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Nsg 210 Peds Resp

Ch. 46 Child w/ Resp Dysfx

What is therapeutic mgmnt for CO poisoning? 100% O2 and prepare for intubation and tracheostomy
What are s/s of CO poisoning? red lips, HA, N, confused
Both parents have the gene for cystic fibrosis, what is % that child will have CF? % that child will be carrier? 25% will have CF 50% be carrier
____ is a hereditary disorder with lung congestion and infection and malabsorption of nutrients by the pancreas cystic fibrosis
1 in __________American children are born with CF 2500
What are the main s/s of CF coughing/wheezing, dry unproductive cough, repeat lung inf., SOB, obstructive emphysema, patchy atelectasis, cyanosis, clubbing, meconium ileus, steatorrhea, prolapse of rectum, poor growth, delay puberty in female, infertility in males, hypoalbuminemia
Blockage of the pancreas can lead to what disorder in children with CF? DM
A parent reports their baby tastes saltier than usual. What test will be performed to dx CF? What values indicate CF? sweat-chloride test >60mmol/L
What is the most traditional infectious pathogen for pulmonary infections in children wtih CF? pseudomonas aeruginosa and burkholderia cepacia
CF can worsen into what respiratory problems? hypoxemia, pulmonary hypertension, cor pulmonale, pneumothorax
CF affects the GI tract by preventing _________ enzymes from reaching the duodenum pancreatic
what is azotorrhea impaired digestion/absorption of protein
These are all GI problems that can arise with CF diabetes mellitus, biliary cirrhosis, impaired salivation, wt loss, steatorrhea, azotorrhea
To diagnose CF when a pt shows patchy atelectasis and obstructuve emphysema, what will be done? Chest xray
What will dx a meconium ileus barium enema
Steroid use for CF can cause what complications in children inhibit growth dev, osteoporosis, moon face, DM
What kind of diet is given to CF pt? High fat/high protein w/ as much as 150%RDA along with pancreatic enzymes
What vitamins are needed with CF pt? Water supplement vit ADEK
What are signs of resp distress in children work of breathing (WOB), nasal flaring, retractions, grunting, stridor, wheezing, restlessness, cyanosis, tachycardia
Pediatric CPR usually follows respiratory failure or progressive shock called an asphyxial arrest
An infant is choking, what procedure should be done? give 5 back blows followed by 5 chest thrusts repeatedly until object is expelled or victim becomes unresponsive
children who continue to show resp distress despite use of albuterol, epinephrine are considered to be in? s/s? status asthmaticus s/s: sweat, restlessness
What is the initial therapy for status asthmaticus? Three treatments of B2 agonists spaced 20-30 min apart, corticosteroids
Air is passed in one direction only, inspiration, but air passages diminish not allowing expiration, what degree of obstruction is this? second degree. 1st degree allows inspiratory and expiratory passage of air. Complete obstruction is just that.
