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N114 EENT
N114 - EENT diseases in children
| Question | Answer |
|---|---|
| What are some early signs of mild/moderate respiratory distress in children? | Increased respirations & heart rate Irritability Mild/moderate labored breathing Subcostal/intercostals retractions – intercostals, substernal, subcoastal Loss of interest in eating, playing Adventitious or diminished breath sounds |
| What are some later signs of severe respiratory distress in children? | Increased heart rate Suprasternal retractions-supraclavicular Grunting on expiration-forcing air out (easier to get air in) Nasal flaring Central cyanosis-circumoral & mucous membranes Increased adventitious breath sounds Lethargy, unresponsive |
| What are the different areas of retractions? | Suprasternal – above the clavicle & sternum Intercostal – between the ribs Subcostal – below the lower costal margin of the rib cage Substernal – below the xiphoid process |
| What is SIDS? | SIDS – sudden infant death syndrome - unexplained death of an infant less than 1 year of age. Leading cause of death in infants between 1 month & 1 year – 95% by 6 months of age Peak age is 2 to 4 months |
| What are some neonatal characteristics of an infant susceptible to SIDS? | Irritability, feeding difficulties Growth lag, muscle hypotonicity – limp muscles May be premature, low APGAR scores, needs O2 at birth. Can be a well developed normal infant, occurs during normal sleep cycle. |
| What are some characteristics of the mother that put an infant at risk? | Severe anemia Cigarette smoker Third trimester bleeding Maternal sedation or anesthesia Methadone use – 10x more risk for SIDS |
| How can SIDS be prevented? | Avoid smoking during and after pregnancy – infants can inhale toxins from clothing Back to sleep campaign Avoid soft mattresses & pillows Avoid overheating during sleep Vary infants head position to prevent flattening of skull |
| What is otitis media? | bacterial or viral infection of the middle ear |
| What are some priority nursing diagnoses related to otitis media? | Pain, hyperthermia, risk for injury |
| What planning or teaching can be done related to otitis media | Teach parents that recurrent infections will eventually cease, avoid smoking around child, give child full course of antibiotics |
| What are the surgical procedures related to otitis media? | Myringotomy is a surgical incision of tympanic membrane. Tympanostomy tubes are used for drainage and ventilation of middle ear. |
| What planning or teaching can be done related to tympanostomy tubes? | Teach parents to give Tylenol as ordered, follow orders related to ear drops, tubes will spontaneously fall out in about 1 year. |
| What is pharyngitis? | Infection of the pharynx often ivolving tonsils. Often viral, if bacterial, most often caused by streptococcus. |
| What symptoms are associated with pharyngitis? | Sore throat, difficulty swallowing, drooling caused by sore throat and inability to swallow saliva, inflammation of pharynx & tonsils, fever, vomiting, cough lymphadenopathy & headache, hoarseness. |
| What are some priority nursing diagnoses related to pharyngitis & tonsillitis? | Pain, deficient fluid volume, risk for hyperthermia, risk for injury (seizures secondary to high temp) |
| What planning & implementation is related to phyaryngitis & tonsillitis? | With viral pharyngitis, offer diet that is easy to swallow and soothing to sore throat, use salt water gargles, throat lozenges or anesthetic sprays to promote pain relief |
| What can you teach the parents related to phyaryngitis & tonsillitis? | Stress importance of completing full course of antibiotics if bacterial. Untreated strep infections can lead to rheumatic fever, glomerulonephritis |
| What is tonsillitis? | Inflammation of tonsils caused by biral or bacterial infection, bacterial often caused by strep |
| What are symptoms associated with tonsillitis? | Enlarged, reddened tonsils with or without exudate, sore throat, difficulty swallowing, drooling, lymphadenopathy, mouth breathing |
| What are some priority nursing diagnoses related to tonsillectomy? | Preoperative: knowledge deficiet, anxiety. Postoperative: risk for aspiration, ineffective airway clearance, risk for deficient fluid volume, pain |
| What planning & implementation is related to a tonsillectomy? | Preop: client & family teaching, lab data: bleeding & clotting times. Postop: pain control, s/s of hemorrhage |
| What can you teach parents related to a tonsillectomy? | Teach parents about analgesic medications, s/s of hemorrhage |
Created by:
jrb265
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