Term
| What are the respiratory rates of adults? |
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Definition
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Term
| What is the RR of children? |
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Definition
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Term
| What is the RR of infants? |
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Definition
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Term
| What do you do during an ACUTE ASTHMA ATTACK? |
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Definition
| FIRST PRIORITY INTERVENTION: Give breathing treatment A.S.A.P |
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Term
| What steps should you take when using bag-valve mask ventilation? |
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Definition
1. Takes universal precautions
2. Connects the bag-valve-mask to an oxygen supply
3. Selects a properly sized mask for the patient
4. Opens the airway by employing the head-tilt/chin-lift or jaw-thrust maneuver
5. Positions self behind the head of the patient
6.Positions the mask over the patient's face, with the apex of the mask positioned over the bridge of the nose and the base resting between the lower lip and the projection of the chin
7.With one hand, firmly holds the mask to the patient's face, ensuring a good seal
8.Squeezes the bag slowly and as completely as possible to move air into the patient's lungs
9.Watches for chest rise and auscultates the lung fields to assure proper ventilation |
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Term
| What does bradycardia cause? |
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Definition
HYPOXIA
always hypoxia in child or infant until proven otherwise |
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Term
| What should you start with in children suffering from bradycardia? |
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Definition
| In children, don’t start with compressions in CPR -> provide airway support 1st. |
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Term
| What is the oxygen in a nasal canula? |
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Definition
flow rate 1-6 LPM, 24-44 percent oxygen concentration
victims with difficulty breathing, sometimes used for victims unable to tolerate a mask. Available in adult and pediatric sizes. |
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Term
| What is the oxygen in a resuscitation mask? |
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Definition
| flow rate 6 -15 LPM, 35-55 percent oxygen concentration breathing and non-breathers |
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Term
| What is the oxygen in a non-rebreather mask? |
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Definition
| flow rate 10-15 LPM, up to 90 percent oxygen concentration. breathing victims only |
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Term
| What is the oxygen in a bag and mask? |
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Definition
| flow rate 15 LPM or more, 90+ percent oxygen concentration, victims with difficulty breathing and non-breathing victims |
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Term
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Definition
| Musical sound on inspiration |
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Term
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Definition
| Musical sound on expiration |
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Term
| What else should you listen for in asthmatic patients? |
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Definition
Rochi/rales - popping nonmusical sounds
Listen to all 4 quadrants |
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Term
| What is the supraglottic area? |
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Definition
| nose, naso-oropharynx, hypopharynx, epiglottis (hear sound during inspiration when this area is edematous |
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Term
| What is the glottis area? |
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Definition
| vocal cords, immediate subglottic, cervical trachea (neutral in stridor evaluation, equal inspiratory and expiratory) |
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Term
| What is the intrathoracic airway? |
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Definition
| thoracic trachea, bronchi, broncioles (small airway collapse cause expiratory wheeze |
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Term
| What are the nursing diagnoses r/t obstruction of airway in children? |
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Definition
Cyanosis
Unstable vital signs
Inc or Dec HR and/or BP
Increase RR
Labored Respiration, retractions, accessory muscle use
Stridor upper airway sounds
Decreased compliance with assisted ventilation |
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Term
| How do you manage airway obstruction? |
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Definition
Open airway
Sitting position
oxygen
Head lift neutral position
chin lift
Oral airway - in unconsciousness
Nasal airway
endotrachial tube
tracheostomy |
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Term
| What is the leading cause of chronic illness in children/ |
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Definition
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Term
| What is asthma a response to? |
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Definition
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Term
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Definition
Viral diseases
Environmental changes
Drugs
Stress
Food additives |
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Term
| What are the characteristics of asthma? |
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Definition
Airway obstruction or narrowing
Airway inflammation
Airway hyper-responsiveness
Consider the absolute smallness of the airway anatomy |
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Term
| What ethnicity is at a higher risk for asthma? |
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Definition
| Black children have a 26% higher asthma rate than white children. In 1995, |
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Term
| Which child is a greater risk for asthma: breast fed or non breast fed? |
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Definition
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Term
| WHy should you avoid feeding solid food to infants until they are 6 months old? |
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Definition
| Aspiration risk and allergies |
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Term
| When is there an increased risk of becoming allergic to certain substances in the air? |
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Definition
| When a child is exposed to them shortly after birth. |
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Term
| What can exposure to dust mites trigger? |
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Definition
| . Development of allergies to house dust mites—microscopic creatures related to spiders that are found in large quantities inside the home—has been linked to the amount of early exposure to these mites |
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Term
| What can reduce the risk of allergy induced asthma? |
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Definition
-Use zippered, plastic covers on pillows and crib mattresses and wash bedding in hot water weekly to kill dust mites
-carpets, upholstered furniture or objects that collect dust should be removed from the infant’s bedroom.
