Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/210

Click to flip

210 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
medical term for the "common cold"
Nasopharyngitis
causes of nasopharyngitis (5)
Viral:
rhinovirus
RSV
adenovirus
influenza
Para influenza virus
prair
What are some s/s of nasopharyngitis?
congestion
runny nose
cough
headache
fever
IgE mediated inflammation of nasal mucosa is known as _____ ______.
allergic rhinitis
What are some causes/triggers of allergic rhinitis?
dust mites
feathers
animal dander
pollens
molds
some foods
What can be done to find out what you are allergic to?
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.
Some s/s of allergic rhinitis
watery rhinorrhea (runny nose)
itching
sneezing
allergic salute (rubbing nose upward with hand)
allergic shiners (dark circles)
Therapeutic management for allergic rhinitis includes eliminating _______, immunotherapy such as allergy ____, antihistamines such as: (3) and intranasal __________.
allergens
shots
claritin, zertec, and benadryl
corticosteroids
An example of an intranasal corticosteroid is _______. What is a main disadvantage?
nasonex
takes several days to start working
True or False: Saline nasal drops are good for kids and it's ok to have one bottle per family.
False: Each kid needs his own, no sharing
Overuse of nasal spray decongestants can cause a _____ effect which makes them ineffective.
rebound
_________ is inflammation of the sinus.
sinusitis
Sinusitis usually follows ...
and may be associated with ____ ____ or o_____ m____ with ______. Sinusitis can also be caused by a foreign body obstruction in the ____.
an URI
allergic rhinitis
otitis media effusion
A sign of infection is ______, another word for bad breath.
halitosis
A cold usually lasts how long?
10-14 days
s/s of sinusitis are similar to cold but do not improve after ___ days.
Other s/s include... (6)
14
low grade fever
purulent nasal discharge
halitosis
cough (from nasal drip)
headache
fatigue
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.
antibiotics
warm, moist compresses
acetaminophen
decongestants
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.
pain
edema
palpate
Teach parents of kids with sinusitis to encourage ___ fluids, a bedside ______, breathing warm ____, and use nasal ____.
clear
humidifier
mist
drops
otitis media (OM) includes which 2 types?
Acute otitis media (AOM)
Otitis media with effusion (OME)
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 .
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 .
S/S of acute otitis media (AOM)
severe otalgia (pain in ear)
fever
irritability
nasal congestion
red, bulging typanic membrane
S/S of otitis media with effusion (OME)
visible fluid behind eardrum
tinnitus (ringing in the ear)
mild balance disturbance
popping sounds
hearing loss--> speech problems
A ________ measures the pressure in the middle ear.
tympanogram
A fancy word for a hearing test is ______.
audiometry
Diagnostic findings for an ear infection include typanogram, audiometry, and ___ & _____ of purelent discharge from nose.
culture & sensitivity
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.
true
The tx for otitis media includes what 4 meds?
antibiotics
analgesics (numbing ear drops)
antipyretics
decongestants
True or FalseDepending on which Dr. you ask, 4-8 ear infections a year constitutes getting myringotomy with tympanostomy tubes placed.
True
Myringotomy is a surgical incision of the eardrum to relieve p_____, p___, and f____. Tubes _____ pressure and keep ear _____.
Myringotomy is a surgical incision of the eardrum to relieve pressure, pus, and fluid. Tubes equalize pressure and keep ear aerated.
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?)
diet- liquids and soft foods
Elevate HOB
Lie with affected ear down (helps with drainage)
Assess ear drainage
Pain Mgmt.- tylenol is usually enough.
True or False: Complications from ear infections include acute otitis media and hearing loss
False, chronic otitis media & hearing loss
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 ____.
don't blow nose
dry
True or False: When surgically placed tubes fall out of a child's ears it is a medical emergency.
False. It's no biggie.
In general, what is usually a more serious infection, bacterial or viral?
bacterial
Pharyngitis can either be viral or bacterial. Bacterial is caused by what?
Group A beta-hemolytic streptococcus
(Group A Strep)
Viral or Bacterial (strep) Pharyngitis: severe sore throat
bacterial (strep)
Viral or Bacterial (strep) Pharyngitis: low grade fever
viral
Viral or Bacterial (strep) Pharyngitis: enlarged cervical lymph nodes
both
VViral or Bacterial (strep) Pharyngitis: mild sore throat
viral
Viral or Bacterial (strep) Pharyngitis: high fever
bacterial (strep)
Viral or Bacterial (strep) Pharyngitis: abrupt onset
bacterial (strep)
Viral or Bacterial (strep) Pharyngitis: hoarseness, cough, rhinitis
viral
Viral or Bacterial (strep) Pharyngitis: white patches on throat
bacterial (strep)
Viral or Bacterial (strep) Pharyngitis: very red pharynx
bacterial (strep)
Viral or Bacterial (strep) Pharyngitis: erythema & inflammation of pharynx and tonsils
viral
Viral or Bacterial (strep) Pharyngitis: positive throat culture
bacterial (strep)

