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Pediatrics > Alteration in Gas Exhange/Respiratory Dx > Flashcards

Alteration in Gas Exhange/Respiratory Dx Flashcards

1
Q

What is the most common cause of illness and hospitalization in children?

A

Respiratory Disorders

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2
Q

How long are newborns typically obligatory nose breathers?

A

4 weeks of age

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3
Q

If the newborns nose is obstructed are they able to open their mouths to breath?

A

No

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4
Q

The Infants Nose

A
  • produce very little mucus which makes them more susceptible to infections
  • small nasal passages more prone to obstruction
  • sinuses are not developed
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5
Q

The Infants Throat

A
  • tongue relative to oropharynx are larger; placement can lead to obstruction
  • enlarged tonsillar and adenoid tissue which can lead to obstruction
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6
Q

Why is the capacity for air passage greatly diminished when edema, mucus, or bronchospasm is present?

A

Airway lumen is smaller

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7
Q

What results in an exponential increase in resistance to airflow causing increased work or breathing?

A

small reduction in diameter of the child airway

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8
Q

What increases the chance of aspiration of foreign material into the lower airway?

A

Congenital laryngomalacia due to funnel shape and location of the larynx

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9
Q

A child’s airway us highly compliant making it more susceptible for what?

A

dynamic collapse during airway obstruction

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10
Q

Where is the trachea located in children?

A

third thoracic vertebra

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11
Q

Where is trachea located in adults?

A

sixth thoracic vertebrae

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12
Q

Children exposed to environmental smoke have an increased risk of what?

A

Respiratory illnesses such as asthma, bronchitis, and pneumonia

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13
Q

Prolonged expiration is a sign of what?

A

bronchial or bronchiolar obstruction

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14
Q

Wheezing

A

high pitched sound on expiration

-may occur w/ obstruction in lower trachea or bronchioles

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15
Q

Rales

A

crackling sound heard when alveoli become fluid filled

-may occur w/ pneumonia

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16
Q

Lab/Diagnostic Tests ordered for Bronchiolitis

A
  • pulse oximetry
  • chest radiography
  • blood gases
  • nasal pharyngeal washings
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17
Q

A chest radiography may reveal what for bronchiolitis?

A

hyperinflation and patchy areas of atelectasis or infiltration

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18
Q

Blood Gases test may show what for bronchiolitis?

A

carbon dioxide retention and hypoxemia

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19
Q

Lab/Diagnostic Tests for Pneumonia

A
  • pulse ox
  • chest x-ray
  • sputum culture
  • white blood cell count
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20
Q

Lab/Diagnostic Tests for Cystic Fibrosis

A
  • sweat chloride test
  • pulse ox
  • chest radiograph
  • pulmonary function test
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21
Q

Common medical treatments for respiratory disorders are?

A
  • oxygen
  • high humidity
  • suctioning
  • chest physiotherapy/postural drainage
  • saline gargles/lavage
  • chest tubes
  • bronchoscopy
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22
Q

Chest Physiotherapy

A

promotes mucus clearance through percussion and vibration

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23
Q

Suctioning

A

removes secretions via bulb syringe or suction catheter

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24
Q

Chest Tubes

A

remove air or fluid through a drain inserted into the pleural cavity

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25
Q

Bronchoscopy

A

intro of a bronchoscope into the bronchial tree for diagnostic purposes

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26
Q

Acute Infectious Disorders

A
  • common cold, sinusitis
  • influenza
  • pharyngitis, tonsillitis, laryngitis
  • croup syndromes
  • RSV (respiratory syncytial virus)
  • pneumonia and bronchitis
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27
Q

Nursing Management for the Common Cold

A
  • symptom relief
  • promote comfort
  • provide family education
  • prevent spread of cold
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28
Q

Sinusitis Symptoms

A
  • cough
  • fever
  • halitosis
  • facial pain
  • eyelid edema
  • irritability
  • poor appetite
29
Q

Severe Influenza Infection

A
  • chronic heart or lung disease
  • diabetes
  • chronic renal disease
  • immune deficiency
  • children w/ cancer receiving chemo
30
Q

Pharyngitis History of Symptoms

A
  • fever
  • sore throat
  • difficulty swallowing
  • headache
  • abdominal pain
31
Q

Nursing Care Post-Tonsillectomy

A
  • promote airway clearance by placing child on side or prone
  • encourage fluids
  • avoid citrus, brown, or red fluids
  • discourage coughing
  • pain relief w/ ice collar and analgesics w/ or w/o narcotics
32
Q

Nursing Management for Mono

A
  • analgesics
  • salt water gargles
  • bed rest
  • rest periods
  • avoid contact sports
33
Q

Croup

A
  • upper airway infection
  • barky-seal like cough
  • significant stridor at rest
  • severe retractions after several hour period of observation
34
Q

Epiglottitis

A
  • inflammation and swelling of epiglottis
  • most often seen b/t ages of 2-7
  • life threatening
  • maintain patent airway
  • IV antibiotics
  • ICU
35
Q

What is Epiglottitis often caused by?

