Term
| What are symptoms of bronchitis? |
|
Definition
| Coarse, hacking cough that is worse at night, fever, wheezing |
|
|
Term
| What age group is unusual to have bronchitis? |
|
Definition
| Childhood age, however if they do contract they are usually 1-4 years old |
|
|
Term
| How do you treat bronchitis? |
|
Definition
| Cough suppressant, expectorant, anti-pyretics |
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Term
|
Definition
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|
Term
| What causes bronchiolitis? |
|
Definition
|
|
Term
| What children are most at risk for bronchiolitis? |
|
Definition
1. Premature children do not receive immunity from their mother for RSV
2. Patients with cardiac &/or pulmonary issues |
|
|
Term
| What immunization is given for bronchiolitis? |
|
Definition
| Palivizumab once per month for high risk |
|
|
Term
| What age group is most at risk for bronchiolitis? |
|
Definition
|
|
Term
| What are symptoms of bronchiolitis? |
|
Definition
| nasal symptoms, cough, vomit, fever, wheezing, tachypnea, retractions, decreased activity level, decreased oral intake, dehydration |
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|
Term
| What is the treatment for bronchiolitis? |
|
Definition
|
|
Term
|
Definition
| ELIZA test; takes 4-6 hours |
|
|
Term
| How long is the incubation period for RSV? |
|
Definition
|
|
Term
| What causes bronchopulmonary dysplasia? |
|
Definition
| Results from acute respiratory disease during neonatal period. Pulmonary epithelial damage. |
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|
Term
|
Definition
| Persistent signs of respiratory distress |
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Term
| Why are BPD patients at risk for right heart failure? |
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Definition
| Pressure build up in the lungs cause more work for the right ventricle to pump blood |
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|
Term
|
Definition
| An airway obstruction due to inflammation & hyperresponsiveness of the bronchioles after exposure to various stimuli |
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|
Term
|
Definition
1. Spontaneously
2. W/ treatment |
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|
Term
| What is the most chronic illness among children? |
|
Definition
| 20% of children 15 years or younger are admitted to the ER because of ASTHMA |
|
|
Term
| What are symptoms of Asthma? |
|
Definition
| cough, wheezing, dyspnea, use of accessory muscle |
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|
Term
|
Definition
| Inflammation or infection of bronchioles & alveoli |
|
|
Term
| What are the types of pneumonia? |
|
Definition
1. lobar
2. bronchial
3. Interstitial (most deadly, seen in immunocompromised patients) |
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|
Term
| What are causes of pneumonia? |
|
Definition
1. Viral, mycoplasmal, bacteria
2. Can result from aspiration |
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Term
| What are symptoms of pneumonia? |
|
Definition
Fever, rhonchi, crackles, wheezes, cough, dyspnea, tachypnea, restlessness, decreased breath sounds, chest pain,
pleuritic effusion that leads to referred pain in the neck or abdomen, pleural rubbing |
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|
Term
| What treatment is used for pneumonia? |
|
Definition
| Antibiotics (bacterial), Oxygen, O2 saturation monitoring, chest PT |
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Term
| What is the RED zone respiratory function & what actions should be taken? |
|
Definition
| 50% of normal respiratory function is considered RED zone and should be taken to the ER immediately |
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|
Term
| What are medications given to treat asthma? |
|
Definition
1. Albuterol
2. Atrovent
3. nebulizer
4. steriods |
|
|
Term
| Why are steroids used for asthma patients? |
|
Definition
| Steroids are used to decrease inflammation |
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|
Term
| What does albuterol do to the lungs? |
|
Definition
| Albuterol is a beta-agonist that is used as a bronchodilator |
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|
Term
| how many alveoli does a newborn have compared to an adult? |
|
Definition
|
|
Term
| Why is a newborn's subglottic area easily obstructed? |
|
Definition
| It is a narrow space and they have a large tongue & soft palate |
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|
Term
| How would you describe the trachea of a newborn? |
|
Definition
| Little smooth muscle & no cartilage |
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|
Term
| How long are newborns obligatory nose breathers? |
|
Definition
|
|
Term
| Why is nasal patency critical for infants? |
|
Definition
| They are obligatory nose breathers |
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|
Term
| Until what age does a child's respiratory tract grow? |
|
Definition
|
|
Term
| How can you estimate the size of a child's airway diameter? |
|
Definition
| It is about the size of their little finger, infant airway is about the size of a straw |