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

Strep:
antibiotics
rest
keep home from school
prevent transmission to others- no sharing drinks etc.
24 h after antibiotics started, get new toothbrush
Tonsillitis is the inflammation of the tonsils that usually results from ______.
pharyngitis
Tonsilitis is caused by either a ____ or bacterial (Group A hemolytic streptococcus) source.
viral
True or False: tonsilitis has same clinical manifestations as pharyngitis.
True
Treatment of tonsilitis includes a _____ gargle, plenty of r____, observe for complications such as a p_______ a______. If chronic tonsilitis, may need a ______.
saline
rest
peritonsilar abscess
tonsillectomy (if done at young age tonsils can grow back)
Post op care for tonsillectomy includes: observe for ______, have ______ available, rest, soft foods, and pain control.
bleeding
suction
An early sign of bleeding after tonsillectomy is .....
frequent swallowing (blood)
may throw it up too


also restlessness
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?
hemorrhage

red/orange- can be confused with blood if they throw up etc.
Give clear or green juices etc.
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)
laryngomalacia
When is laryngomalacia most often seen?
premature babies
(may be slow to gain weight because they have to work harder to breathe)
With laryngomalacia, what will you hear when you listen to the lungs?
noisy, crowing inspiratory stridor
With laryngomalacia, there may or may not be ________ (indicates increased work of breathing)
retractions
With laryngomalacia, is there cyanosis?
No cyanosis
When are symptoms of laryngomalacia increased?
When child is supine or when crying
True or False: laryngomalacia can be present at birth or up to 2 months old.
True
What is the tx for laryngomalacia?
usually s/s resolve without tx by 18-24 months

Very rarely, they need intubation with tracheostomy
Why is it difficult for children with laryngomalacia to gain weight? What helps?
because they can't eat and breathe at the same time

Frequent upright feeding until they outgrow it (epiglottis and larynx firm up)
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?
respiratory difficulties & feeding problems

aspiration
small frequent feedings
Croup includes inflammation of the _____, ____ and ____ tubes that leads to _____ obstruction
inflammation of the larynx, trachea, & bronchial tubes leads to laryngeal obstruction
True or False: Croup Syndromes are usually viral but may be bacterial.
True
What virus usually causes croup?
parainfluenza
In talking about croup, which is more common viral or bacterial? Which is more serious?
viral is more common
bacterial is more serious
laryngotracheobronchitis is the medical term for ______.
Croup
True or False: Croup is the most common cause of airway clearance.
Um... no
most common cause of airway obstruction.
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?
boys
winter
Some clinical manifestations of croup include....
(6)
(SHALLT)
Stridor
Hoarse, barky cough
A sore throat (sore throat)
Low fever
Labored respirations with retractions
Tachypnea
The goal in treating croup is to...
maintain a patent airway and provide adequate gas exchange
In treating croup, ___ humidified mist is helpful and oxygen therapy is appropriate if t is ____.
cool
hypoxic
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.
bronchodilator- nebulized racemic epinephrine

corticosteroids (dexamethasone)

nebulizing
True or False: antibiotics are commonly prescribed for croup.
False, it's viral
Acute epiglottitis is a mild/severe rapid/slow progressing infection of the epiglottis and surrounding ______ leading to marked _____ ______.
Acute epiglottitis is a severe, rapid progressing infection of the epiglottis and surrounding tissue leading to marked airway obstruction.
True or False: Acute epiglottitis can occur in children and adults and occurs more often in girls.
False, occurs equally among boys and girls
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.
True
What are the clinical manifestations of acute epiglottitis?
High fever
Acute sore throat
Irritability
Tachypnea
Inspiratory stridor w/ retractions
Drooling
Dysphagia
Dysphonia
Distressed breathing
(4 D's are cardinal signs)
True or False: A child with acute epiglottitis will have a cough.
False. There is no cough with epiglottitis.
What position does a child with epiglottitis usually assume?

