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Unit 2 Flashcards

1
Q

Tonsils

A
  • Found in pharyngeal area
  • Filter pathogenic organisms (viral and bacterial)
  • Helps protect the respiratory and gastrointestinal tracts
  • Contribute to antibody formation
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2
Q

Palatine tonsils

A
  • Located on both sides of the oropharynx

- Removed during a tonsillectomy

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3
Q

Pharyngeal tonsils

A
  • Also known as the adenoids

- Removed during an adenoidectomy

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4
Q

Risk factors for tonsillitis

A
  • Exposure to a viral or bacterial agent

- Immature immune systems (younger children)

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5
Q

Physical findings of tonsillitis

A
  • Mouth odor
  • Mouth breathing
  • Snoring
  • Nasal qualities in the voice
  • Fever
  • Tonsil inflammation with redness and edema
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6
Q

NSG care for tonsillitis

A
  • Provide symptomatic treatment for viral tonsillitis (rest, cool fluids, warm salt-water gargles).
  • Administer antibiotic therapy as prescribed for bacterial tonsillitis.
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7
Q

What medications are given for tonsillitis

A
  • Antipyretics: acetaminophen (Tylenol) or ibuprofen (Advil)

- Antibiotics: IM PCN G, erythromycin, azithromycin, cephalosporins, amoxicillin

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8
Q

Prior to a tonsillectomy a client should maintain _____ status.

A

NPO

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9
Q

Positioning after a tonsillectomy

A
  • Place in side-lying position or on abdomen to facilitate drainage.
  • Elevate head of bed when child is fully awake.
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10
Q

Assessment after a tonsillectomy

A
  • Assess for evidence of bleeding, which includes frequent swallowing, clearing the throat, restlessness, bright red emesis, tachycardia, and/or pallor
  • Assess the airway and vital signs
  • Monitor for difficulty breathing related to oral secretions, edema, and/or bleeding
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11
Q

Comfort measures post-tonsillectomy

A
  • Administer analgesics
  • Provide an ice collar
  • Offer ice chips or sips of water to keep throat moist
  • Administer pain medication on a regular schedule
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12
Q

Diet post-tonsillectomy

A
  • Encourage clear liquids and fluids after a return of the gag reflex, avoiding red-colored liquids, citrus juice, and milk-based foods initially.
  • Advance the diet with soft, bland foods.
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13
Q

Instructions post-tonsillectomy

A
  • Discourage coughing, throat clearing, and nose blowing in order to protect the surgical site.
  • Refrain from placing pointed objects in the back of the mouth.
  • Alert parents that there may be clots or blood-tinged mucus in vomitus.
  • Ensure the child does not put anything
  • Limit strenuous activity and physical play with no swimming for 2 weeks
  • Full recovery usually occurs in approximately 14 days
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14
Q

Complications of a tonsillectomy

A
  • Hemorrhage
  • Dehydration
  • Chronic infection
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15
Q

Nasopharyngitis (common cold)

A

self-limiting virus that persists for 7-10 days

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16
Q

Clinical manifestations of nasopharyngitis

A
  • Nasal inflammation, rhinorrhea, cough, dry throat, sneezing, and nasal qualities in voice
  • Fever, decreased appetite, and irritability
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17
Q

Bacterial tracheitis

A

Infection of the lining of the trachea

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18
Q

Clinical manifestations of bacterial tracheitis

A
  • thick purulent drainage from the trachea that can obstruct the airway and cause respiratory distress
  • fever, croupy cough, stridor
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19
Q

Bronchitis (tracheobronchitis)

A
  • Associated with an upper respiratory infection (URI) and inflammation of large airways
  • Self limiting and requires symptomatic relief
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20
Q

Bronchiolitis

A
  • Mostly caused by RSV
  • Primarily affects the bronchi and bronchioles
  • Occurs at the bronchiolar level
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21
Q

Clinical manifestations of bronchitis

A
  • Persistent cough as a result of inflammation

- Resolves in 5-10 days

22
Q

Clinical manifestations of bronchiolitis

A
  • Rhinorrhean- intermittent fever, cough, and wheezing
  • Coughing that progresses toward wheezing, increased respiratory rate, nasal flaring, retractions, and cyanosis
  • Possible posttussive vomiting due to coughing
23
Q

