Test #3 Flashcards

Question

All women should be screen for Domestic Abuse, THIS HAS TO BE DONE ALONE, what are some of the questions you would ask?

Answer 1

Has anyone close to you eer threatened to harm you? Have you evern been hit, kicked, slapped or choked by someone close to you? Has anyone including your partner ever forced you to have sex? Are you afraid of your partner or anyone else?

Answer 2

Use assessment techniques to meet laboring client's needs for information and support Know their support system: -Father or support person-What do their caretaker activities involve? Pain/Anxiety: Observe for rapid breathing, nervous tremors, clenching of teeth, thrashing, crying or increased pulse and respirations.

Answer 3

Motivation for the pregnancy Attendance at child birth education class A sense of competence or mastering Self cnfidence and self esteem Positive relationship with male Maintaining control duing labor Trust in medical and nursing staff

Answer 4

Establish rappor with woman and support person Discuss expectations of labor and delivery Provide for privacy Discuss individual expression of pain and discomfort Discuss pain management options and patient preferences

Answer 5

Assist patient to reduce anxiety - may need a paper bag if patients lips are tingling (Hypervent) - Provide information and enhance coping skills - Teach about what to expect during the labor process Promote relaxation techniques Give instructions to woman's support person Administer pharmacologic agents as ordered by physician or certified nurse-midwife Assist with placement of epidural

Answer 6

Provide as much privacy as possible Encourage woman and support person to decide who should be present at delivery Provide praisea nd encouragent of progress Help woman find effective pushing pattern Support woman's attempts to rest between pushes

Answer 7

Encourage womand and support person to hold and look at infant as much as possible Teach woman care to be performed after baby is delivered Provide woman with food and fluids as allowed ENJOY BABY!

Answer 8

It is unique and she has developmental needs as well as physical needs that must be addressed Very young adolescnet has fewer coping mechanisms and less experience to draw on than older laboring mothers - Crucial to have support peson - Adolescnets have high risk for pregnancy and labor complications

Answer 9

One that occurs rapidly Less than 3 hours from start of labor to delivery

Answer 10

Remember mother may fear what is going to happen and feel that everything is out of control Mother needs to assume comfortable position PRIORITY=Safe birth Stay with mom -Delegate someone to call PCP

Answer 11

Nurse scrubs his or her hands if time permits Use preset pack if no time for sterile table When infants head crowns, mother should pant Gentle pressure is applied against fetus head to prevent it from popping out rapidly Perineum is supported and head is born between contractions Pull mucal cord from around baby's neck When the shoulders are being delivered you want to put downward pressure on the 1st and upward pressure on the 2nd DOCUMENT: assessments, actions you took, time you contacted PCP and when they arrived, time started pushing, time of delivery, when membrane ruptured and when placenta came out

Answer 12

Ketones Glucose Protein

Answer 13

Gastric emptying time is prolonged Acidity of gastric contents increase by ~2.5x Risk of aspiration, especially when narcotics or anesthesia are used

Answer 14

Ice chips or sips of clear fluids are usually allowed during early labor Clear fluids are: Tea with honey and lemon, broths, apple juice Other items: Lollipops, hard candy, and popcicle Maintain I&O Fluids provide hydration and calories Ensure frequent emptying of the bladder Offer the bedpan every 2 hours and/or assist to bathroom Patient may have physiologic diarrhea that occurs with labor Be wary of infusing IV glucose: This can lead to hypoglycemia in the newborn Prolonged labor: LR which minimizes acidosis and electrolyte imbalance Active Phase: Monitor degree of bladder fullness and make sure they empty bladder. Prevent dehydration and bladder distention

Answer 15

O2 deman increases at onset of labor because of contractions Anxiety and pain from contractions increase=hyperventillation fall in PaCO2 results in respiratory alkalosis PUSHING: PaCO2 levels may rise alo with blood lactate levels and respiratory acidosis occurs 4th STAGE: acid base returns to normal levels by 24 hours

Answer 16

For prolonged labor or signs of dehydration: Serum Electrolytes, CBC and Urine ketones

Answer 17

Monitor Evaluate Teach

Answer 18

Monitor and report to RN any abnormal findings Reinforce teaching

Answer 19

Vital signs Report patient complaints Provide ice chips, popcicles, etc

Answer 20

Emotional tension, anxiety and fear Uterine contractions Perineal and uterocervial traction

