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13 Cards in this Set

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Acute Epiglottitis
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
Acute Laryngotracheobronchitis (LTB)
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
Acute Spasmodic Laryngitis
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
Acute Tracheitis
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
Progression of Symptoms in Laryngotracheobronchitis (LTB)
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
Nurse Alert
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.
Nurse Alert
Early signs of impending airway obstruction include increased pulse and respiratory rate; substernal, suprasternal, and intercostal retractions; flaring nares; and increased restlessness.
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
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
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
Nurse Alert
Because of concerns about potential toxic or teratogenic effects, pregnant health care providers should not care for a child receiving ribavirin.
Signs and symptoms of Respiratory Syncytial Virus (RSV)
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
Respiratory Syncytial Virus (RSV): Nursing Care Management
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.