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h & illness 4: a & c illness > week 2 : gas exchange pediatrics: resp disorders > Flashcards

week 2 : gas exchange pediatrics: resp disorders Flashcards

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1
Q

nursing care for any respiratory disorder:
easing respiratory efforts: what undergoes this

A

can usually be managed at home
running a steamy shower ( 10-15 mins )

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2
Q

true or false. hot steam or cool mist vaporizers are recommended for easing respiratory efforts

A

false, it is not.

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3
Q

true or false. encourage quiet play, rest is something to do.

A

yes this is true

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4
Q

what undergoes promoting cofort for a ped pt who happens to have a resp disorder ?

A

clear nasal secretions with saline drops, bulb suction
bulb suction
medicated drops not if < 6 years
if >6 years no more that 2-3 days

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5
Q

reducing temperature is also a must, what undergoes this category?

A

monitor temp
acetaminophen or ibuprofen as directed ( do not ever give aspirin )
cool liquids to prevent dehydration ( losing a lot due to diaphoresis )

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6
Q

what undergoes dehydration

A

asses s & s
observe frequency and color of voids
count diapers ( home, ) weigh diapers ( hospital )
continue breastfeeding if pssible
oral rehydration fluids- pedialyte

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7
Q

true or false. it is important to not force food , only give what they can eat. ( popsicles, pudding, soup )

A

true

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8
Q

what are signs of a dehydrated baby

A

rapid breathing
increased heart rate
restlessness and or irritability
lethargy/weakness
poor skin turgor ( pinching a fold of skin at the abdomen results in it returning slowly to normal )

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9
Q

define if these are a sign of a dehydrated baby
sunken fontanelle
sunken eyes
lack of tears when crying
wants to drink a lot of water ( but may vomit )
excessive thrist
decreased urine output

A

all

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10
Q

infants/babies- indicated by no wet diapers in 6-8 hrs eriof or diapers with a little dark - yellow urine
toddlers/older children very little-dark yellow urine
is typically what we see in a dehydrated baby.

A

true

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11
Q

what is a bronciolitis

A

a common vital illness most often caused by respiratory synctial virus

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12
Q

how are broncholiotis transmitted ?

A

by exposure to contaminated secretions. can live on fomitesseveral hrs and hands for 30 mins

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13
Q

where does broncholiotis start?

A

starts with upper airway and moves to lower airway

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14
Q

how are bronchiolitis characterized by

A

acute inflammation of airways, bronchospasm, and increased mucus production

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15
Q

when does bronchiolitis usually occurs?

A

typically occurs during late fall and winter months ( rsv season )

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16
Q

when does incubation occur for bronchiolitis infant pts?

A

5-8 days after contact

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17
Q

what is a fomite?

A

a surface that carries bacteria

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18
Q

what causes destruction?

A

the mucous is causing some destruction,preventing from normal breathing, this is contagious by contaminated excretion

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19
Q

what are some initial signs and symptoms of bronchiolitis

A

rhinorrhea
pharyngitis
coughing/sneezing
wheezing
possible ear or eye drainage
intermittent fever

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20
Q

what is rhinorrhea

A

runny nose

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21
Q

what is pharyngitis

A

inflammation of the pharynx ( throat )

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22
Q

true or false. the more coughing and more wheezing the more complex it gets

A

true

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23
Q

with progression of illness of bronchiliotis what happens?

A

increased coughing and wheezing
tatchypnea and restractions
cyanosis

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24
Q

what happens during severe illness of broncholiotis

A

tatchypnea greater tan 70/min
listlessnes ( lethargic & lazy ) not wanting to participate
apneic cells –> periods of not breathing
poor air exchange, decreased breath sounds

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25
Q

what are the ped resp rate that are considered normals
premature
0-3 months
3-6 months
6-12 months

A

1) 40-70
2)30-60
3)30-45
4)25-40

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26
Q

what are the ped resp rate that are considered normals
1-3 year
3-6 year
6-12 year
12+ year

A

1) 20-30
2)20-25
3)14-22
4)12-18

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27
Q

how do they distinguish that a baby has a rsv

A

they swab nasal secretion- thats how they distinguish that a baby has rsv

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28
Q

rsv - nursing care
what undergoes this

A
  • If resp distress or poor hydration will be hospitalized
  • Assign to separate rooms or grouped with other RSV patients
  • Droplet, contact and routine precautions (gloves, mask, gown)
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29
Q

true or false. these are important when it comes to rsv- nursing care
* O2 to keep sats >90 (Humidified via N/C, mask, hood)
* Clear secretions
* Superficial suctioning in (hosp)
* Bulb suction (at home)
Oxygen

A

true

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30
Q

true or false. a lot of nasal secretion may benefit from this
- superficially into the nare to get rid of some of that secretion
before feeding is best

A

true

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31
Q

rsv- nursing care, what type of medications are we giving?