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|
Term
| What is the relationship between airway diameter and airway resistance? |
|
Definition
| Inverse; bigger the airway less resistance |
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|
Term
| How much of a child's airway is lost with 1mm of swelling? |
|
Definition
|
|
Term
| Why is mucus plug dangerous for infants? |
|
Definition
| Can cause respiratory arrest due to small dimeter of airweay |
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|
Term
| What happens to the lower airway through puberty? |
|
Definition
| The aveoli change in increase in number, size and shape to increase the area for gas exchange |
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|
Term
| When does the smooth muscle of bronchi and bronchioles develop and what is the significance? |
|
Definition
| The first year of life, they are less likely to trap invaders |
|
|
Term
| What are the different types of retractions? |
|
Definition
1. Subcostal
2. Supraclavicular
3. Substernal
4. Suprasternal |
|
|
Term
| Why are young children diaphragmatic breathers? |
|
Definition
| intercostal muscles are immature, ribs are primarily cartilage |
|
|
Term
| Why do infants have less ability to react to low oxygen levels? |
|
Definition
|
|
Term
| What part of the CNS controls the rhythm of breathing? |
|
Definition
|
|
Term
| What part of the CNS controls the rate of breathing? |
|
Definition
|
|
Term
| What does respiratory failure do to ABGs? |
|
Definition
| Results in hypoxemia & hypercapnia |
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|
Term
| What are symptoms of mild respiratory distress? |
|
Definition
1. Restlessness
2. Tachypnea
3. Tachycardia
4. Diaphoresis |
|
|
Term
| What are nursing interventions for Mild respiratory distress? |
|
Definition
| Elevate bed, take vitals, give O2, bloods gases |
|
|
Term
| What are symptoms of moderate respiratory distress? |
|
Definition
1. Nasal flaring
2. Retractions
3. Grunting wheezing
4. anxiety, irritability (crabby), mood changes, confusion (CO2)
5. Hypertension |
|
|
Term
| How does the body respond to mild respiratory distress? |
|
Definition
|
|
Term
| How does the body respond to moderate respiratory distress? |
|
Definition
|
|
Term
| What are symptoms of severe respiratory distress? |
|
Definition
1. Dyspnea
2. Bradycardia
3. cyanosis
4. Stupor/coma |
|
|
Term
| What age group is at the greatest risk for foreign body aspiration? |
|
Definition
|
|
Term
| What are nursing interventions for moderate respiratory distress? |
|
Definition
| Same as mild but also try to prevent child from crying so stomach does not fill up with air. If they get worse they will need to be intubated. |
|
|
Term
| What are nursing interventions for severe respiratory distress? |
|
Definition
1. Endotracheal tube
2. ventilator
3. artificial airway
4. tracheostomy if the patient will require ventilation longterm
paralysis may be induced if child fights the ventilation |
|
|
Term
| How can you judge if a toy is an aspiration risk? |
|
Definition
| If it can fit in a toilet paper roll it is too small |
|
|
Term
| What are clinical manifestations of foreign body obstruction? |
|
Definition
| initial spasmodic coughing or gagging followed by dyspnea. The patient may be asymptomatic for 15-30 minutes then show signs of respiratory distress |
|
|
Term
| How can you tell an object is stuck in a child's nose? |
|
Definition
| green drainage will fall from blocked nostril |
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|
Term
| How can you tell a foreign object has gone down the airway but is not completely obstructed. |
|
Definition
| The child cannot say the letter P. If its in the small bronchi, the child will have a cough. If its in the upper airway, there will be diminished breath sounds and stridor. |
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|
Term
| How will a foreign object be removed from the airway of a child? |
|
Definition
| Bronchoscopy with sedation |
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|
Term
|
Definition
| Sudden infant death syndrome of a child younger than 1 years old determined via exclusion after an autopsy. |
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|
Term
| What is the peak age for SIDS to occur? |
|
Definition
|
|
Term
| What are risk factors for SIDS? |
|
Definition
| Young mother, smoker, live in a city, sleeping with a baby on a sofa, sleeping prone, if room is too hot, use of soft comforter or pillow (they cannot roll over yet), possible brain defects |
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|
Term
|
Definition
| Inflammation of the mucous membrane of the nose |
|
|
Term
| How do you distinguish rhinitis from allergies or a cold? |
|
Definition
| If you look up the nares and it is swollen and pale it is due to allergies. If you look up the nostril and it is swollen and red it is a cold. |
|
|
Term
| What are symptoms of rhinitis? |
|
Definition
| nasal discharge, bad breath in the morning, discharge smells, decreased sense of taste or smell |
|
|
Term
| What are causes of rhinitis? |
|
Definition
| Allergies, virus, sinus infection, foreign body stuck in nose, adenoid infection |
