Respiratory Dysfuntion Flashcards Preview

Pediatric Development > Respiratory Dysfuntion > Flashcards

Flashcards in Respiratory Dysfuntion Deck (64):
1

Difference in childes chest wall and resp mucles vs adults

- Non-rigid, compliant chest wall

2

inspiration causes inward movement of the rib cage

- retractions
- Due to less rigid rib cage, intercostal immaturity, and soft sternum

3

Infants are obligate nose breathers during?

- first 4-6 weeks of life
- because tongue is large in proportion to mouth and epiglottis is large

4

adult no. of alveoli attained by?

6-8 years of age

5

Respiratory rate & oxygen consumption highest at _____ and gradually decreases to adult rate during ____.

- birth
- early adolescence

6

Infant/toddler Eustachian tubes are?

- short, wide & straight

7

Active lymphoid tissue , becomes less active after age ___ , atrophies after age ____.

- 6 y/o
- 12 y/o

8

Cardinal Signs of Respiratory Distress

- Restlessness
- Tachypnea
- Tachycardia
- Diaphoresis

9

Most resp infections occur during which time of the year?

winter to spring

10

highest prevalence of infection at resp infection at what age?

5 y/o

11

Pertussis:
- causes
- transmitted
- lasts
- prevalence

- Bordetella pertussis or Bordetella parapertussis bacteria
- Spread by droplets containing the bacteria
- Lasts 6 weeks.
- Can affect any age
- Now higher percentage of cases is seen among adolescents and adults.
- Vaccine Preventable

12

Acute Otitis Media (AOM) predisposing factors?

- Age
- Gender
- Family Status
- Child’s Health Status
- Feeding practices
- Exposure to passive smoke

13

Acute Otitis Media (AOM) onset?

Abrupt onset

14

Acute Otitis Media (AOM) appearance of TM?

- bulging
- limited/absent mobility
- air-fluid level behind the TM,
- otorrhea
- erythema
- otalgia

15

Treatment/Prevention of AOM?

- Assessment & management of otalgia
- Observation option (“watch and wait”) for selected children with uncomplicated AOM
- Antibiotic therapy
- Amoxicillin is first-line treatment
- Risk factor reduction
- Myringotomy tubes (for recurrrent infections)

16

Most common respiratory emergency in children ages 9 months – 5 years?

Foreign Body Aspiration

17

Syndrome characterized by a brassy barking cough, hoarse cry, inspiratory stridor, and varying degrees of respiratory distress.

Croup

18

Types of croup include?

- acute LTB
- spasmodic croup
- epiglottitis

19

Croup is AKA?

Laryngotracheobronchitis (LBT)

20

Most common age for Acute LTB (AKA Croup)?

3 months - 3 yrs

21

Clinical manifestations
of LBT

- Inspiratory stridor, retractions
- Tachycardia
- slightly increased temp.
- Condition worsens at night

22

Onset of croup?

gradual onset

23

Acute LTB - Treatment

- Cool mist vaporizer or tent (hot shower for steam)
- Maintain hydration – encourage fluids
- Monitor for increased signs of respiratory distress
- One dose oral/IM corticosteroid may reduce inflammation & prevent need for hospitalization
- Home management usually successful

24

May occur as complication of LTB?

- Bacterial tracheitis

25

Most common age of onset for Epiglottitis?

2-7 yrs

26

Most common cause of croup (LBT)?

Virus
(Para-Influenza)

27

Cause of Epiglottitis?

Bacteria
(H. influenza type B)

28

Onset of Epiglottitis?

Sudden; symptoms worsen over the course of several hours

29

Clinical manifestations
of Epiglottitis?

- High fever
- Severe sore throat with dysphagia & drooling
- Muffled voice
- Severe respiratory distress

30

Epiglottitis -Treatment?

- DO NOT ATTEMPT TO VISUALIZE EPIGLOTTIS
- Send child to ER if epiglottitis suspected
- Hospitalization and intubation
- Antibiotic therapy

31

Most common age of onset for Bronchiolitis and peak age?

- < 2yrs
- 6 months

32

Onset of Bronchiolitis?

- Starts with URI symptoms, occurs most often in winter/early spring, boys affected more often than girls

33

Clinical manifestations Bronchiolitis?

Extreme tachypnea, retractions, nasal flaring
Irritability, difficulty feeding, wheezy cough

34

Bronchiolitis: Treatment/Prevention?

- Hydration
- Conservation of energy (quiet environment)
- Oxygen
- Ribavirin therapy
Prevention:
- Monoclonal antibody therapy (Synagis)
- RSV immunoglobulin (RespiGam)

35

Cause of Bronchiolitis?

Virus
(RSV)

36

Occurs when a virus or bacterium causes inflammation of the lung parenchyma (excluding the bronchi), resulting in congestion?

Pneumonia

37

Most common cause of Pneumonia is bacterial or viral?

Viral

38

Why shouldn't OTC be used with children?

- Lack of efficacy
- Risk of overdose
- Risk of side effects

39

OTC should not be used in children what age?

< 4 y/o

40

Criteria for Diagnosis of Respiratory Failure in Children With Acute Pulmonary Disease?