Answer 21

To have a happy, comfortable, safe labor and delivery resulting in a healthy breathing, alert newborn

Answer 22

Pregressive relaxation Touch Relaxation Effleurage Postiioning Backrubs/Massage Warm bath/Whirlpool tub Birthing ball Aromatherapy/Music therapy Duala Nurse's Behavior

Answer 23

Provide maximum pain relief with minimum risk to mother and fetus

Answer 24

All systemic drugs used in labor for pain relief cross placental barrier by simple diffusion Drug action in body depends on rate at which substance is metabolized by liver Fetus has inadequate ability to metabolize analgesic agent

Answer 25

Type of medication being administered Route of administration Expected side effects of medication Implications for fetus or newborn Safety measures needed (ie: stay in bed with rails up)

Answer 26

Narcotics Demerol Morphine Sulfate Stadol Nubain Barbiturates- Seconal, Nembutal Narcotiv Antagonists - Narcan

Answer 27

After a complete assessment: - Analgesic agent generally administered when cervical change has occurred - Pain medication given too early may prolong labor and depress fetus Drugs may cause fetal respiratory depression at birth if given too late in labor Maternal and fetal vital signs must be stable before systemic drugs may be administered Assess mother and fetus and evaluate contraction pattern before administering prescribed medications

Answer 28

Informed consent Lab values Platelet count-If less than 100 CANNOT do if they have been on anticoagulant they must be off for 24 hours before Give 1 Liter bolus of fluid: Lactated Ringers or Normal Saline (So they don't bottom out BP) Get up and go to the bathroom b/c they won't be able to afterwards Make sure they are in the right position: - Sittin on side of bed slouched over - Knees up to chest position Must have pulse ox on

Answer 29

Push epinephrine in and if the Heart rate increase they are in a vein and need to re do

Answer 30

Lay on back Put pillow under right hip Monitor BP every 3 min for 15 min then every 15 min If BP decreaes bolus fluids, if that doesn't work call anestesiologist If it still doesn't go up then administer 5-10mg of Ephedrine

Answer 31

Continuous medications are administered through epidural Provides good analgesia Produces less nausea and provides greater ability to cough May produce breakthrough pain, sedation, respiratory depression Itching and hypotension are side effects

Answer 32

SEVERE headache Give caffeine and fluids if it doesn't get better do a blood patch: A small amount of the patient's blood is injected into the epidural space near the site of the original puncture; the resulting blood clot then "patches" the meningeal leak

Answer 33

Local anesthetic agen injected directly into spinal canal Level of anestesia dependent upon level of administration May be administered higher for cesarean birth or lower for vaginal birth Onset of anesthesia is immediate Wears off in 2-3 hours

Answer 34

Maternal hypotension: Can lead to fetal hypoxia, requiring frequent BP monitoring for health changes Indwelling cUrinary catheter usually nee due to decreased bladde sensation and tone Woman's legs must be protected from injury for 8-12 hours after birth of baby due to decreased movement and sensation

Answer 35

Maternal hypotension from hypovolemia or effects of anesthesia: -Treat with bolus of crystalloid IV fluid and notify anethetist Bladder distention Inability to push during second stage of labor Severe headache with spinal anesthesia Elevated temperature with epidural anesthesia Possible neurologic damage

Answer 36

Local anesthesia injected directly into pudendal nerve which produces anesthesia to lower vagina, vulva and perineum Only produces pain relief at end of labor Has no effect on fetus or progress of labor May cause hematoma, perforation of rectum, trauma to sciatic nerve

Answer 37

Local anesthesia injected into perineum prior to episiotomy Provides pain relief only for episiotomy incision There is no effect on maternal or fetal vital signs Requires large amounts of local anesthetic agents

Answer 38

Always assess pain using a scale and define the scale Record when and how medicine was given Record non-pharmacological pain management techniques evaluate effectiveness of intervention using the pain scale

Answer 39

Assess when mother ate or drank last Administer prescribed premedication such as antacid Place wedge under mother's right hip to displace uteerus and preven vena cava compression Provide oxygen prior to start of surgery Ensure IV access is established Assiste anesthesiologist by applying cricoid pressure (pic) during placement of endotracheal tube

