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PedRespProb

QuestionAnswer
sudden sickness. syndrome often begins with vomiting, which lasts for many hrs. The vomiting is quickly followed by irritable and aggressive behavior. As the condition gets worse, the child may be unable to stay awake and alert.in children ages 4-12 Reye syndrome;children given aspirin when they have chicken pox or the flu. is sudden (acute) brain damage and liver function problems of unknown cause.
FDA; tx s/n/b done w/children w/the common cold under age 2 FDA is against OTC cough and cold meds; risk out ways benefits
tx thats discouraged by the FDA in children with the common cold over age 2yrs use of decongestants nasal sprays and other OTC cough and cold meds
sore throat, painful swallowing, fever,nasal congestion, mouth breathing ->drying of the throat;viral & managed symptomatically tonsillitis and pharyngitis
trmt tonsillitis and pharyngitis warm saline gargles, no asa analgesia/antipyrtics
strep throat with a rash ;GABHS scarlet fever
tonsillitis and pharyngitis are cased by Group A beta hemolytic stretpococcus GABHS
Untreated _____->otitis media, pus-forming infections surrounding tissue, meningitis, rheumatic fever, acute glomerulonephritis strep throat
pus in the back of the throat,one or both tonsils infected;Difficulty and pain opening mouth,Drooling,Facial swelling,Hot potato voice. peritonsillar of retropharyngeal abscess
TX: ABC's ;airway s/b evaluated, possible endotracheal intubation if airway compromised. non asas antipyritic/analgesia, surgical drainage, abx from strep peritonsillar of retropharyngeal abscess
S/P removal NIC: tonsil removal If recurrent strep or lrg tonsils interfere with eating; wait until >3yr to decrease blood loss monitor for bleeding, infections, pain, side lying position to facilitate drainage, no cough or nose blowing, offer non acidic liquids (not red or brown) soft foods-no straws
Parent teaching r/t peritonsillar of retropharyngeal abscess removal watch bleed, infection for next few wks; pain mgt, and soft non acidic diet
CM:Fever,Sore throat,Swollen lymph glands Epstein-Barr virus;via saliva,"kissing disease." Sometimes swollen spleen. Infectious mononucleosis
Trmt of mono No abx - viral; symptomatically for pain and fever, warm salt water gargles;rest and fluids. Restrict activity (sports) r/t possible splenic rupture
inflammation or infection middle ear;tympanic membrane may rupture ->pus in the middle ear space drain into the ear canal.viral, bacterial, or fungal Otitis media
tube that links the nasopharynx to the middle ear. adults longer; Children <3 tube is shorter and horizontal. Eustachian tube
decreases risk of otitis media breastfeeding; positioning while feeding, breast milk las macrophages and they chg when baby or mom is sick so it protects baby
increases rick of otitis media tobacco exposure
CM otitis media pain-crying, pulling or tugging ear, fever, irritable, vomiting, diarrhea, cold s&s, inattentive to voice
strep trmt amoxicillin/penicillin
tx for AOM was amoxicillin or augmenten q12h, however the american academy of pediatrics and the academy of family physicians guidelines suggest watchful waiting for some children w/non-sever acute otitis media b/c often non bacterial
What are some complication r/t AOM and require f/u visits @ 2-4 wks to make sure resolved hearing loss, abscess formation, menigitis, septicemia
time frame to be diag chronic AOM > 2 wks in 6 months
tx for chronic AOM ongoing assessment and antibiotic +/- steroids, tympanostomy, hearing eval
is a small tube inserted into the eardrum to prevent fluid accumulation tympanostomy tube;pressure equalization tube
pt edu r/t AOM/tube complete abx; ear plugs w/swim or bath w/ PE tube
highly contagious bacterial disease that causes uncontrollable, violent "whooping" coughing heard when trying to breath. Pertussis
What precautions s/b initiated w/Pertussis, or whooping cough, uri Bordetella pertussis or Bordetella parapertussis bacteria. droplet for 5 days after initiation of effective therapy or until 3 wks p onset of paroxysms
best tx for pertussis/whooping prevention/immunization