- Decreased or absent inspiratory breath sounds
- Severe inspiratory retractions & use of accessory muscles
- Cyanosis in 40% O2
- Depressed LOC, decreased response to pain, poor skeletal muscle tone
- PO2 < 75 mmHg & PCO2 > 50-75 mmHg in 100% O2

41

Most pediatric cardiac arrest begins as?

respiratory failure or respiratory arrest

42

- Chronic inflammatory disorder of the airways
- Reversible airway obstruction or narrowing characterized by bronchial irritability after exposure to various stimuli

Athmas

43

Most common chronic condition in children?

Asthma

44

Asthma is characterized by?

- Inflammation/edema
- Hypersecretion of mucous
- Bronchospasm

45

Clinical Manifestations of Asthma?

- Dyspnea, cough, wheezing
- Prolonged expiration
- Tachypnea,
- tachycardia
- Diaphoresis
- increased work of breathing
- Restlessness & anxiety
- Hypoxemia
- CO2 retention
- cyanosis

46

Asthma Severity Classifications in Children?

- Intermittent
- Mild Persistent
- Moderate Persistent
- Severe Persistent

47

Asthma Classification:
Symptoms occur
- Two or fewer days per week
- Two or fewer nights per month
- No interference with normal activity
- Peak Expiratory Flow or FEV1%
> 80% of predicted value; Normal between exacerbations

Intermittent Asthma

48

Asthma Classification:
Symptoms occur
- > 2 days/week but not daily
- 3 - 4 nights per month
- Minor limitation or interference with normal activity
- Peak Expiratory Flow or FEV1%
80% or > of predicted value

Mild Persistent Asthma

49

Asthma Classification:
Symptoms occur
- Daily
- > 1x/week but not nightly
- some limitation or interference with normal activity
- Peak Expiratory Flow or FEV1%
60% - 80% of predicted value

Moderate Persistent Asthma

50

Asthma Classification:
Symptoms occur
- Continually throughout the day
- Often 7x/week at night
- Extremely limited in normal activity
- Peak Expiratory Flow or FEV1%
< 60% of predicted value

Severe Persistent Asthma

51

Severe Persistent Asthma Peak Expiratory Flow or FEV1%?

< 60% of predicted value

52

Moderate Persistent Asthma Peak Expiratory Flow or FEV1%?

60% - 80% of predicted value

53

Mild Persistent Asthma Peak Expiratory Flow or FEV1%?

80% or > of predicted value

54

Intermittent Asthma Peak Expiratory Flow or FEV1%

> 80% of predicted value; Normal between exacerbations

55

What Is Cystic Fibrosis?

- An inherited chronic disease that affects the lungs and digestive system.
- A defective gene and its protein product cause the body to produce unusually thick, sticky mucus that:
- clogs the lungs and leads to life-threatening lung infections
- obstructs the pancreas stopping natural enzymes from helping the body break down and absorb food.

56

Respiratory Manifestations of CF?

- S/S are present in almost all, but onset/extent is variable
- Stagnation of mucus and bacterial colonization resulting in chronic infection, destruction of lung tissue
- Tenacious secretions that are difficult to expectorate - obstruct bronchi/bronchioles
- hypoxia
- hypercapnea
- acidosis
- pulmonary hypertension
- cor pulmonale
- respiratory failure and death

57

GI Tract Manifestations of CF

- Thick secretions block ducts, preventing pancreatic enzymes from reaching duodenum
- Impaired digestion/absorption of fat
- Impaired digestion/absorption of protein
- Endocrine function of pancreas initially OK, but eventually pancreatic fibrosis occurs & may result in diabetes mellitus

58

Clinical Presentation of Child with CF?

- Wheezing respirations, dry nonproductive cough
- Generalized obstructive emphysema
- Patchy atelectasis
- Cyanosis
- Clubbing of fingers & toes
- Repeated bronchiolitis and pneumonia
- Gradual respiratory deterioration
- failure to thrive
- weight loss with increased appetite
- prolapse of rectum
- Parents report child tastes “salty”
- Dehydration
- Hyponatremic/hypochloremic alkalosis
- Hypoalbuminemia
- Delayed puberty in females
- Sterility in males

59

Excretion of undigested food in stool – increased bulk, frothy, and foul-smelling?

Meconium ileus
(seen in infants with CF)

60

Treatment and goals of CF therapy?

- No Cure
- Treatment is symptomatic
- Prevent/minimize pulmonary complications
- Adequate nutrition for growth
- Assist child/family in adapting to chronic illness

61

Diet for CF patient?

High-protein, high-calorie diet as much as 150% RDA

62

Management of respiratory component of CF patient?

- CPT & postural drainage
- Pharmacologic therapy
- Aggressive treatment of pulmonary infections
- Treatment of other respiratory problems
- Lung transplant (can develop thick noncompliant lungs)

63

Management of GI component of CF patient?

- high-protein, high-calorie diet as much as 150% RDA
- Pancreatic enzyme replacement
- Salt supplementation
- patient teaching on S/S of Intestinal obstruction and possibility of rectal prolaps

64

Management of psychosocial issues of CF patient?


- Coping with emotional needs of child and family
- Child requires treatments multiple times per day
- Developmental issues
- Frequent hospitalizations
- Implications of genetic transmission of the disease
- Implications of decreased life expectancy