Nursing 2Nd Semester: Peds Exam 2: Respiratory

Front 1

medical term for the "common cold"

Back 1

Nasopharyngitis

Front 2

causes of nasopharyngitis (5)

Back 2

Viral:
rhinovirus
RSV
adenovirus
influenza
Para influenza virus

Hint 2

prair

Front 3

What are some s/s of nasopharyngitis?

Back 3

congestion
runny nose
cough
headache
fever

Front 4

IgE mediated inflammation of nasal mucosa is known as _____ ______.

Back 4

allergic rhinitis

Front 5

What are some causes/triggers of allergic rhinitis?

Back 5

dust mites
feathers
animal dander
pollens
molds
some foods

Front 6

What can be done to find out what you are allergic to?

Back 6

a blood panel

Also with foods, one can eliminate all foods known to cause allergies and then slowly reintroduce foods one at a time and observe for allergic reaction. This can pinpoint which food causes allergy.

Front 7

Some s/s of allergic rhinitis

Back 7

watery rhinorrhea (runny nose)
itching
sneezing
allergic salute (rubbing nose upward with hand)
allergic shiners (dark circles)

Front 8

Therapeutic management for allergic rhinitis includes eliminating _______, immunotherapy such as allergy ____, antihistamines such as: (3) and intranasal __________.

Back 8

allergens
shots
claritin, zertec, and benadryl
corticosteroids

Front 9

An example of an intranasal corticosteroid is _______. What is a main disadvantage?

Back 9

nasonex
takes several days to start working

Front 10

True or False: Saline nasal drops are good for kids and it's ok to have one bottle per family.

Back 10

False: Each kid needs his own, no sharing

Front 11

Overuse of nasal spray decongestants can cause a _____ effect which makes them ineffective.

Back 11

rebound

Front 12

_________ is inflammation of the sinus.

Back 12

sinusitis

Front 13

Sinusitis usually follows ...
and may be associated with ____ ____ or o_____ m____ with ______. Sinusitis can also be caused by a foreign body obstruction in the ____.

Back 13

an URI
allergic rhinitis
otitis media effusion

Front 14

A sign of infection is ______, another word for bad breath.

Back 14

halitosis

Front 15

A cold usually lasts how long?

Back 15

10-14 days

Front 16

s/s of sinusitis are similar to cold but do not improve after ___ days.
Other s/s include... (6)

Back 16

14
low grade fever
purulent nasal discharge
halitosis
cough (from nasal drip)
headache
fatigue

Front 17

Treatment for sinusits include what type of medication? Also warm/cold moist/dry _______ to open passageways, ______ for headache and fever, d________s, and adequate hydration.

Back 17

antibiotics
warm, moist compresses
acetaminophen
decongestants

Front 18

Nursing Considerations for sinusitis include an assessment of location of ____, an inspection of the palate for ____, ______the face for edema, administration of antibiotics, and teaching the parents how to treat the problem.

Back 18

pain
edema
palpate

Front 19

Teach parents of kids with sinusitis to encourage ___ fluids, a bedside ______, breathing warm ____, and use nasal ____.

Back 19

clear
humidifier
mist
drops

Front 20

otitis media (OM) includes which 2 types?

Back 20

Acute otitis media (AOM)
Otitis media with effusion (OME)

Front 21

Risk factors that make kids more likely to get ear infections include _____er, ___er, and _____er _____ tubes, enlarged _______ tissue, passive ______, and bottle feeding or breastfeeding in the ____ position. Also babies who use a ______ and infants who are under 1 year and attend day care have a 3x higher risk .

Back 21

Risk factors that make kids more likely to get ear infections include shorter, wider, and straighter eustachian tubes, enlarged lymphoid tissue, passive smoking, and bottle feeding or breastfeeding in the supine position. Also babies who use a pacifier and infants who are under 1 year and attend day care have a 3x higher risk .

Front 22

S/S of acute otitis media (AOM)

Back 22

severe otalgia (pain in ear)
fever
irritability
nasal congestion
red, bulging typanic membrane

Front 23

S/S of otitis media with effusion (OME)

Back 23

visible fluid behind eardrum
tinnitus (ringing in the ear)
mild balance disturbance
popping sounds
hearing loss--> speech problems

Front 24

A ________ measures the pressure in the middle ear.

Back 24

tympanogram

Front 25

A fancy word for a hearing test is ______.

Back 25

audiometry

Front 26

Diagnostic findings for an ear infection include typanogram, audiometry, and ___ & _____ of purelent discharge from nose.

Back 26

culture & sensitivity

Front 27

True or False: If an eardrum ruptures, it's ok it will heal on its own but it's not good if it happens too many times.