A

medication
◦ Nebulized Epinepherine ?
◦ Tylenol
◦ No abx - viral
◦ No OTC decongestants, cough/cold meds, etc. ◦ nosteroids

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32
Q

is it important for an rsv to be hydrated? if so what do we check or do ?

A

yes Hydration
◦ Hydration!!!
Check skin turgor, U/O
◦ Encourage Breastfeeding if tolerated
◦ Suction before feedings
◦ Small frequent as tolerated
◦ IV fluids or NG feeds

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33
Q

signs of dehydration what do we do?

A

always encourage feeding ( may go iv or ng tube )

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34
Q

prevention of rsv

A

monoclonal antibody : palivizumab

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35
Q

is monoclonal antibody palivizumab an actual vaccine?

A

not a rue vaccine
offers passive protection
antibody activates the immune system

36
Q

monoclonal antibody is a annual injection

A

no monthly

37
Q

which type of babies are monoclonal antibody given to

A

given to high risk babies ( underlying medical conditions that weaken immune system )

38
Q

potential complications of rsv ( otitis media
what is it?

A

fluid/inflammation of middle ear
common to children < 2 years
majority of OM infectios preceded by rsv

39
Q

true or false. chronic OM can cause hearing impairment. difficulties communicating

A

true

40
Q

potential complications of rsv: otis media S & S

A

abrupt onset
- earache
-fever
-purulent discharge
if becomes chronic can cause hearing impairment

41
Q

is this true : this is painful - babies are more cranky children are more common, inflammation of the middle ear with fluid there ( so much pressure it could rupture )

A

true

42
Q

Om- treatment and nursing care what are our goals?

A

relieving pain, facilitating drainage of fluid, preventing complications or recurrence, provide support to child and family

43
Q

what are the treatment for most om: are abx required

A

no abx are not required, for severe OM the abx required is amocillin

44
Q

how do we manage pain and fever for om

A

analgesics/antipyretics ( ibu or acetaminophen )

45
Q

how do we facilitate drainage for om?

A

cotton balls, sterile cotton swabs

46
Q

om- tx and nursing care surgical intervention to drain fluid decrease pain

A

myringotomy- surgical of eardrum - decrease pain

pressure equalizer tubes. tympanoplasty tubes - allows continous drainage

47
Q

how do we prevent om?

A

prevention - rpoutine immunization with pneumococcal vaccine ( the bug can cause om so it is suggested to get this vaccine )

48
Q

why do we not want to prescribe to antibiotics ?

A

doesnt want children to be immune to abx

49
Q

potential complications of rsv: laryngobronchitis
what is it “?

A

inflammation of larynx and tranchea and bronchi

viral ( most ) can be bacterial ( tissue is inflated )

50
Q

what are the signs and symptoms of laryngobronchitis ( croup )

A

hoarse voice, milf fever, restless, irritable

cough ( barking seal )

stridor “ darth vader: inhaaltion sound ( harsh and raspy = inspiratory wheeze )

51
Q

are these true about laryngobronchitis ( croup )
progressive breathing difficulty as the air passages narrow- risk for obstruction

  • increased rr, nasal flaring, restrations
    cyanosis
A

true

52
Q

what would you do if you start hearing stridor ?

A

take the patient to the hospital

53
Q

If mild croup ( no stridor on inhalation ) , what does this mean ?

A

this can be managed at home

  • teach parents to closely monitor breathing ( esp at night ) and seek medical attention if labored respirations or stridor, night air seems to behelpful
54
Q

if more severe will be hospitalized, vigilant assesment/observation by nurse for worsening symptoms

such as

A

02, pulse oximetry, oral fluids, iv
oral steroids ( dexamethasone ) im or iv if cant be tolerate po
nebulized epinephrine

55
Q

true or false. giving abx is rare when a baby has a corup?

A

yes this si true

56
Q

true or false. parent should remain with child as much as possible, hold on lap during tx.

