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13 Cards in this Set
- Front
- Back
Acute Epiglottitis
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Age group affected - 1-8 years
Etiologic agent - Bacterial, usually Haemophilus influenzae Onset - Rapidly progressive Major Symptoms - dysphagia (inability to swallow or difficulty in swallowing), stridor aggravated when supine, Drooling, High fever, Toxic appearance Rapid pulse and respirations Treatment - Antibiotics, Airway protection |
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Acute Laryngotracheobronchitis (LTB)
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Age Group Affected - 3 months - 8 years
Etiologic agent - Viral Onset - Slowly progressive Major Symptoms - URI, Stridor, Brassy cough, Hoarseness, Dyspnea, Restlessness, Irritability, Low-grade fever, Nontoxic appearance Treatment - Humidity, Racemic epinephrine |
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Acute Spasmodic Laryngitis
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Age Group Affected - 3 months - 3 years
Etiologic agent - Viral with allergic component Onset - Sudden; at night Major Symptoms - URI, Croupy cough, Stridor, Hoarseness, Dyspnea, Restlessness, Symptoms awaken child, Symptoms disappear during the day, tends to recur Treatment - Humidity |
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Acute Tracheitis
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Age group affected - 1 month - 6 years
Etiologic agent - Bacterial, usually Staphylococcus aureus Onset - Moderately progressive Major symptoms - URI, Croupy cough, Stridor, Purulent secretions, High fever, No response to LTB therapy Treatment - Antibiotics |
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Progression of Symptoms in Laryngotracheobronchitis (LTB)
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Stage I
Fear, Hoarseness, Croupy cough, Inspiratory stridor when disturbed Stage II Continuous respiratory stridor Lower rib retraction Retraction of soft tissue of neck Use of accessory muscles of respiration Labored respiration Stage III Signs of anoxia and carbon dioxide retention Restlessness Anxiety Pallor Sweating Rapid respirations Stage IV Intermittent cyanosis Permanent cyanosis Cessation of breathing |
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Nurse Alert
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Children with severe respiratory distress (traditionally, a respiratory rate greater than 60 breaths/min for infants) should not be given anything by mouth to prevent aspiration and decrease the work of breathing.
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Nurse Alert
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Early signs of impending airway obstruction include increased pulse and respiratory rate; substernal, suprasternal, and intercostal retractions; flaring nares; and increased restlessness.
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Viral-Induced Asthma
Description: Exaggerated response of the bronchi to infection Bronchospasm, exudation, and edema of the bronchi |
Age group affected: late infancy and early childhood
Etiologic agents: Most often viruses but may be any of a variety of URI pathogens Predominant characteristics: Wheezing, productive cough Treatment: Bronchodilators, corticosteroids |
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Bronchitis
Description: Usually occurs in association with URI Seldom an isolated entity |
Age group affected: Affects children in the first 4 years of life
Etiologic agents: Usually viral, Other agents (e.g., bacteria, fungi, allergic disorders, airborne irritants) can trigger symptoms Predominant characteristics: Persistent dry, hacking cough (worse at night) becoming productive in 2-3 days Treatment: Cough suppressants if needed |
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Bronchiolitis
Description: More common infectious disease of lower airways Maximum obstructive impact at bronchiolar level |
Age group affected: Usually children 2-12 months of age; rare after age 2
Peak incidence approximately age 6 months Etiologic agents: Viruses, predominantly respiratory syncytial viruses; also adenoviruses, parainfluenza viruses, and Mycoplasma pneumoniae Predominant characteristics: Dyspnea, paroxysmal nonproductive cough, tachypnea with retractions and flaring nares, emphysema; may be wheezing Treatment: Oxygen mist Ribavirin may be used for high risk populations |
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Nurse Alert
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Because of concerns about potential toxic or teratogenic effects, pregnant health care providers should not care for a child receiving ribavirin.
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Signs and symptoms of Respiratory Syncytial Virus (RSV)
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Initial: Rhinorrhea, Pharyngitis, Coughing/sneezing, Wheezing, Possible ear or eye drainage
Intermittent fever With Progression of Illness: Increased coughing and wheezing, Air hunger, Tachypnea and retractions, Cyanosis Severe Illness: Tachypnea, greater than 70 breaths/min, Listlessness, Apneic spells, Poor air exchange; poor breath sounds |
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Respiratory Syncytial Virus (RSV): Nursing Care Management
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Children admitted to the hospital with suspected RSV infection should be assigned separate rooms or grouped with other RSV-infected children. The most important infection control measures in caring for these infants and children are consistent handwashing and the use of contact precautions (gloves, gowns, masks, and goggles). Another measure is structuring patient assignments so that nurses assigned to children with RSV do not take care of other patients who are considered high risk.
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