| Question |
Answer |
| What does the nurse look for with respiratory differneces in the child |
Increased RR, weak accesswory muscles of RR,abd.breathing,increased 02 consumption, increased risk for edema, weahk chest wall,increased potentinal for obstruction. |
| What structure on a child increase respiratory differences. |
short neck, large tongue to contribute to obstruction, bronchus becomes shorter airway is small with large amts. of soft tissue |
| Early signs of respiratory compromise |
Restlessnessanxiety level increasedtachypnea/tachycardia |
| Late signes of respiratory compromise |
Bradycardiaextreme restlessnessdyspnea |
| signs of respiratory compromise |
nasal flare, feeding difficulty, wheezing,stridors, grunting cyanosis,pallor, retractions, diaphoresis |
| Name 5 dianositic test for respiratory diease |
clinical exam,cxr,cbc,pulse ox,blood gases |
| Name 7 oxygen devices that ox can be administered to a child |
oxygen hood,tents,nasal cannual,simple mask,venturi,partial rebreather,non-breather |
| When should O2 be adminstered |
As ordered by doctorif O2 sats are less the 95% |
| What is ALTB stand for |
Acute Laryngotracheobronchitis |
| What is the the physicology of ALTB |
acute upper airway respiratory conditionknown as croupcaused by viral illness |
| When is the onset of ALTB |
Gradual cough over 6-12 hoursmay seem abruptmay awaken in middle of night in acute respiratory distress |
| What are the signs and symptoms of ALTB (CROUP) |
Hx of URI,cough,inspiratory stridor,respiratory compromise,fever,hoarsenss |
| Dx of Croup |
TC,neck xray,cbc |
| Home care of child for child with onset of croup |
Keep child calm,use cool mist/hot steam,increase fluid intake, know s/s of respiratory distress |
| Nursing care for child with Croup |
maintain airway,keep child calm, monitor resp/cardiac status,take v/s and pulse oxadminister meds,humidify O2, increase fluid intake, provide emotional support |
| What medications are given to a chld with ALTB |
racemic epip, corticosteroids |
| What are the physicology of Epiglottitis |
life threatening infection of the epiglottiscausing inflammation and leads to complete airway obstruction |
| What can cause epiglottitis |
H-flu Type B bacterial |
| When is onset of epiglottitis |
1-2 hours can complete airway obstruction |
| what diagnostic test dx epiglottitis |
lateral nect exray will show thumb sign |
| What signs/sym occurr with epiglottitisTHE FOUR D'S |
drooling,dysphagia,dysphonia,distressed resp (resp. stridors)tripod position,sore throat,elevated temp 102-104 |
| What vaccine can be given to prevent epilottitis |
HIB VACCINE |
| What is the nursing interventions for epilottiis |
Upright position, give O2,tracheotomy at bedside,iv antibiotics, droplet precautions, monitor resp.status,monitor labs |
| What do you never do to a patient with epiglottitis |
never exam the back of the patients throat |
| What is the physicology of Bronchiolitis |
viral infection of bronchioles and small bronchi, |
| What is the manisfestion of Bronchiolitis |
Edema, increased thick mucus,obstruction,hyperinflation of the lungs and atelectasis,problems with exchanging o2 |
| What age do it hit and what is the most common cause |
under 2 yrs and peaks at 6monthsRSV |
| Brochiolitis is spread by________________ is is highly_________________ |
respiratory secretionshighly contagious |
| Signs and symptomsfor Bronchiolitis |
hx of URI, mild fever,nasal congestion/flaring,hacky-persistent cough,signs of resp distress,wheezing,tachypnea,apnea |
| What diagnostic test are for Bronchiolitis |
CXR, nasal washing, Rapid RSV test |
| Nursing interventions for Bronchiolitis |
monito resp status,keep airway clear,semi folwer position,coll mist tent,O2, maintain fluids,monitor for dehyration, |
| What meds can be given for serious complications of RSV |
Ribavirin (Virole) aerosoldo not give around preg/nursing mothers |
| What medication is avaiable for infants at risk of RSV _______________. What does it provide _______________. How is it given ___________. How often |
Synagis,passive immunity,given once a month frin sept-Mar |
| What is the physicology of tonsillitis/adenoiditis |
enlarged (scarred) tonsils and adenoids, may obstruct airway while sleeping |
