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61 Cards in this Set
- Front
- Back
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Glandular stage |
-Conception until week 16 |
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Canalicular stage |
-Weeks 16 to 24 |
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Alveolar stage |
-Week 24 to birth |
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RR: Infant (1 - 12mo) |
30 - 60 / min |
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RR: Toddler (12 - 36mo) |
24 - 40 /min |
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RR: Preschooler (4 - 5y) |
22 - 34 /min |
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RR: School aged (6 - 12y) |
18 - 30 /min |
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RR: Adolescent (13 - 18y) |
12 - 16 /min |
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Respiratory Distress |
-Body position, mental status, VS, breath sounds, effort, skin color -Aspiration, foreign body, infection, asthma, bronchiolitis, RAD, trauma |
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Respiratory Failure |
-Unrecognized / untreated respiratory distress -Failing to improve /deteriorate with treatment -Most common cause of cardiopulmonary arrest |
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Croup |
-Couple of days with h/o URI -Worsens with agitation, after nap -Comes & goes -Improves in bathroom (steam), humidity from night air -Sitting upright, irritable & anxious, tachypnea, tachycardia, 101-102 deg., barky cough, stridor, hoarse voice, nasal flaring, retractions -Remain in comfortable position -Pulse ox -Blow by humidified O2 -Racemic epinephrine -Dexamethasone -Lateral neck films |
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Racemic epinephrine |
-Croup -Decrease laryngeal edema & bronchospasm -Observe in ED >3h |
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Dexamethasone |
-Croup -PO 0.15 - 0.6 mg/kg -Decrease airway inflammation -Reduces necessity of hospitalization |
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Epiglottitis (streptococcus pyogenes, s. pneumonia, s. aureus) |
-Infection & inflammation in supraglottic area of upper airway & epiglottis -3 - 7y -Unrecognized / untreated: rapid edema, airway obstruction, respiratory failure -No cough, sudden onset of fever + sore throat, tachy, shallow breathing, drooling, muffled voice, tripod position -PPE, position, NPO, pulse ox, blow by O2, x-rays, DO NOT examine airway |
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Foreign bodies |
-Nuts, popcorn, grapes, hot dogs, raw carrots, candy rolls, batteries, marbles, toys, pennies, dried beans -Stridor, wheezes, coughing, cyanosis, unable to speak, drooling, hoarse voice -Unconscious: open airway & BLS, cricothyrotomy -Conscious: abdominal thrust / back & chest blows, ventilation assistance, O2 for respiratory distress, airway adjuncts |
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Otitis Media |
-Short, wide, horizontal eustachian tube -URI: blockage & congestion of tube -Pain, pull on ears, upright, irritability, fever, URI symptoms, red bulging TM -Decongestants, ear drops, antibiotics, antipyretics |
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Myringotomy tubes |
-Inserted to ear to equalize pressure between middle & outer ear -May fall out -Keep ears clean & dry -Ear plugs |
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Tonsillitis |
-Sore throat, difficulty swallowing, fever, bad breath, swollen tonsils -Hydration -Antibiotics -Bleeding postop: first 24h or 7-10d after (scabs come loose) |
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Respiratory Syncitial Virus (RSV) |
-Virus causes respiratory infections -Most common cause of bronchiolitis -Various degrees of respiratory distress -Most common hospitalization cause <1y -Risk factor for asthma |
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RSV: Symptoms |
-Rhinorrhea -Pharyngitis -Coughing, sneezing -Intermittent fever -Increased coughing > tachypnea (<70 + retractions) >cyanosis > apneic spells |
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RSV: Diagnosis |
-Nasal swabs: RVP -Enzyme linked immunosorbant assay (ELISA): detects RSV antigens -Direct fluorescent antibody (DFA) staining |
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RSV: Treatment |
