Respiratory System Disorders Flashcards
(203 cards)
1
Q
Viral cause of bronchiolitis
A
Respiratory syncytial virus (RSV), adenovirus, parainfluenza
2
Q
Part Affected (Laryngo-tracheo Bronchitis)
A
Subglottic
3
Q
Medications for bronchiolitis
A
a. Nebulizer therapy-bronchodilator, corticosteroids and beta agonists
b. Antipyretics(acetaminophen)
c. Mild sedative
d. Antibiotics only if (+) secondary bacterial infection (otitis media)
e. Antiviral therapy
f. RIBAVIRIN (VIRAZOLE)
4
Q
Diagnosis of croup
A
- History (fever, cold symptoms, recent viral infection) and clinical manifestations
- X-ray of the neck
- WBC and differential count
5
Q
→ may go undiagnosed until the child presents with persistent unilateral nasal drainage (if the
neonate develops respiratory infection) and seem to have more nasal obstruction not
proportional to the degree of infection
→ careful questioning reveals an unusual susceptibility to upper respiratory symptoms
A
unilateral choanal atresia
6
Q
Disorders of the respiratory system
A
- Choanal atresia
- Croup
- Bronchiolitis
- Cystic Fibrosis
7
Q
diagnostic tests in cystic fibrosis: insertion of a hollow needle through abdominal wall into the uterus to obtain cells
from amniotic fluid around the baby. The fluid is then tested to see if both of the baby’s CFTR genes
are normal.
A
Amniocentesis
8
Q
less preferred preventive drugs for bronchiolitis
A
RSV-IGIV
9
Q
cystic fibrosis is common to what race
A
caucasians (northern Europe)
10
Q
high-pitched or squeaking noise when breathing in created by narrowing of the
airway
A
inspiratory stridor
11
Q
complications of cystic fibrosis
A
o Chronic Respiratory infection – pneumonia
o Pneumotho rax
o Chronic respiratory failure
o Cor Pulmonale
o Liver Disease
o DM
o Osteoporosis and arthritis
12
Q
– loud, harsh, “brassy” or “barking” cough (similar to a the noise of a seal barking)
o the result of swelling around the vocal cords (larynx) and windpipe (trachea). When the cough
reflex forces air through this narrowed passage, the vocal cords vibrate with a barking noise.
A
croupy cough
13
Q
diagnostic tests in bronchiolitis: shows hyperaeration and consolidation (similar to that of pneumonia); shows collapse
of alveoli/atelectasis
a. major risk factor for COPD in later life
A
Chest X-ray
14
Q
(a drug that stimulates sweating
A
pilocarpine
15
Q
A chronic multisystem disorder characterized by exocrine gland dysfunction, inherited as an autosomal
recessive trait
A
cystic fobrosis
16
Q
diagnostic tests in cystic fibrosis:
* This test is used to evaluate fat absorption as an indication of how the liver, gallbladder,
pancreas, and intestines work. Normal fat absorption requires bile from the gallbladder (or liver
if the gallbladder has been removed), enzymes from the pancreas, and normal intestines.
* 24 hour stool collection (or sometimes 72 hours or days)
* Consume a normal diet containing about 100 grams of fat per day for 3 days before starting the test;
no substances that interfere with result such as enemas, laxatives, mineral oil
A
Fecal fat test
17
Q
How to maintain patent airway in croup
A
-Assess respiratory status every 2-4 hours or more often as indicated.
-Keep emergency suction and tracheostomy intubation tray at bedside.
-Care of the child in a croupette
-Administer meds as prescribed.
-No to visual inspection of mouth and throat unless when “E” intubation can be done
- .Position head of bed up, not supine.
