Peds > respiratory function (1) > Flashcards

respiratory function (1) Flashcards

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1
Q

chronic inflammatory disorder of the airway, airway has increased responsiveness to stimuli

A

asthma

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2
Q

what do bronchioles do in asthma

A

constrict

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3
Q

in asthma, exposure to triggers causes cells in the airway to release what?

A

proinflammatory chemical mediators (histamine, prostaglandins, and leukotrines)

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4
Q

what are symptoms of asthma exacerbation?

A
  • dyspnea/tachypnea
  • insp/exp wheezing
  • use of accessory muscles
  • cough
  • discomfort, irritbility, restlessness, anxiety
  • chest tightness
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5
Q

which of the following are asthma triggers?
a)exercise
b)food additives
c) emotions
d) temp chamges
e) all

A

all

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6
Q

what does the diagnosis of asthma include?

A
  • symptoms of wheezing/obstruction
  • improvement of wheezing/obstruction with short acting beta adrenergic and oral corticosteroid med
  • exclusion of other diagnosis
  • pulmonary function testing (spirometry) assess airway function (older than 5-6 years) (need to follow directions)
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7
Q

What meds would be used for status asthmaticus

A
  • albuterol
  • methylprednisolone or IV solumedrol
  • prednisone or prednisolone orally
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8
Q

which asthma med is a beta adrenergic blocker that causes bronchodilation

A

albuterol

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9
Q

which asthma meds decrease inflammation?

A

prednisone/prednisolone/methylprednisolone

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10
Q

what are the 2 ways albuterol can be given?

A

nebulizer/MDI

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11
Q

steps of using MDI with mask

A
  1. shake 30 sec
  2. put mask on
  3. push first puff
  4. take 6 breaths
  5. wait 30 sec between puffs
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12
Q

steps for using MDI with only spacer and mouthpiece (no mask)

A
  1. shake 30 sec
  2. slow deep breath, let out
  3. put mouthpiece in, push first puff
  4. slow breath 3-5 sec
  5. hold 10 sec
  6. wait 30 sec between puffs
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13
Q

what are the ages for mouthpieve vs. mask for MDI

A

mask used up to 5 y.o., then mouthpiece

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14
Q

what is the purpose of albuterol

A

relax bronchial smooth muscle

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15
Q

side effects of albuterol

A
  • tachycardia
  • nervousness
  • nausea
  • headachesa
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16
Q

how long are oral corticosteroids usually used for?

A

5 days

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17
Q

what asthma meds decrease inflammation

A

oral corticosteroids

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18
Q

what asthma meds inhibit bronchoconstriction?

A

anticholinergics

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19
Q

what meds are used short term MDI with exacerbation of asthma

A

anticholinergics

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20
Q

what is the onset of anticholinergics?

A

30-90 min

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21
Q

what is the most effective long-term control therapy for asthma

A

inhaled corticosteroids

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22
Q

how are inhaled corticisteroids administered

A

MDI with spacer

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23
Q

what can inhaled corticosteroids cause?

