Term
| Cardinal signs of respiratory distress |
|
Definition
a. restlessness
b. increased respiratory rate
c. increased pulse rate
d. diaphoresis |
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Term
| Other signs of respiratory distress |
|
Definition
a. flaring nostrils
b. retractions
c. grunting
d. adventitious breath sounds (or absent breath sounds)
e. use of accessory muscles, head bobbing
f. alterations in blood gases: decreased PO2, elevated PCO2
g. cyanosis and pallor |
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Term
| A pediatric client often goes into respiratory failure before |
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Definition
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|
Term
| Inflammatory reactive airway disease that is commonly chronic |
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Definition
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|
Term
| In asthma, the airways become |
|
Definition
| edematous and congested with mucous |
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|
Term
| In asthma, smooth muscles of the bronchi and bronchioles |
|
Definition
|
|
Term
| In asthma, air trapping occurs in the |
|
Definition
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|
Term
| In asthma, the nurse should take a history of |
|
Definition
| asthma in the family, and allergies, home environment containing pets or other allergens |
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|
Term
| With asthma there is often this type of cough: |
|
Definition
| tight cough (nonproductive) |
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|
Term
| A late sign and symptom of asthma is a chest diameter that |
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Definition
|
|
Term
| With asthma one symptom can be an increased number of schooldays missed during the past |
|
Definition
|
|
Term
| In asthma look for signs of |
|
Definition
|
|
Term
| Nursing diagnoses for asthma |
|
Definition
a. impaired gas exchange related to...
b. ineffective breathing pattern related to... |
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|
Term
| For acute attacks of asthma administer |
|
Definition
| rapid acting bronchodilators and steroids |
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|
Term
| For asthma maintain hydration and monitor blood gas values for signs of |
|
Definition
|
|
Term
| For asthma monitor pulse oximetry and administer |
|
Definition
| oxygen or nebulizer therapy as prescribed |
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|
Term
| For asthma, monitor these commonly used medications for therapeutic effects |
|
Definition
| beta-adrenergic agonists as well as anti inflammatory corticosteroids |
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|
Term
| For asthma teach home care program including |
|
Definition
1. identifying precipitating factors
2. reducing allergens in the home
3.using metered dose inhaler
4. monitoring peak expiratory flow rate at home
5. doing breathing exercises
6. monitoring drug actions, dosages, and side effects
7. managing acute episode and when to seek emergency care |
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|
Term
| For asthma you may need to refer child and family for |
|
Definition
| emotional and psychological counseling |
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|
Term
| Common adrenergic used for asthma |
|
Definition
Epinephrine HCl
(Sus Phrine)INH,
subcutaneous, IM, IV |
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|
Term
| Indications for using the adrenergic Epinephrine HCl |
|
Definition
Rapid acting bronchodilator
Drug of choice for acute asthma attack |
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|
Term
| What adverse reactions are observed in the adrenergic Epinephrine HCl? |
|
Definition
| Tachycardia, hypertension, tremors,nausea |
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|
Term
| What are some nursing implications to use when giving the adrenergic Epinephrine HCL? |
|
Definition
Give subcutaneously, intravenously , or via nebulizer
May be repeated in 20 minutes |
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|
Term
| To convert weight in pounds to weight in kilograms you |
|
Definition
Divide the pounds by 2.2. If weight is expressed in pounds and ounces, convert the ounces to the nearest tenth of a pound, add to the poundage and divide by 2.2
The weight expressed in kilograms should always be a smaller number than weight expressed in pounds |
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|
Term
| Autosomal recessive disease that causes dysfunction of the exocrine glands |
|
Definition
|
|
Term
| In cystic fibrosis, tenacious mucus production |
|
Definition
| obstructs vital structures |
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|
Term
| What problems result from exocrine dysfunction as seen in cystic fibrosis? |
|
Definition
1. lung insufficiency (most critical problem)
2. pancreatic insufficiency
3. increased loss of sodium and chloride in sweat |
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|
Term
| What race is most commonly seen with cystic fibrosis? |
|
Definition
| Most commonly seen in a white infant or child |
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|
Term
| With cystic fibrosis, what percentage of patients have a meconium ileus at birth? |
|
Definition
|
|
Term
| With cystic fibrosis there is recurrent |
|
Definition
|
|
Term
| With cystic fibrosis there is pulmonary |
|
Definition
|
|
Term
| With cystic fibrosis there are excessive fat, greasy stools called |
|
Definition
|
|
Term
| A characteristic of stools in cystic fibrosis |
|
Definition
| foul-smelling, bulky stools |
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|
Term
| Characteristically, a child with cystic fibrosis will have |
|
Definition
| delayed growth and poor weight gain |
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|
Term
| In cystic fibrosis a child's skin will taste this way when kissed |
|
Definition
| salty - caused by excessive secretions from sweat glands |
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|
Term
| Three of the later signs of cystic fibrosis |
|
Definition
1. cyanosis
2. nail bed clubbing
3. congestive heart failure (CHF) |
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Term
| Common nursing diagnoses in cystic fibrosis |
|
Definition
1. ineffective airway clearance related to...
