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Pediatric
Pulmonary Disorders
| Question | Answer |
|---|---|
| ___ to ____ Children are affected by some type of pulmonary alteration? | 2 in 10 children are affected by some type of pulmonary alteration |
| More children are sick with ___ & ___ problmes? | More children are sick with RSV & respiratory problems. |
| If a child has a virus and ashtma they will have a _____? | exacerbation |
| If the house is closed up then what is the child allergic too? | Animal dander |
| What is one of the most frequent reasons for visits to health care providers? | Pulmonary disorders |
| What is the most frequent reason for absenteeism in school? | Asthma |
| What are some intrinsic causes of pulmonary disorders? | Intrinsic: 1. The child airways might be smaller 2. Defect in trachea, it could collapse 3. Congenittal Heart defect |
| What are some extrinsic factors of pulmonary disorders? | Extrinsic factors: 1. anything in environment 2. Aspiration of foreign material (Children asperate food esp. peanuts |
| What is one of the most common foods that children aspirate? | peanuts |
| What are some differences that children have in the pulmonary system compared to adults? | 1. Abdominal breathing 2. Nose breathing 1st 3 weeks 3. smaller airways 4. less muscles airways 5. larynx higher vertebrae 6. cough not well developed until 6 yrs 7.immature immune sys 8. Increased exposure |
| If a child has abdominal distention what will they have problems with? | A child that has abdominal distention will have problems with BREATHING!!! |
| How do babies in their 1st 3 weeks breath? | Through their NOSE, they can NOT breath through their mouth |
| T/F A child who is in their 1st 3 weeks of life gets a virus they do not have to be admitted to the hospital? | FALSE THEY NEED TO BE Admitted to the hospital |
| Since a child's Larynx is heigher in the vertebrae a child has an easier time ____? | An easier time aspirating |
| T/F In children the cartilage trachea & bronchi are well developed? | False they are not well developed |
| Coughing is not well developed until what age? | Coughing not well developed until 6 years old. |
| Since kids don't develope a cough until age 6 they swallow their secretions. They do have a productive cough, but will NOT be able to cough in the sputum cup. What do you do if u need a specimen? | If you need a sputum specimen in a child under six yrs old cut the end of a suction catheter out |
| A child will stop breathing first before u see ____? | A child will stop breathing before u see cardiac abnormalities |
| If a child stop breathing what happens to their heart rate? | It can be normal or they could have an arrhythmias |
| What is the most common arrhythmias in kids and what is it related to? | The most common arrhytmias in kids is PVC related to chronic overload |
| T/F It is IMPORTANT to always find out what the normal oxygne saturation is? | True |
| What is the normal Oxygen saturation for kids? | 95-100% |
| Nasal flaring; head bobbing; stridor; Wheeze-on expiration; reatractions; cyanosis; cough; Changes in Respirations; Clubbing; Chest shape; RAles; Restlessness & Retration of the ribs are all clinical manifestations of? | Children with pulmonary disorders |
| In ___ it is normal for them to breath periodically, there is no defined pattern, maybe frightening to the parent/caregiver? | Newborn babies have an irregular breathing pattern |
| In Newborns it is common for their breathing to pause up to ___ seconds? | 20 seconds |
| If a child has ___ the ribs are pliable. The sternum will go in, and in dent. The intercostals between each rib will go in. | Retractions |
| Restlessness>listlessness; Tachypnea; Tachycardia; Diaphoresis; Dec. striodr or wheezing; Retractions w/o clinical imporvement; respiratory distress are all all cardinal signs of? | RESPIRATORY FAILURE |
| What will u put a babby on if they are in respiratory distress & why? | You will put babies in an open radiator (in a hood) so they can very carefully gauge the oxygen they are recieving |
| Don't put a 2 year old on a nasal cannula w/o ____? | Don't put a 2 year old on a nasal canula w/o protection, put a skin protector (duodem) on then tape to attach to skin |
| What is the highest setting you can put a 2 year old on with a nasal cannula? | 6L it could be very irritating to the mucous. They can tolerate 2-3L |
| When do you want to use a mask on 2yrs old pts? | If they need >6L |
| 2 in 10 children affected by some type of pulmonary alteration. More in ____ due to RSV bronchiolitis, virus, especially with ____? | More in winter, especially with asthma |
