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80 Cards in this Set

  • Front
  • Back
what are some upper repiratory tract infections?
sinusitits, thrush, pharyngitis, tonsillitis, croup, epiglottitis
what are some lower respiratory tract infections?
tracheitis, pneumonis( bacterial- #1 cause is S. pneumoniae, viral- RSV), asthma
the most common respiratory pathogens appear in epidemics during which seasons?
Winter, and srping
What do you include in a repiratory assessment, and look for?
Rate- rapid(tachypnea), normal, or slow (bradypnea) for the particular child.
Depth- retraction; hyopnea-shallow and slow; hypernea- increased depth and rate
ease- effortless, or labored; orthopnes; flares nares; grunting; wheezing.
Rhythm- the variation in rate and depth of respiration.
what can bradypnea (slow breathing rate) cause?
DKA, liver failure, respiratory failure
what can tachypnea (fast breathing rate) cause?
heart or lung disease, lung infections, anemia
what are some repiratory test?
Plumonary function test, which are non invasive. Also pulse ox, arterial blood gases (done by RT), apnea/bradycardia monitor, chest x-ray, CT scan, MRI, bronchoscopy.
What is the function for a child in respiratory distress of a bronchoscopy?
diagnostic or therapeutic (removal of a foreign body)
What are some post procedure things interventions and complications from a bronchoscopy?
interventions- giving fluids after gag/swallowing returns.

complications- hemorrhage, respiratory distress
infants are obligate ____ breathers?
Nose. if nose is stuffy they can't breath.
Infants have ____ airways?
Small. Throat infections can easily lead down to lungs. Its also narrow and can narrow furthur from edematous mucous membranes and increased production of secretions.
with URI ______ is a BIG problem, so give _____ of any kind.
Dehydration, fluids
nasopharyngitis is also referred to as _____. How would you treat this?
Common cold. symptomatic treatment.
You would never give an infant <2 months with a cold an OTC cold remedie becauses it causes _____.
Vasocontriction
Infants less than 2 months old are hospitalized with a fever > ____ even with cold symptoms.
100.4
For oral rehydration infants should get ____ and older children should get____.
pedialyte, gatorade
pg 791
the onset of pharyngitis is characterized by?
headache, fever, and abd pain
What is prescribed for pharyngitis?
oral penicillin
what is the diagnostic method for pharygitis?
throat culture
what causes pharygitis?
group A hemolytic streptococcus. This strep throat can travel to the lungs.
tonsillitis often occurs with what other URI?
pharyngitis
this URI is one of the most prevalent disease of early childhood, whose incidence is higher in the winter months, and mostly occurs in the first 24 months of life.
otitis media
shildren living in households with ____ers are more likely to have OM.
somkers
a child with OM will have and ear drum that looks like?
a tympanic membrane with OM reveals a purulent descolored effusion and bulging, full, or reddened membrane
bottle feeding a baby supine increases the risk for?
OM. reflux of milk in to the eustachian tubes.
What is one reason BreastFed babies are at lesss risk for OM?
The breast milk contains IGA which coats the MM of the eustachian tubes.
in OM pathogens enter the middle ear from where?
the throat
What are some symptoms of OM?
Mild to severe pain, low grade to high fever, nausea and vomiting.
what bacterial is the most common cause of OM?
S. pneumoniae
what to u treat OM with? and if a pt is <6 months you ____, and if the pt is >2 yrs you _____.
Amoxicillin initially.
<6 month- must treat
>2yrs can watch and wait
what are some surgical treatments of OM?
for recurrent OM:
tympanostomy tube palcement,
adenoidectomy
nursing considerations for OM
1. relieving pain, 2. facilitating drainage when possible,3. preventing complications or recurrence
OM with euffsion is characterized by?
-fluid in the middle ear w/o infection

-sounds that are muffled,
feeling fullness in ear
what is treament protocal for OME?
tympanostomy tube palcement
OME can significantly impact ____ and delay _____?
hearing and speech
what does croup cause?
laryngeal and tracheal inflammation and swelling causing narrowing of the airway.
what is croup characterized by?
a hoarseness, a resonant cough described as "barking" or " brassy". With varying degrees of respiratory distress resulting from sewlling or obstuction in the region of the larynx
for a pt with croup the nurse should be vigilant in observation of there ____?
respiratory status. most important. if obstuction is severe enough it can prevent adequate exhalation of CO2 which leads to respiratory acidosis which leads to respiratory failure.
what are some meds for croup (2)?
nebulized epinephrine with severe croup- stridor at rest, retractions, or difficulty breathing.
Corticosteroids- for inflammation, subglottic edema
def of bronchiolitis-RSV
acute swelling of bronchioles with the lumina filling with exudate and mucus
what are some s/s of bronchiolitis-RSV
Wheezing, couging, rhinorrhea, low-grade fever. OM may also be present. in very youn infants apnea may be the first sign.
what is the diagnostic test for bronchiolitis-RSV?
antibody testing - ELISA or IFA
Treatment of bronchiolitis-RSV
treat symptomatically- high humidity, adequate fluid intake and rest
a pt in the hospital for bronchiolitis-RSV is on what type of precautions?
droplet
s/s of pneumonia
abrupt onset following a viral UIR