A

Haemophilus influenzae B

36
Q

Nursing Management for Epiglottitis

A
  • do NOT attempt to visualize the throat
  • do NOT leave unattended
  • do NOT place in supine position
  • provide 100% oxygen in least invasive manner
  • ensure emergency equipment is available
37
Q

If complete airway occlusion occurs with Epiglottitis what intervention may be necessary?

A

Tracheostomy

38
Q

S/S of Bronchiolitis (RSV)

A
  • onset of illness w/ a clear runny nose
  • pharyngitis
  • low grade fever
  • development of cough 1-3 days into the illness, followed by a wheeze shortly after
  • poor feeding
39
Q

Pneumonia

A

inflammation of the lung parenchyma caused by a virus, bacteria, Mycoplasma, or fungus

40
Q

What is the most common cause of pneumonia in younger children?

A

Respiratory virus

41
Q

What is the most common type of bacterial pneumonia in all ages?

A

Streptococcus pneumoniae

42
Q

What is the most common type of bacterial pneumonia specifically for school-age and adolescents?

A

M. pneumoniae

43
Q

Risk factors for Tuberculosis

A
  • HIV infection
  • incarceration or institutionalization
  • positive recent history of latent TB infection
  • immigration or travel to endemic countries
  • exposure at home to HIV-infected or homeless persons, illicit drug users, persons recently incarcerated, migrant farm workers, nursing home residents
44
Q

Acute Non-infectious Disorders

A
  • epistaxis
  • foreign body aspiration
  • RDS
  • ARDS
  • Pneumothorax
45
Q

What is the most important nursing intervention for foreign body aspiration?

A

Prevention

46
Q

Respiratory Distress Syndrome (RDS)

A
  • respiratory disease specific to neonates
  • immature lungs/deficiency in surfactant
  • intensive respiratory care
  • mechanical ventilation
  • new techniques for ventilator support
47
Q

Acute Respiratory Distress Syndrome (ARDS)

A
  • sepsis
  • viral pneumonia
  • smoke inhalation
  • drowning
  • ICU
48
Q

What occurs acutely w/in 72 hours of the insult of ARDS in infants/children w/ previously healthy lungs?

A

Respiratory distress and hypoxemia

49
Q

Pneumothorax

A
  • collection of air in the pleural space
  • chest trauma or surgery
  • intubation and mechanical ventilation
  • history of chronic lung disease such as cystic fibrosis
50
Q

S/S for a Pneumothorax

A
  • chest pain
  • respiratory distress
  • tachypnea
  • retractions
  • nasal flaring
  • grunting
51
Q

Risk Factors for a Pneumothorax

A
  • chest trauma or surgery
  • intubation and mechanical ventilation
  • hx of chronic lung disease such as cystic fibrosis
52
Q

Chronic Respiratory Disorders

A
  • allergic rhinitis
  • asthma
  • chronic lung disease
  • cystic fibrosis
  • apnea
53
Q

Medications

A
  • anti-inflammatory inhaled meds
  • short-acting bronchodilators
  • supplemental long-term oxygen therapy may be required
54
Q

Asthma

A

chronic inflammatory airway disorder characterized by hyperresponsiveness, airway edema, and mucus production

55
Q

Teaching for Asthma

A
  • nebulizers
  • metered-dose inhalers
  • spacers
  • dry-powder inhalers
  • diskus
56
Q

Cystic Fibrosis

A
  • autosomal recessive disorder

- thickened, tenacious secretions in the seat glands, GI tract, pancreas, resp tract, etc

57
Q

What is the most common debilitating disease of childhood among those of European descent?

A

Cystic Fibrosis

58
Q

S/S of Cystic Fibrosis

A
  • salty taste to the skin
  • meconium ileus
  • abdominal pain
  • bulky, greasy stools
  • poor weight gain
  • chronic cough
59
Q

Apnea

A

absence of breathing for longer than 20 seconds

60
Q

How often do you perform tracheostomy care?

A

8 hours

61
Q

What is the life expectancy for someone with cystic fibrosis?

A

30

62
Q

Epiglottitis S/S

A
  • high fever
  • toxic appearance
  • may refuse to speak or speak softly
  • refuses to lie down
  • sits forward w/ neck extended
63
Q

Allergic Rhinitis

A

common chronic condition in childhood, associated w/ atopic dermatitis and asthma
-intermittent or persistent inflammatory state

64
Q

What is treatment for Allergic Rhinitis aimed at?

A

decreasing response to allergic mediators as well as treating inflammation

65
Q

S/S of Allergic Rhinitis

A
  • red-rimmed eyes or tearing
  • mild eyelid edema
  • “allergic shiners” (blue/grayish cast below eyes)
  • “allergic salute” (nasal crease from rubbing)
66
Q

What is therapeutic management of cystic fibrosis aimed at?

A

minimizing pulmonary complications
maximizing lung function
preventing infection
facilitating growth

67
Q

All children with cystic fibrosis who have pulmonary involvement require what?

A

chest physiotherapy and postural drainage several times daily to mobilize secretions from the lungs

68
Q

Nursing Management for Cystic Fibrosis

A
  • maintain patent airway
  • prevent infection through vigorous pulmonary hygiene
  • maintain growth
  • promote family coping

Pediatrics (24 decks)

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