(They naturally go into this position)
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.)
True or False: Never try to visualize the epiglottis. It should only be done by a doctor with emergency equipment and staff on standby.
True! Know this!
Tx for epiglottitis includes endotracheal _________ and IV antibiotics such as .... (3)
intubation

ampicililin,*
ceftriaxone,
or cephalosporins
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 _____.
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.
Inflammation of the trachea and major bronchi in which there is increased mucous production is known as _______.
bronchitis
Bronchitis is almost always viral/bacterial.
viral
Bronchitis occurs with ____ and _____ respiratory infections.
upper
lower
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.
gradual
nonproductive
productive
What kinds of sounds might you hear when you listen to the lungs of a person with bronchitis?
coarse & fine crackles
high-pitched rhonchi
In managing, bronchitis, encourage rest, fluids, and humidification. What kinds of medications might be used?
Bronchodilator
Oral prednizone, prelone
Should we suppress the cough for a child with bronchitis (or any other respiratory issue)? Why or why not?
No we don't really suppress coughs anymore in kids. You want to get the mucous stuff out. If coughing is causing difficulty sleeping.
True Or False: Bronchitis is usually self limiting.
True
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.
antibiotics
Bronchitis usually runs its course for 7-10 days but the _____ may persist for a week or two.
cough
Bronchiolitis is characterized by _______ of the bronchioles, e_____, s_________s, and w_______.
Bronchiolitis is characterized by obstruction of the bronchioles, edema, secretions, and wheezing.
Bronchiolitis is an acute/chronic lower/upper respiratory infection. Children with bronchiolits end up at the hospital because they become _______.
acute
lower

hypoxic
Is bronchiolitis viral or bacterial?
viral
Bronchiolitis can be caused by adenovirus, parainfluenza virus, rhinovirus, but most commonly cause by....
RSV
(Respiratory Syncytial Virus) RSV
RSV attacks the lining of the ____ and ______s.
bronchi
bronchioles
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.
True
How is RSV transmitted? It can also live on toy surfaces and unwashed hands for how long?
droplet
1 hour
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...
immune

wash everything!! toys, hands, countertops, etc.
RSV causes _______ because it makes a lot of mucous and the child can't breathe around it.
hypoxia
Incubation of RSV is 2-8 days and the average span is __.
5
Bronchiolitis caused by RSV occurs primarily in winter and spring during the first ___ years of life. Premature infants are at a higher risk.
2
Diagnostic Findings for bronchiolitis caused by RSV include positive RSV ________ culture (wash)
Chest X-ray shows ....
CBC is positive/negative
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?
If a child has a history of an ________ with a ___ __ fever for a few days, it may progress to RSV.
If a child has an URI (upper respiratory infection) with a
low grade fever for a few days, it may progress to RSV.
S/S of bronchiolitis caused by RSV
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)
Tx for bronchiolitis oxygen treatment given in what different of methods?
cool mist tent with oxygen
hood
nasal cannula
In managing bronchiolitis, we do an intermittent/continuous pulse oximeter. Medications for bronchiolitis include ________ and _______ and possibly antiviral medications such as _____.
continuous

antipyretics
bronchodilators
ribavirin
What is important to know about ribavirin?
It can cause birth defects, no one of childbearing age should breath it in.
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.
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.
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?
Synagis
__________ is an inflammation or infection of the pulmonary parenchyma (tissue) that impairs gas exchange.
pneumonia
4 types of PNA (causes)
Viral (usually RSV)
Bacterial (less common than viral)
Mycoplasma (fungal)
Aspiration of foreign substances
(food - bottle - drowning)
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?
lobar
bronchial
interstitial (tissue around alveoli)
True or False: Pneumonia is less common among infants and young children.
False, more common
S/S of viral PNA (4)
mild to high fever
cough
rhonchi
fine crackles
S/S of bacterial PNA (8)
high fever
cough
tachypnea
rhonchi
crackles
retractions
cyanosis
chest pain
Which more severe, viral or bacterial PNA?
bacterial
viral PNA usually not admitted
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.
patchy infiltrates, atelectasis, and pleural effusion

elevated WBC
Tx of PNA depends on _____.
cause
Tx for viral PNA includes supportive care such as o______, h_______, and maybe b_________s. For bacterial PNA, supportive care and a_______.
oxygen
hydration
bronchodilators

antibiotics
Foreign Body Aspiration is aspiration of an object into the ________ area and /or main stem ________.
laryngotracheal
bronchus
Expain the degrees of obstruction (foreign body aspiration)
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.
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 ________ ________.
degree
respiratory distress
A foreign body aspiration can cause symptoms such as... (depending on degree of obstruction)
stridor
wheezing
may elicit a cough
gagging
diminished breath sounds distal to the foreign body
inability to speak
If aspiration occurs, a child may exhibit symptoms of a _________ ______.
respiratory infection
How is foreign body aspiration resolved?
bronchoscopy
Risk factors associated with exposure to passive smoking
Impacts on Pregnancy
-placental insufficiency
-IUGR
-spontaneous abortion