| ____ most frequent reason for absenteeism in school | Asthma |
| T/F intrinsic factors that cause pediatric pulmonary disorders are congenital. | True - example born with small airways |
| T/F extrinsic factors that cause pediatric pulmonary disorders are things found in the environment. | True - example airborn allergens or food allergies |
| Adults breathing is thorasic where children's breathing is ____? | abdominal |
| Infants breath primarly through their nose the first ____ weeks | three |
| Smooth muscle formation around bronchials are not complete until ____ years of age | six |
| Smooth muscles around bronchials develop enough to cause asthma at age ____ months. | five to six months |
| ____ is higher in child and easier to aspirate. | Larynx |
| Cough not well developed until ____ years old. Don’t cough out mucus like adult. | six |
| pediatric pulmonary disorders are more common in children due to their immature immune system and Increased exposure to different ____ around other kids | viruses |
| T/F cardiac problems occure at the same time the child stops breathing | False - After a child stops breathing, cardiac problems appear which is opposite from adults |
| ____ is a deformity of the fingers and fingernails that is associated with a number of diseases, mostly of the heart and lungs. | Clubbing |
| Chest shape of children with pulmonary disorders includes ____ around potions of the ribs and barrel chest | retraction |
| ____ is a high pitched sound resulting from turbulent gas flow in the upper airway. It may be inspiratory, expiratory or present on both inspiration and expiration. It can be indicative of serious airway obstruction from severe conditions. | Stridor |
| T/F Stridor is indicative of a potential medical emergency and should always command attention | True |
| wheeze is heard on inhalation or exhalation | exhalation |
| Rales are heard on exhalation or inhalation | inhalation |
| In a newborn it is common to have a pause up to ____ seconds in breathing. | 20 |
| A newborn with oxygen distress can have up to ____ liters of oxygen but at this level can cause problems with ____. | 6 liters can have problems with integument |
| 6 cardinal signs of respiratory failure | Restlessness, tachypnea, tachycardia, diaphoresis, decreased stridor or wheezing due to total obstruction, retractions without clinical improvement |
| ____ is a chronic lung disorder that is most common among children who were born prematurely, with low birthweights and who received prolonged mechanical ventilation to treat respiratory distress syndrome. It has inflammation &scarring in the lungs | Bronchopulmonary Dysplasia (BPD) |
| ____ is aChronic neonatal respiratory problem expect to be hospitalized at least once, use all energy to breath & less growth and development, airway increase in size due to scars in lungs, long term don’t know consequences previously did not live. | Bronchopulmonary Dysplasia (BPD) |
| Bonchopulmonary Dysplasia (BPD) etiology ____ babies per year US, 9 out of 10 are less than ____ grams and less than ____ weeks gestation | 5,000 - 10,000 babies per year, under 1500 grams & 28 wks gestation |
| Risk factors for Bronchopulmonay Dysplasia (BPD) when tx with O2 more than ____ days | more than 28 days |
| Bronchopulmonary Dysplasia (BPD) morbidity & mortality include recurrent ___, delays in ____, and ____ lung funcation | Recurrent respiratory infection, delays in growth and development and abnormal persistent lung function in absence of O2 administration |
| Managment of Bronchopulmonary Dysplasia (BPD) includes: maintain adequate arterial blood gases with administration of oxygen and to avoid ____ of the disease. | progression |
| Managment of Bronchopulmonary Dysplasia (BPD) includes: ____steroid therapy, oral ____, ____dilators | corticosteroid therapy (side effects not good for long time), oral diuretics (prone to fluid overload and pulmonary edema), Bronchodilators. |
| Managment of Bronchopulmonary Dysplasia (BPD) includes: Prophylactic administration of Palivizumab (Synagis) medication given each month during ___ season given as an IM injection up to $1500 ea. Worth it due to high chance of getting ___. | RSV season. RSV |
