Peds- Exam 1 Respiratory

Front 1

The most common infection problems in infants and children

Back 1

respiratory

Front 2

infants and children less than three years old have an immature ________ ________, therefore are at greater risk for developing respiratory infections

Back 2

immune system

Front 3

the respiratory tract continuously grows and develops until what age

Back 3

around 12 years old

Front 4

in relation to an adult airway, described a child's airway

Back 4

shorter and narrower, and the tangle of the main stem bronchi is more acute

Front 5

while the airway is still developing

Back 5

the smaller oral cavity and a larger tongue, smaller nares and nasopharynx, long floppy epiglottis, larger amount of soft tissue, fewer alveoli, and more compliant chest wall

Front 6

all of these underdeveloped features put the infant and child at greater risk for?

Back 6

Obstruction of the airway

Front 7

respiratory assessment begins with a general assessment

Back 7

how does the patient look? Alert? Restless or irritable? Skin color?

Front 8

When auscultating the chest for breath sounds, do they sound ________?

Back 8

clear, coarse, wheezy, crackly, stridor?

Front 9

What is the cough producing?

Back 9

What's the quality, is it dry, wet, brassy, barking? Is the effort strong, weak, or absent?

Front 10

Another key area of the respiratory assessment

Back 10

vital signs… what's the temperature, heart rate, respiratory rate, blood pressure

Front 11

early signs of respiratory distress

Back 11

tachypnea, tachycardia, retractions, nasal flaring, grunting, stridor or wheezing, mottled color, changes in responsiveness, hypoxemia

Front 12

late signs of respiratory distress

Back 12

poor air entry, weak cry, apnea or gasping, deterioration in systemic perfusion, bradycardia

Front 13

tonsillitis/pharyngitis is usually ________, unless a strep test is positive

Back 13

viral

Front 14

symptoms of viral tonsillitis include

Back 14

sore throat, fever and malaise, and swollen lymph nodes

Front 15

strep throat is caused by the group A strep bacteria... classic symptoms include

Back 15

fever, red sore throat, exudative tonsils, palatal petechiae, and swollen sub mandibular lymph nodes

Front 16

if red sandpaper rash develops, this is a sign that strep has progressed to ________ ________.

Back 16

scarlet fever

Front 17

treatment of strep throat is usually this antibiotic ________

Back 17

penicillin

Front 18

school-age children must be on ________ for 24 hours before they can return to school

Back 18

antibiotics

Front 19

indications for tonsillectomy

Back 19

frequent strep infections, hypertrophy obstructing breathing and/or eating, i.e. sleep apnea

Front 20

frequent ________ can indicate excessive bleeding postop

Back 20

swallowing

Front 21

after a tonsillectomy is important to teach the patient to

Back 21

be careful using straws, and avoid blowing nose and coughing

Front 22

what will most likely happen if excessive blood is swallowed?

Back 22

Emesis, a.k.a. they're going to blow chunks!

Front 23

Otitis externa is an external ear infection, also known as ________

Back 23

swimmers ear

Front 24

swimmers ear is caused by normal ear flora under the conditions of excessive wetness or ________.

Back 24

dryness

Front 25

treatment of swimmers ear includes

Back 25

keeping it dry and clean, analgesics, otic drops-polymyxin or neomycin and corticosteroids

Front 26

otitis media with effusion or OME is the presence of fluid in the middle ear WITHOUT what?

Back 26

Signs of acute infection

Front 27

acute otitis media or AOM is sudden onset, tympanic memory is bulging and erythemic with otalgia… it has two possible causes

Back 27

viral or bacterial

Front 28

what is the usual initial treatment for AOM

Back 28

if no other complications, watchful waiting for 24 to 72 hours

Front 29

treatment for chronic OME

Back 29

steroids, tympanostomy tubes

Front 30

strong recommendations for prevention of otitis

Back 30

breast-feeding for least six months, and avoiding daycare

Front 31

softer recommendations for prevention of otitis

Back 31

no bottles in bed, avoid or decrease pacifier use after six months, and avoid secondhand smoke

Front 32

what is a life-threatening condition that causes swelling of the epiglottis and surrounding tissue, which can result in total occlusion?

Back 32

Acute epiglottitis

Front 33

Acute epiglottitis has a characteristic appearance of an edematous, Cherry red epiglottis, and what four cardinal signs/symptoms are present? Hint- the fourth Ds

Back 33

drooling, dysphagia, dysphonia, distressed inspiratory effort… they will possibly a tripod position

Front 34

Laryngotracheobronchitis or LTB is usually seen in children less than _______ years of age, and is caused by a _______ infection. characterized by a ______ cough.