-.Suction PRN
18
Q
Medications for bronchiolitis: for high risk infant/child
A
antiviral therapy
19
Q
sex affected in cystic fibrosis
A
male and females are equal
20
Q
-decreases viscosity of mucus
A
dornase alfa
21
Q
diagnosis of choanal atresia:
to determine the exact location of obstruction
A
Radiography using contrast material
22
Q
croup is most common at what age
A
3mos to 5yrs
23
Q
clinical manifestations of bronchiolitis
A
o Preceded by URI, manifested as nasal stuffiness, mild fever progressing to increased respiratory
distress (after 1-2 days)
➢ Tachypnea
➢ Nasal flaring
➢ Intercostal and subcostal retractions in inspiration
➢ Dyspnea
➢ Apnea
➢ Mild fever
➢ Tachycardia results from hypoxia
24
Q
affected individual married to unaffected individual will have =
A
all children will be carriers
25
Manifestation (Laryngo-tracheo Bronchitis)
Low grade fever
Non toxic appearance
26
diagnostic tests in cystic fibrosis to check absence of pancreatic enzymes
a. FECAL FAT TEST/ QUANTITATIVE STOOL FAT DETERMINATION
b. TRYPSIN AND CHYMOTRYPSIN IN STOOL
c. SECRETIN STIMULATION TEST/ PANCREATIC FUNCTION TEST
27
Route of RSV-IGIV
IV (infused in 3-4 hours)
28
40% of patients with cystic fibrosis are diagnosed at what age
18 y/o and above
29
what results from unabsorbed food fractions excreted in the stool
steatorrhea
30
Croup management
a. Mild cases are managed at home
✓ Cool air vaporizer in child’s room
✓ Sometimes spasm relieved by sudden exposure to cold air- Breathing in cool night air/air
from open freezer/taking child to a cool basement/garage
✓ Warm mist by steam from hot running water in a closed bathroom could be helpful
✓ Hot steam in a pan because of hazards (burns)
b. When condition does not improve or becomes severe, needs to be hospitalized
31
surgeries for choanal atresia
-transnasal
-transpalatal
32
Treatment (Laryngo-tracheo Bronchitis)
Humidity
Racemic epinephrine
33
Bacterial cause of bronchiolitis
Mycoplasma pneumonia
34
Onset (Acute Epiglotitis)
rapidly progressive
(hours)
35
sex at risk in choanal atresia
females
36
Severity in Acute Laryngitis Spasmodic
least serious
37
Causative
Agent (Acute Epiglotitis)
Bacterial: usually HIB
38
Where do you take temperature?
Axillary
39
cystic fibrosis is inherited as
autosomal recessive trait
40
Types of choanal atresia
unilateral and bilateral
41
chest physiotherapy: high frequency chest wall oscillation to loosen secretions
Devices Thairapy rest device
42
peak year of croup
2nd year
43
diagnostic tests in cystic fibrosis for Chronic pulmonary involvement
a. CHEST X-RAY
b. PULMONARY FUNCTION TEST
44
Part Affected in Acute Laryngitis Spasmodic
glottic
45
anti-inflammatory effects decrease subglottic edema
corticosteroids
46
nursing care for choanal atresia
1. Airway support
2. Hydration and nutrition
47
when to suction in croup
bacterial tracheitis
48
complication of choanal atresia
restenosis
49
diagnostic tests in bronchiolitis
1. History (exposure to cold the previous week) and physical exam
2. Nasal or nasopharyngeal culture
3. Chest X-ray
4. Pulse oximetry
5. ABG
6. CBC
50
what results from absence of enzymes that causes malabsorption of CHO,
fats and CHON
malnutrition
51
diagnostic tests in cystic fibrosis which are Prenatal genetic tests can find out if baby has CF:
amniocentesis
chorionic villus biopsy
52
In sweat test, how many hour is it in paraffin before transferring into the weighing jar
1 hour
53
loosens and liquefies pulmonary secretions
mucolytics
54
Management of fluid and electrolyte balance in cystic fibrosis
1. add salt to all meals, especially in summer
2. give salty snacks
55
NURSING DIAGNOSES for croup
➢ Altered tissue perfusion (cardiopulmonary) r/t partially obstructed airway
➢ High risk for fluid volume deficit r/t inability to meet body requirements and increased
metabolic demands
➢ Fear/anxiety r/t acute illness, hospitalization and uncertain course of illness and treatment
➢ Knowledge deficit r/t diagnosis, treatment, prognosis and home care needs
56
