Chapter 40- The Child With Respiratory Dysfunction

Front 1

Infectious mononucleosis

Back 1

An acute self-limiting infectious disease that is common among people younger than 25 years of age

Front 2

Mononucleosis etiology

Back 2

The Epstein-Barr virus is the primary cause of infectious mononucleosis

Front 3

Diagnostic test for mononucleosis

Back 3

*Heterophile antibody test determine the extent to which the patient serum will agglutinate cheap red blood cells.

*The spot test also known as mono spot is a slide test a venous blood that has high specificity. It is rapid, sensitive, inexpensive, and easy to perform and have the advantage over the Paul Bunnell test in that it can detect significant agglutions

at lower levels, thus

Front 4

Infectious mononucleosis

Back 4

An acute self-limiting infectious disease that is common among people younger than 25 years of age

Front 5

Acute epiglottis

Back 5

An acute medical emergency. A serious obstructive inflammatory process that occurs predominantly in children 2 to 5 years of age

Front 6

Causes of acute epiglottis

Back 6

The primary organism responsible is usually h influenzae

Front 7

Clinical manifestations of acute epiglottis

Back 7

*Rapid Progressive onset

*dysphagia

*Strider aggravated when supine *drooling,

*high fever,

*toxic appearance,

* rapid pulse and respiration.

* 3 clinical observations that are predictive of epiglottis or absence of spontaneous cough, presence of drooling, and agitation

Front 8

How will a child with acute epiglottitis present and what are some subjective findings

Back 8

*The child will have an Abrupt onset with a rapid progression to severe respiratory distress.

*The child usually goes to bed asymptomatic to awaken later complaining of sore throat and pain while swallowing.

* The child has a fever and appears sicker than clinical findings suggest and insist on sitting upright and leaning forward with the chin thrust out, mouth open, and tongue protruding. This is known as the tripod position.

*The child will be irritable and extremely restless and anxious with apprehension and frightened expression.

*The Voice will be thick and my muffled with a frog like croaking sound on inspiration.

*The throat is red and inflamed in a distinctive large cherry red edematous epiglottis is visible what throat inspection

Front 9

When should the child with epiglottitis be examined?

Back 9

Throat inspection should be attempted only by experienced Personnel when equipment is available to proceed with the immediate intubation or tracheostomy. There should be emergency Airway equipment readily available

Front 10

What type of inspection is contraindicated in a child with acute epiglottis?

Back 10

Examination of the throat with a tongue depressor is contraindicated until experienced personnel and Equipment are available to proceed with immediate intubation or tracheostomy

Front 11

Treatment for acute epiglottis

Back 11

Airway protection

corticosteroids- to reduce edema

fluid antibiotics

reassurance

Humidified oxygen

Front 12

Therapeutic care for a acute epiglottis

Back 12

Epiglottis is a serious and frightening disease. It is important to act quickly and calmly provide reassurance without increasing anxiety. The child is allowed to remain in the position that provides the most comfort and security.

Front 13

Acute laryngotracheobronchitis LTB

Back 13

The most common croup syndrome. It affects primarily children 6 months to 3 years of age

Front 14

Causes of acute laryngotracheobronchitis

Back 14

Viral agent particularly the parainfluenza virus has 1, 2, and 3, adenovirus, enterovirus, RSV, rhinovirus, and influenza A and B. Bacterial organisms are rarely a causative organism but can include M pneumonia and diphtheria

Front 15

Signs and symptoms of LTB

Back 15

Slow Progressive onset, URI, Strider, Brassy cough, hoarseness, dyspnea, restlessness, irritability, low grade fever, non-toxic appearance

Front 16

How will a child with LTB prevent?

Back 16

It is characterized by a gradual onset of low-grade fever, and the parents often report that the child went to bed and later awoke with a brassy, barky cough. The child struggles to inhale air pass the obstruction into the lungs the typical child with LTB develop The Classy barking or seal like cough

Front 17

Therapeutic management for LTB

Back 17

The application of humidity with cool mist provide some relief for most children with mild croup. A cool air vaporizer can be used at home. In the hospital, a nebulizer must may be used for older infants and toddlers and May provide increase humidity and supplemental oxygen. A ride in the car with the windows down may help relieve symptoms as well.

Nebulized epinephrine for severe cases

Oral steroids

Front 18

What is the most important nursing function in the care of children with LTB?

Back 18

Continuous Vigilant observation and accurate assessment of respiratory status. Cardiac, respiratory, and pulse oximetry monitoring supplement visual observation

Front 19

What are early signs of impending Airway obstruction?

Back 19

Increase pulse and respiratory rate, substernal, suprasternal, and intercostal retractions. Flaring of Nares and increase restlessness

Front 20

Acute spasmodic laryngitis also known as spazmatic croup

Back 20

A disease of the croup syndrome. It is characterized by recurrent paroxysmal attacks of laryngeal obstruction that occur chiefly at night

Front 21

Signs and symptoms of acute spasmodic laryngitis

Back 21

Sudden onset at night, URI, croupy cough, stridor, hoarseness, dyspnea, restlessness, symptoms Awakening child but disappearing during the day, signs of inflammation are absent or mild.