Back 27

true

Front 28

The tx for otitis media includes what 4 meds?

Back 28

antibiotics
analgesics (numbing ear drops)
antipyretics
decongestants

Front 29

True or FalseDepending on which Dr. you ask, 4-8 ear infections a year constitutes getting myringotomy with tympanostomy tubes placed.

Back 29

True

Front 30

Myringotomy is a surgical incision of the eardrum to relieve p_____, p___, and f____. Tubes _____ pressure and keep ear _____.

Back 30

Myringotomy is a surgical incision of the eardrum to relieve pressure, pus, and fluid. Tubes equalize pressure and keep ear aerated.

Front 31

After having the surgery for an ear infection, Myringotomy with tympanostomy tubes, what are some postop considerations? (What is diet like? Bed position and child position? Assess for .... and what do we use for pain management?)

Back 31

diet- liquids and soft foods
Elevate HOB
Lie with affected ear down (helps with drainage)
Assess ear drainage
Pain Mgmt.- tylenol is usually enough.

Front 32

True or False: Complications from ear infections include acute otitis media and hearing loss

Back 32

False, chronic otitis media & hearing loss

Front 33

Family teaching concerning ear infections includes information about prevention, early recognition, and post op instructions for tube placement. Additionally, it is important to make sure the client does not do what for 7-10 days? Some doctors say it's important to keep the ears ____.

Back 33

don't blow nose
dry

Front 34

True or False: When surgically placed tubes fall out of a child's ears it is a medical emergency.

Back 34

False. It's no biggie.

Front 35

In general, what is usually a more serious infection, bacterial or viral?

Back 35

bacterial

Front 36

Pharyngitis can either be viral or bacterial. Bacterial is caused by what?

Back 36

Group A beta-hemolytic streptococcus
(Group A Strep)

Front 37

Viral or Bacterial (strep) Pharyngitis: severe sore throat

Back 37

bacterial (strep)

Front 38

Viral or Bacterial (strep) Pharyngitis: low grade fever

Back 38

viral

Front 39

Viral or Bacterial (strep) Pharyngitis: enlarged cervical lymph nodes

Back 39

both

Front 40

VViral or Bacterial (strep) Pharyngitis: mild sore throat

Back 40

viral

Front 41

Viral or Bacterial (strep) Pharyngitis: high fever

Back 41

bacterial (strep)

Front 42

Viral or Bacterial (strep) Pharyngitis: abrupt onset

Back 42

bacterial (strep)

Front 43

Viral or Bacterial (strep) Pharyngitis: hoarseness, cough, rhinitis

Back 43

viral

Front 44

Viral or Bacterial (strep) Pharyngitis: white patches on throat

Back 44

bacterial (strep)

Front 45

Viral or Bacterial (strep) Pharyngitis: very red pharynx

Back 45

bacterial (strep)

Front 46

Viral or Bacterial (strep) Pharyngitis: erythema & inflammation of pharynx and tonsils

Back 46

viral

Front 47

Viral or Bacterial (strep) Pharyngitis: positive throat culture

Back 47

bacterial (strep)

rapid strep test

Front 48

If the cause of pharyngitis is viral, we do ________ tx. If strep throat, what is the treatment?

Back 48

symptomatic

Strep:
antibiotics
rest
keep home from school
prevent transmission to others- no sharing drinks etc.
24 h after antibiotics started, get new toothbrush

Front 49

Tonsillitis is the inflammation of the tonsils that usually results from ______.

Back 49

pharyngitis

Front 50

Tonsilitis is caused by either a ____ or bacterial (Group A hemolytic streptococcus) source.

Back 50

viral

Front 51

True or False: tonsilitis has same clinical manifestations as pharyngitis.

Back 51

True

Front 52

Treatment of tonsilitis includes a _____ gargle, plenty of r____, observe for complications such as a p_______ a______. If chronic tonsilitis, may need a ______.

Back 52

saline
rest
peritonsilar abscess
tonsillectomy (if done at young age tonsils can grow back)

Front 53

Post op care for tonsillectomy includes: observe for ______, have ______ available, rest, soft foods, and pain control.

Back 53

bleeding
suction

Front 54

An early sign of bleeding after tonsillectomy is .....

Back 54

frequent swallowing (blood)
may throw it up too


also restlessness

Front 55

We have suction ready after tonsillectomy in case of bleeding, but don't suction when there is no bleeding or you might break off the scabs and cause _______. Be careful when checking throat with tongue blade, even 10 days after surgery which may cause the same serious thing. Don't give anything to eat/drink of what color? Why?

Back 55

hemorrhage

red/orange- can be confused with blood if they throw up etc.
Give clear or green juices etc.

