Respiratory Textbook Information Flashcards
(200 cards)
1
Q
When talking about respiration what are we mainly looking at?
A
The chest & lungs
Airway!
2
Q
What should the nurse be assessing when talking about respiration?
A
Chest & pattern of movement
Rate
Regularity
Symmetry
Depth
Effort
Accessory muscles
3
Q
When is respirations determined best in a child?
A
At sleep or quietly awake
4
Q
The following couple of flashcards will be about terminology according to respiratory
What does Tachypnea mean?
When does it normally occur?
A
Rapid respirations
Anxiety, excitement, metabolic acidosis
5
Q
What does hyperpnea mean?
A
Too deep in respiration
Like the depth of a respiration
6
Q
What does hypopnea mean?
A
Too shallow of a depth in respiration
7
Q
What does retractions mean?
Subcostal retractions?
A
Sinking of soft tissues relative to the cartilaginous and bony thorax and may occur in some pulmonary disorders.
Observed anteriorly at the lower costal margins
8
Q
What is nasal flaring?
A
A sign of respiratory distressed & enlargment of nostrils help reduce nasal resistance and maintains airway patency
9
Q
What is head bobbing?
A
Sleeping if exhausted infant is a sign of dyspnea
10
Q
What is noisy breathing?
A
Snoring!!!
11
Q
What is stridor?
What is it best heard at inspiration or expirations?
A
High pitch noisy respiration
Narrowing of the upper airway typically
Inspiration
12
Q
What is grunting?
A
Frequently sign of pain in older children
13
Q
What is wheezing?
Inspiration or expiration?
A
Continuous musical sound originating from vibrations in narrow airways
Expiration
14
Q
Color changes of the skin can be from mottling, pallor or cyanosis
But these usually all result from a cardiopulmonary disease
However what does acrocyanosis usually from?
A
Cool environment for the newborn
Causing that bluish discoloration
15
Q
What is chest pain?
A
Literally pain in the chezt
16
Q
What is clubbing?
A
Fingers and toe nails have big nail beds usually resulting from chronic hypoxia
17
Q
What is a cough?
A
Just literally cough
Protective mechanisms and indicator of irritation
18
Q
General aspects of respiratory tract infections!
A
19
Q
The upper respiratory tract or upper airway consists of what? (4)
A
Oronadopharynx
Pharynx
Larynx
Upper part of the trachea
20
Q
What does the lower respiratory tract consists of? (4)
A
Lower trachea
Bronchi
Bronchioles
Alevoli
21
Q
It’s important to note that respiratory tract infections spread from one structure to another because of the ?
What does this mean for us tho?
A
Continuous nature of the mucuous membrane lining the entire tract
That infections of the respiratory tract involve multiple structures instead of one, although one may be effected more
22
Q
What are the main infectious that are causing respiratory infections? (5)
A
RSV
influenza
Strep
Pertussis
Pneumonia
23
Q
In a healthy full term infant, typically younger than 3 months have a lower respiratory tract infection why?
A
Because they still have plenty of antibodies from their mother
24
Q
Why does the infection rate increase around 3-6months for an infant?
A
Because the maternal antibodies are disappearing and now it’s the infants turn to make them
25
Why are children more prone to get an infection than an adult?
Because their size
Think about how every structural is closer to each other and how it easily spreads throughout the body !
26
How does resistance play a role in respiratory infection, in CHILDREN?
They lack the fully developed immune system
27
When is the most common time to get a respiratory infection?
Winter and spring months
28
When does mycoplasma infections occur?
Autumn and early winter
29
When does RSV occur?
Winter and spring months
30
When does infection related to asthma occur?
Just cold weather really
31
What are some super common signs and symptoms of associated respiratory tract infections in infants and small children?
Dont over think it
Fever
Anorexia / vomit / diarrhea
Nasal blockage
Nasal discharge
Cough
Respiratory sounds
Sore throat
32
How do we assess the respiratory function in a child?
Rate
Depth
Rhythm
Labored breathing
Ease
How does it sound like it ?
How does it smell like?
How does it look like?
33
What measurement tool should be placed on all children with respiratory illness as part of the routine physical assessment?
Pulse oximeter
Oxygen saturation
34
What is an at home remedy parents can do to help a child with symptoms of respiratory tract infection?