Answer 40

Fetal Depression: If mother receives general anesthesia, infant may have respiratory depression Method not advocated when infant is considered high risk Uterine relaxation: Most general anesthetic agents cause some uterine relaxation Vomiting Aspiration: Agents may also cause vomiting and aspiration

Answer 41

Fundal height disproportionately large for dates Difficulty palpating fetus and auscultating FHR Tense, tight abdomen on inspection Large spaces between fetus and uterine wall on ultrasound

Answer 42

Diabetes Rh Sensitization Large Placenta

Answer 43

Hydrops fetalis: serious condition in which abnormal amounts of fluid build up in two or more body areas of a fetus or newborn Malformation of fetal swallowing Neural tube defects Anencephaly Cardiac anomalies Twins

Answer 44

Shortness of breath Greatly increased cesarean rate Uterine dysfunction Abruptio Placentae Postpartum Hemorrhage Preterm labor

Answer 45

Malformations Preterm birth increased mortality rate prolapsed cord Malpresentation

Answer 46

Fundal height small for datesFetus easily palpated and outlined Ftus no ballottable Variable Decelerations: Because less water to cushion Reduced AFI (Amniotic Fluid Index) on ultrasound

Answer 47

Postmaturity IUGR secondary to placental insufficiency Major renal malformations: - Renal Agenesis - Dysplastic Kidneys - lower urinary tract ostructive lesions

Answer 48

Dysfunctional labr with slow progress Fetal Deformation defects: - Adhesions - Skin and skeletal abnormalities - Pulmonary hypoplasia - Dysmorphic faces - Shor ubilical cord Umbilical cord compression Head compression

Answer 49

Provide information and encourage questions Evaluate EFM tracinfor variable decels or nonreassuring fetal status rposition mother to relieve cord compression Notify clinician of signs of cord compression Evaluate Newborn: - Anomalies - Pulmonary Hypoplasia - Postmaturity

Answer 50

Premature rupture of Membranes occunig before 37 weeks gestation Assciated with infection, previous hx of PROM, hydramnios and multiple pregnancies PROM Nursing care focuses on prevention of infection The fetus is monitored carefully If term and labor does not start on it's own labor augmentation may be started to have infant delivered before 24 hours of the ruptured membranes Limit vaginal exams to dec inf risk Change bed pads frequently If very premature we may delay delivery: - Give corticosteroids for lung development - May have antibiotics to prevent infection - Transfer while still pregnant to regional facility

Answer 51

Increased contraction frequency (Closer than 2 min) Decreased contracion intensity Increased uterine resting tone (no uterine resting during in between) Prolonged latent phase Increased discomfort due to uterine muscle cell anoxia Stress on coping abilities

Answer 52

Prolonged labor resulting in: - Maternal exhaustion - Dehydration - Increased incience of infection Decreased uteroplacental flow=Nonreassuring fetal status Prolonged pressure on fetal head reslting in: - Excessive molding (Swelling from excessive pressure) - Caput Succedaneum (Swelling all over skull) - Cephalhematoma(Blood is accumulated & bruising on one side of head or other

Answer 53

Bedrest and relaxation measures Pharmacologic sedation Low doses of oxytocin (Get the contractions stronger & further apart & to progress labor) Amniotomy (Break water) More effective labor pattern

Answer 54

Fetal Macrosomia (BIG baby) Multiple gestation Hydramnios ``` Grand Multipariy (Several deliveries make uterus stretch so not as effective) ```

Answer 55

stress on coping abilities Prolonged labor resulting in: - Maternal Exhaustion - Dehydration - Increased incidence of infection Postpartum heorrhage due to uterine atomy (Uterus not muscly) Nonreassuring fetal status due to prolonged laor Pattern Fetal sepsis from pathogens ascending from birth canal

Answer 56

Maternal fever Foul smelling amniotic fluid Tachycardia

Answer 57

Oxytocin infusion Nipple stimulation Amniotomy IV fluids Surgival birth, if needed Provide emotional support

Answer 58

Placenta separates at its edge Blod passes between fetal membranes and uterine wall Blood escapes vaginally

Answer 59

Placenta separates centrally Blood trapped between placenta and uterine wall Concealed bleeding