SIDS

Respiratory Conditons
-bronchiolitis
-asthma

Otitis media

-Role modeling to child that smoking is ok
True or False: Smoke inhalation causes more deaths than fire.
True
Smoke inhalation causes airway ______, inflammation, and damage.
irritation
interferes with cellular expiration and is known as the "silent killer"
carbon monoxide poisoning
therapeutic management of smoke inhalation can include ________ _____ % O2, blood gases, may need intubation or ________, and medications like _______ or ________.
therapeutic management of smoke inhalation can include humidified 100 % O2, blood gases, may need intubation or tracheostomy, and medications like corticosteroids, bronchodilators
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....
removing patient from area/ getting into fresh air, oxygen therapy, IV fluids, and hyperbaric pressure if severe.
Apnea is the cessation of breathing for ___ seconds or longer, a change in ____ or _____ tone
20
color
muscle
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?
CNS

gentle stimulation
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.
seizures
GER
hypoglycemia

usually
Drugs that help with apnea include what 2?
caffeine
theophylline
There is no known cause of SIDS. What are some risk factors?
prone sleeping position
prematurity
botulism (honey)
reactions to immunizations
passive smoking
What is the leading chronic lung disorder in children?
asthma
Asthma is a ________ airway disease.
reactive
Three factors contribute to airway obstruction in asthma:
-______ and ______ of the mucous membranes

-accumulation of tenacious ______________

-______muscle ______ of bronchi and bronchioles
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
tenacious
- thick, goopy
With asthma, air has hard time moving through tight spaces and we hear ______.
wheezes
Give some examples of some trigger factors for asthma
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)
Clinical manifestations of asthma
CERB the NERD

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

Nasal Flaring
Expiratory Wheezes
Retractions
Dyspnea
If asthma is chronic you may see _____ chest and ________ shoulders. You may also see these in ____ _____.
barrel
elevated

Cystic Fibrosis
Signs of respiratory distress in pediatrics include _____ flaring, sternal _______, the position: ______, use of accessory ______, tachypnea/bradypnea, and a color change: ______.
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.
What is it called when a patient with asthma does not respond to treatment?
status asthmaticus
Diagnostic tests associated with asthma include pulse _____, ABG's, _______ function tests, peak flow meter, ____ testing to determine specific ______, and a ____ x-ray.
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.
True or False: on an ABG for a person with asthma, you will see increased PO2 and decreased PCO2.
False, you will see
decreased P02, increased PCO2
On a chest x-ray looking at a person with asthma you may see h________ and bronchial ______.
hyperinflation
thickening
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 ___ ______.
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.
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 ______.
peak flow meter
age and weight
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.
yellow
red
What is an MDI?
metered dose inhalor
In treating a person with an asthma attack, give _____ as tolerated and bronchodilators like racemic _________ and ______ can be given for quick relief.
oxygen

epinephrine
albuterol
True or False: Bronchodilatros open the airway and nebulizers get medication deeper into lungs.
True
There are many bronchodilators used for asthma. Some include racemic epinephrine, albuterol, Bitolterol (Tornalae), Pirbuterol (MaxAir), and Luvobuterol (Xopenex). What form is each available?
Racemic epinephrine - nebulizer
Albuterol- MDI, nebulizer
Bitolterol- MDI
Pirbuterol- MDI
Levobuterol- nebulizer
Albuterol comes in two forms, what are they?
Proventil and Ventolin
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.
short
Serevent
corticosteroid
True or False: Always give the bronchodilator after the corticosteroid to keep the bronchioles open.
False, Open up the airway with the bronchodilator, then give the corticosteroid.
After taking in MDI, hold breath for ____ seconds to get meds into lungs.
10
True or False: Avoid swimming if you are an asthmatic.
False, swimming is a beneficial form of exercise and exercise is important.
The MDI is empty if it _____.
floats
Some complications caused by asthma include what 4?
-status asthmaticus
-chronic emphyzema/ chronic bronchitis
-cor pulmonale
-pneumothorax
Cor pulmonale is a _____ issue.