Warm or cool mid to help soothen those mucus membranes
35
What is a cardinal sign that a child is feeling better from a respiratory tract infection?
Increase in activity
36
How are we going to prevent the spread of respiratory infection?
Hand washing!!!
Wearing mask!!
Don’t touch your face !!
37
Upper respiratory tract infections!!
38
What is acute viral nasopharyngitis?
A number of viruses usually rhinovirus that causes the common cold
39
What are some clinical manifestations of acute viral nasopharyngitis?
Dont over think it!
Fever
Decreased appetite & fluid intake
Decreased activity
Nasal inflammation
Coughing
Sneezing
40
Is acute viral nasopharyngitis usually self limiting? And if so? How long does it last?
And when is the peak of the symptoms?
It is self limiting
Usually last 10-14days
2-3 peak
41
What is the therapeutic management of acute viral nasopharyngitis?
Usually it’s self limiting at home
Prescribed antipyretics are given to help aid with fever and discomfort
Decongestants to help open up those nasal airways
42
It’s important to note to avoid the overusage of decongestations
This is called what?
Rebound congestion
43
To avoid rebound congestion, what should happen?
Do not administer for more then 3 days
44
Nasopharyngitis is so widespread in general population that it is impossible to prevent
However what can we do to try to limit that spread?
Hand washing
Avoid touching the face!
45
How can we educate parents on what to do to help aid their child with nasopharyngitis? (2)
Elevate the head of the bed
Suctioning and vaporization
46
It’s super important to support and reassure the parents that URIs are going to be frequent and like an endless rollercoaster. However we as nurses should understand that this is just a normal part of childhood and will ultimately help the child what?
Built immunity!!!
47
Acute streptococcal pharyngitis!!!
48
What is acute streptococcal pharyngitis?
GABHS Infection of the upper airway ( strep throat ) is not itself a serious disease but affect children are at risk for serious illnesses
49
GABHS infection is famously known for causing acute glomerulonephritis, which is an acute kidney infection.
And causing impetigo and pyoderma
But what is the biggest symptoms it can cause?
Scarlet fever !
50
Scarlet fever may occur from the same group A strep that causes most strep throat
But what is the biggest clinical manifestations?
Sand paper like rash
51
What are clinical manifestations of GABHS? (5)
Headache
Fever
Abdominal pain
Tonsils covered with exudate
Pain when swallowing
52
How do you diagnose acute streptopharyngitis?
Culture it
Rapid antigen testing
( vigorous swabbing on both tonsils )
53
What are the medications we are going to give a patient who has streptopharyngitis?
And for how long?
Oral penicillin
Amoxicillin for 10 days
54
What other medications do we usually use if a child may be allergic to penicillin ?
WHAT IS THE ORHER MEDICATION FHAT YHEY COUOD BE ALLERGIC TO BUT WE CAN TRY GIVINH?
Marcolide
Cephalosporins
55
Notes
IM penicillin G benzathine is appropriate to use for GABHS but it is extremely painful so use with caution
56
What should we teach the parent regarding strep throat?
Don’t away tooth brushes to prevent recurrent of infection
Follow antibiotic regime
Avoid close contact personal who are sick
Don’t take child to school for 24 hours
57
How do you prevent acute strep pharyngitis?
Hand washing
Avoid close contact with people
Replace tooth brush
58
Tonsillitis!!
59
What is tonsillitis?
Inflammation of the tonsils
60
What causes tonsillitis?
Bacterial or viral infection
Usually paired with pharyngitis
61
What are clinical manifestations of tonsillitis? (5)
Difficult swallowing
Mouth breathing
Mouth odor
Voice is like muffled
Persistent cough
62
Since tonsillitis is usually self limited, treatment for viral pharyngitis and a positive viral tonsillitis is ?
Supportive care truly
63
Do we use antibiotics on a viral infection?
NO!
64
What do we do first when we see tonsillitis?
Culture it
65
When the culture comes back positive for bacteria what do we usually do!?
Antibiotic treatment
66
Surgical treatment of chronic tonsillitis is controversial, however it may aid in some patients who have recurrent, frequent strep infection !
What is the 2 surgery called that we can perform?
Tonsillectomy
( removal of the palatine tonsils )
Adenoidectomy
( remocal of the adenoids )
67
Is surgery for your tonsils indicated for a child who has recurrent pharyngitis?
