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69 Cards in this Set
- Front
- Back
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Acute otitis media
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Rapid onset - can last 3 weeks
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Otitis media with effusion
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Inflammation and fluid buildup in middle ear
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Chronic otitis media with effusion
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**middle ear effusion lasting more then 3 months with feeling of fullness in ear**
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Causes of otitis media
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GER, URI, allergies
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What environmental factor can cause otitis media?
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Second hand smoke
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What physical abnormalities are associated with otitis media?
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Cleft lip
Craniofacial abnormalities Trisomy 21 (low set ears) |
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GI symptoms of otitis media
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Diarrhea (from hypersensitivity receptors in gut)
Yellow/green stools |
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Late sign of otitis media
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Purulent discharge - may indicate ruptured TM
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Problems from chronic OM
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Hearing loss
Speech delay Tinnitis Vertigo |
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otitis media with effusion
-pain -fever |
Pain and fever absent
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Drug treatment of OM
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Antibiotics: topical or PO
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Myringotomy
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Surgical incision into the TM
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Tympanostomy
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Tubes placed in TM for drainage and ventilation
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When is a tympanostomy indicated? 3 situations
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1. When child is not responsive to antibiotics
2. Is immunocompromised 3. Has had fluid for more than 3 months |
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Bathing care for child with ear tubes?
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Use ear plugs
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What happens to tubes within a year of placement?
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Fall out
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Common cause of pharyngitis
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Infection of beta hemolytic strep URI
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Pharyngitis usually caused by
-can involve |
Viral infection
Can involve tonsils |
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Serious sequealae of pharyngitis (3)
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Rheumatic fever
Glomerulonephritis Obilterated heart valves |
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Common sx of pharyngitis
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Pain with swallowing
Tonsils covered with exudates Bad breath Stomach pain |
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Complications of pharyngitis
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Increased intracranial pressure
Meningitis Brain abcess Sinus thrombosis |
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Complications of pharyngitis
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Increased intracranial pressure
Meningitis Brain abcess Sinus thrombosis |
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Common age for pharyngitis
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Age 4-7; rare in infancy
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Dx of pharyngitis
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Strep culture (not quick test)
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When can child return to school when receiving penicillin for strep?
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In 24 h
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Main symptoms of pharyngitis
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Inflammed pharynx
Difficulty swallowing Drooling |
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Tonsillitis common cause
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A beta hemolytic strep
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Tonsillectomy contraindicated when (2)
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When tonsils are merely too big
When child is on anticoagulants |
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Tonsillectomy indicated when (3)
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When tonsils are hypertrophied
Causing DIB Repeated strep infections |
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Post op tonsillectomy diet and activity
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Quiet activity
Soft diet with liquids |
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Coughing and nose blowing after tonsillectomy
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Don't!!!!
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Observe for post op tonsillectomy
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Difficulty swallowing
Tachycardia Hemataemesis Continued swallowing |
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Croup
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Respiratory stridor, hoarseness, resonant cough, some degree of respiratory distress
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What causes croup
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An obstruction in larynx
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Two important changes in croup
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Epiglottis swells - obstructing airway
Trachea swells against cricoid cartilage - causes restriction |
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Stridor
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Turbulent air flow through narrow segment of airway
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Emergent sign associated with croup
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DIB with acute onset of drooling and absence of voice sounds
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What to do if you suspect epiglottitis?
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Call intubation
DO NOT use tongue blade Allow them to tripod position |
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Medication of choice for laryngobracheobronchitis
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Racemic epi
-acts immediately to reverse edema |
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Bronchiolitis - most common cause
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RSV - respiratory syncytial virus
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Bronchiolitis symptoms
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Starts out as common cold symptoms - moves to respiratory distress
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Bronchiolitis dx
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Culture of nasal drainage and/or CXR showing peribronchial markings
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Two other manifestations of bronchiolitis
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Low pulse ox
Progressive lobular atelectasis |
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What most often causes bronchiolitis?
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RSV
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Signs of RSV
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Tachypnea, retractions, nasal drainage, wheezing
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Dx of RSV
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Culture of nasal drainage
CXR showing peribronchial markings |
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Pulse ox reading with RSV
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Low
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Meds given for RSV
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Bronchodilators
Gamma globulin (from adult plasma) Inotropes Oxygen |
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Severe deterioration of RSV requires:
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ECMO
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Synagis
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Drug that prevents RSV, given monthly
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IRDS
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Idiopathic respiratory distress syndrome
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What occurs in IRDS
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Baby is born early, before type II alveolar cells mature (28-32 wks), and doesn't have enough surfactant. Causes atelectasis & hypoxia.
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What do you do before administering surfactant to baby with IRDS?
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Suction and assess RR, rhythm, color ABG
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How do you ensure proper ET tube placement before giving surfactant?
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Bag them and look for symmetric chest expansion
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How do you make sure the surfactant gets to both lungs equally?
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Change infant position during administration
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What do you do after surfactant administration?
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Assess RR, color, ABG
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What do you not do after surfactant administration?
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Suction for one hour
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Adverse effects of surfactant?
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May block airways
May cause pneumothorax May cause pulmonary hemorrhage |
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Bronchopulmonary dysplasia
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Alveolar damage from prolonged exposure to high inspiratory pressure
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What are the alveoli and respiratory like with BPD?
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Immature alveoli and respiratory tract - no hyaline membrane present
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Signs of BPD
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Dyspnea
Barrel chest Inability to wean off mechanical ventilation Wheezing |
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Apnea of prematurity
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Cessation of breathing for 20 seconds or more
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What may cause apnea?
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Sepsis, seizures, intrauterine drug exposure
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Which section of the brain is awry with premature apnea?
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Medulla oblongata
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What drug used to treat premature apnea?
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Theophyline
Stimulates respirations |
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Three things to document during apnea epsiode
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Duration
Lowest HR during Time of last feeding |
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Where does FB usually get stuck in respiratory tract?
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Right main bronchus b/c short and wide.
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At what age can you do heimlich?
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1 year or older
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What do you do to children?
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Back blows
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