Front 56

A softtness of the larynx and flaccidity of the epiglottis and supraglottic aperture with weakness of airway walls is known as .....

(Basically it's a soft and floppy larynx and epiglottis)

Back 56

laryngomalacia

Front 57

When is laryngomalacia most often seen?

Back 57

premature babies
(may be slow to gain weight because they have to work harder to breathe)

Front 58

With laryngomalacia, what will you hear when you listen to the lungs?

Back 58

noisy, crowing inspiratory stridor

Front 59

With laryngomalacia, there may or may not be ________ (indicates increased work of breathing)

Back 59

retractions

Front 60

With laryngomalacia, is there cyanosis?

Back 60

No cyanosis

Front 61

When are symptoms of laryngomalacia increased?

Back 61

When child is supine or when crying

Front 62

True or False: laryngomalacia can be present at birth or up to 2 months old.

Back 62

True

Front 63

What is the tx for laryngomalacia?

Back 63

usually s/s resolve without tx by 18-24 months

Very rarely, they need intubation with tracheostomy

Front 64

Why is it difficult for children with laryngomalacia to gain weight? What helps?

Back 64

because they can't eat and breathe at the same time

Frequent upright feeding until they outgrow it (epiglottis and larynx firm up)

Front 65

Some nursing considerations for a child with laryngomalacia include observing for _______ difficulties and ______ problems. What position is best for feeding? Teach parents the signs of respiratory difficulties such as with a______. and instruct few large feedings or small frequent feedings?

Back 65

respiratory difficulties & feeding problems

aspiration
small frequent feedings

Front 66

Croup includes inflammation of the _____, ____ and ____ tubes that leads to _____ obstruction

Back 66

inflammation of the larynx, trachea, & bronchial tubes leads to laryngeal obstruction

Front 67

True or False: Croup Syndromes are usually viral but may be bacterial.

Back 67

True

Front 68

What virus usually causes croup?

Back 68

parainfluenza

Front 69

In talking about croup, which is more common viral or bacterial? Which is more serious?

Back 69

viral is more common
bacterial is more serious

Front 70

laryngotracheobronchitis is the medical term for ______.

Back 70

Croup

Front 71

True or False: Croup is the most common cause of airway clearance.

Back 71

Um... no
most common cause of airway obstruction.

Front 72

Croup is most common in children 3 months to 7 years old and the incidence is higher among boys or girls? What season does it usually occur?

Back 72

boys
winter

Front 73

Some clinical manifestations of croup include....
(6)

Back 73

(SHALLT)
Stridor
Hoarse, barky cough
A sore throat (sore throat)
Low fever
Labored respirations with retractions
Tachypnea

Front 74

The goal in treating croup is to...

Back 74

maintain a patent airway and provide adequate gas exchange

Front 75

In treating croup, ___ humidified mist is helpful and oxygen therapy is appropriate if t is ____.

Back 75

cool
hypoxic

Front 76

Medications for croup include what 3?

-a ______ to open the swollen airway

- a _____ to decrease inflammation

(include example of each)

-may also be a _____ treatment in hospital to get medication deeper into lungs.

Back 76

bronchodilator- nebulized racemic epinephrine

corticosteroids (dexamethasone)

nebulizing

Front 77

True or False: antibiotics are commonly prescribed for croup.

Back 77

False, it's viral

Front 78

Acute epiglottitis is a mild/severe rapid/slow progressing infection of the epiglottis and surrounding ______ leading to marked _____ ______.

Back 78

Acute epiglottitis is a severe, rapid progressing infection of the epiglottis and surrounding tissue leading to marked airway obstruction.

Front 79

True or False: Acute epiglottitis can occur in children and adults and occurs more often in girls.

Back 79

False, occurs equally among boys and girls

Front 80

True or False: a child with epiglottitis will be markedly ill and the parents should have no doubt it's time to take the child to get treatment.

Back 80

True

Front 81

What are the clinical manifestations of acute epiglottitis?

Back 81

High fever
Acute sore throat
Irritability
Tachypnea
Inspiratory stridor w/ retractions
Drooling
Dysphagia
Dysphonia
Distressed breathing
(4 D's are cardinal signs)

Front 82

True or False: A child with acute epiglottitis will have a cough.

Back 82

False. There is no cough with epiglottitis.

Front 83

What position does a child with epiglottitis usually assume?

(They naturally go into this position)

Back 83

Tripod position:
leaning forward with hands on floor
head tilted in sniffling position (to relieve airway obstruction)
mouth open w/ tongue protruding

(Don't have them lay down, put in position of most comfort.)

Front 84

True or False: Never try to visualize the epiglottis. It should only be done by a doctor with emergency equipment and staff on standby.