2. imbalanced nutrition, less than body requirements related to... |
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|
Term
| In cystic fibrosis you monitor and assess for |
|
Definition
| respiratory status and signs of respiratory infection |
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|
Term
| For cystic fibrosis Administer IV |
|
Definition
| antibiotics as prescribed, manage vascular access |
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|
Term
| For cystic fibrosis administer the following pancreatic enzymes |
|
Definition
| Cotazym-S, Pancrease: for infants give with applesauce, rice or cereal, for older child with food |
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|
Term
| Administer the following fat-soluable vitamins |
|
Definition
| A,D,E,K - administer in water soluble form |
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|
Term
| For cystic fibrosis administer oxygen and the following nebulizer treatments as prescribed: |
|
Definition
| recombinant human deoxyribonuclease (DNase) or dornase alfa (Pulmozyme) |
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|
Term
| For cystic fibrosis a child needs 150% of |
|
Definition
| the usual calorie intake for normal growth and development |
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|
Term
| For cystic fibrosis teach the family |
|
Definition
a. percussion and postural-drainage techniques
b. dietary recommendations - high in calories, high in protein, moderate to high fat, moderate to low carbohydrates (avoid increase in CO2 drive) |
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|
Term
| For respiratory clients, an oxygen hood is used for |
|
Definition
|
|
Term
| For respiratory clients, nasal prongs provide |
|
Definition
| low to moderate concentrations of oxygen |
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|
Term
| For respiratory clients, tents provide |
|
Definition
| mist and oxygen. Monitor a child's temperature, keep edges tucked in and keep child dry |
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|
Term
| Pulse oximetry measures this and is attached how in children? |
|
Definition
| Measures oxygen saturation (SaO2) of arterial hemoglobin noninvasively via a sensor that is usually attached to the finger, toe or in an infant to the sold of the foot. |
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|
Term
| In children when should you become concerned with decreased pulse oximetry? |
|
Definition
|
|
Term
| Blood gas evaluatioh is usually monitored in respiratory clients through |
|
Definition
|
|
Term
| Norms for PO2 and PCO2 in children |
|
Definition
PO2: 80 to 100 mm Hg
PCO2: 35 to 45 m Hg |
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|
Term
| Life-threatening infection of the epiglottis |
|
Definition
|
|
Term
|
Definition
| rapidly, causing acute airway obstruction |
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|
Term
| The organism responsible for epiglottitis is |
|
Definition
| Haemophilus influenzae (H. influenzae; primarily type B) |
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|
Term
| The nursing assessment of epiglottitis is |
|
Definition
a. sudden onset
b. restlessness
c. high fever
d. sore throat; dysphagia
e. drooling
f. muffled voice
g. child assuming upright sitting position with chin out and tongue protrudiing (tripod position) |
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|
Term
| Nursing diagnoses with epiglottitis |
|
Definition
Ineffective breathing pattern related to...