Answer 60

Total separation Massive vaginal bleeding

Answer 61

Abdominal pain that doesn't go away Painful bleeding(May or may not see blood) If internal bleed would see sign of shock: decrease in blood pressure, rapid, weak, or absent pulse, irregular heart rate, confusion, cool, clammy skin, rapid and shallow breathing, anxiety, lightheadedness. Fetus may have late decels Decrease in variability (Move from tachycardia to brady) Abdomen feels board like

Answer 62

Intrapartum hemorrhage DIC Hypofibrinogenemia Ruptured uterus from over distention Fatal hemorrhagic shock Pospartum complication: - Vascular spasm - Intravascular clotting - Hemorrhage - Renal Failure - Fatal shock

Answer 63

Prematurity Hypoxia Anemia (Due to blood loss) Brain damage Fetal Demise DELIVER NO MATTER WHAT!!

Answer 64

Maintain two large bore IV sites Monitor fetus an uterine activty electronically - Assess restine tone every 15 minutes - Assess fetal status every 15 minutes Monitor intake and output and urine specific gravity Measure abdomial girth hourly as ordered Review and evaluate diagnostic tests Moniture for signs of DIC Assess maternal cardiovascular status frequently - Vitalsigns every 5-15 minutes - Skin color and pulse quality hourly - Measur CVP hourly as ordered Prepare for cesarean as needed Neonatal resuscitation as needed Provide information and emotional support | (For fluids and blood products as ordered)

Answer 65

The internal OS is completely covered

Answer 66

The internal OS is partially covered

Answer 67

The edge of the OS is covered

Answer 68

Implanted in lower segment in proximity to the OS

Answer 69

Maternal psychologic stress Transverse lie common Changes in FHR Fetal compromise (Hypoxia) Cesarean birth Neonatal Anemia

Answer 70

NO NO NO NO NO

Answer 71

NO VAGINAL EXAMS Objectively and Subjectively assess blood loss, pain and uterine contractability Continuous external monitoring of FHR and uterine actity - NO interal monitoring Monitor aternal vital signs and I&O every 5-15 minutes with active hemorrhage (We need to make sure the kidney's are working) Obtain/Evaluate labs Maintain large bore IV access - Available whole blood setup Verify familiy's abiliy to copwith anxiety of unknown outcome Provide information and emotional support Anticipate cesarean delivery

Answer 72

Chorionic villi attach directly to myometrium of uterus May result in maternal hemorrhage/failure of placenta to separate from uterus May result in need for hystrectomy at time of birth

Answer 73

Placenta not delivering more than 30 minutes after birth Occurs in 1-100/200 vaginal births If not expelled placenta must be manually removed

Answer 74

Preterm birth Placenta previa Hydramnios Multiple gestation Uterine anomalies-IE. Bicornate uterus Fetal Anomalies: Anecephaly Hydrocephaly Most won't be delivered vaginally External Version: Turn baby in abdomen 36-38 weeks, if not successful then C-Section will be required

Answer 75

Likely cesarean birth Increased perinatal morbidity and mortality rates Increased risk of prolapsed cord Increased risk of cervical spinal cord injuries Increasd rish of asphyxia and non-reassuring fetal status

Answer 76

Grand multiparity with lax musculature Preterm fetus Abnormal uterus Excessive amniotic fluid Placenta previa Contracted pelvis High risk of prolapsed cord Cesarean birth

Answer 77

Newborn weighing more than 4500g (9.9 lbs)

Answer 78

Palpation of fetus in utero Ultrasound of fetus X-ray Pelvimetry

Answer 79

Cesarean birth performed if fetus is greater than 4500g Continuous fetal monioring if labor is allowed to progress Requires notification of physician for early decelerations, labor dysfunction or nonreassuring fetal status

Answer 80

Assess for nonreassuring fetal status If a loop of cord is discovered, the examiner's gloved fingers must remain in vagina to provide firm pressure on fetal head until provider arrives Oxygen via face mask Monitor FHR to determine if cord compression is adequately relieved WOman assumes knee-chest position or bed is adjusted to Trendelenburg position Transport to the operating room in this position

Answer 81

Brachial plexus Subdural hematoma Broken clavical

Answer 82

Hemorrhage

Answer 83

Dyspnea Cyanosis Frothy sputum Chest pain Tachycardia hypotension Mental confusion Massive hemorrhage Difficulty Breathing

Answer 84

Occurs when amniotic fluid — the fluid that surrounds a baby in the uterus during pregnancy — or fetal material, such as hair, enters the maternal bloodstream.

