Test-2 Respiratory Flashcards
(84 cards)
1
Q
Breathing remains primarily nasal until
A
5-6 months of age
2
Q
Infants normally breathe with an
A
Irregular rhythm
3
Q
Children breathe
A
Abdominally and diaphragmatically
4
Q
Chest radiograph
X ray
A
See respiratory disease in lungs
5
Q
CT scan
A
See tumors and large masses
6
Q
Bronchoscopy
A
Biopsy of lung tissue/lesion, remove foreign tissue
7
Q
Laryngoscopy
A
Direct view of larynx . Diagnosis of stridor
8
Q
PULMONARY function testing
A
Spirometer direct measure of vital capacity and expiratory flow rate
9
Q
Sputum cultures
A
Isolate pathogens
10
Q
Transcutaneous monitoring
A
Electrode used to detect O2 and co2 concentrations
11
Q
Cystic fibrosis
A
Inherited progressive autosomal recessive disorder affecting cells that produce mucous, sweat and digestive juices
12
Q
People with cystic fibrosis
A
Have inherited two copies of the defective CF gene-one from each parent
13
Q
Cystic fibrosis cause
A
Gene changes. Protein that regulates movement of salt in and out of cells
14
Q
Cystic fibrosis results
A
Abnormal accumulation of thick, sticky mucus. Leads to obstruction in pancreas, respiratory, GI and GU systems
15
Q
Cystic fibrosis in the respiratory system
A
Chronic infection, inflammation, bronchispasms Impaired has exchange Hypoxia Increased vascular resistance Heart pumps harder CHF
16
Q
Cystic fibrosis early manifestation
A
Wheezing
Dry, non productive cough
Frequent respiratory infections
17
Q
Cystic fibrosis late manifestations
A
Digital clubbing
Barrel chest
Nasal polyps
18
Q
Cystic fibrosis digestive system pancreas
A
Mucus prevents release of digestive enzymes that allow body to break down food
Diabetes type 1
Bowel obstruction
Poor absorption of proteins, cholesterol, fats
19
Q
Cystic fibrosis digestive
Bowel
A
Fecal impaction Intussusception Meconium ileus in newborn Recap prolapse Steatorrhea Growth retardation Delayed bone age
20
Q
Cystic fibrosis physical manifestations
A
Protuberant abdomen
Wasted buttocks
Thin extremities
21
Q
Chaotic fibrosis and skin
A
Parent may report salty taste when kissing infant
Xerostoma
Increased sodium and chloride in sweat
22
Q
Cystic fibrosis reproductive system
A
Males are sterile
Females- fertility problems
23
Q
Cystic fibrosis Dx and tests
A
DNA screenings Family history Clinical signs Pilocarpine lontophoresis (sweat test) Measures Na and Cl > 60mEq/l is diagnostic
24
Q
Additional tests for cystic fibrosis
A
72 hour fecal fat Liver function Fasting glucose Chest X ray Sputum PULMONARY function
25
Cystic fibrosis goal
Prevent and treat lung infection
Nutritional
Adaptation to disease
26
Cystic fibrosis therapy
Segmental percussion and postural drainage
Excercise
Vitamin supplement a d e k
Antibiotics
Steroids PRN
Pancreatic enzymes( adjusted with stool fat)
27
Cystic fibrosis nursing care
Respiratory assessment every shift and PRN
Weight/ height
Malabsorption?
Calodrie intake?
Stools? Pain, blood in stool comstipation?
28
Cystic fibrosis interventions
```
Airway
Infection
Nutrition growth
Excercise
Emotional
Home care
```
29
Acquired respiratory health problems
Asthma
Apnea
SIDS
30
Asthma - reactive airway disease
Genetics and environment
Decreased elastic lung recoil
Pro e to airway obstruction
Flexible rib cage, underdeveloped chest muscles lead to exhaustion
31
Asthma pathophysiology
Increased airway responsiveness to stimuli
Inflammation and EDEMA of mucus membranes
Bronchospasm
Hypoventilation indicates worsening condition
32
Asthma clinical manifestations
Wheezing
Hypoxia signs
Worsening symptoms after child goes to bed
33
Asthma diagnosis
```
Good response to nebulizer
Strong family Hx of asthma or allergies
PULMONARY function tests
Peak expiratory flow rate
X ray
```
34
Intermittent asthma
Symptoms < twice a week
Rx SABA albuterol
15 minutes before exercise
35
Mild persistent asthma
Symptoms > twice per week but < once per day, 1-4 nighttime symptoms/ month
36
Mild persistent asthma Rx
Beclomethasone by MDI > 5 yo
Budesonide- nebulizer for younger children
SABA used to relieve Sx
37
Moderate asthma
Daily symptoms, bronchodilator used daily, sleep disturbance greater than once per week
38
Moderate asthma Rx
Same as mild
| May add LABA for children > 5 yo
39
Severe persistent asthma
Symptoms all day, sleep disturbance
Rx corticosteroids
LABD daily
Leukotriene blockers
40
Asthma therapy
Apply dust proof covers on pillows mattress
Over humidify rooms
Wood/ tile floors
Peak flow meter can detect start of attack
41
Asthma in the hospital
```
Cardiopulmonary status q 15-30 minutes until condition improves
Humidified O2
IV fluids Rxs
NPO status; monitor I&O
Rest
```
42
Apnea
Cessation of breathing for 20 seconds or more cyanosis bradycardia
Often seen in premature infants
43
Apnea manifestations
Apparent life threatening events
Observer may relate infant would have died without intervention
Occur most often in 37 weeks or greater while sleeping eating or awake
44
Apnea: nursing
Continuous heart/ respiration monitoring
If apnea observed, record time, duration, skin color, HR and O2 sat
Set monitor alarm for respiration pause >15 seconds
Gently tap foot or trunk
Resuscitative equipment ready
45
SIDS
```
Unknown cause
2-4 months of age
Winter and spring
Prematurity
Soft bedding
Sleeping in prime position
Maternal smoking
Sibling died from SIDS
LBW, poor
```
46
SIDS manifestations
Silent death
47
SIDS nursing considerations
Pacifier to sleep
| On back
48
Croup
General term applied to a broad classification of upper airway illness result from swelling of the epiglottis and larynx
49
Croup cause
Parainfluenza virus
50
Types of croup
```
Laryngotracheobronchitis
6 months- 6 years
More female, winter
Acute spasmodic- 1-3 yo, anxious child, hereditary
Bacterial tracheitis-
Epiglottitis- unique
```
51
Epiglottitis
Medical emergency!!!!!!!