Back 84

True! Know this!

Front 85

Tx for epiglottitis includes endotracheal _________ and IV antibiotics such as .... (3)

Back 85

intubation

ampicililin,*
ceftriaxone,
or cephalosporins

Front 86

Nursing considerations for a patient with acute epiglottitis include monitoring for increasing ________ distress through frequent assessments, maintain in position of ______, provide a ____ environment, monitor h______ status (important b/c of tachypnea), administer analgesics and antip_____s, support child and _____.

Back 86

Nursing considerations for a patient with acute epiglottitis include monitoring for increasing RESPIRATORY distress through frequent assessments, maintain in position of COMFORT, provide a CALM environment, monitor hydration status, administer analgesics and ANTIPYRETICS, support child and FAMILY.

Front 87

Inflammation of the trachea and major bronchi in which there is increased mucous production is known as _______.

Back 87

bronchitis

Front 88

Bronchitis is almost always viral/bacterial.

Back 88

viral

Front 89

Bronchitis occurs with ____ and _____ respiratory infections.

Back 89

upper
lower

Front 90

Bronchitis has an acute/gradual onset. It usually begins in the upper respiratory tract and moves down lower. Bronchitis usually begins with a nonproductive/productive cough and then becomes nonproductive/productive.

Back 90

gradual
nonproductive
productive

Front 91

What kinds of sounds might you hear when you listen to the lungs of a person with bronchitis?

Back 91

coarse & fine crackles
high-pitched rhonchi

Front 92

In managing, bronchitis, encourage rest, fluids, and humidification. What kinds of medications might be used?

Back 92

Bronchodilator
Oral prednizone, prelone

Front 93

Should we suppress the cough for a child with bronchitis (or any other respiratory issue)? Why or why not?

Back 93

No we don't really suppress coughs anymore in kids. You want to get the mucous stuff out. If coughing is causing difficulty sleeping.

Front 94

True Or False: Bronchitis is usually self limiting.

Back 94

True

Front 95

Viral bronchitis can end up bacterial, in which ______________ would be prescribed. These may also be prescribed to prevent pneumonia such as if the patient is a smoker.

Back 95

antibiotics

Front 96

Bronchitis usually runs its course for 7-10 days but the _____ may persist for a week or two.

Back 96

cough

Front 97

Bronchiolitis is characterized by _______ of the bronchioles, e_____, s_________s, and w_______.

Back 97

Bronchiolitis is characterized by obstruction of the bronchioles, edema, secretions, and wheezing.

Front 98

Bronchiolitis is an acute/chronic lower/upper respiratory infection. Children with bronchiolits end up at the hospital because they become _______.

Back 98

acute
lower

hypoxic

Front 99

Is bronchiolitis viral or bacterial?

Back 99

viral

Front 100

Bronchiolitis can be caused by adenovirus, parainfluenza virus, rhinovirus, but most commonly cause by....

Back 100

RSV
(Respiratory Syncytial Virus) RSV

Front 101

RSV attacks the lining of the ____ and ______s.

Back 101

bronchi
bronchioles

Front 102

True or False: Infants can share RSV for about a month after having the illness while older children and adults are rid of it in 3-4 days.

Back 102

True

Front 103

How is RSV transmitted? It can also live on toy surfaces and unwashed hands for how long?

Back 103

droplet
1 hour

Front 104

RSV travels through daycares like wildfire. It's more serious in children because adults have a more developed ______ system that makes antibodies against RSV so that the next time they get it, it's a milder case. It's important to teach the parent to...

Back 104

immune

wash everything!! toys, hands, countertops, etc.

Front 105

RSV causes _______ because it makes a lot of mucous and the child can't breathe around it.

Back 105

hypoxia

Front 106

Incubation of RSV is 2-8 days and the average span is __.

Back 106

5

Front 107

Bronchiolitis caused by RSV occurs primarily in winter and spring during the first ___ years of life. Premature infants are at a higher risk.

Back 107

2

Front 108

Diagnostic Findings for bronchiolitis caused by RSV include positive RSV ________ culture (wash)
Chest X-ray shows ....
CBC is positive/negative

Back 108

Positive RSV nasopharyngeal culture (wash)
Chest X-ray shows hyperinflation with air trapping.
CBC is negative. (viral, WBC don't attack viruses) lymphoctes may go up?

Front 109

If a child has a history of an ________ with a ___ __ fever for a few days, it may progress to RSV.

Back 109

If a child has an URI (upper respiratory infection) with a
low grade fever for a few days, it may progress to RSV.