incubation period of pertussis 3-12 days
infants under 6 mo are less likely to pertussis-whoop, but are at risk for exhaustion and apnea
breathing difficulty; "barking" cough,parainfluenza virus, between 3 mo-5yrs ,common October and March. (Winter Months) Croup
Rest and comfort, fluids, nebulized epinephrine or corticosteroids, cool mist blow-by,take child outside briefly at night or stand by a cool shower TX for croup
bacterial infection by the(H. influenzae). inflammed tissue can cover the trachea (windpipe). Epiglottitis
child in epiglottitis distress is sitting forward w/jaw thrust out, not talking or taking fluids, drooling, anxious looking, not coughing...remeber the 4 D's which are... Drooling,Difficulty breathing,Difficulty swallowing(dysphagia)Voice changes (hoarseness)[Dysphonia]
keep child calm, do not examine throat, Moistened (humidified) oxygen, Breathing tube (intubation) ready, diag w/xRAY,watch airway, antibiotic,fluids, and supportive measures for mgt of... Epiglottitis
a routine childhood immunization used help prevent Epiglottitis H. influenzae type B (Hib)
swelling and mucus buildup in the smallest air passages (bronchioles), usually due (RSV) affects children under 2.Wheezing and crackling sounds heard. Bronchiolitis
starts out as a URI, then symptoms worsen with wheezing and s/s of resp distress, retraction-ribs, substernal, clavicular, nasal flare,lethargic,cyanosis around mouth,pallor,grunting,and coughing are cm of Bronchiolitis
complication of Bronchiolitis are apnea, atelectasis, 2ndary bacterial infection, resp failure. What diagnostic testing s/b done physical exam, chx, wbc will be norm, sputim culture
Drinking plenty of fluids.Breathing moist air to help loosen sticky mucus Getting plenty of rest.Ribavirin (antiviral) only in high risk population Trmt Bronchiolitis
inflammation of the lungs caused by infection via Bacteria, viruses,or fungi.often mimics the flu, beginning with a cough and a fever. pneumonia
more diffuse, involving bronchi and general lung fields bronchial
Diag of pneumonia by cm, physical exam, sputum culture, chx to id extent or loc of involement
is inflammation of the lungs and airways to the lungs (bronchial tubes) from breathing in foreign material. Increased risks w/feeding & neuro problemsin w/child Aspiration pneumonia
prevention of Aspiration pneumonia feeding techniques, positioning, avoid aspiration risks such as oily nose drops, solvents, talcum powder
acute onset involving skin, mucus membrane (hives, itching, swelling of lips, tongue uvula)-resp distress and/or hypotension,syncope incontinence peditric anaphylaxis
epinephrine first drug of choice. 0.01-0.5mg mg/kg s/b admin. may be repeated q5-15min;nebulized albuterol for bronchospasm tx of anaphylaxis
seasonal-outdoor allergens, trees,grass, weed pollens; perennial-indoor allergens, dust mites, molds, per dander; linked to chronic otits media b/c eusation tube swells and gets blocked Allergic rhinitis ;Hay fever; Nasal allergies
nasal congestion, runny nose, itchy eyes, nose ears hay fever/allergic rhinitis
general allergy mgt;claritin used in children as young as 2 yrs (no benadrly b/c of hyperactivity)
general allergy mgt; zyrtec in infants ages.. >6 months (no benadrly b/c of hyperactivity)
this is a common chronic d/o of the airways that is complex and characterized by vaiable and recurring sympeoms, airflow obstruction, bronchial hyper-responsiveness, and an underlying inflammaion asthma
antigens, irritant,infections,asa,nsaid,gi reflux,food and food preservatives,emotional stress, and excercise can trigger what asthma inflammatory response
hx and phy, chgs in pulmonary function, esp PEEK rates responseive w/trmt, chx to rule out other diseases or food in lung are diag criteria for childern under 3 who wheeze, 30% will later id as asthmatic
T&C for: expiratory wheezing, chronic cough, dyspnea, also chg in peak flow volume variation in am and pm, tachypnea, restractions nasal flaring, orthopnea, anxiety sit pt up overhead table,Oxygen ,Juice , soda, fluids. Coke has caffeine old fashioned treatment for asthma
medication bb causing smooth muscle relaxation dilates bronchial in asthma albuterol; used for exacerbations / short acting