-Avoid exposing infants from allergic families to animals with fur, including dogs, cats, rabbits and other rodents |
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Term
| Should you smoke during pregnancy? |
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Definition
| Don’t smoke during pregnancy, and avoid exposing your infant to smoke. |
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Term
| What does smoking during pregnancy increase? |
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Definition
increased
wheezing during infancy in the children of smokers. Exposing children to |
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Term
| What is secondhand smoke r/t? |
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Definition
| shown to increase asthma and other chronic respiratory illnesses during childhood |
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Term
| What happens during as asthma attack? |
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Definition
1.)Cells in the air tubes make more mucus than normal. This mucus is very thick and sticky, and tends to clog up the tubes.
2.)Cells in the airways get inflamed, causing the air tubes to swell.
3.)The muscles around the air tubes tighten. |
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Term
| What are triggers of allergy induced asthma? |
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Definition
| house dust mites, cat dander, dog dander, cockroach feces, molds, and pollens (from trees, grasses and weeds). Irritants which may trigger asthma include tobacco smoke, strong odors (perfumes, cleaning products) and pollutants (sulfur dioxide). Other triggers of asthma episodes are exercise (especially in cold, dry air), viral respiratory tract infections (such as the common cold), medications (such as aspirin and beta-blockers), and chemicals (such as sulfites in wine). |
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Term
| What are the leading cause of acute asthmatic episodes? |
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Definition
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Term
| What are the goals of therapy r/t asthma? |
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Definition
Prevent chronic and troublesome symptoms
Maintain "normal" lung function
Maintain normal activity levels (including exercise and other physical activity)
Prevent recurrent episodes of asthma
Minimize (ideally eliminate) the need for emergency department visits or hospitalizations
Provide optimal medications with minimal or no side effects
Meet patients' and families' expectations of satisfaction with asthma care |
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Term
| What is intermittent asthma? |
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Definition
| A child is defined as having intermittent asthma if he or she has asthma with minimal symptoms and infrequent asthma flares. |
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Term
| What are the characteristics of intermittent asthma? |
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Definition
Symptoms of asthma occur two or fewer times per week
●Asthma does not interfere with daily activities
●Awakenings during the night due to asthma symptoms occur two or fewer times per month
●Asthma flares require oral glucocorticoids (also called corticosteroids or steroids) no more than once per year |
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Term
| What is persistent asthma? |
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Definition
| Children with persistent asthma have symptoms regularly. There may be days when activities are limited due to asthma symptoms, and the child may be awakened from sleep. Lung function is usually normal between episodes, but becomes abnormal during an asthma attack. Persistent asthma can be mild, moderate, or severe. |
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Term
| What are the characteristics of persistent asthma? |
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Definition
●Symptoms, such as cough, wheeze, or shortness of breath
●Awakenings during the night due to cough or wheeze
●Use of a bronchodilator (reliever medication)
●Symptoms that affect the child's ability to participate in normal activities |
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Term
| What is used as a rescue inhaler? |
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Definition
| Bronchodilators — Short-acting bronchodilators (also called beta-2 agonists) relieve asthma symptoms rapidly by relaxing the muscles around narrowed airways |
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Term
| What is an example of a bronhcodilator? |
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Definition
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Term
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Definition
| use compressed air to change a medication from liquid form to a fine spray that can be inhaled through a mask or mouthpiece |
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Term
| What is a metered dose inhaler? |
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Definition
| Metered-dose inhalers dispense liquid or fine powder medications, which mix with the air that is breathed into the lungs. |
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Term
| What are the side effects of bronchodilators? |
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Definition
| Some children feel shaky, have an increased heart rate, or become hyperactive after using a short-acting bronchodilator. The side effects often decrease over time. |
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Term