Front 110

S/S of bronchiolitis caused by RSV

Back 110

Wheezing
Tachypnea
Retractions
Lethargy
Irritability
Dyspnea
Difficulty feeding
(using all their energy just to breathe)
(You don't care about finding the lid to your waterbottle because you're just trying to breathe with RSV caused by bronchiolitis, you don't care about your WTR LIDD)

Front 111

Tx for bronchiolitis oxygen treatment given in what different of methods?

Back 111

cool mist tent with oxygen
hood
nasal cannula

Front 112

In managing bronchiolitis, we do an intermittent/continuous pulse oximeter. Medications for bronchiolitis include ________ and _______ and possibly antiviral medications such as _____.

Back 112

continuous

antipyretics
bronchodilators
ribavirin

Front 113

What is important to know about ribavirin?

Back 113

It can cause birth defects, no one of childbearing age should breath it in.

Front 114

In managing bronchiolitis, be sure to practice and encourage good _________. Child should take in lots of _______ and needs a ____ room upon admission. ______ as needed because there's lots of mucus. The head of the bed should be _____ and promote rest by by organizing care to minimize disturbances.

Back 114

In managing bronchiolits, be sure to practice and encourage good handwashing. Child should take in lots of fluids and needs a private room upon admission. Suction as needed because there's lots of mucus. The head of the bed should be elevated and promote rest by by organizing care to minimize disturbances.

Front 115

High risk infants should receive a monthly injection for about 6 months (Sept - March). It works for 28 days, is very expensive, but can prevent RSV bronchiolotis. What is this medication called?

Back 115

Synagis

Front 116

__________ is an inflammation or infection of the pulmonary parenchyma (tissue) that impairs gas exchange.

Back 116

pneumonia

Front 117

4 types of PNA (causes)

Back 117

Viral (usually RSV)
Bacterial (less common than viral)
Mycoplasma (fungal)
Aspiration of foreign substances
(food - bottle - drowning)

Front 118

Kids can usually tell you where it hurts if they have PNA. It is classified according to location and extent. How are the locations classified?

Back 118

lobar
bronchial
interstitial (tissue around alveoli)

Front 119

True or False: Pneumonia is less common among infants and young children.

Back 119

False, more common

Front 120

S/S of viral PNA (4)

Back 120

mild to high fever
cough
rhonchi
fine crackles

Front 121

S/S of bacterial PNA (8)

Back 121

high fever
cough
tachypnea
rhonchi
crackles
retractions
cyanosis
chest pain

Front 122

Which more severe, viral or bacterial PNA?

Back 122

bacterial
viral PNA usually not admitted

Front 123

Diagnosis of PNA involves a CXR which shows .......
CBC differential will show...
Also a blood culture might be done to test which organism tests positive.

Back 123

patchy infiltrates, atelectasis, and pleural effusion

elevated WBC

Front 124

Tx of PNA depends on _____.

Back 124

cause

Front 125

Tx for viral PNA includes supportive care such as o______, h_______, and maybe b_________s. For bacterial PNA, supportive care and a_______.

Back 125

oxygen
hydration
bronchodilators

antibiotics

Front 126

Foreign Body Aspiration is aspiration of an object into the ________ area and /or main stem ________.

Back 126

laryngotracheal
bronchus

Front 127

Expain the degrees of obstruction (foreign body aspiration)

Back 127

1st - allows air to pass both ways
2nd- allows air to pass in 1 direction only
3rd- complete obstruction, no airflow, can't talk etc.

Front 128

Clinical manifestations of Foreign Body Aspiration depend on the _____ of obstruction and nature of foreign body.
history of swallowing or playing with a small object followed by a sudden onset of ________ ________.

Back 128

degree
respiratory distress

Front 129

A foreign body aspiration can cause symptoms such as... (depending on degree of obstruction)

Back 129

stridor
wheezing
may elicit a cough
gagging
diminished breath sounds distal to the foreign body
inability to speak

Front 130

If aspiration occurs, a child may exhibit symptoms of a _________ ______.

Back 130

respiratory infection

Front 131

How is foreign body aspiration resolved?

Back 131

bronchoscopy

Front 132

Risk factors associated with exposure to passive smoking

Back 132

Impacts on Pregnancy
-placental insufficiency
-IUGR
-spontaneous abortion

SIDS

Respiratory Conditons
-bronchiolitis
-asthma

Otitis media

-Role modeling to child that smoking is ok

Front 133

True or False: Smoke inhalation causes more deaths than fire.

Back 133

True

Front 134

Smoke inhalation causes airway ______, inflammation, and damage.

Back 134

irritation

Front 135

interferes with cellular expiration and is known as the "silent killer"

Back 135

carbon monoxide poisoning

Front 136

therapeutic management of smoke inhalation can include ________ _____ % O2, blood gases, may need intubation or ________, and medications like _______ or ________.