| Managment of Bronchopulmonary Dysplasia (BPD) includes: increase ____ due to using extra energy to breath, but be careful not to increase ____ due to possible ____ overload. | Increase calories without increasing fluid due to possible fluid overload |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): ____ detection of problems (especially signs of further respiratory compromise & overhydration and underhydration) Make sure not ____ | Early detection. Make sure not overhydrated |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD):• Providing periods of ____. | Providing periods of rest. Child gets tired of breathing and needs rest |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): Evaluation of the need for ____ if lots of respiratory problems. | suctioning - and avoid unless necessary bc makes child irritable and causes bronciospasms |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): • Control & evaluation of ____ from respiratory support | weaning |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): ____ evaluation & techniques. Increase calories about _/_ more (120-150 kcal/kg/day) | Feeding evaluation & techniques – increase about ¼ more calories than needed for weight |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): Increase Fi____, and promote non-nutritional _____ when not eating give pacifier so they can learn to ____. | non-nutritional sucking, so they can learn to suck. |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): • Decrease environmental ____ so the baby can rest. | Decrease environmental stimuli - Play tape of parents voice and put in isolate. |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD) ____ as they get older increase stimulation | swaddle |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): while feeding ____ head of bed | elevate - more prone to reflux |
| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): Consistency of ____ and parental ____ and teaching | consistency of caretakers and parental involvement and teaching |
| Home care of bronchopulmonary Dysplasia (BPD) includes ____ assessment & ____ support and follow up, | Home assessment and family support and follow-up |
| Teaching plan for home care of BPD include: | disease process, ability to evaluate infants respiratory status, feeding plan, meds, care of O2 equipment, special care needs and indications for emergency action with steps to be taken. |
| Inflammation of the palatine tonsils (lymphoid tissue) | tonsillitis |
| T/F tonsillitis can be caused by bacteria or virus | True - bacterial is redder and more swollen |
| viral pharyngitis is self limiting just treat ____ with Tylenol for discomfort. | symptoms |
| With tonsillitis, obtain a throat culture to test for ___. If have it treat with antibiotics | Group A strep (GABHS) |
| How many strep infections occure in one year before insurance usually pays for tonsillectomy | six |
| Before age ___ tonsils usually grow back | four |
| Two nursing interventions for tonsillitis | compliance with medication and symptomatic care |
| Nursing condideration for tonsillectomy: position on ____ or ____ for drainage | side or stomach (prone) |
| Nursing condideration for tonsillectomy:swallowing frequently is a classic sign of ____. An infection can cause ____ a week or two later. | hemorrhage |
| Nursing condideration for tonsillectomy: diet - depends on doctor, regular food may cause ____, give liquids then ____ food. | regular cause hemorrhage. soft food |
| Name the 4 croup syndromes | acute epiglottitis, acute larnygotracheobronchitis (LT, Acute spasmodic laryngitis, acute tracheitis |
| A serious bacterial infection, usually ____ causing inflammation of epiglottis is called ____. | Hemophilus influenzae Type B (there is a vaccine), acute epiglottitis |
| Acute epiglottitis is usually seen in children between the ages of ___ - ____ | 1-8 years |
| No spontaneous cough, drolling on one side (can't swallow secretions) and agitation are the three cardinal signs of | acute epiglottitis |
| T/F sever expiratory stridor is seen in epiglottitis | False - severe inspiratory stridor is seen in epiglottitis |
| no hoarseness, temp greater than 39, tripod position, sudden onset and complete obstruction may occure 6-12 hours is seen in what type of inflammation | epiglottitis |
| medical management of epiglottitis includes endotracheal intubation or ____ | tracheostomy |
| Antibiotic given for epiglottitis to decrease swelling so child can be intibated | cefurozime 100mg/kg/24 hrs) and / or corticosteroids |
| Which croupe syndrome shows a "thumb sign" when x-rayed | acute epiglottitis |
| What medication is given to a child over 4 years who has come in contact with epiglottitis | Rifampin 20mg/kgX1 |
| Inflammation mucosa lining larynx & trachea causing narrowing airway- subglottic area narrowest part is called ____. | Acute Laryngotracheobronchitis (LTB) |
| Acute Laryngotracheobronchitis (LTB) etiology between ____ months and ____ years | 3 months - 8 years of age |