| What is the controller medication for asthma? |
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Definition
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Term
| How do inhaled gluccocorticoids work? |
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Definition
| reducing swelling and sensitivity of the bronchial tubes, thereby reducing their exaggerated reaction to asthma triggers. These medications are the preferred treatment for persistent asthma. Regular treatment with an inhaled glucocorticoid medication can reduce the frequency of symptoms (and the need for inhaled bronchodilators), improve quality of life, and decrease the risk of a serious asthma attack. |
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Term
| What are the effects of glucocorticoids? |
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Definition
-oral candidas
-modest growth reduction in children |
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Term
| What is a combination drug used to treat asthma? |
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Definition
| an inhaled corticosteroid (which decreases airway inflammation) and a long-acting bronchodilator (beta2-agonist) |
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Term
| When is the combination used? |
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Definition
| Combination therapy is used as step up therapy for children not well controlled on inhaled glucocorticoids |
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Term
| Why is the combination preferred to just steroids? |
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Definition
| addition of a long-acting beta2-agonist results in superior asthma control compared with doubling the dose of the inhaled steroid |
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Term
| Who uses systemic corticosteroids? |
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Definition
| reserved for those patients with the most severe form of asthma. |
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Term
| What is an example of corticosteroids? |
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Definition
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Term
| What is the risk with leukotriene modifiers? |
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Definition
| There are worries that montelukast might be linked to an increase in side effects like mood changes and aggressive behavior. Parents should notify the child’s healthcare provider if any changes in mood or behavior occur after starting this medication |
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Term
| What is leukotriene modifiers good in treating? |
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Definition
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Term
| What is the emergency care plan associated with asthma? |
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Definition
-quick acting reliever medication
-call 911 |
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Term
| What is the advantage to calling 911? |
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Definition
●From the moment EMS personnel arrive, they can begin evaluating and treating asthma. If a parent drives to the hospital, treatment cannot begin until the child arrives at the emergency department.
●If a dangerous complication of asthma occurs on the way to the hospital, EMS personnel may be able to treat the problem immediately. |
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Term
| What is given after an asthma attack? |
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Definition
| Following an asthma attack, most children are given a 3- to 10-day course of an oral glucocorticoid medication (eg, prednisone, prednisolone). This treatment helps to decrease the swelling and mucus production in the lungs and reduces the risk of a second asthma attack. |
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Term
| What are indicators of poor controlled asthma? |
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Definition
Awakened at night with symptoms
An urgent care visit
Pt has inc. need for rescue inhaler
Assess:
Compliance
Environment
Inhaler technique
Other disease process |
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Term
| What is nocturnal asthma? |
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Definition
| Most common respiratory disease in childhood |
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Term
| What causes nocturnal asthma? |
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Definition
Unknown etiology
May be allergies, reflux, position, decresed volume of circulating epinephrine
Use environmental allergy control |
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Term
| 7 y/o w/ tachypnetic, afebrile, and a respiratory rate of 36 BPM. What’s happening? |
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Definition
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Term
| School age child is getting 2 L of O2 via nasal canula. How often should you check his O2 SAT? |
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Definition
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Term
| 19 y/o has acute asthma, respiratory rate is 44 BPM and is in acute respiratory distress. What should you do first? |
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Definition
| GIVE BRONCHODILATOR BY NEBULIZER |
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Term
| Emergency treatment of a client in status asthmaticus includes which of the following? |
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Definition
| INHALED BETA ADRENERGIC AGENTS = RESCUE |
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