Answer 85

Suden onset respatory distress Acute Hemorrhage Circulatory collapse Cor Pulmonale Hemorrhagic Shock Coma and maternal death Fetal death if birth not immediate

Answer 86

Call ressucitation team Give O2 Large bore IV access May have to do CPR Prepare for emergency C-Section May administer blood

Answer 87

Frequent assessment of feal heart tones of each fetus Education of mother about signs and symptoms of preterm labor Encouragement of mother to ret frequently prior to birth Preparation of equipment needed to care for each individual newborn

Answer 88

Probable labor induction Decreased perfusion to the placenta Decreased amount of amniotic fluid and possible cord compression Meconium aspiration Macrosomia or a loss of fat and muscle mass resulting in small-for-gestational age (SGA) newborn

Answer 89

Turn woman to left lateral position to treat hypotension Begin or increase IV flow rate Discontinue Pitocin or administer a toclytic agent to decrease contraction frequency/intensity Administer oxygen Perform vaginal exam toheck for dilation and cord prolapse Notify Physician Obtain additional information about fetus by fetal scalp blood sampling

Answer 90

Lung size is proportionate to body height Alveoli develop from aprox 25 million - 300 million by age 3 Lung surface increases until 5-8 years Actual lung growth continues into adolescence Trachea size approximately tripled by adulthood Tonsillar tissue is normally enlarged in early school children Flexible larynx is more susceptible to spasm Infants are nose breathers!! Diaphram is a neonates major respiratory muscle - Intercostal muscles are not well developed - Retractions are more common in the infant than in older chilren and adults Brief periods of apnea (10-15 secs) are common in neonate - Respiratory pattern may also be irregular - Respiratory rate is higher than an adult Increased metabolic rate raises O2 need Lack of surfactant -Increases risk of Respiratory distress syndrome(RDS) prior to 34 weeks Underdeveloped supporting carilage and smaller lower airways -Predisposes child to increased risk of obstruction (Mucus, edema, foreign body) Any factor that decreased the size of passage, increased airway resistance -Hampers breathing and feeding | (Neonates airway is 50% smaller than adults)

Answer 91

Choanal Atresia Esophageal Atresia tracheoesophageal Fistula Diaphragmatic Hernia

Answer 92

Blockage of the posterior side of the nose Noisy respirations Cyanosis at rest Difficulty breathing during feeding Interventions: - Listen to brath sounds holding the mouth closed and 1 nostril - Pass msall catheter through each side - Hold spoon under to see if it fogs - Call PCP - Give O2 STAT - Raise HOB

Answer 93

Congenital malformation which the esophagus terminates before it reaches the stomach and or a fistula is present that forms an unnatural connection between the esophagus and the trachea Assessments: - Vomiting - Abdominal distention - Failure to pass suction catheter - Excessive oral secretions, coughing and choking - Food comes out as soon as you feed

Answer 94

Fistula at the connectionbetween the trachea and esophagus Assessments: - Coughing - Apnea - cyanosis - Frothy Saliva At risk of aspiration of stomach contents Interventions: Suctioning every 5 min Assess family (Therapeutic responses & keep family in loop)

Answer 95

Portion of the intestines is in the thoracic cavity through abnormal opening in the diaphragm LIFE THREATENING

Answer 96

Abdominal organs in chest (by fetal ultrasonography). Diminished or absent breath sounds on affected side. Bowel sounds that may be heard over the chest. Cardiac sounds that may be heard on the right side of the chest Respiratory distress developing soon after birth—dyspnea, cyanosis, nasal flaring, tachypnea, retractions. Scaphoid abdomen.

Answer 97

If diagnosed prenatally, mother moved to tertiary care center before delivery. In utero surgery may be performed. Neonatal emergency NG intubation with suction. Ventilate with high-frequency ventilation. Manage acidosis with bicarbonate and ventilation. ECMO. Liquid ventilation. Manage pulmonary hypertension; inhaled nitric oxide may be used. Surgical reduction of hernia after physiologically stable; may wait 6-18 hr after birth. Respiratory support and ECMO until lungs functioning after surgery. (McKinney 1077) McKinney, Emily, Susan James, Sharon Murray, Kristine Nelson, Jean Ashwill. Maternal-Child Nursing, 4th Edition. W.B. Saunders Company, 2013. VitalBook file.

