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pds test 2

wwallace pds 2

CF is a hereditary autosomal disease that controls movement of Cl ions through the cell membrane
Affects of CF on mucous glands is abnormal production of thick secretions
CF affects which exocrine glands sweat glands, pancreas, lungs
Exocrine pancreatic insufficiency causes what in CF patients sever decrease in digestive enzymes causing decreased digestive enzymes, malnutrition and diarrhea and sometimes diabetics
The standard test for CF is the sweat test, checks for increased sodium and chloride in perspiration
A positive sweat test is what greater than 60 mEg/L Cl
Does CF affect sterility? yes in males
What is an autosomal disease hereditary with both parents carriers, 50% chance of offspring being a carrier, 25% chance offspring having disease, 25% no disease no carrier
CF survival age is 29 years
Increased mortality in year 1 because of recurrent infections
CF children present with respiratory distress, hypoxemic and cyanotic, appear malnourished often admitted with failure to thrive
CF infections usually are what type staph and pseudomonas
Newborns with in 2 days present with what, are highly suggestive of CF meconium illeus (blocked poop)
The most common signs of CF are digital clubbing, chronic sinusitis, crackles in upper lobes
CF CXR will show hyperinflation due to always trying to take deep breaths
Why do CF patients have cor pulmonale chronic hypoxemia
The best way to treat and prevent respiratory tract infections in CF is bronchial hygiene
CPT in CF postural drainage, percussion, PEP and flutter
Percussion in CF 2-3 mins in 10 diff postural drainage positions for adequate clearance 45 minutes total 3-4 times per day
Bronchial hygiene in CF includes CPT, hydration of secretions, pt and family education, antibiotics, bronchodilators, pulmonzyme (dnase mucolytic), O2 therapy PRN, lung transplant
RX for pancreatic insufficiency includes pancreatic enzymes, vitamin supplements, both prior to meals or heavy snacks
Supraglottic involves not just epiglottis, but also aryepiglotic fold and arytenoids cartilages (folds around the hole)
Epiglottitis acute inflammation and selling of the supraglottic structures and partial or complete upper airway obstruction…a true airway emergency for 2-6 yr olds
Why is epiglottitis not as common as it once was development of the H-flu vaccine
How can we differentiate Epiglottitis from croup drooling, pt with Epiglottitis cannot swallow so they are big droolers
Symptoms of Epiglottitis high fever, sore throat, toxic appearance, apprehensive/irritated, drooling, muffled voice but not hoarse, inpir stridor, tachycardic, no cough, sterna retractions
Dx of Epiglottitis lateral neck xray with oblong swollen epiglottis with thumb print, ballooning of the hypopharynx
Tx of Epiglottitis first priority in all cases is establishing artificial airway, ETT 1 size smaller, o2 for hypozemia, monitor SaO2, freq spO2 & vitals, cyanotic O2 with blow by, sedation PRN, cultures, ICU 24-48 hrs, antibiotics, IV fluid, humidity, CPT if secretions
What is the most common cause of upper airway obstructions in children croup
What is the most common cause of croup acute laryngotracheobronchitis LTB
What population gets croup 6 months to 3 years
What causes LTB parainfluenza type I is most common at 75%, RSV, flue and mycoplasma pneumonia at 25%
Is the onset of Epiglottitis fast or slow very fast 4-5 hours
Is the onset of croup fast or slow slow 2-3 days
Symptoms of croup are swelling of subglottic area leading to partial obstruction, inspiratory stridor, hoarse, barking cough, low grad or no fever, suprasternal reatractions tachypnea, prefers to lie down
1mm of edema in subglottic area can lead to how much decrease in airflow 60%
Moderate stages of croup symptoms will be anxious, increased WOB, audible stridor, decreased breath sounds, dyspneic, decreased PaO2
Severe stages of croup symptoms will be increased anxiety, lethargic, dusky or cyanotic, pronounced stridor, barely audible, breath sounds way decreased, gasping totally exhausted leading to respiratory failure
DX of croup neck xray with hourglass or steeple sign, ballooning hypopharynx, lateral neck will have normal epiglottis
Tx of Croup cool mist, O2, racemic epi, hydration, primary caregiver present, steroids, avoid intubation if possible
Spasmodic croup accours with prodrome, child just wakes with barking cough, hoarseness and insp stridor
Prodrome is with out precursor symptoms
RX for spasmodic croup cool mist or cool nite air, usually gone after a nite or two
Bacterial tracheitis aka pseudomembranous croup
Bacterial tracheitis is a rare bacterial croup that looks like LTB, but have staph. 25% have sudden repiatory arrest
RX bachterial tracheitis IV antibiotics, humidity for crusty secretions, bronchoscopy to remove obstructive exudates, artificial airway for airway mgmt and pulm toilet, intub, long resolution, trach is often
ICU with bacterial tracheitis when stridor at test, suprasternal chest wall retractions, SaO3 less 95% on 50% fio2, vapo, heliox, Decadron, intubate