(what system?)
cardiac
A pneumothorax is a spontaneous lung _______.
collapse
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.
respiratory
elevate HOB, put in position of comfort for sleep

fluids
feedings
Cystic Fibrosis is an acute/chronic disorder than can affect some/any body organ.
chronic
any
Cystic Fibrosis often includes the triad:
1. progressive COPD
2. pancreatic enzyme deficiency
3. marked elevation of sweat electrolytes (sodium & chloride)
True or False: Cystic Fibrosis is caused by an autosomal recessive genetic disorder
true
Cystic Fibrosis is both a ________ and _______ disease which leads to excessive and abnormally thick _______ which leads to ______ of tubes, ____, and airways.
pulmonary, pancreatic
secretions
obstruction
ducts
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
true
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.
COPD
barrel chest
lung
List some examples of nursing diagnosis appropriate for a patient with cystic fibrosis.
ineffective airway clearance
impaired gas exchange
risk for infection
imbalanced nutrition
activity intolerance
low self-esteem
inefficient coping
anticipatory grieving
What age of CF patients are the most non-compliant?
Teenagers
Many children with CF also develop ______ because the pancreas does not function correctly.
diabetes
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 ______ ______.
pancreatic

meconium ilius
Symptoms of meconium ileus in infants.

How is it treated?
failure to pass mec, abdominal distention, vomiting that smells like mec

tx: enema, x-ray with watered down dye, or surgically cleaned out.
What medications commonly prescribed for CF?
(7)
bronchodilators (2-3 x per day)
mucolytics
pancreatic enzymes
Vitamins A, D, E,K, Fe
Antibiotics (frequently)
Salt replacement
Annual Flu Shot
True or False: Kids with CF need fat soluble vitamins because they have problems with absorption
True
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.
physiotherapy
aerosol (nebulizer tx such as Aluterol and prednisone)
suction
supplements
Chest physiotherapy include ______ drainage and ________ to loosen secretions. Describe this.
postural
percussion (manual or machine)

Head is down, hips up on pillow to facilitate drainage
Causes a lot of coughing, get secretions out.
If the sweat chloride test is above ____, it is considered CF.
60
After a baby with CF passes meconium, the stools become....
frothy, foul smelling
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 _____.
weight
Signs and Symptoms of CF include history of meconium _____ at birth, poor _____ gain, lung sounds like _____ and ______, thick _______, repeated bouts of ______, and _____ skin.
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.
True or False: Women with CF can't ever get pregnant.
False, sometimes they can, sometimes they can't.
A red flag that makes you think a patient may have CF at birth is...
failure to pass meconium
Infectious Mononucleosis peaks between ages 14-18. It is caused by ___- _____ virus. The virus grows in ___ lymphocytes and ________ cells.
Epstein-Barr
B
oropharyngeal
The incubation period of mononucleosis is between 4-8 weeks and the virus is shared/shed for about ____ months after primary infection.
18
Prodromal (early indicators) of infectious mononucleosis
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.
Symptoms of "full blown" mono
fever
painful lymph node enlargement
severe sore throat (worst ever)
dysphagia
spleen enlargement

(FLEDS)
Mono can commonly be confused with ____ _____. How can you tell the difference?
strep throat

strep has white patches
mono has firey red throat,
Mono usually lasts 2-3 weeks and ______ is usually the lingering symptom.
malaise
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.
fluids, rest
acetaminophen
saline
What is the main complication of mono and how can it be avoided?
rupture of spleen

avoid contact sports
heavy lifting
avoid valsalva's maneuver with bowel movements
stool softeners
What is the medical term for "whooping cough?"
pertussis
Pertussis is acute/chronic, highly/not very contagious, respiratory/urinary infection.
acute
highly
respiratory
What causes pertussis?
Bordetella pertussis
There is an immunization for pertussis, but who are we most concerned about getting it?
Especially babies, need more than one shot to be immune
Shots are given at 2, 4, and 6 months
Pertussis occurs most often in non-________ children under age ___.
immunized
4
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.
upper
dry, hacking
"whooping"
Pertussis can last 2 or more weeks (sometimes up to 3-4 months) and there is sometimes post-tussive _______ because they cough so hard.
vomitting
True or False: Pertussis is often not treated because the child doesn't really look sick.
False, they really look sick.
Treatment for pertussis includes the antibiotic _________ and other antimicrobials. They need to maintain respiratory precautions such as ________. Bed rest is promoted/discouraged.
erythromycin
isolation
promote