old open mouth to breathe when nose is obstructed?

Answer 13

no

Question 14

which parts of the resp system are bigger than others?

Answer 14

tongue and epiglottis (can cause obstructiob)

Question 15

how many alveoli are there at birth and adulthood

Answer 15

birth= 25 million, not fully developed
adult= 300 million

Question 16

at what age to alveoli increase in size and complexity

Answer 16

8 years old

Question 17

at what age does the infant have enough muscles to react to irritants by bronchospasm and muscle contraction

Answer 17

5 months

Question 18

how long are children diaphragmatic breathers?

Answer 18

6 years old

Question 19

what are ribs like in pediatrics

Answer 19

mostly carilage

Question 20

what do you visually assess in respiratory?

Answer 20

• symmetry of chest
• abdomen breathing
• color of skin

Question 21

how long of not breathing classifies true apnea?

Answer 21

20 sec

Question 22

normal respiratory rate of a child 1day-1 year old

Answer 22

30-60

Question 23

what is the normal respiratory rate of a child 1 year-3 years old

Answer 23

24-40

Question 24

what is the normal respiratory rate of a child 3 years-5 years

Answer 24

22-34

Question 25

what is the normal respiratory rate of a child 5 years-12 years

Answer 25

18-30

Question 26

what is the normal respiratory rate of a child 12 years and older

Answer 26

12-18

Question 27

what do you assess for in respiratory palpation

Answer 27

deformities of chest wall and tactile fremitis

Question 28

what part of the stethoscope do you use to listen

Answer 28

diaphragm

Question 29

what parts of the lungs do you listen to anteriorly

Answer 29

upper and middle lobes

Question 30

what parts of the lungs to you lsiten to posteriorly

Answer 30

upper and lower lobes

Question 31

what are low pitched, swishing, soft expiratory sounds heard in older children

Answer 31

vesicular

Question 32

What are medium pitched, hollow, blowing breath sounds that are heard equally on inspiration and expiration, heard in all ages

Answer 32

Bronchovesicular

Question 33

What are hollow and higher pitched breath sounds than vesicular

Answer 33

Bronchial/tracheal

Question 34

what is a normal pulse ox for children?

Answer 34

95-98

Question 35

What can a change in muscle tone, becoming floppy, mean?

Answer 35

Hypoxia

Question 36

What kind of sounds are from the lower airway, are heard at the end of inspiration, and is air passing through secretions in alveoli and bronchials

Answer 36

Fine crackles

Question 37

What is a musical squeaking or hissing noise that is continuously heard during inspiration or expiration: louder on expiration. It is a Bronchospasm or anatomic narrowing of the bronchials

Answer 37

Wheeze

Question 38

what is a coarse low pitched noise that sounds like a snore that is air passing through thick secretions that partially obstruct the larger bronchi and trachea

Answer 38

Sonorous rhonchi

Question 39

what is a high pitched inspiratory crowing sound that originates in the layrynx or trachea. From Upper Airway Obstruction from swollen inflamed or lodged foreign body. Croup or epiglottis

Answer 39

Stridor

Question 40

What are tight breath sounds?

Answer 40

High pitched or squeaking sounds. small Airways have more constriction

Question 41

What are diminished or absent breath sounds

Answer 41

When the Airways become completely closed or almost closed

Question 42

what is the sinking in of soft tissues relative to the cartilaginous and bony thorax

Answer 42

retractions

Question 43

what retractions are below the ribcage "using abdominal muscles"

Answer 43

subcostals

Question 44

what retractions are below the sternum

Answer 44

substernal

Question 45

what retractions are between the ribs (anterior and posterior)

Answer 45

intercostals

Question 46

what retractions are above the sternum

Answer 46

suprasternal

Question 47

what retractions are above the clavicles

Answer 47

supraclavicular

Question 48

which retractions indicate mild distress?

Answer 48

subcostal, substernal, mild intercostal

Question 49

which retractions indicate moderate distress

Answer 49

subcostal, substernal, moderate intercostal

Question 50

which retractions indicate severe distress?

Answer 50

subcostal, substernal, severe intercostal, suprasternal, supraclavicular

Question 51

what is enlargement of the nostrils that helps reduce nasal resistance and maintain airway patency

Answer 51

nasal flaring

Question 52

what does nasal flaring indicate?

Answer 52

severe distress

Question 53

what does head bobbing indicate

Answer 53

severe distress

Question 54

what does grunting indicate?

Answer 54

severe distress

Question 55

what color changes indicate distress?

Answer 55

mottling, pallor, gray, cyanosis

Question 56

when assessing a 4 year olds chest the nurse would expect: a) movement of the chest wall to be symmetrical bilaterally and coordinated with breathing b) respiratory movement to be throacic c) anteroposterior diameter to be equal to the transverse diameter d) retraction of the muscles between the ribs on respiratory movement

Answer 56

A

Question 57

of the following respiratory system structures which one does not distribute air? a) bronchiole b) alveolus c) bronchus d) trachea

Answer 57

b) alveolus

Question 58

the infant primarily relies on a) mouth breathing b) intercostal muscles for breathing c) diaphragmatic abdominal breathing d) all

Answer 58

c) diaphragmatic abdominal breathing

Question 59

room air is what percent oxygen?

Answer 59

21%

Question 60

what is the best way to stimualte deep breathing in a child

Answer 60

use games to extend expiratory time and pressure

Question 61

what is an early and subtle sign of early hypoxia?

Answer 61

mood changes and restlessness

Question 62

what is cardiac arrest in the pediatric population usually resulting from?

Answer 62

prolonged hypoxia

Question 63

what is the cause of most respiratory infections in children

Answer 63

viruses

Question 64

what is the reason that infection rate drastically increases in 3-6 months?

Answer 64

maternal antibodies have disappeared and the infants own antibody production is immature