Anxiety related to ... |
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|
Term
| In epiglottitis, encourage prevention with |
|
Definition
|
|
Term
| In epiglottitis, maintain child in an |
|
Definition
|
|
Term
| In epiglottitis, prepare for |
|
Definition
| intubation or tracheostomy |
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|
Term
| With epiglottitis administer |
|
Definition
| antibiotics as prescribed |
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|
Term
| With epiglottitis prepare for hospitalization in |
|
Definition
| the intensive care unit (ICU) |
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|
Term
| For epiglottitis restrain |
|
Definition
| as needed to prevent extubation and employ measures to decrease agitation and crying |
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|
Term
|
Definition
| examine the throat of a child (i.e. do not put a tongue blade or any object into throat)because of risk of obstructing the airway completely |
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|
Term
| Viral infection of the bronchioles that is charaterized by thick secretions |
|
Definition
|
|
Term
| What usually causes bronchiolitis? |
|
Definition
| Bronchiolitis is usually caused by respiratory syncytial virus (RSV)and is found to be readily transmitted by close contact with hospital personnel, families, and other children |
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|
Term
| Who primarily gets bronchiolitis? |
|
Definition
| Primarily occurs in young infants |
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|
Term
| What does a nurse assess for bronchiolitis? |
|
Definition
a. history of upper respiratory infections
b. irritable distressed infant
c. paroxysmal coughing
d. poor eating
e. nasal congestion
f. nasal flaring
g. prolonged expiratory phase of respiration
h. wheezing, rales can be auscultated
i. deteriorating conditions that is often indicated by shallow, rapid respirations |
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|
Term
| Nursing diagnoses for bronchiolitis: |
|
Definition
a.Impaired gas exchange related to...
b. Ineffective airway clearance related to... |
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|
Term
| With bronchiolitis/RSV isolate the child |
|
Definition
|
|
Term
| To prevent transmission of the RSV virus that causes bronchiolitis, assign nurses |
|
Definition
| to clients with RSV who have no responsibility for any other children |
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|
Term
| In bronchiolitis, monitor respiratory status and observe for |
|
Definition
|
|
Term
| With bronchiolitis, clear airway of secretions using |
|
Definition
| a bulb syringe for suctioning |
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|
Term
| With bronchiolitis, provide care in a |
|
Definition
| mist tent, administer oxygen as prescribed |
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|
Term
| With bronchiolitis, maintain |
|
Definition
| hydration with oral and IV fluids, evaluate response to respiratory therapy treatments |
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|
Term
| To provide passive immunity against RSV in high risk children (younger than 2 years of age with history of prematurity, lung disease or CHF)administer |
|
Definition
|
|
Term
| What is always a priority of care, regardless of age? |
|
Definition
|
|
Term
| Inflammatory disorder of the middle ear |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Anatomic structure of the ear predisposes |
|
Definition
| young child to ear infections |
|
|
Term
| If Otitis media is left untreated or incompletely treated there is a risk for |
|
Definition
|
|
Term
| Nursing assessment for Otitis media: |
|
Definition
a. fever, pain; infant may pull at ear
b. enlarged lymph nodes
c. discharge from ear (if drum is ruptured)
d. Upper respiratory symptoms
3. vomiting, diarrhea |
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|
Term
| Nursing diagnoses for Otitis media |
|
Definition
a. risk for infection related to...