Back 136

therapeutic management of smoke inhalation can include humidified 100 % O2, blood gases, may need intubation or tracheostomy, and medications like corticosteroids, bronchodilators

Front 137

The goal of treatment for carbon monoxide poisoning is to remove carbon monoxide from the hemoglobin (Hgb) in the blood and return the level of oxygen in the blood back to normal as quickly as possible. Treatment for carbon monoxide poisoning includes....

Back 137

removing patient from area/ getting into fresh air, oxygen therapy, IV fluids, and hyperbaric pressure if severe.

Front 138

Apnea is the cessation of breathing for ___ seconds or longer, a change in ____ or _____ tone

Back 138

20
color
muscle

Front 139

Apnea of prematurity is common in neonates of 24-32 weeks gestation due to an immature _____ system. To help make the baby breathe, what do we do?

Back 139

CNS

gentle stimulation

Front 140

Infant apnea has no known cause. You first want to rule out _____, ______ and _____. They child needs to be put on a/an ________ monitor, and they usually/never outgrow it.

Back 140

seizures
GER
hypoglycemia

usually

Front 141

Drugs that help with apnea include what 2?

Back 141

caffeine
theophylline

Front 142

There is no known cause of SIDS. What are some risk factors?

Back 142

prone sleeping position
prematurity
botulism (honey)
reactions to immunizations
passive smoking

Front 143

What is the leading chronic lung disorder in children?

Back 143

asthma

Front 144

Asthma is a ________ airway disease.

Back 144

reactive

Front 145

Three factors contribute to airway obstruction in asthma:
-______ and ______ of the mucous membranes

-accumulation of tenacious ______________

-______muscle ______ of bronchi and bronchioles

Back 145

Three factors contribute to airway obstruction in asthma:
-inflammation and edema of the mucous membranes
(narrowing of bronchioles)
-accumulation of tenacious secretions/ mucous

-smooth muscle spasm of bronchi and bronchioles

Front 146

tenacious

Back 146

- thick, goopy

Front 147

With asthma, air has hard time moving through tight spaces and we hear ______.

Back 147

wheezes

Front 148

Give some examples of some trigger factors for asthma

Back 148

inhaled allergens (dust mites, cockroach excretia, pollens, saliva & dander of cats & dogs)

viral infections (RSV,
parainfluenza, rhinoviruses)

Cigarette smoke

Air pollutants

aerosolized chemicals

strong aromas (perfumes)

Medications such as NSAIDs
(can trigger bronchospasm)

cold air

stress

exercise (can induce asthma attach)

Front 149

Clinical manifestations of asthma

Back 149

CERB the NERD

Coarse Cough
Expirations are prolonged
Rhonchi (coarse)
Blue (cyanosis)

Nasal Flaring
Expiratory Wheezes
Retractions
Dyspnea

Front 150

If asthma is chronic you may see _____ chest and ________ shoulders. You may also see these in ____ _____.

Back 150

barrel
elevated

Cystic Fibrosis

Front 151

Signs of respiratory distress in pediatrics include _____ flaring, sternal _______, the position: ______, use of accessory ______, tachypnea/bradypnea, and a color change: ______.

Back 151

Signs of respiratory distress in pediatrics include NASAL flaring, sternal RETRACTIONS, the position: TRIPOD, use of accessory MUSCLES, tachypnea/bradypnea, and a color change: CYANOSIS.

Front 152

What is it called when a patient with asthma does not respond to treatment?

Back 152

status asthmaticus

Front 153

Diagnostic tests associated with asthma include pulse _____, ABG's, _______ function tests, peak flow meter, ____ testing to determine specific ______, and a ____ x-ray.

Back 153

Diagnostic tests associated with asthma include pulse OXIMETRY, ABG's, PULMONARY function tests, peak flow meter, SKIN testing to determine specific ALLERGENS, and a CHEST x-ray.

Front 154

True or False: on an ABG for a person with asthma, you will see increased PO2 and decreased PCO2.

Back 154

False, you will see
decreased P02, increased PCO2

Front 155

On a chest x-ray looking at a person with asthma you may see h________ and bronchial ______.

Back 155

hyperinflation
thickening

Front 156

In managing asthma it is important to avoid known or suspected a________ and i_______. Evaluate with ____ ____ meter, avoid s_____ in the home, and get an annual ___ ______.

Back 156

In managing asthma it is important to avoid known or suspected ALLERGENS and IRRITANTS. Evaluate with PEAK FLOW meter, avoid SMOKING in the home, and get an annual FLU SHOT.

Front 157

A _____ _____ _____ is the gold standard for monitoring asthmatics and is a great tool to use at home. It monitors air flow and is calculated based on ____and ______.