|
|
Term
| What is the tx for rhinitis? |
|
Definition
| Saline nose drops if symptomatic |
|
|
Term
| What is the difference between viral & bacterial tonsillitis? |
|
Definition
Viral- more gradual low grade fever, pharynx is red
Bacterial- more abrupt, high fever, sore throat, abdominal pain, tonsils red & swollen with white exudate |
|
|
Term
| What is the etiology of tonsillitis? |
|
Definition
| 30-40% betahemolytic strep |
|
|
Term
| How is tonsillitis diagnosed? |
|
Definition
|
|
Term
| What is the treatment for tonsillitis? |
|
Definition
| antibiotics, removal of lymph nodes if severe |
|
|
Term
| What are complications that can arise from tonsillitis? |
|
Definition
| Skin rash, paratonsillar abscess, sinusitis, otis media infection (ear drum/tympanic membrane inflamed, mastoiditis, meningitis, rheumatic fever, glomerular nephritits |
|
|
Term
|
Definition
| insertion of a tube into the eardrum as a Eustachia tube, allowing air exchange between the middle and outer ear that may lead to tympanosclerosis (scarring of tympanic membrane) |
|
|
Term
| What are the reasons for an adenoidectomy? |
|
Definition
| The pharyngeal tonsils are removed if the child as 4 or more infections in one year, if they are mouth breathers (it will affect how teeth come in) |
|
|
Term
|
Definition
| Removal of palatine or facial tonsils indicated by 4 or more infections in one year. Normal immune function causes them to shrink by age 12 |
|
|
Term
| What are nursing considerations for a child prior to undergoing a tonsillectomy? |
|
Definition
Take a careful hx
Make sure the child does not have a high temperature or infection |
|
|
Term
| What is a complication from a tonsillectomy? |
|
Definition
| Bleeding that comes within 24 hours can be fatal |
|
|
Term
| What are nursing considerations for a child after undergoing a tonsillectomy? |
|
Definition
| Child should be lying flat on their side so they don't swallow their own blood, constant swallowing may be a sign of bleeding, no red popsicles, do no give aspirin or NSAIDS because it causes bleeding, frequent vital signs, pt should not suck thru a straw (pressure could cause bleeding) |
|
|
Term
| What are some discharge instructions for parents after a tonsillectomy? |
|
Definition
1. No coarse or spicy for for a week
2. Avoid aggressive coughing
3. Pain after 1 week is abnormal
4. hemorrhage after 5-10 days is likely due to infection |
|
|
Term
|
Definition
| Broad term for an upper airway illness that causes an obstructive narrowing of the larynx. |
|
|
Term
| What is laryngothracheobronchitis? |
|
Definition
| It is a slower onset of croup that caused by a virus |
|
|
Term
| What are general characteristics of laryngothracheobronchitis? |
|
Definition
1. From the parainfluenza virus
2. There are genetic predispositions
3. Stress makes it worse
4. Bad cough occurs at night with stridor but subsides by morning
5. Afibrile
6. Barking seal noise
7. hoarse voice
8. mild to moderate respiratory distress
9. 3 mos- 8 years |
|
|
Term
|
Definition
| Treat with humidity by taking them to the bathroom & putting them in the shower |
|
|
Term
|
Definition
1. Humidity
2. Single dose of steroids or adrenaline if HR increases and Resp Rate is >60 |
|
|
Term
| What should a child avoid if they have LTB? |
|
Definition
| Cough syrup because it thickens the mucus and makes it worse. |
|
|
Term
|
Definition
| Inflammation of the epiglottis caused by that we don't see much of anymore because of the Hib vaccine. If we see it now it is the result of strep or staph |
|
|
Term
| What is the peak age of epiglottitis? |
|
Definition
|
|
Term
| Symptoms of epiglottitis? |
|
Definition
| High fever, drooling b/c of throat closing, difficulty swallowing, tripod position, muffled voice, thumb sign on x-ray |
|
|
Term
| What are epiglottitis interventions? |
|
Definition
1. Avoid inspecting throat or mouth
2. Allow child to be in comfortable position
3. Child may go straight to OR |
|
|
Term
| What is the tx of epiglottitis? |
|
Definition
|
|
Term
| What is bacterial tracheitis? |
|
Definition
| It is an upper trachea infection caused by S. aureus and is typically a secondary infection seen in children from 1 month -13 years old. Cause can be from intubation in PICU |
|
|
Term
| Signs and symptoms of tracheitis? |
|
Definition
| high fever, productive cough, stridor, purulent secretions |
|
|
Term
| What is the Tx of tracheitis? |
|
Definition
| Antibiotics for 10-14 days |
|
|
Term
|
Definition
| It is an inherited autosomal disorder that affects the cells that produce mucus, sweat, and digestive juices. It causes these fluids to become thick and sticky. They then plug up tubes, ducts, and passageways. |
|
|
Term
|
Definition
| Meconium illeus, fatty stools, frequent infections, poor weight gain, voracious appetite, delayed on set of puberty |
|
|
Term
| What does it mean if a child has >60mmo/L of Cl- found in their blood? |
|
Definition
| The child possibly has CF |
|
|
Term
| What are two medications used to treat CF? |
|
Definition
Kalydeco (only for 2% of the CF types)
Pulmazyme nebulizer that breaks up the mucus
Tobramycin is inhaled |
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