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Nsg 210 Peds Resp
Ch. 46 Child w/ Resp Dysfx
| Question | Answer |
|---|---|
| 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
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