Croup Syndromes affect what respiratory elements? infections of epiglottis, larynx
What vaccine is given against the Haemophilus influenzae? At what age? What resp illness can this prevent? Hib vaccine, 2mos, Acute Epiglottitis
Children >5 years increase in what respiratory infections mycoplasma pneumonia and B-strep infections
RSV is most common when? mycoplasmal pneumonia inf most common when? Asthmatic bronchitis when? RSV: winter/spring myco: fall/winter bron: cold weather
True/False...A steam humidifier is a good therapeutic to put in a child's room that has a respiratory infection? False, never place steam humidifiers in room cause of risk of burn
At what age is RSV most common 6mos - 18mos
At what age can cough suppressants be given? 4-5y
With nasopharyngitis, what is therapeutic mgmt? antipyretics(tylenol/ibuprofen), decongestants(nasal sprays for only 3 days), cough suppressants(4-5y), antihistamines
In Pharyngitis, what tests can rule out group A B-hemolytic strep? Rapid tests throat culture to confirm neg rapid strep test
What are s/s of pharyngitis? abrupt onset w/ sore throat, HA, fever, abd pain, cervical lymphadenopathy, tonsils have exudate
What is taught to parents about toothbrushes with pharyngitis? discard after 24hr on medication
Which tonsils are removed in a tonsillectomy? In an adenoidectomy? palatine tonsils pharyngeal tonsils
A person is contagious with the flu virus __ day before s/s and up to __days after becoming sick. 1, 5
At what age can you take the flu mist? flu vaccine? 2-49y 6mos and older adults
Which antiviral is most used for flu type A? Amantadine
which antiviral is used for Flu type A in adults? rimantidine
When is Tamiflu given? within 2 days of s/s for A & B
What is classic s/s of croup barking cough, inspiratory stridor
Epiglottitis, layngitis, LTB, and tracheitis all are called croup syndromes
This is an emergency caused by the Haemophilis influenza type B and presents an swollen and red throat Acute Epiglottitis
Name the key s/s for epiglottitis absence of cough, drooling, tripod positioning, inspiratory stridor
What should a nurse never do in assessing pt with Acute Epiglottits? examine throat wtih tongue depressor
Pt complains of hoarseness, what might they have? Acute Laryngitis
What is the tx for acute laryngitis? fluids and humidified air
What is the most common of the croup syndromes? laryngotracheobronchitis LTB, caused by RSV and dx by steeple sign on chest xray
What is the "midnight" croup? tx? acute spasmodic laryngitis, child 1-3y tx: cool/warm mist
A nonproductive cough that worsens at night indicates? bronchitis
This lower respiratory tract disorder has highest incidence in spring/summer, contagious and affects mainly non-immunized child whooping cough/pertusis
You see a pt go into respiratory arrest, what is your immediate action? Call 911, then CPR. If you don't see pt go down, start CPR.
Oily nose drops, solvents, talcum powder are all avoided to prevent what? aspiration pneumonia
__ is inflammation of the large airways(trachea/bronchi) bronchitis
__acute viral infection of bronchioles in children <2y and dx with nasal wash for RSV bronchiolitis and RSV
What is tx for severe RSV? ribavirin, but pregnant workers can not be around
What is prophylactic for RSV? RSV-IVIG(infusion monthly), Synagis(IM injection), vial good for 6h
What are s/s of TB? fever, night sweats, malaise, wt loss, cough, pallor, fatigue
A 2y old pt shows a 10mm induration after the Manteaux Test with no past exposure or medical hx, what will nurse do? report findings and Dr will order chest xray bc shows positive
A pt has had close contact with TB pt and shows a 5mm induration after skin test, is this person positive for TB? Yes, this is a positive reaction and will have to follow up with chest xray.
A child, age 10, shows a 14mm induration after skin test, what will the nurse do? Document and that's all, not positive for TB
Who might be tested for TB? foreign travel/immigrant/exposure to TB/incarcerated/HIV/homeless/institutionalized/drug user/someone who got BCG vaccine
Drug therapy for TB is what INH, Rifampin/PZA(pyrazinamide) for 9-12mos
What is definitive dx for TB sputum smear
Waht precautions should nurse take wtih pt wtih TB airborne precautions/neg pressure room/fitted respirator N95
Classic s/s for asthma? At what age is child dx with asthma? wheezing/dyspnea/coughing after 5y
Mild Intermittent Asthma? Mild, persistent? moderate, persistent? severe, persistent? Mild, int: s/s <2x/wk mild, per: s/s >2x/wk, <1x/day mod: daily s/s severe: continual s/s
How to dx asthma? PFTs, Peak Exp Flow Rate(max flow of air that can be forcefully exhaled in 1 sec), skin test for allergens
Name long term meds for asthma inhaled steroids, Cromolyn sodium/Nedocromil(good for prophylactic tx b4 exercise), Singulair
Short term meds for asthma rescue meds: B2 adrenergic agonists(albuterol, metaproterenol, terbutaline)
Short term anticholinergics Atrovent(inhaled)
When are methylxanthines used in asthma tx? theophylline is 3rd line agent, monitor levels 5-15.
Which excercise is most tolerated with asthma swimming
Created by: palmerag