| Acute Laryngotracheobronchitis (LTB) AKA ____ | Croup |
| Acute Laryngotracheobronchitis (LTB) is caused by ____ virus type 1 | Parainfluenza virus type 1 (also RSV, adenovirus) |
| Acute Laryngotracheobronchitis (LTB) takes 1 - ___ days to develope | 1 - 3 days to develop (usually has a history of URI) |
| Type of cough that accompanies Acute Laryngotracheobronchitis (LTB) | Harsh, barky cough |
| Other than harsh, barky cough, Acute Laryngotracheobronchitis (LTB) is accompanies by | low grade fever, hoarse voice, mild inspiratory stridor and mild to moderate respiratory failure |
| Medical management of MILD Acute Laryngotracheobronchitis (LTB) | Corticosteroids 2mg/kg x1 up to 4 doses po daily or Dexamethasone 0.6mg/kg IM x1 – shortly improve after that. Do not give antihistamines |
| Non-medical management of MILD Acute Laryngotracheobronchitis (LTB) | coll air vaporizer and encourage fluids |
| Medical management of SEVERE Acute Laryngotracheobronchitis (LTB) | Corticosteroids (not antibiotics), Nebulized racemic epinephrine. Will have normal WBC and blood culture |
| Non medical management of SEVERE Acute Laryngotracheobronchitis (LTB) | symptomatic care and mist tent (cool not warm). |
| Acute Laryngotracheobronchitis (LTB) x-ray shows subglottic narrowing also called "____" | steeple sign |
| One of the nursing interventions for Acute Laryngotracheobronchitis (LTB) include: continuous assessment of____ status | respiratory |
| One of the nursing interventions for Acute Laryngotracheobronchitis (LTB) include: look for signs of secondary ____ | secondary infections such as an ear infection |
| One of the nursing interventions for Acute Laryngotracheobronchitis (LTB) include:have ____ equipment near and keep calm | intubation |
| One of the nursing interventions for Acute Laryngotracheobronchitis (LTB) include:IV therapy - be take in nutrition ____ if respiratory rate is less than 60 per minute | by mouth - PO |
| One of the croup syndromes that include paroxysmal attacks of laryngeal obstruction that occur chiefly at night (mild) wake up with barking cough. Keep the child calm and after a few hours the sx go away If not they go to hospital and treated like LTB. | Acute Spasmodic Laryngitis (ASL) |
| Acute Spasmodic Larngitis (ASL) occures in children usually between 1 - ___ years of age with a history of ___ & ____? | Acute Spasmodic Larngitis (ASL) occurs in children usually between 1 to 3 years of age with history previous attacks & history of allergies. |
| Clinical Manifestations of ___ include goes to bed with mild resp sx, sudden barky cougy with noisy inspirations, no fever and sx subside in a few hours | Acute Spasmodic Laryngitis (ASL) |
| Tx of Acute Spasmodic Laryngitis: managed at ____, if sx moderate to severe then treated at ____ similar to acute Laryngotracheobronchitis (LTB). | Home - Hospital |
| Nursing interventions of acute spasmodic layngitis: ____ care and ____ support. | symptomatic care and family support |
| Which croup syndrom is an Infection of the mucosa of the upper trachea usually due to staph infection Need to be suctioned due to secretions. | Bracterial Tracheitis |
| Bracterial Tracheitis (Acute tracheitis) is usually caused by which bacteria, and what age group? | Staphylococcus aureus - 1 month to 6 years |
| What are the manifestations of bacterial tracheitis (acute tracheitis? | URI, croupy cough, stridor, thick purulent secretions, fever, no response to LTB therapy |
| Medical management of bacterial tracheitis (acute tracheitis) includes which antibiotic? Why must the first dose be given while in the hospital? | Clindemyacin - tastes bad (also given for MRSA), must give child first dose while in hospital to make sure they will take at home. |
| Non medical management of bacterial tracheitis (acute tracheitis) includes | humidified oxygen, frequent endotracheal intubation and antipyrtics |
| ____ is inflammation of the bronchioles, the smallest air passages of the lungs. | Bronchiolitis |
| 80% or more cases of bronchiolitis is due to which virus? | Respiratory Syncytial Virus (RSV) |
| Bronchiolitis is most common during ____ and peak incidence is ____ months of age | winter & early spring, peak at 6 months |
| ____% of bronchiolitis cases are hospitalized | 10 |
| Bronchiolitis is transmitted through ____ with secreations and found more in what living conditions | direct contact, crowded living conditions such as day cares. |
| ____% of bronchiolitis pt develop asthma, and ____% mortality | greater than 50% develop asthma and 1-3% mortality |
| Manifestations of bronchiolitis | URI sx several days with clear nasal drainage and sneezing causing difficulty in feeding, caugh may develop, wheezing, rales, retractions |