-Cool humidified O2 -Hydration -Suction -Bronchodilators -Racemic epinephrine -Steroids |
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RSV: Prevention |
-palivizumab (Synagis): antibody -15 mg / kg / mo IM -Infants <32 wk gestation -<2y with BPD, received treatment in 6mo of RSV season -Severe BPD treatment for 2 RSV seasons |
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RSV: Nursing Care |
-Isolation, respiratory & contact precautions -Respiratory therapy: O2, humidity -Monitor: CRM, pulse ox -Maintain airway: elevate HOB -Suction -Rest & hydration -Relieve anxiety |
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RSV: When to contact PCP |
-Increased RR -Increased effort of breathing -No improvement -Not feeding or sleeping -Deterioration |
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RSV: Parent Teaching |
-Bulb syringe -Adequate hydration -Handwashing -Rest |
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Asthma |
-Chronic inflammatory disorder of airways -Recurrent episodes of: wheezing, breathlessness, chest tightness, cough |
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Asthma: Risk Factors |
-Maternal history -LBW or smaller airways -Patient / family history of allergy or asthma -Second hand smoke -Viral respiratory infections |
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Asthma: Patterns |
-Early response: symptoms last about an hour & resolve -Late response: 6-8h after early response, reoccurrence of symptoms |
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Asthma: Manifestations |
-Respiratory problems worse at night -Chest tightness -SOB w/w/o exertion -Allergen or emotional response -Increased work of breathing -Prolonged expiration -Wheezes -Dry cough -NO wheezing: severe respiratory distress |
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Asthma: Nursing Care |
-PPE -Reverse hypoxia -Hydration -Monitor: pulse ox, cardiac -O2 -Medications -IV therapy |
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Asthma: Longterm control |
-Inhaled corticosteroids -Long-acting beta2-adrenergic agonists -Combos: Symbicort, Advair -Leukotriene blockers: Montelukast |
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Asthma: Rescue medications |
-Short-acting beta2-adrenergic agonists: albuterol (Ventolin) -Anticholinergic: ipratropium bromide (Atrovent) -Mast cell inhibitors: cromolyn sodium -Systemic corticosteroids: prednisone -Epinephrine -Magnesium sulfate: IV, unresponsive to others |
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Asthma: Nursing care |
-Physical characteristics R/T chronic involvement -Support -Education: inhaled meds, triggers & allergens to avoid, written action plan |
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Pneumonia |
-Lung tissue inflammation > fluid exudate & fibrin deposits in lungs |
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Pneumonia: Viral causes |
-RSV -Flu -Adenovirus -Rhinovirus -Measles, rubella -Varicella |
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Atypical pneumonia |
-Mycoplasma, chlamydia -Community-acquired pneumonias ->5y |
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Pneumonia: Bacterial |
-Group B streptococci: newborn aspiration during delivery -Staph. aureus, strep. pneumoniae: <3y -Strep. pneumoniae, mycoplasma pneumoniae: >3y |
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Pneumonia: Manifestations |
-Fever (chills), cough, tachypnea -Crackles, retractions, nasal flaring -Malaise, lethargy, decreased appetite -Pallor or cyanosis -Abdominal pain |
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Pneumonia: Nursing care |
-PPE -Assessment: breath sounds, RR & rhythm, color, VS, degree of restlessness -Airway & breathing support -Turn q2h, assist with coughing -Pulse ox -Meds: antipyretics, antibiotics, analgesics -Hydration -Labs |
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Bronchopulmonary Dysplasia (BPD) |
-Acute lung injury that is complication of longterm ventilator assistance & high O2 concentrations -Premies -Unable to handle secretions secondary to ciliary inhibition -Epithelial damage > thick, fibrotic alveolar walls |
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BPD: Consequences |
-Developmental delay -Growth retardation -Continuing airway obstruction |
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BPD: Progression |