at what year of age can surgery be done in unilateral choanal atresia
2-3 y/o
57
Part Affected (Acute Epiglotitis)
Supraglottic
58
most common age of affected in bronchiolitis
6mos, rare after 2yrs
59
CLINICAL MANIFESTATIONS of choanal atresia
➢ Difficulty of breathing following birth which may result in cyanosis (unless infant is crying
➢ Inability to nurse and breathe at the same time
➢ Unable to pass a catheter through each side of the nose into the throat
➢ Persistent one-sided nasal blockage/discharge
60
depth of insertion of catheter in choanal atresia
3-4 cm in nasopharynx
61
cystic fibrosis is characterized by
exocrine gland dysfunction
62
cause of cystic fibrosis
defect in the gene cystic fibrosis transmembrane conductance regulator (CFTR)
63
Lower respiratory illness that occurs when an infecting agent causes inflammation and
obstruction of the bronchioles
BRONCHIOLITIS
64
Manifestation in Acute Laryngitis Spasmodic
Afebrile Mild distress
respiratory
65
Disadvantage/advantage of PALIVIZUMAB
▪ Does not interfere with
MMR, and varicella vaccine
▪ Pain and mild transient
erythema at the site
66
Nursing care for croup
A. Maintain patent airway and provide for adequate respiratory exchange
B. Promote balanced fluid and nutrition
C. Promote rest and comfort
D. Support and educate child and parents
67
opens large and small airway
bronchodilators
68
o causes mucosal vasoconstriction and subsequent decrease in edema
o rapid action but sometimes symptoms “relapse” within 2 hours (assessment is
important)
racemic epinephrine (nebulized)
69
surgeries for choanal atresia: requires less operative time and causes slightly less morbidity
related to the incision, but the risk of the nasal passages closing later may be higher.
transnasal
70
70% of patients with cystic fibrosis are diagnosed at what age
2 y/o
71
Manifestation (Bacterial Tracheitis)
High fever
Thick purulent
tracheal secretions URI
appears as viral
croupy cough but no
response to LTB
therapy
72
In pancreatic function test,
* An NGT is inserted into the duodenum. Secretin is given through this tube, and the contents of
the released material from the duodenum are removed through the tube over a period of
about 2 hours.
* Fast for 12 hours prior to the test
73
most croup is caused by
virus
74
In sweat test, The negative
electrode is covered with gauze and saturated with
bicarbonate solution
75
cause of croup
virus
bacteria/allergic reaction
76
4F’s of Cystic Fibrosis
❖ Frothy (bulky and large quantity)
❖ Foul-smelling
❖ Fat-containing (greasy)
❖ Float
77
risk factors for bronchiolitis
o Children in day care
o Kids who are exposed to cigarette smoke
o Formula-fed infants
o Those at high risk for asthma
o exposed to an adult or another child with a cold in the previous
week.
78
In sweat test, positive electrode is covered by
gauze and saturated with
pilocarpine
79
A term applied to a broad classification of UPPER AIRWAY illness that result from inflammation and
narrowing of the larynx (voice box), the trachea (windpipe) and the bronchi (larger branching air tubes)
croup
80
closure of a normal opening
Atresia
81
diagnosis of choanal atresia: done to evaluate the extent of the choanal atresia once a feeding tube fails to pass through the nasal
passage; it detects the composition (membranous or bony) and thickness of the atresia, the depth of the
nasopharynx and any associated skull base anomalies
CT scan
82
preventive drugs for bronchiolitis
RSV-IGIV (RESPIGAM)
PALIVIZUMAB
83
diagnostic tests in cystic fibrosis:
* These tests are most often done in young children suspected of having cystic fibrosis.
* This test is used as a screening tool for cystic fibrosis but it does not diagnose it. Other
testing is needed to confirm a diagnosis of cystic fibrosis
TRYPSIN AND CHYMOTRYPSIN IN STOOL
84
Why avoid inspection of mouth and throat in croup
to avoid laryngopasm
85
what side is more common in unilateral choanal atresia
right (60%)
86
after how many weeks the doctor removes the stents under general anesthesia.
