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PEDS RESP DIFF
Physiologic Differences
| Question | Answer |
|---|---|
| neonate, obligatory nose breathers- | nasal congestion is provlem |
| infant basal metabolic rte much higher | metabolic needs increase with illness |
| infants depend more ON | the MUSCLES of the diaphragm to breathe- abd distention is a problem it can cause resp distress |
| nasal flaring and grunting | attempt to OPEN nares and maintain constant positive airway pressure C-PAP |
| infants can not increase tidal volume | compensate for increased o2 demand by increasing respiratory rate |
| SIGNS OF DISTRESS | begins |
| retrations | the dravwing inward of soft tissue across an underlying bony prominence due to increased INSPIRATORY effort, retration ate described according to location adn classified according to degree or depth |
| chest wall movement | synchronized of rise and fall of the upper chest wall and the abdomen, grade 0 - chest and abdmen rise and fall together, grade 1 - rise of chest lags behind the rise of the abdomen(slight delay), grade 2 - chest and abd rise and fall in see-saw pattern( |
| nasa flaring | grade0- no nasal flaring seen, grade 1 - minimal flaring seen on inspiration, grade 2 - marked flaring seen |
| expiratory grunting | grade 0- no grunting present, grade 1- grunting heard with stethoscope, grade2 -grunting heard with naked ear |
| ABNORMAL BREATH SOUNDS | begins |
| Rales | bubbling or rattling heard as a result of air moving thru fluid in the airways , heard on INSPIRATION |
| rhonchi | harsh sounds heard as a result of air moving thru TENACIOUS fluids or CONSTRICTED airways, heard primarily on EXhallation(fluids moving thru larger spaces) |
| wheezing | whistling sound heard in the airways as a result of constriction, may be EITHER inspiratory or expiratory(fxn of decreased lumen) |
| stridor | harsh crowing sound on INSPIRATION as a result of airway constriction(fxn of decreased lumen) |
| vesucular breathing | normal quiet , rushing sounds heard as air moves through the terminal broncioles and alveoli |
| brinchial breathing | normal loud, hollow blowing sounds as air moves through trachea and maain bronchi |
| ASSESSMENT OF RESP DISTRESS | assess for resp status and patency of the arway, assess for work of breathing , effectiveness of resp effort (o2 sat) |
| monitor/observe | rate(depends age, & as reps rate increses depth decreases)depth, pattern (use of diaphragm+access muscles, retractions (present or ab), nasal flaring, use of diaphragm, use of accessory muscles |
| auscultate/listen | breath sounds= rales, fhonci, wheezes, stridor?, lung sounds=present, equal, absent,loud, soft?, grunting=none , audible with stethoscope, ear? |
| asess oxygenation | skin color, pallor, cyanosis, mucus membranes, nail beds |
| observe behavior | restlessness, irritability, apprehension, lethargy, REMEMBER tachy, hyper irritable=early , brady, hypo, lethargic=late |
| monitor heart rate | count &compare to baseline |
Created by:
meinmethoo