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BSN 346 Nrs Conc III
asthma in the peds patient
| Question | Answer |
|---|---|
| Upper respiratory tract | nose, pharynx, and larynx |
| Lower respiratory tract | trachea, bronchi, bronchioles, and lungs including alveoli |
| what comprises lower respiratory airway. | The trachea, bronchi, bronchioles, and lungs including alveoli |
| The trachea | conducts air between the larynx and the lungs. It divides into right and left main bronchi at its lower end, the carina. |
| right main bronchu | shorter and wider than the left and branches off the trachea higher than in adults, making aspiration into the right bronchus more likely. |
| main bronchi divide into | lobar bronchi, segmental bronchi, and bronchioles and terminate in alveoli. Mucus-secreting goblet cells line the bronchi and protect the lungs from dust and bacteria. |
| right lung | three lobes (upper, middle, and lower) |
| left has two lobes | upper and lower |
| parietal pleura | lines the entire thoracic cavity |
| visceral pleura | encases each lung |
| alveoli | Distal to the terminal bronchioles where gas exchange occurs |
| adventitious sound | a breath sound that is not normally heard, such as a crackle, gurgle, rhonchus, or wheeze. It may be superimposed on normal breath sounds. |
| Crackles (rales, crepitations) | Discontinuous, short, crackling, popping sounds heard during inspiration and not cleared by coughing. Described as discrete (short), discontinuous. Fine crackles are high pitched whereas coarse crackles are louder and lower pitched. |
| Crackles (rales, crepitations) mechanism | Heard when air moves through airways narrowed by fluid. Airways suddenly pop open, creating crackling sound as gas pressures between the two compartments equalize. |
| Clinical Example Crackles (rales, crepitations) | Late inspiratory crackles occur with restrictive disease: pneumonia, congestive heart failure, and interstitial fibrosis. Early inspiratory crackles occur with obstructive disease: chronic bronchitis and asthma. |
| Pleural friction rub | A very superficial sound that is coarse and low-pitched. Grating quality, as if two pieces of leather were being rubbed together. may sound just like crackles but closer to the ear and louder. |
| Pleural friction rub Mechanism | Caused when pleurae become inflamed and lose their normal lubricating fluid. Opposing roughened pleural surfaces rub together during respiration. Best in the anterolateral wall, where lung mobility is greatest. |
| Pleural friction rub Clinical Example | Pleuritis, accompanied by pain with breathing. (Rub disappears after a few days if pleural fluid accumulates and separates pleurae). |
| High-pitched wheeze heard with narrowing of the air passages from fluid, swelling, spasm, and tumors | High-pitched, musical squeaking sounds that predominate in expiration. May occur in both expiration and inspiration. Coughing frequently will change the character of the sound |
| Low-pitched wheeze (sonorous rhonchi) | Low-pitched, musical snoring, moaning sounds. Heard throughout the respiratory cycle, although they are more prominent on expiration and may clear somewhat with coughing. |
| fremitus | a tremulous vibration of the chest wall caused by vocalization that is primarily palpated during physical examination. |
| Arterial blood gas values most frequently assessed include: | Partial arterial oxygen pressure (PaO2) Partial pressure of carbon dioxide in arterial blood (PaCO2) Acid-base balance (pH) Bicarbonate (HCO3-) |
| Allen's test | a test for the patency of the radial artery after insertion of an indwelling monitoring catheter. |
| hypercapnia | greater than normal amounts of carbon dioxide in the blood. |
| 12-mo child w a respiratory inf begins crying while the nurse is auscultating for posterior lung sounds. Which is most appropriate? Stop assessment to avoid stressing the child Compress the stethoscope against the chest wall Allow parent to hold chil | Allow parent to hold child and continue with assessment Allowing the parent to hold a child who begins crying while the nurse is auscultating the lungs may console the child from crying and it is the most appropriate intervention for this situation. |
| Demonstrate the appropriate method of conducting respiratory assessment in this child by organizing the sequential steps listed. | After inspecting the chest, the nurse should count the respiratory rate, auscultate lungs sounds from posterior to anterior thorax, palpate the chest, and finally percuss the chest. |
| nurse notes an increased resp rate and retractions while the child is supine on the examining table. action nurse to perform next to obtain an accurate resp assessment? Reposition the child upright. Begin auscultating the lungs. Ask the child to blow | Positioning the child upright (a position of comfort) can assist with auscultation of the lungs, which is the next step of the assessment for a child with signs of respiratory distress, and can facilitate precise respiratory assessment findings. |
| Which test is appropriate to evaluate the effectiveness of oxygen therapy in a 2-year-old child? Pulse oximetry Chest radiography Arterial blood gas Pulmonary function test | Pulse oximetry is useful to determine oxygenation status and is the most appropriate method to evaluate the effectiveness of oxygen therapy in a 2-year-old child. |
| Grade 0 | upper chest synchroinzed lower chest no retractions xiphoid retractions none |
| Grade 1 | upper chest lag on inspiration lower chest and xiphoid retractions just visible |
| Grade 2 | upper chest see-saw lower chest and xiphoid retractions marked |
| How does the respiratory system facilitate movement of mucous? Cilia move mucous to the pharynx. Goblet cells move mucous to the lungs. Alveoli move mucous during sneezing. Coughing moves mucous to the trachea. | Cilia move mucous to the pharynx. |
Created by:
adricela55