6 weeks
87
Onset (Laryngo-tracheo Bronchitis)
gradual; starts as URI,
progresses to
symptoms of
respiratory distress
88
concentrations of ***** highly suggestive-repeat test
40-60 mEq/L
89
Management of GIT problem in cystic fibrosis
1. Administer pancreatic enzymes with meals and do not mix enzymes until ready to use
2. Provide nutritional supplements
3. Teach on high calorie, high protein and moderate fat diet
90
Treatment in Acute Laryngitis Spasmodic
Humidity
Severe: Racemic
epinephrine
Mild: home but must
seek medical help if
(+)s/s of respiratory
distress
91
Manifestation (Acute Epiglotitis)
High fever Toxic
appearance 4Ds
Dysphonia
Dysphagia Drooling
Distressed
respiratory effort
92
long-term support to child and family client teaching and discharge planning on cystic fibrosis
* genetic counseling
* promotion of child’s independence
* no cigarette smoking in the house
* availability of support groups/agencies
93
Infection control measures for bronchiolitis
a. Isolation
b. Handwashing, avoid touching nasal mucosa/conjunctiva
c. Decrease number of hospital personnel, visitors and uninfected patients in contact with the
child
d. Making patient assignments so that nurses assigned to children with RSV are not taking
care of other patients who are considered at risk
e. SPAG-wait for a few moments before opening tent
94
Medications for bronchiolitis: which act directly on
inflamed and obstructed airways
Nebulizer therapy-bronchodilator, corticosteroids and beta agonists
95
proteolytic enzymes released from the pancreas during
normal digestion
Trypsin and chymotrypsin
96
Causative
Agent in Acute Laryngitis Spasmodic
Viral with allergic/
psychosomatic
component
97
Causative
Agent (Bacterial Tracheitis)
Bacterial: usually
staphylococcus aureus
98
surgeries for choanal atresia: provides better exposure and more accurate bone removal.
transpalatal
99
diagnostic tests in cystic fibrosis:
* This test measures the ability of the pancreas to respond to secretin.
SECRETIN STIMULATION TEST/ PANCREATIC FUNCTION TEST
100
croup usually occur in what season
winter or early spring
101
size of catheter for confirmation of choanal atresia
Fr. 6
102
Onset in Acute Laryngitis Spasmodic
sudden; typically
occurs at night; tends to
recursudden; typically
occurs at night; tends to
recur
103
viruses most commonly involved in croup are
PARAINFLUENZA VIRUS
(accounting for most cases), adenovirus, respiratory syncytial virus, influenza, and measles.
104
the medical term for HOARSENESS
o As laryngeal involvement often dominates the clinical picture
dysphonia
105
Cause of bronciolitis
Viral (generally)
Bacterial
106
type of preparation of PALIVIZUMAB
monoclonal antibody
107
condition in which the posterior nares are obstructed by membranous septum or bone either
bilaterally or unilaterally
Choanal atresia
108
chest physiotherapy: a small handheld plastic pipe with a stainless steel on the inside
that facilitate removal of mucus.
Flutter Mucus device
109
what precedes partial obstruction in bronchiolitis
complete obstruction-atelectasis-resp acidosis-hypoxia
air trapping-emphysema-resp acidosis-hypoxia
110
what is primarily affected in pancreatic enzyme deficiency
acinar cells
111
diagnosis of choanal atresia: to look into the nose to make sure the airways are open and to assess healing after
surgery.
Fiberoptic endoscope
112
sex at risk in bronchiolitis
males
113
viral cause in most cases in bronchiolitis; easily spread direct contact/droplet
Respiratory syncytial virus
114
Medications for bronchiolitis:only if (+) secondary bacterial infection (otitis media)
Antibiotics
115
Alternative names for sweat chloride test
Sweat Test; Sweat Chloride; Iontophoretic Sweat Test; Pilocarpine
Iontophoresis
116
Severity (Acute Epiglotitis)
Most life threatening
117
diagnostic tests in bronchiolitis: Respiratory acidosis =Hypercapnea (↑pCO2); hypoxemia (↓pO2)
ABG
118
Early s/s of impending airway obstruction
* Tachycardia
* Tachypnea
* Substernal, suprasternal and intercostals retractions
* Flaring of nares
* Increasing restlessness
119
Management of croup
1. HUMIDITY
2. MEDICATIONS
3. IVF for hydration
4. ARTIFICIAL AIRWAY = ET intubation/tracheostomy
120
what happens in respiratory system in cystic fibrosis
- repeated
episodes of bronchitis and pneumonia
- emphysema and atelectasis
pulmonary hypertension (cor pulmonale)
-s/s dyspnea, cyanosis, clubbing of the fingers and toes
-death (lung failure)
121
Severity (Laryngo-tracheo Bronchitis)
most common; most
serious viral croup;
progresses if
untreated
122
→ Feeding tube for bilateral choanal atresia until defect is corrected.