| pt are hospitalized with bronchiolitis if respirations are over ____/min and or less than ____ weeks of age or has other chronic resp illnesses | 60 respirations / min, 6 weeks old |
| Other than Ribarvirin (broad spectrum antiviral agent (controversial tetragenic) ____ medications are available to treat RSV. | No |
| _____ is used prophylactically to prevent high-risk infants one month prior to RSV season which is ____ in Missouri | Palivizumab (Synagis) - November |
| Nursing Interventions for bronchiolitis: ____ care, isolation precautions, ____ elevated, frequent assessment of VS & ____ status, nutrition includes ____ because they tire easy | symptomatic care, HOB elevated, respiratory status, small frequent feedings |
| Highly contagious (direct contact or droplet) acute respiratory infection caused by Bordetella pertussis | Pertussis (Whooping Cough) |
| Pertussis is primarily in children under ____ years and not immunized, as well as ____ aged kids and ____ get it from their mother | primarily in children under 4 and college aged kids. 30% get from their mother. |
| Incubation of pertussis is ____ - ____ days | 5-21 usually 7-10 |
| Pertussis (Whooping Cough) has increased/decreased since 1976 | increased |
| Kids going to college should be re-immunized for ____ | pertussis (whopping cough) |
| Manifestations of first (catarrhal) stage pertussis | sneezing, dry hacking cough, lowgrade fever lasts 1 to 2 weeks |
| Manifestations of second (paroxysmal) stage pertussis | short, rapid cough (maching-gun burst) usually at night followed by sudden inspiratory high pitched "whoop" flushed or cyanotic cheeks bulged eyes and protruded tongue, continue until cough mucus (usually vomits afterwards) lasts 4-6 weeks |
| Manifestations of third (convaescent stage of pertussis | cough gradually decreases in frequency and may be louder at times lasting for several weeks |
| Pertussis three stages usually lasts less than ____ months and ___/___ are hospitalized due to stress | less than 6 months, 3/4 go to hospital |
| Medical management of pertussis includes ____ for 14 days first line, also give _____ for pain and ____ for fever | erythomycin. Analgesic for pain and antipyretics for fever |
| non medical management for pertussis include | bedrest and hospitalization if cant drink or dehydration or respiratory complications |
| A nursing intervention for pertussis includes: ____ during first (catarrhal) stage | isolation |
| A nursing intervention for pertussis includes: reduce ____ that may promote paroxysms | environmental factors such as dust, smoke and perfumes |
| A nursing intervention for pertussis includes: encourage frequent small amounts of ____, observe signs of ____ obstuction and family ____ | encourage frequent small amounts of fluid, observe signs of airway obstruction and family support |
| ____ includes familial predisposition and exposure to allergen | allergic rhinitis |
| Allergic rhinitis affects ____% of the populaiton | 20% |
| Manifestations of allergic rhinitis: | watery rhinorrhea, nasal obstruction, sneezing, nasal pruritus, allergic shiners (discoloration under eyes, allergic gape, and allergic salute |
| Diagnostic tests of allergic rhinitis | nasal smear, blood test for total IgE, RAST radioallergosorbent test) (and skin testing |
| Medical management to prevent allergic rhinitis | nasal corticosteroids. also try immunotherapy which is 40-50% effective. Also, stay away from the allergen |
| Nursing intervention of allergic rhinitis includes educating pt that allergy shots are not given at home because | may have an allergic reaction, must be done in doctor's office and prepare pt for tx |
| airway obstruction and inflammation in response to a variety of factors | asthma |
| factors that cause asthma include: ____ of airway smooth muscle, ____ of airway mucosa, ____ mucus secretion, ____ cell infliltration of airway walls, and ____ of the airway epithelium | spasm of airway smooth muscle, edema of airway mucosa, increased mucus secretion, celluar eosinophilic inflitration of airway walls and injury of the airway epithelium |
| factors involved in asthma | biochemical, immunologic, endocrine, infectious, autonomic, and psychological factors |
| T/F asthma is outgrown | False, as reach adolescent ormones improve and may go yrs then cal be later exposed to a respiratory virus and get asthma again |
| Asthma: ____% diagnosed between ages 4 and 5 | 80% |
| T/F Asthma is hereditary due to a specific chromosome | False there are notches on several chromosomes which is why asthma differs between individuals |