NO!
68
What is the nurses job to help the parent and child when they are having tonsillitis?
Think of what type of diet they should and shouldn’t be on?
Soft to liquid diet
Avoid milk, ice cream and pudding as they coat the mouth
Avoid citrus& anything hot
69
What type of pain management will we be doing for these children with tonsillitis?
Analgesic- antipyretic drugs
Acetaminophen and anti inflammatory medications ( IB )
70
After surgery of removing their tonsils, what usually do we do for the patient?
Put some coldness on the throat to aid the inflammataion
Rest up to!
71
What medication is contraindicated in pediatric patients after tonsillectomy and adenoidectomy?
Codeine
72
Infectious mononucleosis !!
73
What is infectious mononucleosis?
The Epstein Barr virus
Known as kissing disease!!!
74
What is the etiology of infectious mononucleosis?
Kissing!
Oral secretions
75
What is the clinical manifestation of mono!? (5)
Malaise
Sore throat
Fever
Fatigue /lack of energy
Spleen enlarged 2-3cm
76
How do we diagnosis mono? (2)
CBC
Spot test ( monospot )
77
What is the therapeutic mangement we are going to do as nurses for these patients?
Really not much can help aid with mono since it’s a virus
However we can help with like symptoms of headache fever and malaise
Rest!
78
What is the prognosis of mono?
Usually really good and most children do not find living with the disease to be hard
79
Influenza !!
80
What is influenza?
How does it spread?
A virus normally known as orthomyxovirus
Droplet : direct contact; sneezing talking coughing
81
What are clinical manifestations of influenza?
Dry cough
Fever & chills
Flushed face
Sore throat
82
What are two medications that can help with influenza?
Tamiflu
Relenza
83
When should we give Tamiflu and relenza?
Like what is the time frame?
48 hours of onset of symptoms
After it doesn’t work
( 2 day onset )
84
Why should children not receive aspirin?
Because of reye syndrome
85
How do we prevent influenza?
Vaccine!
86
Why is influenza administer yearly?
Because of the different strains of influenza
87
When should the flu vaccine start in children?
At 6 months
88
When giving the flu vaccine for the first time in a 6 month old
How does it go?
Like why are the steps?
They receive 2 shots
1 month apart
So baby is 6 months in August
1st shot
Then they get another shot in September
89
How do we prevent the spread of influenza? There are 2 ways ?
Hand washing
Vaccination
90
Otitis media!!!
91
What is otitis media?
Fluid in the middle ear along with acute signs of illness and symptoms of middle ear inflammation
An inflammation of the middle ear without reference to etiology or pathogenesis
92
Breastfed infants have less OM or more OM than bottle feed infants?
Less OM
93
What is the patho behind OM?
Primarily result of a dysfunction Eustachian tube
94
What’s the biggest complication behind OM?
Hearing loss
95
What is the clinical manifestation behind OM? (4)
Pain or discomfort when pulling or holding the ears
Fever
Loss of appetite
Vomiting : diarrhea
96
How do we diagnose OM?
Visualization of the ear
97
What is the treatment for OM?
Antibiotics !
98
What is the first line antibiotics for OM?
amoxicillin
99
What is the second line of antibiotics? (2)
Augmentin
( amoxicillin clavulanate )
Cephalosporins
100
According to the textbook
____ vaccine has reduced the rates of OM in infants and children
Pneumococcal vaccine
101
If the child is feeling pain in the ear, what do we usually recommended too? (2)
Acetaminophen
IB ( only 6 months and above )
102
What do we not give to OM? (4)
Steroids
Antihistamines
Decongestants
Antibiotic ear drops
103
There is a surgery we can do, called?
Which helps how for OM?
Myringotomy
Which simply helps alleviate the severe pain by draining the infected ear
104
Otitis externa!
105
What is otitis externa common referred to? And what is it?
Swimmers ear
Infections of the external ear canal
106
What is otisis externa usually caused by?
Staphylococcus or corynebacterium
107
What is the clinical manifestation of otisis externa? (2)
Pain at the tragus ( pinna )
Odor can be present
108
Croup syndrome !
109
What is croup syndrome?