-fever, tachypnea, cough, chest pain, malaise, abd pain
bacterial pneumonia treatment
antibiotic therapy, liberal fluid intake, activity as tolerated with rest, antipyretic for fever
respiratory dirtress symptoms
-must be aware pt is getting worst-

- tachypnea
- infants >60
-nasal flaring
-retraction
- substernal, inter costal
-cyanosis
-accessory muscel use
- neck
-grunting
-collapse of vocal cords with each breath
-mental status
-restlessness (sometimes all u got)
-confusion
respiratory dirtress treatments
-immediate repiratory support w/ o2
-stablize pt
-oxygen - meds
-albuterol, epinephrine (vasodilators)
- if unable to stabilize may need ventilation or intubation
respiratory failure causes 5
1. air way obstruction
-foreign body, CF, increased secretions, asthma, anaphylaxis
2. lund disease
-severe pneumonia, asthma, CF, pulmonary edema
3. weakness affecting breathing
-drugs, severe obesity, sleep apnea
4. muscle weakness
-muscular dystrophy, spinal cord injury
5. Adnormal chest wall
what are some durgs (2) to use during respiratory failure?
corticosteroids and epinephrine
a pt could have a ____ reaction to epinephrine?
hypersensitivity-anaphylaxis
what is the max dose of epi and how often can it be givien?
0.5 mg, can repeat q 20 min for 4 hours.
what should you monitor when you give epi?
hypertension, tachycardia and EKG changes
what is naloxone (Narcan) used for?
opiate intoxication -resp. depression
is naloxone (Narcan) short or long acting?
very short acting, must repeat q 2-3 min.
SE of naloxone (Narcan)
n/v, diaphoresis, tachycardia, hypertension, tremors
def of asthma
chronic, reversible inflammatory airway disorder involving mast cells, leukotrienes, eosinophils, characterized by airflow obstruction.
what are the manifestations of asthma?
wheezing, breathlessness, chest tightness, and cough esp. at night or in the early morning. also tachypnea, restlessness, anxiety, sweating
diagnosis of asthma?
pulmonary function test, serum IgE levels, chest x-ray
asthma management
prevention- identify and avoid triggers (key)
-annual influenza immunization b/c asthma gets worst w/ this
-desensitization (if stimulas can be avoided)
-meds
what is the #1 rescue med used to treat symptoms and exacerbations?
albuterol-short acting
what is the function of the short acting med albuterol
dilate smooth muscle, decreasing spasms
sort acting meds short be used up ___ times a day
four
se of short acting meds
tremors, tachycardia, insomnia, dry mouth, hypertension (cardiac se)
how is albuterol delivered?
nebulizer or MDI.
oral not affective
for a pt using corticosteroids what should u advise them to do after using the med?
wash mouth good to prevent trush
what is the function of the short acting med corticosteroids?
decrease inflammation to treat airflow obsturction
corticosteroids should be used in the lowest dose to avoid the SE which are...
osteoporosis, immune problems, hypertention
do not take ______ with grapefruit juice.
prednisolone a corticosteroids
_______ can be given IV for hospitalized patients (asthma med)
prednisolone
long acting asthma meds are used for?
control or prevention
for a pt using a long acting asthma med u should advise pt to discontinue their_____ and restart only if acute exacerbation occurs
rescue bronchodilator
name one anti-inflammatory agents for control of asthma
pulmicort- an inhaled corticosteroid, for the prevention of symptoms and suppression, control and reversal of inflammation.
name one leukotriene modifier use for the control of asthma
singular
singulair, a leukotriene modifier, prevents asthma by?
preventing bonchospasm, mucosal edema and increased secretions caused by the luekotrienes
exercise induced bronchospasm peak in 5- 10 min after _____ and resolvesin 20-30 min _____.
after ending axercise and resolves on its own
what asthma group is used for exercise induced bronchospasm
long acting agonists- foradil or serevent
for status asthmaticus improve ventilation by
using short acting agonists and corticosteroids
use should re-hydrate status asthmaticus with fluids given at maintenance rate only to avoid what complication?
pulmonary edema
for status asthmaticus if they don't improve with short acting agonists or corticosteroids u should admin?
epinephrine