Front 22

Bronchitis

Back 22

Sometimes referred to as tracheobronchitis, an inflammation of the large Airways the trachea and bronchi, which is frequently associated with upper respiratory infections

Front 23

Clinical manifestations of bronchitis

Back 23

Persistent dry, hacking cough that's worse at night, becoming productive in 2 to 3 days,

Front 24

Treatment for bronchitis

Back 24

Bronchitis is a mild, self-limiting disease that requires only symptomatic treatment including analgesics, antipyretics, and humidity. Cough suppressants may be useful to allow rest but can interfere with the clearance of secretions. Most patients recover uneventfully and 5 to 10 days

Front 25

Bronchiolitis

Back 25

Most common infectious disease of the lower Airways. Infection and inflammation of the bronchioles

Front 26

Signs and symptoms of bronchiolitis

Back 26

Labor respirations, poor feeding, cough, tachypnea, retractions, nasal flaring, emphysema, increased nasal mucus, may have fever

Front 27

Who does bronchiolitis most commonly affect and when does it most commonly occur

Back 27

Usually children 2 to 12 months of age with Peak incidence around 6 months of age in addition the infections occur primarily in the winter and early spring

Front 28

Causes of bronchiolitis

Back 28

Predominantly RSV

Front 29

Pathophysiology of RSV with bronchiolitis

Back 29

RSV affects the epithelial cells of the respiratory tract the walls of the bronchi and bronchioles or infiltrated with inflammatory cells, and varying degrees of intraluminal obstruction lead to hyperinflation, obstructive emphysema resulting from partial obstruction,

Front 30

Pneumonia

Back 30

Inflammation of the pulmonary parenchyma. May occur as a primary disease or complication of another illness

Front 31

Viral pneumonia

Back 31

Occurs more frequently than bacterial pneumonia. Can be caused by RSV, parainfluenza, influenza, enterovirus, adenovirus.

Front 32

Signs and symptoms of pneumonia

Back 32

Cough, tachypnea, crackles with diminished breath sounds, dullness with percussion, chest pain, retractions, nasal flaring, pallor to cyanosis.

May also see irritability, restlessness, malaise, lethargy.

Gastro we'll see anorexia, vomiting, diarrhea, abdominal pain

Front 33

What will pneumonia look like on a chest x-ray?

Back 33

Diffuse or patchy infiltration with Perry Bronco distribution

Front 34

What is the treatment for viral pneumonia

Back 34

Treatment is symptomatic and includes measures to promote oxygenation and comfort, such as oxygen Administration with cool mist, postural drainage, antipyretics for fever management, monitoring fluid intake, and family support.

Front 35

Atypical pneumonia

Back 35

Refers to pneumonia that is caused by pathogens other than the traditionally most common and readily culture bacteria is. M pneumonia is the most common cause of community-acquired pneumonia.

Front 36

Bacterial pneumonia

Back 36

Pneumonia caused by a bacteria

Front 37

How are bacterial pneumonia is distinct from other forms of pneumonia

Back 37

The onset is abrupt and generally follows a viral infection that disturbs the natural defenses. The child will appear suddenly ill. Symptoms include fever, malaise, rapid and shallow respiration, cough and chest pain.

Front 38

Where is pneumonia pain sometimes referred to in young children?

Back 38

In the abdomen

Front 39

Complications of pneumonia

Back 39

Empyema pyopneumothorac, tension pneumothorax. Aom and pleural effusion are common in children with pneumococcal pneumonia

Front 40

Treatment for complications of pneumonia such as pneumothorax

Back 40

Continuous closed chest drainage may be instituted when per unit fluid is aspirated. If a large amount of purulent drainage is obtained, and appropriate antibiotic may be and still into the chest cavity, and chest drainage is discontinued after approximately one hour after the installation. Closed drainage via a chest tube is continue until drainage what is the minimum.

Front 41

Care of the child with pneumonia

Back 41

primarily supportive asymptomatic but Necessities through respiratory assessment and administration of fluid and antibiotics may be needed

Front 42

Nursing interventions for pneumonia

Back 42

Assess respiratory status oxygenation, General disposition, and level of activity. Prevent dehydration, fluids are frequently administered intravenously. Fluid intake is encouraged. If chest tube is in place Ensure chest tube and drainage device or monitor and vacuum setting is correct, tubing is free and a king, dressing covering the chest tube insertion site is intact, Water Seal is maintained..

Front 43

pertussis whooping cough

Back 43

An acute respiratory infection caused by B. Pertussis. It is highly contagious.

Front 44

What position should you place a child in respiratory distress

Back 44

Children place in semi-erect positions are often more comfortable and this position and enhances diaphragm expansion. However the child should be allowed and whatever position makes them the most comfortable

Front 45

Treatment of pertussis

Back 45

Most children can be managed at home and Care is supportive in nature. Encourage adequate hydration and administer antipyretics. When coughing spasms occur they can be frightening for the patient and family

Front 46

Tuberculosis in children

Back 46

An infectious disease caused by m tuberculosis, a acid fast bacillus

Front 47

Latin TB

Back 47

Used to indicate infection in a person who has a positive CST, no physical findings of disease and normal chest x-rays.

Front 48

Foreign body aspiration

Back 48

When a foreign body is aspirated into a part of the respiratory tract and causes obstruction

Front 49

Cardinal signs of choking for foreign body aspiration

Back 49

The chow and severe distress, can I speak, becomes cyanotic, and collapses. These three signs indicate the child is truly stroke choking and requires immediate action because the child can die within 4 minutes.

Front 50

Diagnostic studies for foreign body aspiration

Back 50

Mainly done off the basis of history and physical signs. Choking, gagging, wheezing or coughing may be present. Laryngeal tracheal obstruction most commonly causes dyspnea oh, cough, stridor, and horsnesses because of decreased air entry. Cyanosis may occur if the instruction becomes worse. When an object is lodged into the larynx the child is unable to speak or breathe