A

true

57
Q

what could possible happen when an infant has a croup?

A

possible intubation, be ready for emergencies

as this can lead to destruction so intubation is a must

58
Q

where does the intubation goes ?

A

go in through the mouth and then through the larynx , tranchea, and then ventilate and regulate

59
Q

what is this describing : requiring of symptom and constriction of bronchioles

A

asthma

60
Q

what is asthma, ( explain )

A

chronic pulmonary disorder
causes inflammation
bronchiole constriction
mucus hyper secretion
OBSTRUCTION

61
Q

what age is common for asthma to be hospitalized

A

hospitalized common < 5 years

62
Q

true or false. asthma is life threatening if not controlled.

A

true

63
Q

what are the classic s&s for asthma

A

recurrent episodes of wheezing, breathlessness, chest tightness, and cough, especially at night or in the early morning

64
Q

recall that recurrent episodes of wheezing, breathlessness, chest tightness, and cough, especially at night or in the early morning are a part of the classic s & s of asthma
what else?

A

restlessness, agitation common, may experience itching ( on front og the neck and chest ) prior to attack

65
Q

what would be a warning sign of asthma ?

A

if they become hypoxic- restless and agitated ( itchiness prior to having an attack )

66
Q

asthma therapeutic management ( long term )
what are out goals ?

A

maintian normla activity, normal pulmonary function, prevent symtoms and reccurent exacerbations

67
Q

true or false. we do not want kids to participate in family school activities and sports as this can cause exhaustion

A

false, we still want them to be involved.

68
Q

how will our goals with asthma therapeutic management ( long term ) be accomplished ?

A

*Regular HCP visits (1-6 mths), Prevent exacerbations (avoid triggers), use meds as prescribed and adjust when needed
* Pulmonary Function tests done to assess for changes *Encourage activity and exercise and teach how to manage

69
Q

these are encouraged for out goals to be accomplished when it comes to asthma therapeutic management :

*Optimum medication therapy that is individualized for the child
*Long Term Asthma Good teaching to child and parents with child being part of the plan

A

true

70
Q

medication therapy ( for long term )

medications will prevent , what are the the 2 main categories?

A

1) controllers or preventers

  • decrease inflammation and prevent episodes

2) relievers

  • treat symptoms quickly
71
Q

what would help for accuracy when it comes to inhalers?

A

spacers

72
Q

if coming to er with severe symptoms of asthma will step up therapy until under control. true or false?

A

true

73
Q

what are some examples of controllers or preventers inhalers?

A

corticosteroids or long term treatments

74
Q

what are example of releivers?

A

bronchodialator ( resuce drug ) very quick acting

75
Q

what are some examples of triggers that precipitate/aggravate asthma exacerbations

A

smoke
colds
animals
pollens
molf
dust
strong smells
weather changes
string emotions

76
Q

allegy proofing the home and community to avoid asthma exacerbations

A

air quiality
cleaning …..

77
Q

acute asthma - nursing care
exercise induced bronchospasm
is what ?

A

is acute and reversible
cough, sob, chest pain, tightness, wheezing that develops during activity or after

78
Q

what can u tak before exercise for prevnetion of asthma

A

sabas ( salbutamel )

79
Q

what is staus asthmaticus?

A

med emerg, comes to er and then most often go to peds icu

80
Q

what are the sympotoms of resp distress ( status asthmaticus )

A

may developgradullay or suddenly

severe sob, 02 sats is <94 , profuse diaphoresis, sitting upright, refusing to lie down

81
Q

what are the most severe of status asthmaticus symptoms

A

changes in loc, wheezes that become absent ( silent chest )

82
Q

what is a sign of distress in status asthamaticus?

A

silent chest ( concern if cannot hear the wheezes anymore= tired and just not breathing )

83
Q

true or false. we must keep sats > 94% . ventilator if resp stress worsens on a pt who has status asthmaticus

A

true

84
Q

true or false. will increase inhaled drugs ( step up ) if continue on someone who has staus asthmaticus

A

true

85
Q

what can we add for someone who has status asthmaticus

A

will add oral/iv steroids and muscle relexants to decrease increase pulmonary function

86
Q

what will we monitor for someone who has status asthmaticus

A

will monitor and correct deydation, hypoxia, acidosis ( ventilation is necessary )

h & illness 4: a & c illness (11 decks)

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