→ For unilateral, feed infant slowly with a small nipple in upright position and with frequent pauses to
permit breathing
123
MANIFESTATIONS (triad symptoms) of cystic fibrosis
1. progressive chronic lung disease
2. pancreatic enzyme deficiency
3. sweat gland dysfunction
124
(the top of the airway narrows to a point)
steeple sign
125
route of PALIVIZUMAB
IM
126
diagnostic tests in bronchiolitis: leukocytosis, ↑ESR
CBC
127
nursing diagnosis for cystic fibrosis
➢ Ineffective airway clearance r/t thick mucus in lungs
➢ Altered nutrition: less than body requirements r/t inability to digest nutrients
➢ Knowledge deficit (parent/child) r/t diet, therapies and follow-up care
128
Diagnosis of croup : (usually not required but used to rule out foreign body obstruction /
epiglottitis) = steeple sign (the top of the airway narrows to a point)
xray of the neck
129
3 chest physiotherapy
o (+) postural drainage
o Devices Thairapy rest device
o Flutter Mucus device
130
Disadvantage/advantage of RSV-IGIV
▪ Interferes with MMR and varicella
vaccines (live virus vaccines)- deferred
for 9 months after Respigam infusion
▪ Volume of drug may not be well
tolerated by infants (not given to
children with
congenital heart
defects)
131
Most common congenital malformation of the nose
Choanal atresia
132
diagnosis of choanal atresia
1. Physical exam for obstruction of the nose
2. Radiography using contrast material
3. Fiberoptic endoscope
4. CT scan
133
what happens in skin in cystic fibrosis
a. abnormally increased concentrations of Na and Cl in sweat
b. parents report that infants taste salty when kissed (with salt frosting)
c. dehydration and electrolyte imbalances especially during hotseasons=heat exhaustion during summer
134
o Generally extubated untilspasm and edema are no longer a problem and the child can
manage secretions successfully (Usually within 24-36 hours)
ARTIFICIAL AIRWAY = ET intubation/tracheostomy
135
Types of croup
-Acute Laryngitis
Spasmodic
-Laryngo-tracheo
Bronchitis
-Bacterial Tracheitis
-Acute Epiglotitis
136
in surgery of choanal atresia, In both approaches, the doctor stitches tubes (small plastic) called *** into the passages
to keep it open
nasal stents
137
Diagnostic test for cystic fibrosis
1. History and clinical manifestations
2. Sweat chloride test
3. Fecal Fat test/ Quantitative stool fat determination
4. Trypsin and chymotrypsin in stool
5. Secretin stimulation test/ Pancreatic function test
6. Chest X-ray-shows hyperinflation
7. Pulmonary function test
8. Upper GI and small bowel series
9. Serum Immunoreactive trypsin (IRT)
10. Prenatal genetic tests-amniocentesis, chorionic villus sampling
138
Diagnosis of croup : to distinguish between bacterial and viral illnesses
WBC and differential count
139
when to prescribe NPO
severe resp distress (>60bpm)
140
a hormone
produced by the small intestine when partially digested food has moved into the intestine from
the stomach.
- causes the pancreas to release a fluid with a high concentration
of bicarbonate. Acting as an antacid, this fluid works against the acid in the material from the
stomach, so that enzymes in the small intestine can work properly. These enzymes are responsible for breaking down food and helping in the absorption of nutrients.
Secretin
141
Severity (Bacterial Tracheitis)
