Respiratory System

Question 1

Inflammation and/or infection of the outer ear

Answer 1

Otitis externa

Question 2

Inflammation or infection of the middle ear

Answer 2

Otitis media

Question 3

Otitis externa risk factors

Answer 3

Swimming, ages 7-14, foreign object insertion into ears

Question 4

S/S of otitis externa

Answer 4

Ear pain, swelling, redness, discharge

Question 5

Otitis externa treatment

Answer 5

Otic drops usually containing both and antibiotic (such as ciprofloxacin) and steroid (such as dexamethasone)

Question 6

Administration of otic drops to children

Answer 6

Lay on on unaffected side, warm drops to room temp, instill drops into ear, have child lay for 3-5 min after instillation

Question 7

_____ _____ is usually preceded by an upper respiratory infection that causes congestion and inflammation in the ear

Answer 7

Otitis media

Question 8

Otitis media risk factors

Answer 8

Exposure to cigarette smoke**, ages 6-24 months

Question 9

S/S of otitis media

Answer 9

Drainage from affected ear, child frequently pulling on ear, increased irritability and crying, impaired sleeping

Question 10

When visualizing the tympanic membrane of a child with otitis media, it may appear

Answer 10

Red and bulging

Question 11

Otitis media treatment

Answer 11

Analgesics (acetaminophen, NSAIDs), antibiotics

Question 12

Treatment for recurrent middle ear infections

Answer 12

Myringotomy (tubes that helps drain fluid from ears)

Question 13

What are two key complications of untreated strep throat?

Answer 13

Rheumatic fever, acute glomerulonephritis

Question 14

Treatment for chronic tonsillitis

Answer 14

Tonsillectomy

Question 15

Tonsillectomy pre-op nursing care

Answer 15

Run labs to check for bleeding disorders or assess for family hx of bleeding disorders

Question 16

Tonsillectomy post-op nursing care

Answer 16

Provide an ice collar for patient, assess patient carefully for frequent swallowing or clearing of the throat (sign of bleeding)

Question 17

Tonsillectomy patient education

Answer 17

Do not consume red foods or liquid, avoid spicy foods, NO straws, avoid coughing or blowing nurse vigorously

Question 18

Epiglottitis is life-threatening because it can lead to

Answer 18

Airway compromise

Question 19

Population commonly affected by epiglottitis

Answer 19

Children between 2-5; unvaccinated (Hib) children

Question 20

T or F: a throat culture should be obtained from a child with suspected epiglottitis

Answer 20

FALSE; do not insert ANYTHING into mouth as this could result in loss of airway

Question 21

Epiglottitis treatment

Answer 21

Secure airway through intubation, antibiotics, corticosteroids

Question 22

Epiglottitis nursing consideration

Answer 22

Do not lay patient supine as this can worsen symptoms

Question 23

Acute laryngotracheobronchitis is also referred to as

Answer 23

Croup

Question 24

Inflammation of the larynx, trachea, and bronchioles

Answer 24

Croup

Question 25

Hallmark signs of croup

Answer 25

Barking cough, inspiratory stridor (high-pitched sound that occurs when there is narrowing of airway)

Question 26

Treatment for croup

Answer 26

Nebulized epinephrine, corticosteroids, intubation (in severe cases)

Question 27

Bronchiolitis is caused by

Answer 27

RSV

Question 28

RSV, pertussis (whooping cough), and influenza are spread through

Answer 28

Droplets

Question 29

S/S of pertussis

Answer 29

Low-grade fever, rapid coughing, followed by high-pitched inhalation with a characteristic “whoop” sound

Question 30

A pause in breathing in a premature infant (born before 37 weeks gestation) caused by immature respiratory control centers in the medulla

Answer 30

Apnea of prematurity

Question 31

With apnea of prematurity, the pause in breathing will last more than ___ seconds, or there may be a shorter period of apnea that occurs with _________ and _________

Answer 31

20; bradycardia, oxygen desaturation

Question 32

Apnea of prematurity treatment

Answer 32

Theophylline, caffeine, CPAP

Question 33

Apnea of prematurity nursing care

Answer 33

Stimulate baby during periods of apnea, perform car seat challenge prior to discharge (place baby in car seat and observe for s/s of apnea of prematurity)

Question 34

Breathing disorder primarily found in premature infants that causes the abnormal development of lung tissues

Answer 34

Bronchopulmonary dysplasia (BPD)

Question 35

BPD risk factors

Answer 35

Prematurity, LBW, mechanical ventilation/high levels of O2

Question 36

S/S of BPD

Answer 36

Pulmonary distress — grunting, nasal flaring, subcostal retractions, tachypnea, cyanosis; difficulty feeding, apnea

Question 37

BPD treatment

Answer 37

CPAP, O2, diuretics, bronchodilators, corticosteroids

Question 38

BPD nursing care

Answer 38

Small frequent feedings, increase calorie and protein intake using human milk fortifiers

Question 39

Breathing disorder caused by immature lungs due to lack of surfactant

Answer 39

Respiratory Distress Syndrome (RDS)

Question 40

RDS risk factors

Answer 40

Prematurity, maternal infection or diabetes

Question 41

RDS S/S

Answer 41

Respiratory distress symptoms, difficulty feeding

Question 42

If mom gets an amniocentesis prior to delivery, and the LS ratio in amniotic fluid is under ___:___, then that is indicative of immature lungs

Answer 42

2:1

Question 43

RDS treatment

Answer 43

Artificial surfactant, O2, CPAP, mechanical ventilation (if necessary)

Question 44

Restlessness, agitation, and symptoms of dyspnea are _____ signs of respiratory distress

Answer 44

Early

Question 45

Decreased LOC, bradypnea, bradycardia, and cyanosis are signs of

Answer 45

LATE respiratory distress or respiratory failure

Question 46

Labs associated with respiratory distress/failure

Answer 46

Decreased PaO2, increased PCO2, decreased SpO2 (<95%)

Question 47

Nursing interventions for respiratory distress/failure

Answer 47

Secure airway, provide O2, apply CPAP or BIPAP, mechanical ventilation, CPR

Question 48

Sudden onset of breathing difficulty, color changes such as pallor or cyanosis, change in muscle tone, or decreased level of responsiveness

Answer 48

Brief resolved unexplained event (BRUE) and Apparent Life-Threatening Event (ALTE)

Question 49

BRUE risk factors

Answer 49

Previous BRUE, prematurity, infants <2 months

Question 50

BRUE patient education

Answer 50

Safe sleep guidelines, avoid infant exposure to smoke, CPR training

Question 51

The unexplained and unexpected death of an infant under 12 months of age

Answer 51

Sudden Infant Death Syndrome (SIDS)

Question 52

Prevention of SIDS

Answer 52

Sleep safety, pacifier use and breastfeeding, no smoke exposure during pregnancy and after birth, prenatal care during pregnancy, routine health check ups and immunizations for baby