Bronchiolitis is highly contagious acute infection of the lower respiratory tract that causes inflammation, swelling and constriction of the bronchioles and small bronchi
What causes Bronchiolitis RSV
What precautions need to be taken with bronchiolitus gown, mask, gloves shower and change prior to picking up own kids
Bronchiolitis usually affects what age 6 months to 2 years
What kids are most susceptible to bronchiolitus cf bpd and asthma
Bronchiolitis usually starts with what URI or common cold, runny nose, cough and fever
Signs of Bronchiolitis are small airway obst and congestion, intercostals retraction, wheezes, fine crackles, tachypnea, tachycardia and poor feeding
Most severe symptoms of bronchiolitis lasts for how long 2 to 3 days
CXR in bronchiolitis looks like hyperinflation, peribronchiolar thickening, patchy consolidation
How is bronchiolitis diagnosed presents with rsv culture from nasopharynx positive with lower respiratory tract infection
Prevent rsv and bronchiolitis with immunoglobulin Synagis given monthy during winter
Hypoxemia in kids is SPO2 less than 92% and PaO2 less than 70 mmhg
Drugs for bronchiolitis are albuterol and racemic epi, hydration and antibiotics and cpt
Complications of bronchiolitis are apnea, residual decrease in pulm func, may dev asthma later
ARDS is adult resp distress syndrome, caused by lung injury, from sepsis, trauma, aspiration
Signs of are ARDS are sever dyspnea, hypoxemia, refractory to o2, rales or crackles, sterna retractions from decreased CL CXR
Treatment of ARDS includes intubation and ventilation with PEEP for decreased PaO2 and Increased PaCO2, diuretics, vasoactive agents for BP, inotropic cardiac, in haled b drugs and antibiotics
Near drowning is less than how long 24 hours
What age do most drowning happen 1 to 4 years and teen boys
Result of near drowning is what hypoxia and acidosis
What is dry drowning laryngospasm reflex
What is diving reflex face hits cold water and cns stimulated trigeminal nerv causes body to slow down, bradycardia, transient increase in arterial BP, peripheral vasoconstricion
CPR in children compress to breaths is 30 compressions 2 breaths or 15 to 2 with a partner
Infant cpr compressions per min is 80
What first cpr or 911 in kids cpr for 5 cyes then 911 in adults 911 then cpr
Treatment for hyperhydration in near drowning is continuous PEEP, 02 diuretics
Treatment for hyperventilation is intubate, vent and sedation
Treatment for Hyperpyrexia in near drowning is induce hypothermia with cooling blanket
Treatment Hyrexcitability in near drowning is barbiturate sededation
Treatment of hyperrigidity in near drowning is posturing
Close monitoring in near drowning includes ABG, CBC, electrolytes, CXR, hemodynamic status and ICP needs to be low 20’s
Febrile seizures are 6 months to 3 yrs, at 101.8, happen at temp rise
Pneumonia inflammation of gas exchange units, common in children, viral more common than bacterial, common with uri and rsv
Pneumonia presents with fever, malaise, rapid shallow breath, cough chest pain, chills
Pneumonia rx is abx, bedrest, oral fluid, antipyretics for fever
Muscular dystrophies are largest group of muscle diseases affecting children, progressive weakness wasting of muscles, degeneration of muscle fibers
What is most common Muscular dystrophy duchenne’s, age 3, waddling gate, wheelchair by 12, scoliosis causes resp probs, death by 20
What is milder form of muscular dystrophy becker’s, milder and presents older in life
AIDS risk factors for prenatal are parents esp mom are IV drug user, maternal promiscuity or prostitution, parental homosexuality
Other causes of pediatric aids exposure to infected blood products, infected breast milk, and small percentage of unkown
Kids who do not meet requirements of aids are said to have ARC aids related complex
Incubation of aid is 6 weeks to 10 years
Kids with aids present with failure to thrive, developmental delays, lymphadenopathy, chronic diarrhea, progressive neurologic dysfxn, hepatosplenomegaly, thrush, sepsis, hep b
Opportunistic infections in aids are pcp, Kaposi sarcoma, tb, cmv retinitis, MAC
Aids is diagnosed by ELISA, western blot, PRC, P24, HIV culture, ILISPOT, IVAP, IgA, IgM
What AIDs test does not check for antibodies PCR
What pulmonary symptoms do aids pt get severe dyspnea, fever, cough, toxic appearance, chest pain, variable sputum, thrush, lymphadenopathy
Aids meds are antiretrovirals, Abx, antifungals, antiparasitic, Zidovudine or ZDV when tcells below 500, ddl and ddC, IV TMP SMX, dapsone and aerosolized pentamidine and steroids for PCP
Precautions with aids is hand washing , eye shields, clothing covers, gloves, masks
SIDS happens at what age 40 percent at 1 to 12 months
Risk factors of sids are apnea, prematurity, sib with sids, low birth weight, maternal drug use, maternal smoking, more males, low apgar, history of alte’s prone position
What is ATLE apparent life threatening event, episode frightening enough to cause apnea, cyanosis or pallor, change in muscle tone (limp)
What do most ATLE result from GI reflux, upper airway obstruction, congenital anomalies of airway or heart, infection
SIDS monitors for what apnea of 10-15 seconds, low or high HR
Created by: williamwallace