-Immature lung (unable to produce surfactant) > respiratory failure -Mechanical ventilation >barotrauma >inflammation >O2 toxicity >fibrosis >bronchiole edema >cellular damage |
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BPD: Treatment |
-Assess & treat hypoxia -Bronchodilators, dexamethasone, diuretics, O2 -High calorie meals: increased O2 consumption >increased caloric needs -Supplemental O2 & humidity -Chest PT -Rest & normal development |
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BPD: Nursing Care |
-Rest during feedings -Increased caloric feedings -Adequate O2 -Administer diuretics, bronchodilators, inhaled steroids -Monitor for & prevent infection |
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Pertussis |
-Respiratory droplets -Incubation period: 7 - 10d -Tdap vaccine substitutes for Td booster |
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Pertussis: Catarrhal Stage |
-Gradual onset -Runny nose, mild cough, fever <101 deg. -Cough increasing severity over 1-2wk |
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Pertussis: Paroxysmal Stage |
-Lasts 1-6wk -Cough bursts 15 episodes / day: ad noc (thick mucus in tracheobronchial tree) -Cyanosis -Loud whooping noises when inhaling -Inhalation lengthened -Fatigue |
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Pertussis: Convalescent Stage |
-Gradual recover -Over 2-3wk -Treat patients & close contacts with erythromycin -Droplet precuations |
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Cystic Fibrosis |
-Inherited disease of mucus and sweat glands -Affects: lungs, pancreas, liver, intestines, sinuses, & sex organs -CF transmembrance conductance regulator (CFTR): transmission -Mucus thick & sticky |
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CF: Manifestations |
-Meconium ileus: lack of pancreatic enzymes; abdominal distention, vomiting, failure to defecate, rapid dehydration -GI: large, bulky, loose, frothy, foul stools (malabsorption); voracious appetite s weight gain; loss of appetite (later); weight loss; failure to grow; anemia |
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CF: Pulmonary Manifestations |
-Initial signs: wheezy, dry, non-productive cough -Eventually: increased dyspnea, paroxysmal cough -Progressively: barrel-shaped chest, cyanosis, clubbing, repeated episodes of bronchitis & bronchopneumonia |
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CF: Diagnosis |
-Meconium ileus -FTT -Recurrent respiratory infections -Pilocarpine iontophoresis (sweat test) |
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CF: Treatment |
-Exercise -Chest PT -Flutter mucus clearance device -Antibiotics -Immunizations -Tune ups -Complication treatment -Lung transplant |
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CF: GI & Nutritional therapy |
-Zantac / acid suppression med -Isotonic fluid lavage: distal intestinal obstruction -Hyperosmolar enemas: infants c meconium ileus -120 - 150% caloric RDA -200% protein RDA, moderate fate -Pancreatic enzyme supplements |
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CF: Medications |
-Bronchodilators -Aerosol DNAs -Corticosteroids & NSAIDS -Pancreatic enzymes -Multivitamins & fat-soluble vitamins (A, D, E), iron -Ursodeoxycholate: delay liver progression & portal HTN -Lactulose: prevents distal intestinal obstruction -Treat DM -Annual flu vaccine |
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CF: Nursing care |
-Respiratory & GI assessment -Newborn: feeding & stooling patterns -Treat infections aggressively: increased lung damage -Nutritional support -CPT: pulmonary hygiene 2-4x/d -Assist with mechanical vest -O2 -Exercise + rest |
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Sudden Infant Death Syndrome (SIDS) |
-Sudden unexplained death of healthy baby -Leading COD for >1wk to <1y -Postmortum exam diagnosis -Intrathoracic petechiae, pulmonary edema |
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SIDS: Risk Factors |
-Prematurity, seizure disorders, family history of SIDS, apnea -Lower socioeconomic class -Males -Non-caucasians |
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SIDS: Prevention |
-Apnea assessment in newborns -Apnea monitoring with home teaching -BLS for caregivers -"Back to Sleep" |
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SIDS: Treatment |
-Offer momentos: bereavement boxes -Contact ME -Family support -Allow family to remain during CPR efforts -Give info for support groups |