| Not so ovious asthma triggers | asprin, bananas, stress and strong emotions such as crying or laughing for long periods, very low temperature,cockroaches |
| #1 reason kids give to an asthma trigger | smoke |
| Asthma diagnostic evaluation of pulmonary function tests used to evaluate what 3 aspects of lung function | lung volume, airway funcation and gas exchange |
| Asthma affects inspiration or expiration | expiration - due to loss of patency and elasticity of airway |
| pulmonary function test where pt takes a full breath in and blows out hard and completely as possible | spirometer - test repeted 2-3 times with average of 2 highest readings recorded |
| the spirometer pulmonary function test measures ___ + ___ = ___ | Forced vital capaciity(FVC) max amount of air expired quickly after a max inspiration + residual volume (RV) volume of air remaining in the lungs = total lung capacity (TLC) |
| Nursing interventions of spirometer | assess knowledge, explain procedure, monitor respiratory status, reassure and assist and no bronchodilaters 6 hr b4 so med doesn't interfere with test or see how bronchodilator works |
| Before age ___ tonsils usually grow back | Peak Expiratory Fow Rate (PEFR) |
| Procedure for peak expiratory flow rate (PEFR): ____ forcefully over a short period of time to obtain the ____ level on a meter | exhale forcefully = highest level, use the highest of 3 readings |
| Peak expiratory flow rate (PEFR) need to take ____ times per day over a ____ week period during normal respirations to determine patient's personal ____ reading | 2 times per day over 2 week period to determin a patient's personal best reading between age 4-6 can do it |
| peak expiratory flow rate (PEFR) green zone is ____-____% personal best, yellow zone is ____ - ____ % personal best and red zone is ____ or less personal best | green = 80-100%, yellow = 50-80%, red = less than 50% |
| peak expiratory flow rate (PEFR) yellow zone start to see sx of ____ cough, make sure pt is ____ medications. red zone sx ____, use ____ immediate | PEFR yellow zone start to see sx of nighttime cough, make sure pt is taking meds. red = sx of wheezing, use bronchodilator immediate |
| If use bronchiodiolator more than ____ times a week except for exercize, need preventitive medication | three times a week |
| With mild intermittent asthma, symptoms are brief, usually less than or equal to ____ per week and at nighttime less than ___ per month | 2 - 2 |
| With mild intermittent asthma, peak efficiency flow is greater than ____ predicted value, and asymptomatic between episodes. | 80% - green zone |
| With mild persistent asthma symptoms are greater than ___ per week and more than ___ per month | 2 - 2 |
| With mild persistent asthma, peak efficiency flow is greater than ____% with some variability and episodes may affect activity | 80% - green zone |
| With moderate persistent asthma, symptoms are more than ____ per week and nighttime symptoms are more than __ per week. | greater than 2 per week and nighttime greater than 1 per week. |
| With moderate persistent asthma, symptoms and use of bronchodilators are used ____ and episodes affect ____ | used daily, episodes affect activity |
| With moderate persistent asthma, the peak efficiency flow is between ____% & ____% and increased variability | PEF between 60% & 80% - yellow zone |
| With severe persistent asthma, daytime symptoms are ___ episodes and nighttime symptoms are ____? | With severe persistent asthma, daytime symptoms are continuous episodes and nightime symptoms are frequent. |
| With severe persistent asthma, peak efficience flow is less than ____% with increased variability wich limits activity | PEF less than 60% - red zone |
| clinical manifestations of asthma include: ____ peak flow readings, cough, chest ____, ____ intolerance, wheezing, restlessness and signs of ___ failure | drop peak flow readings, cough, chest tightness, exercise intolerance, wheezing restlessness, and signs of respiratory failure |
| Medical management of asthma includes ____-term control medications and ____-term relief medications | long-term control medications and short-term relief medications |
| medical management of asthma includes taking ____ and leukotriene ____ as well as hyposensitization | corticosteriods, leukotriene modifiers, and hyposensitization |
| Different types of asthma inhalers | MDI, turbuhaler, diskus inhaler, and nebulization |