| Common cause of tonsillitis and what are they at risk for |
strep throat, glomerulonephritis or rheumatic fever |
| What does the nurse assess for with tonsillitis |
sore throat,fever,difficulty breathing;eating;swallowing,snoring,apnea |
| Medical treatment for tonsillitis |
tonsils and /or adenoids ectomy |
| Pre op for T & A |
decrease the anxiety and fear or parent/childpre-hospital tour,play therapy,simulate procedure, report loose teeth,monitor pt,ptt levels, report family hx of bleeing disorders,teaching increased risk to bleeding 1st 24 hours |
| Post Op nursing care |
monitor resp. status,assess for bleeding,freq swallowing,clearing throat,vomiting bright red bld. increased HR,RR,anxiety/restlessness,decreased B/P |
| Post op diet after T & A |
clear liquidsWthen soft, increase po intake |
| What are the dietary No NO's |
no dairy,OJ,RED/Brn liquids,spicy foods,nose blowing, coughing, or clearing throat , straws |
| Home care for child post op T & A |
fever/pain control,ABX,Na H2o gargles,ice chipsS/s of bleeding |
| What is Asthma |
obstruction or blockage of the airways reversible by medication |
| What are the 3 fold reaction of the airway |
inflammation/edema, bronchospasms and increased mucus |
| What does the nurse asses with asthma patients |
, thgihtness in chest,crackles. |
| What diagnostic test can be done to dx asthma |
pulmonary functin test PFT,allergy testing |
| What nursing intervention does the nurse do |
monitor for increased resp distress, assess lung func (peak flow) monitor O2 sats ABG,give O2 and meds |
| Home management of Asthma |
avoid triggers,teach the use of peak flow and MDI,take meds as prescribed,monitor pat response to meds taken |
| What the characteristics of Cystic Fibrosis |
autosomal recessive trait,both parents must be a carrier,dysfunction of the exocrine glands |
| Unaffected mom and unaffected dad |
unaffected,carrier,carrier,affected |
| What is the pathophysiology of Cystic Fibrosis |
Lack of CF protein,The body has a increased loss of NACL in their sweat which in result leaves a thick sticky mucus build up in the lungs and GI sys to dangerous levels |
| With the loss of NACL what all does this affec |
Bronchioles,bile duct,pancreatic duct,leads to chronic disease with exacerbation |
| What usually causes death in Cystic Fibrosis childern |
cor pulmonale and heart strain |
| Nursing assessments with Cystic Fibrosis |
hx of recurrent resp infections,salty taste to skin,steatorrhea in stools,poor wt gain,clubbing,cyanosis and CHF will be noted,meconium lileus at birth,no meconium stool,vomiting,abd distention,family hx |
| Diagnostic testing to determine CF |
positive seat choloride test,pulmonary function test,liver function,fancreatic function,sputum |
| Nursing goals for CF patient |
prevent resp infections,propylactic abx,limit resp damage,promote optimal nutrition,promote growth and development,support grp |
| Nursing care given to CF patient |
Adminster medications,IV abx,02,breathing tx,provide CPT |
| What 3 meds are given in breathing treatments to CF patient |
Mucolytic agents,bronchodilators,expectorants |
| How often are the CPT does on CF patients |
Done 2 hours after meals |
| What is given with meals to patients with CFand why |
Pancreatic enzymes (Pancrease)to help breakdown of fats and protiens |
| What type of vitamins are given to patients with CF |
water soluble form. VIT ADEK |
| What is the normal blood flow thur the heart |
Superior Vena Cava-RA-Tricuspid-RV-Pulmonary valve-Lungs-Pulmonary Vein-LA-Bicuspid-LV-Aorta |
| What is the areas of the electrical system of the heart |
SA node-AV node-Bundle of his-purgenki fibers |
| What is a shunt in the heart |
blood flow through an opening between 2 structures or vessels of the heart |
| What is a murmur |
sound heard when listening to the heart;caused by blood leaking through openings that have not closed as they should before birth |
| What does the ductus venosus do |
diverts bld away from the leiver as it returns to the placenta |
| What does the foramen ovale do |
diverts most bld from the RA to the LA rather than circulate to the lungs |
| What does the ductus arterious do |
diverts most bld from the pulmonary artery to the aorta |
| What type of vitamins are given to patients with CF |
water soluble form. VIT ADEK |