Back 157

peak flow meter
age and weight

Front 158

In monitoring the peak flow meter to determine air movement in a person with asthma, there is a green, yellow, and red zone. If the meter is in the _____ zone, it's time to start nebulizing treatments. If it's in the ___ zone, it's time to go to the doctor.

Back 158

yellow
red

Front 159

What is an MDI?

Back 159

metered dose inhalor

Front 160

In treating a person with an asthma attack, give _____ as tolerated and bronchodilators like racemic _________ and ______ can be given for quick relief.

Back 160

oxygen

epinephrine
albuterol

Front 161

True or False: Bronchodilatros open the airway and nebulizers get medication deeper into lungs.

Back 161

True

Front 162

There are many bronchodilators used for asthma. Some include racemic epinephrine, albuterol, Bitolterol (Tornalae), Pirbuterol (MaxAir), and Luvobuterol (Xopenex). What form is each available?

Back 162

Racemic epinephrine - nebulizer
Albuterol- MDI, nebulizer
Bitolterol- MDI
Pirbuterol- MDI
Levobuterol- nebulizer

Front 163

Albuterol comes in two forms, what are they?

Back 163

Proventil and Ventolin

Front 164

Maintenance medications for people with peristent asthma include daily medications. There may be a ___-acting bronchodilator PRN or a sustained released bronchodilator such as _____.
An anti-inflammatory inhaled _________ is given after the bronchodilator.

Back 164

short
Serevent
corticosteroid

Front 165

True or False: Always give the bronchodilator after the corticosteroid to keep the bronchioles open.

Back 165

False, Open up the airway with the bronchodilator, then give the corticosteroid.

Front 166

After taking in MDI, hold breath for ____ seconds to get meds into lungs.

Back 166

10

Front 167

True or False: Avoid swimming if you are an asthmatic.

Back 167

False, swimming is a beneficial form of exercise and exercise is important.

Front 168

The MDI is empty if it _____.

Back 168

floats

Front 169

Some complications caused by asthma include what 4?

Back 169

-status asthmaticus
-chronic emphyzema/ chronic bronchitis
-cor pulmonale
-pneumothorax

Front 170

Cor pulmonale is a _____ issue.

(what system?)

Back 170

cardiac

Front 171

A pneumothorax is a spontaneous lung _______.

Back 171

collapse

Front 172

In managing asthma, it is important to do ongoing _________ assessments, put head in what position ? Encourage f_____ and small, frequent _______. Maintain appropriate oxygen therapy and family needs ongoing teaching with lots of reinforcement.

Back 172

respiratory
elevate HOB, put in position of comfort for sleep

fluids
feedings

Front 173

Cystic Fibrosis is an acute/chronic disorder than can affect some/any body organ.

Back 173

chronic
any

Front 174

Cystic Fibrosis often includes the triad:

Back 174

1. progressive COPD
2. pancreatic enzyme deficiency
3. marked elevation of sweat electrolytes (sodium & chloride)

Front 175

True or False: Cystic Fibrosis is caused by an autosomal recessive genetic disorder

Back 175

true

Front 176

Cystic Fibrosis is both a ________ and _______ disease which leads to excessive and abnormally thick _______ which leads to ______ of tubes, ____, and airways.

Back 176

pulmonary, pancreatic
secretions
obstruction
ducts

Front 177

True or False: Cystic Fibrosis is the most common fatal genetic disorder affecting caucasions and effects about 30,000 adults and children in the US. >10 million are carriers

Back 177

true

Front 178

Many children who were diagnosed as infants with cystic fibrosis end up with _____ by the time they are 13-14. They usually present with a b_____c_____ and need a ____ transplant. However, some people have milder cases.

Back 178

COPD
barrel chest
lung

Front 179

List some examples of nursing diagnosis appropriate for a patient with cystic fibrosis.

Back 179

ineffective airway clearance
impaired gas exchange
risk for infection
imbalanced nutrition
activity intolerance
low self-esteem
inefficient coping
anticipatory grieving

Front 180

What age of CF patients are the most non-compliant?

Back 180

Teenagers

Front 181

Many children with CF also develop ______ because the pancreas does not function correctly.

Back 181

diabetes

Front 182

Babies with CF have decreased _________ enzymes and less fluid in GI tract, they end up with very hard sticky meconium that can't pass, known as a ______ ______.

Back 182

pancreatic

meconium ilius

Front 183

Symptoms of meconium ileus in infants.

How is it treated?

Back 183

failure to pass mec, abdominal distention, vomiting that smells like mec

tx: enema, x-ray with watered down dye, or surgically cleaned out.