| Discharge Teaching Nursing interventions for asthma include identifying ____, ____ control measures, recognizing signs and symptoms of an ____, importance of relaxation & ____, daily ____ readings | discharge teaching nursing interventions for asthma include identifying triggers, environmental control measures, recognize s/s of an episode, importance of relaxation & exercise and daily PEFR (Peak Expiratory Flow Rate)readings |
| discharge teaching nursing interventions of asthma include: ___ plan, correct use of med and ____, breathing techniques using ____, importance of ____ care, teaching ____ involved with patient, and ____ groups. | discharge teaching nursing interventions of asthma include:tx plan, correct use of med and equipment, breathing techniques use spacer, importance of foll-up care, teaching others involved with pt, and support groups like camp for kids with asthma |
| • Respiratory distress despite vigorous therapeutic measures is called | status asthmaticus |
| When a child has status asthmaticus they go to the ____ or ____ | ER or PICU |
| A child with status asthmaticus needs fequent assessment of ____ status, O2 kept above ____%, and kept in ____ position | frequent assessment of respiratory status, keep O2 above 90% and keep in High-Fowler position |
| Medical management of status asthmaticus includes inhales aerosolized short-acting ___ agonists, IV ____ and correct ____osis | inhales aerosolized short-acting B2-agonists, IV corticosteroids (don't overhydrate with IV fluids, and correct acidosis |
| pulmonary disorder that is inherited autosomal resessive trait | cystic fibrosis |
| ___% white population are carriers of cystic fibrosis | 3.3% |
| with cystic fibrosis abnormal ____ movements in cells causing increases in viscosity mucus gland secretions | chloride |
| In the 70's life expectancy was ____ yo, if born recently, life expectancy is ____ yo due to ____ generation antibiotics | 70's expected to live to 31, now expected to live to 40 due to 3rd generation antibiotics |
| One of the first signs a newborn has cystic fibrosis is the ____ has not passed in first 2 hours | meconium ileus GI has not passed, need to look for obstruction |
| Children with cycstic fibroses are usually ____ due to obstruction of the GI or they have ____ stools with foul odor? | Chlidren with CF are usually constipated due to obstruction of the GI or they have Large, frothy, loose stools with foul odor. |
| Need to rule out cystic fibrosis if a child shows signs of failure to thrive due to having ____ more than once or not ____ weight? | Need to rule out cystic fibrosis (CF) if a child shows signs of failure to thrive due to having pneumonia more than once or not gaining weight. |
| The reproductive system of someone with cycstic fibrosis includes a ____ puberty, infertility ____% males and ____% females; resulting in ____ birth and lowbirthweight...The mother has ____ during pregnancy | The reporductive system of pt c CF includes a delayed puberty, 90% male and 50% female infertility; resulting in premature birth and LBW...The mother has decreased respiratory status during pregnancy |
| integument of child with cycstic fibrosis includes abnormal high consentations of ____ & ____, and diminished protein absorption causes ____ | high sodium & chloride, diminished protein absorption causes edema |
| T/F there is a newborn screening for diagnosis of cystic fibrosis | False |
| Sweat ____ test (Gold standard) need to be at least 3 weeks of age, put conductor pad on arm and disk to heat up encourage skin to sweat and collect and measure ____ | Sweat chloride test - sodium |
| The sweat chloride test needs ____ positive results of ____meq/liter of chloride for diagnosis? | The sweat cholride test needs 2 positive results of 60 meq/liter of chloride for diagnosis. |
| T/F a chest x-ray can be used as a diagnosis for cystic fibrosis | True - example airborn allergens or food allergies |
| Disgnosis for cycstic fibrosis includes stool analysis for ____ & ____ | fat and enzyme |
| A sputum culture of an infant or child usually shows which type of bacterias | staph aureus & haemophilus influenza |
| A sputum culture of an adolescent with cycstic fibrosis usually shows which bacteria | pseudamonas aeruginosa |
| What is the primary treatment goal in the medical mangement of cycstic fibrosis? (Hint: effective ___ clearance with CPT ___ & flutter ____ clearance device) | The primary treatment goal in the medical mangement of cycstic fibrosis is effective AIRWAY CLEARANCE with CPT 2-3X/day and flutter MUCUS clearance devise. |
| A pt with cycstic fibrosis is given ____ vitamins (__) 2x more than the usual amount given for patients? | Fat soluable vitamins (ADEK) |
| Pt with cystic fibrosis are given ____ enzymes at meals to break down fat? | pancreatic enzymes |