guarded; observation
required close
142
Normal value of fecal fat test
less than 7 g of fat per 24 hrs
143
In sweat test, how many mins is current applied
5-12 mins
144
PEDIATRIC DIFFERENCES
UPPER AIRWAY
1. Small cavity and large tongue
2. Rapid growth of lymph tissue (tonsils and adenoids) during early childhood; atrophy after 12 y/o
3. Larynx and glottis high in neck
4. Thyroid, cricoid and tracheal cartilages immature and incomplete
5. Large amount of soft tissues and loosely anchored mucus membrane lining length of airway
6. Long, floppy epiglottis
7. Fewer functional muscles in the airways
145
factors of choanal atresia
* Genetic factor
* Environmental factor
* Developmental factor
* Trauma
* Idiopathic
146
Pediatric Differences
LOWER AIRWAY
1. Trachea is shorter and higher
2. Angle of right bronchus is more acute that in the adult (sleeper slope) intercostal muscles immature.
3. Alveoli changes in size, shape and increases in number until maturity is altered at 12 years old
4. Newborns don’t have enough smooth muscle bundles to help trap airway invaders
147
Nursing care for bronchiolitis
1. Maintain respiratory function
2. Promote rest and comfort
3. Promote balanced fluid and nutrition
4. Infection control measures
148
normal sweat chloride concentration
less than 40 mEq/L
149
earliest manifestation of cystic fibrosis in NB
meconium ileus
150
Causative
Agent (Laryngo-tracheo Bronchitis)
Viral: parainfluenza,
influenza A & B, RSV,
Mycoplasma pneumonia
151
mucus produced by the exocrine glands is abnormally thick, causing
obstruction of the small passageways of the affected organ
exocrine gland dysfunction
152
2 important changes in the upper airway in croup
1. the epiglottis and larynx swells thereby occluding the airway
2. the trachea swells against the cricoid cartilage causing restriction
153
diagnostic tests in cystic fibrosis: uses ultrasound to guide a thin tube through the vagina and cervix into the
uterus and remove a tiny piece of the placenta to biopsy. The cells of the placenta are then tested to
see if the baby has CF.
Chorionic villus biopsy
154
respiratory therapy for cystic fibrosis: for all lung segments usually BID or often if with respiratory infection
(bilateral percussion-vibration and forceful coughing) to mobilize secretions to bronchi for
expectoration
chest physiotherapy
155
* both parents are unaffected but carry trait
* occurs in 1 of 4 children
autosomal recessive inheritance
156
In trypsin and chymotrypsin in stool,
* When there is decreased pancreas function, smaller-than-normal amounts of these enzymes
are detected in the stool. =An abnormal result is if the trypsin or chymotrypsin levels in the
stool are below the normal range
* A drop of emulsified stool is placed on a thin layer of gelatin. If trypsin or chymotrypsin are
present, the gelatin will be digested, which will produce a clearing of the gelatin.
157
chloride concentration greater than *****is a (+) test result
60 mEq/L
158
what happens in reproductive system in cystic fibrosis
a. delayed puberty in females
b. males are usually sterile (due to persistent plugging and blocking of the vas deferens from tenacious
seminal fluid)
c. mucus plug-females can conceive but increased mucus in the vaginal tract makes conception difficult
d. pregnancy causes increased stress on respiratory system of the mother
159
Age affected in bronchiolitis
infants
160
GENERAL CLINICAL MANIFESTATIONS in croup
➢ CROUPY COUGH
➢ DYSPONIA
➢ INSPIRATORY STRIDOR
➢ RESPIRATORY DISTRESS
161
Management of pulmonary problem in cystic fibrosis
- Administer meds
- Cautious administration of oxygen
- Encourage deep breathing exercises
-Encourage physical exercise
162
Part Affected (Bacterial Tracheitis)
Upper Trachea
163
what happens in gut/pancreas in cystic fibrosis
- meconium ileus
- malnutrition
- failure to thrive
- steatorrhea
- rectal prolapse
164
nebulization treatments in cystic fibrosis
mucolytics, bronchodilators, dornase alfa
165
diagnostic tests in cystic fibrosis: determine the extent of lung involvement- atelectasis and emphysema are present ( increased
airway resistance)
pulmonary function test
Alternative names: PFTs; Spirometry; Spirogram; Lung function tests
166
Medications for bronchiolitis: * Controversial-cost, benefit, safety and variable efficacy (APA, 2000) = case to case basis
* Aerosolized, delivered via small particulate generator thru mask, ventilator tubing or
tent
* Pregnant health care providers should not care for a child receiving ribavirin
* If with contact lenses, wear goggles-may dissolve it
* Wait for a few moments before opening tent to prevent contamination
Ribavirin
167
Signs and symptoms are typically most severe in children ***** because their airways
are narrower and more likely to become blocked when there is infection
age 3 and younger
168
cool, moist air with oxygen provides needed extra oxygen and
moisture
Mist tent/croupette
169
associated congenital anomalies in choanal atresia
-craniofacial syndrome
-skull-based defects (encephalocele)
170
in, surgery of choanal atresia, The fenestrated opening was stented with ***** which was inserted from
posterior choana and anchored external to the collumella.