Answer 98

Monitor intake and output. Document vomiting. Observe for respiratory distress. Provide routine postoperative care for GI surgery Identify clinical findings and report immediately Place child in semi-Fowler position on affected side with head of bed elevated. Maintain patency of NG tube. Monitor IV fluids. Maintain mechanical ventilation, ECMO, chest tubes. Assess oxygenation. Do not use facemask or bag-valve-mask for ventilatory support because air can enter stomach and further impair respiratory function. Provide minimal stimulation. Provide routine postoperative care. Monitor for signs of infection, respiratory distress, and feeding difficulties; report to physician. Support family mourning loss of perfect child.

Answer 99

Caused by insufficient surfactant Surfactant prevents alveoli from collapsing with expiration Each breath takes a log of energy and effort to inflate the alveoli LACK OF CHEST EXPANSION CAN LEAD TO RESPIRATORY ACIDOSIS Associated with: - Preterm infants - Infants of diabetic mothers - Multifetal gestation - Infant with difficulty deliveries - C-Sections

Answer 100

Usully shows a progressive pattern Respiratory rate increases Nasal flaring, retractions and cyanosis Expiratory grunt Apical pulse incrases at first - Later becomes bradycardia Abdominal seesaw pattern Decreased breath sounds and rates may occur Retractions: - Subcostal and xiphoid - Progressing to intercostal, supracostal and clavicula Color Changes: - Pink to circumoral pallor to circumoral cyanosis - Acrocyanosis deepens (Could get so dark almost black) Body Temperature Drops -Avoid rapid rewarming-may bring on apneic spell (Stop breathing) Incrase number of apneic spells Tachypnea (80-100 breaths per minute) May have a decrease in musce tone, decreased response to painful stimuli adn apneic spells

Answer 101

NICU Optimum oxygenation Stabilization of vital signs Correction of acid-base balance

Answer 102

Surfactant Ox hood - Start at 40% and wean down to 21% O2 with pulse ox at 94-98% - Monitor continuously CPAP, intubation, Ventilator Blood gas monitoring -Draw from femoral artery Thermoregulation -Put pad over liver | (Given via ET Tube)

Answer 103

Presisent lung disease following a premature birth A complication of prolonged O2 therapy Chronic Lung disease

Answer 104

Signs of tachypnea Nasal flaring Grunting Retractions Wheezing Crackles Irritability Increased breathing workload Cyanosis Activity intolerance

Answer 105

Clinical manifestations X-Ray abnormalities Resp symptoms beyond 28 days of age, O2 suppement or mechanical ventilation PROBLEMS SEEN AT BIRTH

Answer 106

O2 & drug therapy Nutritional Support

Answer 107

In utero the fetus is stressed and meconium is expelled

Answer 108

If fluid has green specs or smells like BM At birth: Signs of distress like pallor, cyanosis, apnea, bradycardia, low apgar -Skin, nails, cord may be stained with meconium

Answer 109

Suction ASAP ECMO if severe Home with monitor-If respiratory difficulties of hx prematurity Teach parents to watch for respiratory distress

Answer 110

sudden and unexpected death of an apparently healthy infant youner than 2 Remains xplained after complete autopsy Cause is unknown: - Intrinsic and extrinsic risk factors commonly said - Majority had 1 intrinsic and 2 extrinsic factors

Answer 111

Prevention of extrinsic risk factors Teaching is PRIORITY when it comes to newborns Back to sleep

Answer 112

Genetic Disorder Cuases mucus in the body to become sticky and thick Glue like mucous builds up and causes problems in the organs, mainly lungs & pancrease Children have serious breathing problems and lung disease Also have problems with nutrition, digestion, growth and development No cure & it gets worse over time Most common lethal genetic disease in whites

Answer 113

Talk with parents about financial concerns and determine if financial assistance is needed Changes in body image Help parents create schedule for medication administration -Pancrease meds at EVERY snack/meal Teach respiratory therapy techniques; create schedule Plan for exercise (Jogging, swimming, weight training) -Makes them stronger and helps move mucous Genetic testing Teach diet high in protein and calories but low in fat DO NOT GIVE ANTIHISTAMINE (Pseudafed, Benadryl)