Resonate cough described as barking or brassy
Varying degreases of inspiratory stridor and varying degrees of respiratory resulting from swelling and obstruction of the larynx
110
Epiglottitis!!
111
What is acute epiglottis?
A serious medical emergency in which where we can see the eplogittis in the children throat
112
What is the clinical manifestation of epiglottis? (8) !!!!!!!
Abrupt onset of cold symptoms
Sore throat
Tripod positing
Retractions
Inspiratory stridor
Mild hypoxia
Distress
Fever
113
Nurses who suspect epiglottis should not attempt to what? (2)
Look with a tongue depressor or take a culture !!
114
If the child is better off sitting in tripod position, why does the nurse encourage this behavior for epiglottis?
Because it’s an emergency and if the epiglottis were to get worse
We have complete respiratory distress
115
What should always be at the bed side of things with epiglottis ?
Tracheostomy kit
116
How do we prevent epiglottis?
HIB VACCINE!!!!
117
Acute laryngitis
118
What is acute laryngitis?
Usually caused by?
Acute infectious inflammation of the larynx
Virus
119
Acute laryngitis is most common in who?
Older children and adolescents
120
What is the main complaint about acute laryngitis?
Hoarseness
121
How do we usually treat acute laryngitis?
It’s generally is self limited so we usually just do supportive care
Like fluids and humidified air
122
Acute laryngotracheobronchitis
123
What is Acute laryngotracheobronchitis ?
It is a common type of croup you see in children, typically they go to bed and then wake up with this bark sounding cough
124
What is the management of LTB?
Maintaining airway and provide adequate respiratory exchange
125
What do we teach parents about LTB?
Humidors
Cool night air
Stand in front of an open freezer
126
She mentioned in class that kids usually will do a whole lot better when they go to the hospital because they got exposed to the cold air
When having LTB
127
acute spasmodic laryngitis
128
What is acute spasmodic laryngitis?
Midnight croup
To differentiate from laryngitis and LTB, this is only at night!!
129
What do we usually treat with these kids ?
Cool mist!!
130
Bacterial tracheitis
131
What is bacteria tracheitis?
Infection of the mucosa and soft tissues of the upper trachea
132
What is the clinical manifestations?
Stridor
Toxicity
Drooling
Dysphagia
133
How do we manage bacteria tracheitis? (3)
Antibiotics, steroids and antipyretics
134
Infections of the lower airway!!!!!!
135
What is bronchitis?
Inflammation of the large airways ( trachea and bronchi )
136
What is the clinical manifestation of this?
Dry hacking nonproductive cough
137
Is bronchitis mild and self limiting?
Usually the use of analgesics, antipyretics and humidity help
Yes
138
Bronchiolitis and RSV
139
What is bronchiolitis?
Acute viral infection that is caused by RSV
140
When is bronchiolitis most common to get?
Winter and spring months
141
Who is at risk for getting RSV?
Premature infants
Congenital heart or lung disease
Immune compromised
Neuromuscular disorder
142
RSV occurs less frequently in who?
Breast or formula?
Breast feed babies
143
What is the transmission of RSV?
Direct contact with respiratory secretions
144
What are some clinical manifestation of RSV?
Rhinorrhea
Wheezing
Fever
Ear /eye infection
Copious secretions
Cyanosis is severe
145
How do we diagnosis RSV?
Usually look at a culture test for it
146
How do we help manage bronchiolitis ? (3)
Adequate fluid intake
Airway Maintance
Medications
147
There is one thing that is a 100% cure of RSV but it’s super hard to get because it’s expensive and it’s called what?
Palivizumab
148
Patients with RSV will be in seperate rooms in order to what?
Avoid further complications or possible infection spreading
Hand washing is a must with these babies too
149
Pneumonia
150
What is Pneumonia?
Inflammation of the pulmonary parenchyma
151
What is viral pneumonia?
Vital that causes inflammation of the pulmonary parenchyma
152
What is the clinical manifestation of viral pneumonia?
Fever
Slight cough
Fatigue
153
How do we treat viral pneumonia?
Genuinely with oxygenation and comfort
154
What is primary atypical pneumonia ?
Bacteria causing pneumonia
Also known as community acquired pneumonia
155
What is the clinical manifestation of atypical pneumonia?
Muscle pain ( myalgia)
Fever
Headache
156
What is management for atypical pneumonia?