b. Acute pain related to... |
|
|
Term
|
Definition
| antibiotics if prescribed |
|
|
Term
| Otitis media if body temperature gets high (may get very high with risk for seizures) reduce temperature by |
|
Definition
a. tepid baths
b. acetaminophen (Tylenol) if prescribed |
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|
Term
| With Otitis media you Position child on |
|
Definition
|
|
Term
| With Otitis media, provide comfort measures such as |
|
Definition
| warm compress on affected ear |
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|
Term
| With Otitis media, teach the following home care |
|
Definition
a. teach to finish all prescribed antibiotics
b. encourage follow-up visit
c. monitor for hearing loss
d. teach preventive care such as no smoking, do not bottle feed when child is in supine position. These are predisposing factors. |
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|
Term
| Inflammation of the tonsils is called |
|
Definition
|
|
Term
|
Definition
| It may be either viral or bacterial |
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|
Term
| Tonsillitis may be related to infection by a |
|
Definition
|
|
Term
| If related to strep, treatment is very important because of the risk for |
|
Definition
| developing acute glomerulonephritis or rheumatic heart disease |
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|
Term
| For tonsillitis, the nurse should assess the following: |
|
Definition
a. sore throat and may have difficulty swallowing
b. fever
c. enlarged tonsils (may have purulent discharge on tonsils)
d. breathing may be obstructed (tonsils touching, called "kissing tonsils")
e. throat culture to determine viral or bacterial cause |
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|
Term
| The nurse should be sure of |
|
Definition
| Prothrombin time (PT) and partial prothrombin time (PTT) have been determined prior to a tonsillectomy. Nurse should know if there is a history of of bleeding or prolonged or excessive bleeding or if any bleeding disorders in the family |
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|
Term
| Nursing diagnoses for tonsillitis |
|
Definition
Impaired swallowing related to...
Risk for injury related to... |
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|
Term
| For tonsillitis instruct the parents in the following home care |
|
Definition
a. encourage warm saline gargles
b. provide ice chips
c. administer antibiotics if prescribed
d. manage fever with acetaminophen |
|
|
Term
| In tonsillitis, if surgery is indicated provide |
|
Definition
| preoperative teaching and assessment |
|
|
Term
| In tonsillitis, monitor for the following signs of postoperative bleeding |
|
Definition
a. frequent swallowing
b. vomiting fresh blood
c. clearing throat |
|
|
Term
| With tonsillitis encourage |
|
Definition
| soft foods and oral fluids (avoid red fluids which mimic bleeding) Do NOT use straws |
|
|
Term
| With tonsillitis provide comfort measures such as |
|
Definition
| ice collar helps with pain and vasoconstriction |
|
|
Term
| With a tonsillectomy the highest risk for hemorrhage is |
|
Definition
| during the first 24 hours to 5 to 10 days after surgery |
|
|
Term
| Describe the purpose of bronchodilators |
|
Definition
|
|
Term
| What are the physical assessment findings for a child with asthma? |
|
Definition
| Expiratory wheezing, rales, tight cough, and signs of altered blood gases |
|
|
Term
| What nutritional support should be provided for a child with cystic fibrosis? |
|
Definition
| Pancreatic enzyme replacement, fat-soluble vitamins, and a moderate to low carbohydrate-high protein, moderate to high fat diet |
|
|
Term
| Why is genetic counseling important for the family of a child with cystic fibrosis? |
|
Definition
| Because the disease is autosomal recessive in its genetic pattern. |
|
|
Term
| List seven signs of respiratory distress in a pediatric client. |
|
Definition
| restlessness, tachycardia, tachypnea, diaphoresis, flaring nostrils, retractions and grunting |
|
|
Term
| Describe the care of a child in a mist tent. |
|
Definition
| monitor child's temperature, keep edges tucked in, keep clothing dry, assess respiratory status, look at child inside tent |
|
|
Term
| What position does a child with epiglottitis assume? |
|
Definition
| upright sitting, with chin out and tongue protruding(tripod position) |
|
|
Term
| Why are IV fluids important for a child with an increased respiratory rate? |
|
Definition
| The child is at risk for dehydration and acid-base imbalance. |
|
|
Term
| Children wiht chronic otitis media are at risk for developing what problem? |
|
Definition
|
|
Term
| What is the common postoperative complication following a tonsillectomy? Describe the signs and symptoms of this complication. |
|
Definition
| Hemorrhage --- frequent swallowing, vomiting fresh blood, and clearing throat. |
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|