| What is the normal blood flow thur the heart |
Superior Vena Cava-RA-Tricuspid-RV-Pulmonary valve-Lungs-Pulmonary Vein-LA-Bicuspid-LV-Aorta |
| What is the areas of the electrical system of the heart |
SA node-AV node-Bundle of his-purgenki fibers |
| What is a shunt in the heart |
blood flow through an opening between 2 structures or vessels of the heart |
| What is a murmur |
sound heard when listening to the heart;caused by blood leaking through openings that have not closed as they should before birth |
| What does the ductus venosus do |
diverts bld away from the leiver as it returns to the placenta |
| What does the foramen ovale do |
diverts most bld from the RA to the LA rather than circulate to the lungs |
| What does the ductus arterious do |
diverts most bld from the pulmonary artery to the aorta |
| What does a heart cath detect |
valves,vessels,chambers |
| What do you need to prepare a child pre0op |
with play therapy |
| Post op care with heart cath |
keep bed flat for 6 hours,assess pressure bandage for 24 hours,monitor for bleeding or hematoma,check v/s,pedal pulses,assess incision site for REEDA,ensure adequate intake |
| What are the 5 P's |
pulse,pain,parasthesia,pallor,perfusion |
| What are common diagnostic test for CHD |
EKG,echocardiography,heart cath |
| What are the risk factors of CHD |
rebella in 1st trimester,is diabetic,uses ETOH and/or drugs,dietary problems,greater than 40 |
| What symptoms are found on CHD |
Difficulty in feeding,poor wt gain,cyanosis,murmur,irregular pulse rate and rhythm |
| What are the assessment findings with CHD |
tachypnea,dyspnea,clugging,fre.resp infections,intolerance with activity |
| What is Congestive Heart Failure |
conditon of the heart unable to pump blood effectively that is emptied into it |
| CHD is a very common complication of |
CHF |
| Which side is most common in childern with CHF |
left |
| Early signs of CHF in childern |
tachycardia at rest,fatigue during feddings,sweating around scalp and foreheads,dyspnea,and sudden wt gain |
| What is left sided failure |
bolld backsup into the lungs |
| S/S of CHF left sided |
tachycardia,cyanosis,fatigue,tachynpnea,cough,dyspnea and crackles,orthopnea |
| S/S of CHF right sided |
tachycardia,cyanosis,fatigue,wt gain/edemajugular distended |
| Nursing care for promoting cardiac output and decreasing cardiac demands |
give meds,keep child warm,high fowlers position,O2 |
| What medications are given to decrease cardiac demands on a child with CHF |
digoxin, Aldactone |
| Name some nursing care for the CHD child |
I&0 with diapers 1gm=1mlmaintain fluid restrictions,low Na diet, assess fontanels and skin turgor |
| Safe Digoxin Adminstration when do we withhold |
Check APR for 1 full mininfants to 12 month < 110 small kids< 90Older kids<70 |
| What are the administration no no's of Digoxin |
no skipping doses, no making up doses, no mixing with food or formulas |
| What are the safe digoxin adminstration of Digoxin |
monitor for toxicity,suspect toxicity do dig level per dr order,dbl check all dosage calulations with another nurse |
| What do we monitor with diuretic administration |
heart rate and rhythm,electorlyte levels and signs of hypokalemia |
| What do we instruct families on to decrease the risk for bacterial endocarditis |
take prophylactic antibiotic before any dental procedures and take as prescribed |
| What is done to correct a ASD defect |
Surgery before school age dacron patch |
| What is done to correct a VSD defect |
small defects close spontaneouslylarger defects causing CHF suture with dacron patch |
| What is done to correct a PDA defect |
Premies-indocin 3 doses 12hrs apart will then close off. term infants surgery ligation/sutures |
| What is Coarctation of the aorta (COA) |
narrowing of the aorta due to a constricting band.elevated B/P in upper extremeties lower B/P in lower extremeties |
| Medical tx for COA |
mild- follow up with heart drmod-severe surgical resectionsevere constriction - or in 24-48 hours stablilize with Prostaglandie E will improve O2 sats |
| What is done to correct TOF |
Staged surgeriesblalock-taussig shuntbrock procedure |
| General cardiac complications of CHD |
pulmonary HTN,endocarditis,colts/emboli,valve insufficiency and death |
5th Grade Science