Acute inflammation of epiglottis and surrounding tissue
Rapid onset
Complete airway obstruction
52
Epiglottitis cause
H influenzae
53
```
Affects 3-7 yo girls and boys equally
Hib vaccine ( vaccine failure, atypical organism)
```
Epiglottitis
54
Epiglottitis assessment
```
4 Ds
Dyspnea
Dysphagia
Drooling
Distress
DO NOT assess throat!!!!!! May cause complete obstruction
```
55
Croup manifestations
```
Barking cough
Worse at night
Inspiratory stridor
Accessory muscles
Frightened
Agitation
Cyanosis
```
56
Epiglottitis manifestations
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Abrupt onset
Rapid
Tripod position.
Chin thrust, mouth open
Fever 102-104
Tacky
Hypoxia symptoms
```
57
Croup Dx
Symptoms
Croup score
O2 status
58
Epiglottitis Dx
Exam of throat
Only do when intubating
Increased WBC
Lateral neck radiograph
59
Croup therapy
```
Humidity
Increase fluids
Antipyretics
IV fluid
IV antibiotics
Racemic epinephrine
Possible intubation
```
60
Epiglottitis therapy
Intubation
Fluids
Antibiotics
61
Bronchiolitis
Inflammation of bronchioles
Winter, spring
RSV 80% of cases
Inadequate hand washing
62
Bronchiolitis transmission
Live on paper up 1 hour
No porous surfaces up to 6 hours
Not airborne
Younger than 2 months hospitalized
63
Bronchiolitis pathophysiology
Upper respiratory infection (rsv)
EDEMA , mucus, cellular debris, obstruct bronchioles
Bronchioles constrict during expiration, cause hyperinflation of lungs
Atelectasis
Hypoxemia
64
Bronchiolitis manifestations
```
URI for days
Tachypnea
Wheezing, crackles, rhonchi
Intercostal retractions
Cyanosis
```
65
Bronchiolitis Dx
Chest X ray
| Enzyme immunosorbent assay of nasal secretions
66
Bronchiolitis therapy
```
At home, fluids, rest
Hospitalized:
Cool, humidified O2 if says <90
IV fluids
Assess repiratory status q 1-2 hrs
```
67
Bronchiolitis Rx
Palivizumab (synagis) IM Q month during RSV season used to reduce hospitalization of premature infants or children with heart/lung issues
68
Pneumonia
Infection of lung parenchyma
| Bacterial, viral, aspiration, chemical
69
Pneumonia manifestations
```
Fever
Cough
Tachypnea
Rhonchi, crackles, wheeze
Retractions
Nasal flaring
Chest pain
Cyanosis pallor
Irritable
Anorexia
Vomiting diarrhea
```
70
Pneumonia Dx
X ray
Blood culture
Gram stain and culture of sputum
71
Pneumonia at home
Acetaminophen
Cool mist humidifier
Warm fluids
No smoking
72
Otitis media
Otitis media= effusion of middle ear
| Otitis media with effusion= fluid behind tympanic membrane without signs of infection
73
Otitis media causes
Streptococcus pneumonia
Haemophilus influenzae
Nora Ella catarrhalis
Allergies
74
Otitis media manifestations
May start with symptoms of upper respiratory infection
75
Otitis media Dx
Hx
Pneumatic otoscopy
Typanometry
76
Otitis therapy
Prophylactic antibiotics for child with 3 or more distinct episodes in 6 months for four in one year
Myringotomy with tympanostomy tube persistent for more than 3 months associated with hearing loss
77
Foreign body aspiration
Normally less than 3 years
Leading cause of death under 1 year
Usually lodge in right main bronchus
78
Foreign body aspiration manifestations
```
Hoarseness
Croup cough
Wheezing stridor
Cyanosis
Dysphagia
Dypnea
```
79
Foreign body aspiration Dx
Fluoroscopy and chest X ray
80
Tonsillitis
Inflammation and infection of palatine tonsil
81
Adenoiditis
Inflammation and infection of pharyngeal tonsils
82
Pharyngitis-tonsillitis causes
Adenoviruses
Coronaviruses
Enteroviruses
Tonsillitis- group A beta-hemolytic streptococcus
83
Pharyngitis- tonsillitis manifestations
Throat culture- bacterial or viral
84
Pharyngitis -tonsillitis therapy
Symptoms
Cool, bland diet
Pain
Rest