A

thrush and dyspnea

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24
Q

what is important to do after inhaled steroid use

A

rinse mouth

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25
what is the purpose of leukotrine receptor antagonist?
prevent asthmatic episodes
26
what is an objective assessment of signs and symptoms of asthma
pediatric asthma score
27
what is looked at for a pediatric asthma score?
respiratory rate, oxygen, retractions, dyspnea, auscultation
28
what is a history of coughing, breathlessness, chest pain, or wheezing during and after exercise
exercise induced bronchospasm
29
what prevents exercise induced bronchospasm
albuterol immediately prior to exercise prevents and provides relief for 2-4 hours
30
what is chronic lung disease called
bronchopulmonary dysplasia (BPD)
31
how long is supplemental oxygen needed after premature birth?
28 days at least
32
describe alveoli with BPD
* fewer and larger with less functional area * fibrosis if alveoli
33
what is the severity of BPD determined by?
respiratory support interventions required at birth and long term
34
what are characteristics of BPD
persistent signs of increased resp effort (tachypnea/dyspnea, retractions, flaring, grunting, irritability, wheeze/crackle, edema, failure to thrive)
35
clinical theraoy of BPD
* symptom treatment that supports resp function * good nutrition which accelerates lung maturity
36
can BPD be outgrown?
yes, with lung development
37
what can BPD turn into
asthma (chronic lung disease)
38
what meds are used for BPD
* bronchodilators * corticosteroids * diuretics to remoce excess fluid
39
what is synagis
injection used for BPD
40
what problem is a defective CFTR involved in?
cystic fibrosis
41
what kind if things does a defective CFTR protein cause?
* sodium/chloride problems * secretions thickened * airway obstructions * ciliary action and cough
42
how is cyctic fibrosis inherited
autosomal recessive, inherits from both oarents
43
what is the incidence of cystic fibrosis
1:4
44
is gender a factor in cyctic fibrosis?
No
45
is cystic fibrosis curable?
no
46
what high screening is indicative for cystic fibrosis
immunoreactive trypsinogen (IRT)
47
when is the second IRT for CF done?
2-3 weeks
48
what is the "gold standard" for CF diagnosis?
sweat chloride test by pilocarpine iontophoresis
49
when is genetic testing done for CF?
whena adulta have positive family history, to the partner of a CFer, and to identify carriers
50
which of the following is accurate regarding clinical manifestations of CF? a) secretions very thick b) decreased ciliary action in resp tract c) increased obstruction with mucus d) effective cough e) frequent resp infections
a, b, c, e
51
you might expect which symptoms with CF? a) chronic harsh cough b) wheezes, crackles c) stridor d) clubbing if fingers
a, b, d
52
which of the following are manifestations of CF? 1. foul smelling flatulus 2. excess stool fat 3. difficulty maintaining weight 4. meconium ileus 5. constipation
all
53
what body systems does CF eventually effect?
all
54
describe pancreas in CF
* thickened mucous damages pancreatic ducts and obstructs enzymes to digest fats, fat soluble vitamins, and proteins * produces inadequate insulin (diabetes)
55
which vitamins are deficient in CF
A,D,E,K (fat soluble)
56
what kind of diet are people with CF on?
high calorie diets
57
CF effects on reporductive system in females?
* fallopian/ovaries uneffected * fertility inhibited due to thick secretions and decreased cervical secretions
58
CF effects on reproductive system in men?
sterile due to blockage or abscence of vas deferens
59
effects of CF on sweat glands
* skin salty due to high sodium and chloride in sweat * loss of electrolytes in sweat, saliva, and mucous * at risk for hyponatremia
60
what does bronchial hygeine therapy include?
* chest physiotherapy * therapy vest
61
chest physiotherapy vs. therapy vest
* physiotherapy= for infants and toddlers, percussion and vibration of multiple areas of lung in different position * therapy vest= hugh frequency chest wall oscillation (older than 4 y.o.)
62
what is the order of aerosol meds given for CF?
1. bronchodilator 2. hypertonic 7% NS (to mobilize mucus/improve airway) 3. dornase alfa (pulmozyme): thin secretions 4. bronchial hygeine therapy 5. inhaled antibiotics 6. inhaled steroid
63
should people with CF eat before or after their aerosol/hygeine routine?
after
64
what is needed to help nutrition in CF?
enzymes given before all meals and snacks, will not be digested wothout
65
what kind of isolation is CF patients in?
contact/droplet
66
an exacerbation of asthma will include which? a) wheezing on inspiration and expiration b) inspiratory stridor c) dyspnea/tachypnea d) hoarse barky cough e) moist cough
A, C, E
67
how is pediatric asthma diagnosed? choose all 1. diagnosis of bronchiolitis with wheezing 2. bronchospasm 3. reversal of bronchospasm with beta adrenergic meds 4. exclusion of airway diagnosis 5. resp swab isolation 6. spirometry after 5-7 y.o.
B, C, D, F
68
what are corticosteroids used to treat in asthma?
inflammation
69
treatment of bronchopulmonary dysplasia could include which of the following? choose all 1. beta adrenergic meds 2. corticosteroids 3. high calorie formula 4. low calorie formula 5. alpha adrenergic meds 6. oxygen
1,2,3, 6
70
how many states is there a screening for cystic fibrosis in newborns?
all 50
71
what are pancreatic enzymes used to promote?
digestion and absorption of nutrients
72
which CF intervention are teens more likely to be non-compliant with in order to have more time with friends?
bronchial hygeine therapy
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