Allergic rhinitis

A

-Cause by seasonal reaction to allergens most often in the autumn or spring

24
Q

Clinical manifestations of allergic rhinitis

A
  • Watery rhinorrhea
  • nasal congestion
  • itchiness of the nose, eyes, and pharynx
  • watery eyes
  • nasal quality of the voice
  • dry, scratchy throat
  • snoring
  • poor sleep leading to poor performance in school
  • fatigue
25
Clinical manifestations of Pneumonia (RSV, Streptococcus pneumonia, Haemophilus influenza, Mycoplasma pneumonia)
- High fever - cough that may be unproductive or productive of white sputum - retractions and nasal flaring - rapid, shallow respirations - report of chest pain - adventitious breath sounds (rhonchi, crackles) - pale color that progresses to cyanosis - irritability, anxiety, agitation, and fatigue - abdominal pain, diarrhea, lack of appetite, and vomiting - sudden onset, usually following a viral infection (bacterial pneumonia)
26
Clinical manifestations of Croup syndromes: Bacterial epiglottis (acute supraglottitis)
MEDICAL EMERGENCY - Predictive signs: absence of cough, drooling, and agitation - Sitting with chin pointing out, mouth opened, and tongue protruding - Dysphonia (hoarseness or difficulty speaking) - Dysphagia (difficulty swallowing) - Inspiratory stridor (noisy inspirations) - Sore throat, high fever, and restlessness
27
Clinical manifestations of Croup syndromes: | Acute laryngotracheobronchitis
- Low-grade fever - Restlessness - Hoarseness - Barky cough - Dyspnea - Inspiratory stridor - Retractions
28
Clinical manifestations of Croup syndromes: | Acute spasmodic laryngitis
- Barky cough - Restlessness - Difficulty breathing - Hoarseness - Nighttime episodes of laryngeal obstruction
29
Clinical manifestations of Influenza A and B
- Sudden onset of fever and chills - Dry throat and nasal mucosa - Dry cough - Flushed face - Photophobia - Myalgia - Fatigue
30
Pt centered care of Nasopharyngitis
- Give antibiotic for fever - Rest - Provide vaporized air (cool mist) - Give decongestants for children older than 1 yr - Give cough suppressants wit caution (avoid over sedation) - Antihistamines are not recommended - Antibiotics are not indicated
31
Pt centered care of Bacterial tracheitis
- Adminster oxygen as prescribed - Monitor continuous oximetry - Administer antipyretics for fever - Administer IV antibiotics as prescribed
32
Pt centered care of Bronchitis
- Give antipyretics - Give cough suppressant - Provide increased humidity (cool mist vaporizer)
33
Pt centered care of Bronchiolitis
-Provide humidified oxygen as prescribed -Monitor continuous oximetry -Encourage fluid intake if tolerated -Administer IV fluid intake if tolerated -Administer IV fluids if oral intake not tolerated -Suction nasopharynx as needed -Administer nebulizer bronchodilator Corticosteroids and antihistamines are not recommended -Antibiotics are not recommended for RSV -Chest percussion and postural drainage is not recommended -Ribavirin administration is controversial
34
Pt centered care of Allergic rhinitis
- Avoid allergens - Give antihistamines - Give nasal corticosteroids
35
Pt centered care of Pneumonia (viral)
- Administer oxygen with cool mist as prescribed - Monitor continuous oximetry - Administer antipyretics for fever - Monitor intake and output
36
Pt centered care of Pneumonia (bacterial)
- Encourage rest - Promote increased oral intake - Monitor I&O - Administer antipyretics for fever - Chest percussion and postural drainage is controversial - Administer IV fluids as prescribed - Administer oxygen as prescribed - Monitor continuous oximetry - Administer IV antibiotics as prescribed
37
Pt centered care of Bacterial epiglottitis
- Protect airway - Prepare for intubation - Provide humidified oxygen - Monitor continuous oximetry - Administer racemic epinephrine, corticosteroids, and IV fluids as prescribed - Administer antibiotic therapy
38
Pt centered care of Acute laryngotracheobronchitis and acute spasmodic laryngitis
- provide humidity with cool mist - adminster oxygen if needed - monitor continuous oximetry - administer nebulized racemic epinephrine, corticosteroids, and IV fluids as prescribed - Encourage oral intake if tolerated
39
Pt centered care of Influenza
- Promote increased fluid intake - Rest - Give medications as prescribed - Influenza vaccine- prevention - Antipyretic (pain or fever)
40
Pneumothorax
accumulation of air in the pleural space
41
Clinical manifestations of pneumothorax and pleural effusion
- dyspnea - chest pain - back pain - labored respirations - decreased oxygen saturation - tachycardia
42
NSG interventions for pneumothorax and pleural effusion
- prepare for an emergent needle aspiration with insertion of chest tube or closed drainage - provide for chest tube management - assess respiratory status - administer oxygen as prescribed
43
Pleural effusion
accumulation of fluid in the pleural space
44
Asthma
A chronic inflammatory disorder of the airways that results in intermittent and reversible airflow obstruction of the bronchioles.
45
Intermittent asthma
- Symptoms occur two or fewer times per week - No interference with normal activity - Uses short-acting B-agonist less than two times per week
46
Mild persistent asthma
- Symptoms occur more than twice a week, but not daily - Minor limitations with activity - Use of short-acting B agonist more than two days per week but not daily
47
Moderate persistent asthma
- Daily symptoms - Some limitations in activity - Uses short-acting B-agonist daily
48
Severe persistent asthma
- Symptoms occur continually - Limited activity - Use short-acting B agonist several times per day
49
Risk factors for asthma
- Family history of asthma - Family history of allergies - Allergies
50
How to use a peak flow meter
- Ensure the marker is zeroed - Have the child stand up straight - Close lips tightly around the mouthpiece (ensure the tongue is not occluding) - Blow out as hard and quickly as possible - Read the number on the meter - Repeat two more times (wait at least 30 seconds between attempts) - Record highest number
51
Pt education for pts with asthma
- encourage fluids - encourage taking oral corticosteroids with food - Instruct child to rinse mouth after corticosteroid use - Instruct to watch for redness, sores, white patches in the mouth - Follow prescription (dosage, tapering off, length of time to take)

Pediatrics ATI (2 decks)

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