| Over ____% of pt with cycstic fibrosis have asthma | over 50% |
| pt with cycstic fibrosis have problems absorbing food so they need to increase caloric intake ____% and include ___ & ___? | increase 150% and include high protein and low fat |
| Medical management of pt with cycstic fibrosis includes: wearing a ____ vest, inhaling recombinant human ____ 1X/day, tx of asthma, free water and ____, take ___ for secondary infection, and bronchoscopy to ____ brachial tube mucus? | Medical mangement of pt w/ cycstic fibrosis includes: wear thAIRaot vest, inhale recombinant human D'Nase 1x/day, free water and salt, take antibiotics for secondary infection, and bronchoscopy to remove brachial tube mucus. |
| T/F lung transplants are usually successful after 5 years for pt with severe cycstic fibrosis | False - survival rate is about 50% after 5 years - trying to campaign to get lung transplants before lung function is low |
| nursing inervention for cystic fibrosis includes assessment of ____ & ____ | respiratory and GI |
| nursing interventions for cystic fibrosis includes monitoring ___ administration carefully | oxygen |
| nursing inerventions for pt with cystic fibrosis includes ____ and fluid managment, ____ administration, skin care, education ____ care and ____ support for chld and family | nutrition and fluid managment, medication administrationm, skin care, education home care and psychological support for child and family |
| ____ is an acute exacerbation of asthma that does not respond to standard treatments of bronchodilators and corticosteroids. Symptoms include ? | Status asthmaticus and symptoms include chest tightness, rapidly progressive dyspnea (shortness of breath), dry cough and wheezing. |
| ___ failure means that O2 can no longer be provided, CO2 can no longer be eliminated, which leads to ___? | The lung failure means that oxygen can no longer be provided, carbon dioxide can no longer be eliminated, which leads to acidosis. |
| ____ refer to the visible sinking in of the chest wall with inspiration in a child with respiratory difficulty. | Retractions |
| Where are retractions generally seen? | 1. in the area above the collarbone (supraclavicular) 2. between the ribs (intracostal) 3. below the ribcage (subcostal) |
| ____ are wet, crackly lung noises heard on inspiration which indicate fluid in the air sacs of the lungs. ____ are often indicative of ____. | Rales (ralz, not rails) are wet, crackly lung noises heard on inspiration which indicate fluid in the air sacs of the lungs. Rales are often indicative of pneumonia. |
| Define Rhinorrhea. | runny nose |
| ____ is a sudden outburst of emotion or action. It can also be a sudden attack, recurrence, or intensifiaction of a disease. Another definition for it is a spasm or fit; convulsion. | Paroxysm |
| The person with allergic rhinitis (hay fever) often rubs his/her nose using the index finger. This is the so-called "_____." | The person with allergic rhinitis (hay fever) often rubs his/her nose using the index finger. This is the so-called "allergic salute." |
| ___ is chronic mouth breathing? | Allergic gape |
| _____ is an abnormal, high-pitched, musical breathing sound caused by a blockage in the throat or voice box (larynx). It is usually heard when ...? | Stridor is an abnormal, high-pitched, musical breathing sound caused by a blockage in the throat or voice box (larynx). It is usually heard when taking in a breath. |
| _____ is a barky, raspy cough that sounds like a seal asking for his next meal. | croupy cough |
| ___ is a form of chronic lung disease that develops in preterm neonates treated with oxygen & positive pressure ventilation. Like Respiratory Distress Syndrome neonates. | Bronchopulmonary Dysplasia |
| What is the highest level of oxygen you can give a infant? | 2L always humidified |
| What is the highest level of oxygen given to a toddler? | humidified 4L |
| What is the highest level of oxygen given to a school age child? | 6L humidified |
| When do you not feed a child with respiratory infection or problems orally? | When their respirations are greater than 60 do not feed them orally |
| Following a endoscopic procedure on a baby what do you as a nurse need to look for prior to feeding the baby? | Look for the GAG REFLEX |
| Baby boy smith is breastfeeding. What will you teach his new parents about voiding and stooling patterns? | Expect stool color; frequency stool & urine 1st day 2-6 times and after 6-8 at least and 5-25; as milk come in what the stool color will look like |
Created by:
cgwayland
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