Macrolides treatment
Erythro
Azthrio
Clairtho
157
What is bacterial pneumonia?
Aspiration or Hematogenous dissension
Serious infection
Strep usually caused it
158
What is the biggest clinical manifestation of bacteria pneumonia?
Meningism ( meningal symptoms )
159
How do you diagnose any pneumonia?
The crackles in the chest
Radiography
160
How do you treat bacterial pneumonia!?
Anti microbial
161
What is mycoplasma pneumonia or chapdmyial pneumonia!?
Caused by mycoplasma bacteria
162
What is the manifestation of chlamydia pneumonia?
Same as others really
Fever
Malaise
Tachypnea
Cough
Chest or abdominal pain
Nausea
163
How do we diagnosis the chlamydia pneumonia?
Cultures
- sputum test , blood culture
Lung aspiration and biopsy
WBC
164
How do we prevent pneumonia?
PCV vaccine !
165
When do we see chlamydia pneumonia?
Usually 2-19 weeks after delivery
Comes from the mom via ascending infection or during delivery
166
Notes
All babies with a fever before age 2 need a full Septic work!
167
Pertussis !!
168
Pertussis is caused by what?
Bordetella pertussis
Bacteria
169
What is the one way to prevent pertussis ?
vaccine!!
Dtap and Tdap
170
What is the biggest clinical manifestation of pertussis?
Whooping cough!!
171
TB!
172
What is TB?
M.tuberculosis which is a bacterial infection gets into the lungs
173
What is the clinical manifestation of tuberculosis?
Fever
Cough
Night sweats
Delayed growth
Crackles
174
How do we diagnosis TB?
Culture
X ray
Blood
Skin test
175
What is the TB vaccine?
BCG vaccine
176
BCG vaccine is also known to cause what in test?
Positive result
177
How does a positive site look like when doing a skin TB test?
Induration of 10-15mm
And a small bump
178
When should you come back to be assess for a skin test?
48 hours !!!
179
What is a negative TB test?
Anything below 5mm
And simply no bump
180
What is latent TB?
No symptoms
Just have bacteria
181
What is active tb?
Symptoms
And infected
182
What do we normally do for immunologic testing for tb?
Quantiferon and T-spot
183
How do we management TB? 4 medications
INH
ethmabutol
Rifampin
Pyrandixe
184
What is the recommend test we use for TB?
Mantoux test
Uses ppd ( purifed protein derivative )
185
Since TB is so resistant we have something called DOT
What is that?
Where people literally come to your house and look at you drink the pills
186
Notes
Foreign body ingestion and aspiration
Where a child ingest something they aren’t suppose to, it can be toxic and they could potentially choke
Keep things away from the babies!!
Keep an eye on them!!
187
What is aspiration pneumonia?
When food, secretions go into the lungs and cause inflammation
188
What do we avoid for aspiration pneumonia?
Oily nose drops and petroleum distillates
Solvents
Talcum powder
189
What do we educate parents on with aspiration pneumonia?
Better feeding habits
And proper sitting up
190
Suspicion for inhalation injuries !!
191
Notes
HOARSE VOICE AND COUGH!!!
Soot around the nose and sputum
Heat injury
- reflex glottis closure
Local chemical injury
- insoluble gases in the lower respiratory tract
Systemic injury
- carbon monoxide causing tissue hypoxia
Therapeutmic management
- scope of the problem
- typically 100% oxygen!!!
192
Congenital diaphragmatic hernia
193
What is congenital diaphragmatic hernia?
Results when the diagram does not form completely, resulting in an opening between the throat and abdominal cavity
194
What is the clinical manifestations?
Respiratory distress and pneumothorax
195
How do we diagnosis it?
Ultrasound
196
What is the management for this?
Surgery
Fetoscopic endoluminal tracheal occlusion
197
After birth we do bag and mask for ventilation
They can’t breathe on their own
It’s hard
We need surgery on the mean time too
198
What is allergic rhinitis?
Seasonal allergies
OTC medications
Zyrtec or clartin
Flonase
Eye drops
199
Asthma !
200
What is asthma main characteristic?
What is it doing ? (2)
What do we treat first and with what?
What do we help with inflam?
What is first?
Wheezing
Constriction & inflammation
Constrictioj & albuterol
Corticosteroid
Albuterol