Front 184

What medications commonly prescribed for CF?
(7)

Back 184

bronchodilators (2-3 x per day)
mucolytics
pancreatic enzymes
Vitamins A, D, E,K, Fe
Antibiotics (frequently)
Salt replacement
Annual Flu Shot

Front 185

True or False: Kids with CF need fat soluble vitamins because they have problems with absorption

Back 185

True

Front 186

Treatments for CF other than medications include chest _______, oxygen and _____ therapy, and dietary _______. Also assist to cough or use ______, refer to support groups and family needs lots of teaching and support.

Back 186

physiotherapy
aerosol (nebulizer tx such as Aluterol and prednisone)
suction
supplements

Front 187

Chest physiotherapy include ______ drainage and ________ to loosen secretions. Describe this.

Back 187

postural
percussion (manual or machine)

Head is down, hips up on pillow to facilitate drainage
Causes a lot of coughing, get secretions out.

Front 188

If the sweat chloride test is above ____, it is considered CF.

Back 188

60

Front 189

After a baby with CF passes meconium, the stools become....

Back 189

frothy, foul smelling

Front 190

Patients with CF need pancreatic enzymes sprinkled on their food for each snack and meal. A pill with pancreatic enzymes can also be taken or get a G tube to help gain _____.

Back 190

weight

Front 191

Signs and Symptoms of CF include history of meconium _____ at birth, poor _____ gain, lung sounds like _____ and ______, thick _______, repeated bouts of ______, and _____ skin.

Back 191

Signs and Symptoms of CF include history of meconium illeus at birth, poor weight gain, crackles, wheezes, thick secretions, repeated bouts of PNA, and salty skin.

Front 192

True or False: Women with CF can't ever get pregnant.

Back 192

False, sometimes they can, sometimes they can't.

Front 193

A red flag that makes you think a patient may have CF at birth is...

Back 193

failure to pass meconium

Front 194

Infectious Mononucleosis peaks between ages 14-18. It is caused by ___- _____ virus. The virus grows in ___ lymphocytes and ________ cells.

Back 194

Epstein-Barr
B
oropharyngeal

Front 195

The incubation period of mononucleosis is between 4-8 weeks and the virus is shared/shed for about ____ months after primary infection.

Back 195

18

Front 196

Prodromal (early indicators) of infectious mononucleosis

Back 196

headache
fever
malaise
chills
fatigue
puffy eyelids
anorexia
distaste for cigarettes

Basically just feel crappy, puffy eyelids, fever, and cigs don't taste as good if they're a smoker.

Front 197

Symptoms of "full blown" mono

Back 197

fever
painful lymph node enlargement
severe sore throat (worst ever)
dysphagia
spleen enlargement

(FLEDS)

Front 198

Mono can commonly be confused with ____ _____. How can you tell the difference?

Back 198

strep throat

strep has white patches
mono has firey red throat,

Front 199

Mono usually lasts 2-3 weeks and ______ is usually the lingering symptom.

Back 199

malaise

Front 200

Treatment for mononucleosis includes plenty of ____ and _____, ______ for fever, and _____ gargle for sore throat. Good teaching is important so they don't spread the illness to others.

Back 200

fluids, rest
acetaminophen
saline

Front 201

What is the main complication of mono and how can it be avoided?

Back 201

rupture of spleen

avoid contact sports
heavy lifting
avoid valsalva's maneuver with bowel movements
stool softeners

Front 202

What is the medical term for "whooping cough?"

Back 202

pertussis

Front 203

Pertussis is acute/chronic, highly/not very contagious, respiratory/urinary infection.

Back 203

acute
highly
respiratory

Front 204

What causes pertussis?

Back 204

Bordetella pertussis

Front 205

There is an immunization for pertussis, but who are we most concerned about getting it?

Back 205

Especially babies, need more than one shot to be immune
Shots are given at 2, 4, and 6 months

Front 206

Pertussis occurs most often in non-________ children under age ___.

Back 206

immunized
4

Front 207

Clinical Manifestations of pertussis include an upper/lower respiratory infection that develops into a severe, prolonged ___, ______ cough with episodes usually ending in an inspiratory _____ sound.

Back 207

upper
dry, hacking
"whooping"

Front 208

Pertussis can last 2 or more weeks (sometimes up to 3-4 months) and there is sometimes post-tussive _______ because they cough so hard.

Back 208

vomitting

Front 209

True or False: Pertussis is often not treated because the child doesn't really look sick.

Back 209

False, they really look sick.

Front 210

Treatment for pertussis includes the antibiotic _________ and other antimicrobials. They need to maintain respiratory precautions such as ________. Bed rest is promoted/discouraged.

Back 210

erythromycin
isolation
promote