modified endotracheal tube
171
nursing responsibilities in croupette
✓ Keep the child dry
✓Tuck loose edges under mattress to prevent oxygen and moisture loss within the tent
✓Roomed near nurses station and resuscitation equipment at bedside
✓No to battery/friction/fur toys=fire hazard
172
medications for croup
a. RACEMIC EPINEPHRINE
b. CORTICOSTEROIDS
c. ANTIBIOTICS for bacterial croup
d. ANTIPYRETICS for fever
173
type of preparation of RSV-IGIV
Ig G
174
Diagnostic test for cystic fibrosis to determine Increased electrolyte concentration of sweat
SWEAT CHLORIDE TEST
175
Medical management for cystic fibrosis
1. Respiratory therapy
a. Nebulization treatments
b. Chest physiotherapy
c. Oxygen administration
2. Infection
3. Nutritional needs
4. Lung transplant
176
Management of choanal atresia
1. airway support – oral intubation or tracheostomy
2. cure the obstruction through SURGERY
177
preferred preventive drugs for bronchiolitis
PALIVIZUMAB
178
NURSING DIAGNOSES for bronchiolitis
➢ High risk for fluid volume deficit r/t inability to meet body requirements and increased
metabolic demands
➢ Fear/anxiety r/t acute illness, hospitalization and uncertain course of illness and treatment
➢ Knowledge deficit r/t diagnosis, treatment, prognosis and home care needs
179
other diagnostic tests in cystic fibrosis:
a. Upper GI and small bowel series for obstruction
b. Serum Immunoreactive trypsin (IRT) increased in NB with CF because pancreas is obstructed
even during fetal life
180
Management of bronchiolitis
1. Cardiorespiratory monitor and pulse oximetry
2. Oxygen therapy
3. Hydration (oral/IV)
4. Medications
181
what cause rectal prolapse
large bulky stools and lack of supportive fats
182
Neonates become apneic or cyanotic at birth and require resuscitation in order to prevent
asphyxia/severe hypoxia (artificial airway)
Bilateral choanal atresia
183
Post op care for choanal atresia
1. Adequate nasal cleaning & suctioning frequently
2. Antibiotics & decongestants as ordered
3. Frequent follow up check-up
184
time of the year risk for brinchiolitis
late fall, early spring (Oct-Mar)
185
Treatment (Acute Epiglotitis)
Antibiotics
Airway protection
186
diagnostic tests in cystic fibrosis: shows hyperinflation
chest xray
187
standard diagnostic test for CF
SWEAT CHLORIDE TEST
188
what happens when airway is irritated
swelling, increased mucus production, bronchospasm
189
Onset (Bacterial Tracheitis)
Progressive from URI
190
Treatment (Bacterial Tracheitis)
antibiotics
191
what results from loss of nutrients and inability to absorb fat soluble
vitamins
failure to thrive
192
diagnostic tests in bronchiolitis:presence of RSV through enzyme linked immunosorbent assay
(ELISA)/immunoflourescent antibody ( IFA)
Nasal or nasopharyngeal culture
193
sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.
Sudden infant death syndrome
194
Peak age of sids
2-4 months
195
Age where sids occurs 90%
6mos
196
Sex at risk with SIDS
Males
197
Time of the year risk for SIDS
Winter (peaks at January)
198
Race greater of incidence of SIDS
Native Americans and African Americans
199
Triple risk model of SIDS
1. Critical development period
2. Vulnerable infant
3. External stressors
200
Pathological findings in autopsy of SIDS
Pulmonary edema and intrathoracic hemorrhage
201
Nursing care for SIDS
-Emotional support for parents
-family counseling
-referral to support group
-provide reading materials for them to understand the phenomenon and reassure it is not their fault
202
Prevention of SIDS
-always put baby to sleep on its back
-only put babies to sleep in crib
-let baby sleep in the same room with parents but not the same bed
-avoid soft bedding materials
-make sure room temp is not too hot
-let baby sleep with pacifier
203
Recommendations from SIDS experts
-keep baby in smoke-free environment
-breastfeed baby if possible
-never give honey to baby less than 1y/o
-parents and caregivers trained in CPR