leukotriene receptor antagonist used for asthma and to relieve s/s of seasonal allergies montelukast (singular)
for chronic asthma CC blocker->inhibits histamine release in asthma cromolyn
is an anticholinergic drug that opens bronchi and providing releif ipratroium
steroids given w/ asthma and may be given as a short burst to manage an attack or long term every morning or every other morning methyprednisone,prednisone,prednislolne
this caffeine from tea leaves not used much today since new drugs available that are effective and easier to manage theophylline
attack PEF >50% and or O2 sat>92% on RA moderate asthma attack
PEF <50% and or O2 sat <92% or refractory to initial reatment Severe asthma attack
emergent phase prehospital asthma oxygen,albuterol, epi 1/1000 if severe distress and very poor air exchg
er care-mild to moderate asthma attack albuterol (saba), 2-6 puffs w/or w/out mask (2yo get mask; nebulizer 0.15mg/kg to a max of 5mg, q 20 mon up to 3 doses; oral dexamethasone 0.6mg/kg/doae or oral prednisone 2mg/kg/dose
tx severe asthma attack nebulizee ipratroium bromide (atrovent) and short acting beta agonists q 20 min up to 3 treatments; oxygen via mask; oral dexamethasone 0.6mg/kg/dose ir irak oredbusibe 2mg/kg/dose or may need to go parenteral
try and avoid intubation in non responsive status asthmaticus continue... inhaled trmt,nebulized ipratropium (atrovent), IV dexamethasone, IV magnesium all concurrently; IV hydration, o2 monitoring
nic w/asthma, child in what position upright over bed table
understand disease, early cm of attacks, prevention/triggers, infection,avoidance, lifestyle choices; dont over use inhalers Pt edu asthma
genetic disease that causes thick,sticky mucus to build up in the lungs, digestive tract, and other areas of the body. r/t 2 defective gene on chrom 7.It is one of the most common chronic lung diseases in children & young adults CF, instead of acting like a lubricant, mucus plugs things up
Neonatal cystic fibrosis screening blood test screens nb for increased levels of immunoreactive trypsinogen (IRT), a protein produced by the pancreas that is linked to CF.
Sweat chloride test for ____the disease. A high salt level in the patient's sweat is a sign of Cystic fibrosis
Meconium ileus,failure to grow,bulky greasy stools,frequent resp infections are cm of Cystic fibrosis
airway medication that makes mucus thinner and easier to cough up pumozyme
bronchodilator albuterol
CF bronchial airway draings at least 2 x day for 20-30 min
bronchial airway drainage manual clappinng and postural dranage, inflatable vest that vibrate at high frequency chest physical therapy
foreign body aspiration most common at age 6mo-4yr
restrict activity, no sports to prevent possible splenic rupture in what resp disease infectious mononucleosis, tetanus-diphtheria-acellular pertussis vaccination
expiratory wheezing, productive cough, thick sputum, dyspnea asthma
______is derived from a hormone called epinephrine, which is released when stressed. used w/ asthma and labor b/c it relaxes smooth muscles; used in prehosp astma attack mgt Terbutaline
Mast cell stabilizer, ccb inhibits histamine related mediators cromolyn
anticholinergic opens the bronchi, and provides relief Ipratropium (trade name Atrovent
PEF >50% and or O2 sat>92% on RA moderate asthma attack
PEF <50% and or O2 sat <92% or refractory to initial treatment Severe asthma attack
Prehospital- Oxygen, cardiorespiratory monitoring with pulse ox, beta-agonist nebulizer (albuterol, alupentterbutaline, etc), IV ( if moderate), s/c turb or epinephrine 1/1000 (0.01 ml/kg) if severe distress and very poor air exchange astma attack prehosp treatment
L/S ratio of 3:1 or more or the presence of _________(a component of surfactant) in the amniotic fluid is more indicative of adequate lung maturity. phosphatidylglycerol
hypoglycemia manifests w/in the first 1 to 6 hrs after birth. S/s of hypoglycemia include jitteriness, apnea, tachypnea, and cyanosis.
mothers have antibodies for HBsAg or hep developed during preg or the postpartum period s/b treated with hepatitis B immunoglobulin (HBIG)
Created by: troop27