Answer 114

Chronic disorder characterized by: - Smooth muscle spasms - Bronchial Edema - Tenacious mucous Contributing Factors: - Genetics - Environmental/Extinsic factors - Intrinsic issues

Answer 115

Wheezing Tachypnea Retractions Nasal Flaring Paroxymal, irritative and non-productive cough Prolonged expiratory phase

Answer 116

Medications: Daily Control Quick Relief

Answer 117

Long acting beta 2 agonists Inhaled corticosteroids Mehtylzanthines Mast cell inhibitors Leukotriene receptor antagonist

Answer 118

Short acting Beta 2 Agonists Corticosteroids Anticholinergics

Answer 119

Pertusis Interventions: Immunize, promote rest and fluids, contact and droplet precautions, oxygenation Tuberculosis Person to person airborne droplet, maybe asymptomatic, symptoms same as adult Influenza Droplet directly or indirectly, rest and fluids, antipyretics, comfort Pneumonia Rest and fluids, antipyretics, analgesics, antibiotics if bacterial, Repositition every 2 hours so it doesn't set up in the lungs (Even at home)

Answer 120

Croup Inflammation of the larynx, trachea and bronchi

Answer 121

Irritability Horseness Inspiratory stridor Respiratory distress Low grade fever Barking cough Stridor Cyanosis Retractions

Answer 122

Epinephrine UNLESS SEVERE: Can cause rebound effect Oral Dexamethasone to open airway Usually hospitalized Give O2 and encourage rest/fluids

Answer 123

Acute viral infection Involves bronchioles and aveoli Most common for children under age of 2 -Usually Nov-Mar Immunizations available -Synagis: Monthly if high risk and over 2 Can be fatal for preterm infants an children with chronic illness

Answer 124

URI with serious nasal drainage that just gets worse Cough, fever, RR \>70 Decreased breath sounds -apneic spells lead to respiratory acidosis Increased respiratory rate

Answer 125

Nasal washing Child's age Direct aspiration of nasalecretions CXR & ABG

Answer 126

Maintain respiratory function Hydration Reduce anxiety and prepare for home care Droplet precautions -HIGHLY COMMUNICABLE: Can stay on crib and other surfaces for 6 hours and 1 hour on skin and paper

Answer 127

Occurs when the body can no longer maintain effective gas exchange Hypoventilation results in hypoxemia and hypercapnia When oxygen and carbon dioxide reach abnormal levels, hypoxia occurs and respiratory failure begins Caponography: Tells what their carbon dioxide levels are

Answer 128

Body is attempting to compensate Restlessness Tachypnea Tachycardia Diaphoresis

Answer 129

Early decompensation Nasal flaring Retractions grunting wheezing Anxiety, Irritability, mood changes, confusion Hypertension

Answer 130

Respiratory Failure Leading towards imminent event Dyspnea Bradycardia Cyanosis Stupor Coma

Answer 131

Pulse Ox AG Sputum/throat/blood cultures Radiology (CXR) PFT Bronchoscopy Hematology

Answer 132

Expectorants Mucolytics (Humibid) Bronchodilators Antipyretics Antibiotics Corticosteroids Oxygen

Answer 133

RN MUST DO ASSESSMENT Put in High Fowler's Bad Lung down

Answer 134

LIFE THREATENING Inflammation of epiglottis caused by bacterial invasion of the soft tissue of the larynx by streptococus, staphylococcus, or haemophilus influenza type B in unimmunized children

Answer 135

Suddenly Ill High fever sore throat Four Classic Signs: Dysphonia (Inability to talk) Dysphagia (Difficulty swallowing) Drooling Distressed respiratory effort with inspiratory stridor Sitting up and leaning forward - Sniffing or tripod

Answer 136

Clinical manifestations Exam and observation are contraindicated until intubation and qualified personnel are available

Answer 137

DO NOT leave child unattended until intubated NO cultures or things in mouth until intubation Will stay intubated 1-2 days Epinephrine and corticosteroids are NOT effective Antibiotics- Rifampin Prophylaxis Thrat cultures (MUST be intubated to obtain)

Test #3 Flashcards

(182 cards)