Back 34

Five, viral, barking

Front 35

LTB progresses through ____ stages

Back 35

four

Front 36

LTB management includes

Back 36

maintaining airway and adequate gas exchange, nebulized epinephrine, corticosteroids, oxygen administration, Heliox (a mixture of helium and oxygen)

Front 37

this is an acute viral infection, most commonly caused by RSV, seen typically in the winter months, and rarely in patients over two years old

Back 37

bronchiolitis- large amounts of thick secretion in a small airway

Front 38

bronchiolitis management includes

Back 38

frequent assessment of respiratory status and oxygenation, Heliox, suctioning as needed to clear mucus from the airway, and remember to include parents and care as much as possible to provide education and decrease anxiety

Front 39

RSV prevention is for at-risk infants under two years of age under two years of age, who meet specific criteria... those criteria:

Back 39

born prematurely, have a congenital heart disease, or have a chronic lung disease that requires oxygen treatment

Front 40

pneumonia is inflammation of the lung parenchyma, and may be viral or bacterial… 3mo-5years is usually ________ and 5-12years is usually ________.

Back 40

pneumococcal, Mycoplasma

Front 41

how is treatment for pneumonia determined?

Back 41

Treatment is determined by age due to age specific bacteria or virus

Front 42

if pneumonia is treated with antibiotics and there is no response after 24 to 48 hours…

Back 42

cultures will be grown to determine actual cause

Front 43

chlamydial pneumonia is seen in infants newborn up to the age of ___ weeks, and is passed from infected mother just before or during the birthing process

Back 43

19

Front 44

treatment of chlamydial pneumonia is...

Back 44

a 21 day course of erythromycin

Front 45

pertussis is also known as…

Back 45

whooping cough

Front 46

whooping cough is spread through direct contact and droplet exposure, making it

Back 46

highly contagious

Front 47

whooping cough lasts around 4-6 weeks and has the highest incidence in _____ and _____.

Back 47

spring, summer

Front 48

prevention of whooping cough with what vaccine?

Back 48

TDAP

Front 49

pertussis has three stages:

Back 49

Catarrhal stage- Coryza, mild cough, lacrimation, low-grade fever. Paroxysmal stage- increasing cough, whoop. Convalescent stage-gradually diminishing symptoms

Front 50

infants under six months may not present with typical cough

Back 50

apnea is common in this age group

Front 51

influenza is a _____ elements

Back 51

respiratory

Front 52

pediatric and geriatric patients with influenza have an increased risk for secondary bacterial ________ infection

Back 52

pneumonia

Front 53

what is the most prevalent type of influenza? This is the one we’re vaccinated for

Back 53

type A influenza

Front 54

what is the protocol for the patient who has never been vaccinated for influenza?

Back 54

If they are less than nine years old, two doses given at least one month apart

Front 55

if a patient has an immune deficiency, i.e. there are chemotherapy, what type of flu vaccination should they receive?

Back 55

Trivalent inactivated

Front 56

asthma therapy goals

Back 56

prevent chronic symptoms, reduce the use of the short acting beta agonist (SABA) less than two times a week, maintain normal pulmonary function

Front 57

cromolyn sodium

Back 57

a nonsteroidal anti-inflammatory drug that blocks early and late reactions to allergens. Not recommended for first-line preventive therapy

Front 58

nedocromil sodium

Back 58

both anti-allergenic and anti-inflammatory properties. For use in children over five years old. Not effective for acute exacerbations.

Front 59

Acute asthma sympathomimetics

Back 59

are used for quick relief of acute exacerbations, i.e. terbutaline and albuterol

Front 60

beta agonist side effects

Back 60

decreased diastolic and mean arterial pressure, tachycardia, jitteriness, myocardial ischemia

Front 61

what serious issue can arise from the use of terbutaline?

Back 61

Hypokalemia

Front 62

maintenance medications for asthma

Back 62

corticosteroids, leukotriene modifiers, monoclonal antibodies

Front 63

status asthmaticus

Back 63

when a patient does not respond to medication and is a medical emergency that can result in respite for a failure and death… treatment requires establishment and maintenance of adequate airway and oxygenation

Front 64

cystic fibrosis is an odd and somewhat recessive transmission, meaning that…

Back 64

it can only be passed to offspring both mother and the father pass their recessive genes

Front 65

how does cystic fibrosis affect the body?

Back 65

It is an exocrine dysfunction where there is increased mucus viscosity with multi-system effects-pancreas, lungs, and GI

Front 66

concurrent with the earliest findings, there is an abnormal transport of chloride

Back 66

sweat contains 2 to 5 times more sodium and chloride = salt

Front 67

signs and symptoms of cystic fibrosis

Back 67

continual weight loss, frequent pulmonary infections, bulky loose stools, inability to absorb fat-soluble vitamins ADEK, and in both males and females an inability to have children

Front 68

treatment of cystic fibrosis

Back 68

pancreatic enzymes with all food, water soluble forms of vitamins ADEK, high calorie high protein diet, and may need extra sodium

Front 69

sudden infant death syndrome, a.k.a. SIDS highest risk are

Back 69

ages 1 to 3 months, babies with low birth weight, black and Native American

Front 70

speculated cause of SIDS is...

Back 70

most likely a pre-existing condition and an initiating event

Front 71

recommendations for reducing SIDS

Back 71

supine sleeping, firm surfaces, no smoking during pregnancy or secondhand smoke, baby sleeps in a separate crib, avoid overheating