Week 4: CH 20 Respiratory

Question 1

upper airway differences in pediatric vs adults

Answer 1

airway is much smaller

Question 2

why is the respiratory rate higher in younger children

Answer 2

smaller the airway the quicker the air moves

Question 3

ET tube in children

Answer 3

easier to put in right stem due to it being smaller

Question 4

alveoli in kids

Answer 4

• 36 weeks alveoli begin to differentiate
• sized normally by 8 years old

Question 5

diaphragm in children

Answer 5

• use diaphragm to breathe for the first 6 years of life due to the intercostal muscles being immature

Question 6

why do retractions happen

Answer 6

the ribs are made of a flexible cartilage and respiratory distress causes the chest wall to be drawn in

Question 7

upper airway conditions

Answer 7

• croup
• epiglottitis

Question 8

croup

Answer 8

• broad class of airway illnesses
• results in inflammation and swelling of the epiglottis and larynx

Question 9

laryngotracheobronchitis

Answer 9

viral infection that causes the swelling

Question 10

radiology of croup

Answer 10

steeples sign

Question 11

treatment of croup

Answer 11

• oral dexamethasone
• nebulized racemic
• epi
• fever reducer

Question 12

epiglottitis

Answer 12

• bacterial infection
• caused by flu
• inflammation and swelling of the epiglottis and larynx

Question 13

is epiglottitis life threatening

Answer 13

• yes
• progresses rapidly and causes complete airway obstruction

Question 14

s/s of epiglottitis

Answer 14

expected symptoms but there is NOT a barky cough

Question 15

radiology of epiglottitis

Answer 15

thumb sign

Question 16

treatment of epiglottitis

Answer 16

• antibiotics
  DO NOT UPSET be prepared to
  put in IV dexamethasone
• nebulize

Question 17

lower airway conditions

Answer 17

• bronchiolitis
• pneumonia

Question 18

bronchiolitis

Answer 18

lower respiratory tract infection which occurs when a viral or bacterial organism causes inflammation/obstruction of the bronchioles

Question 19

common months of RSV

Answer 19

october to march

Question 20

s/s of bronchiolitis

Answer 20

• cough
• runny nose
• congestion
• fever
• wheezing
• tachypnea

Question 21

nursing considerations for bronchiolitis/pneumonia

Answer 21

• obtain nasal swabs
• administer humidified O2
• nasal suctioning

Question 22

high flow nasal cannula

Answer 22

provides oxygen and “flow” to keep positive pressure and help keep alveoli open for gas exchange

Question 23

pneumonia

Answer 23

inflammation of bronchioles AND alveoli

Question 24

types of pnemonia

Answer 24

-viral (common under 5yr)
- bacterial
- mycoplasmal (common over 5yr)

Question 25

s/s of pneumonia

Answer 25

- cough - congestion - fever - poor appetite

Question 26

auscultating bronchiolitis vs pneumonia

Answer 26

- bronchiolitis is wheezing/crackles - pneumonia is rhonchi/crackles

Question 27

antibiotics for pneumonia

Answer 27

- amp for inpatient - high dose amp for outpatient - azithromycin for mycoplasmal - ceftriaxone for high risk/unvaxxed children

Question 28

chronic airway conditions

Answer 28

- asthma - cystic fibrosis

Question 29

asthma

Answer 29

- persistent inflammation of the airway - causes excess mucous formation, swelling and airway muscle contraction

Question 30

s/s of asthma

Answer 30

- wheezing - cough - decreased air movement

Question 31

treatment for asthma

Answer 31

- short acting beta 2 agonist relax smooth muscles by bronchodilation - corticosteroids decrease airway inflammation through bronchodilation - anticholinergics stop bronchoconstriction and decrease mucous production

Question 32

rule of 2

Answer 32

- use rescue inhaler 2x per week? - awake due to asthma 2x per month? - refill rescue inhaler more than 2x per year? - if yes to any of these the asthma is out of control

Question 33

using a spacer

Answer 33

- shake - head back and breathe in for 5sec - hold for 10sec - exhale for 5sec

Question 34

cystic fibrosis

Answer 34

- inherited disorder that causes sever damage to the lungs and other organs - autosomal recessive disorder

Question 35

patho of cystic fibrosis

Answer 35

- caused by mutated gene called CFTR - chloride ion transport is impaired which causes reduced water movement across cell membranes - reduced water movement causes thickened secretions

Question 36

dx of cystic fibrosis

Answer 36

- sweat test - chloride concentration