Prenatal and pediactric
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What symptoms are similar to those of an asthmatic?
What is included in supportive therapy?
Diagnosis test for RSV?
Nasal pharangeal aspiration
Medications for RSV?
Steriods- (Flovent, pulmocort)
List three indications for Ribavirin therapy for RSV?
Less than 6 weeks of age or getting worse
How is the CXR for RSV similar to asthma?
Immunization for RSV is indicated for which group of patients?
What are some of the things you can do to decrease the chances of having a baby die of SIDS?
Have baby sleep on back
Don't over dress baby
Have bed clear
Classification of Respiratory Disturbances associated with sleep in pediatric patients!
Apnea in preterm infant
Apnea in term neonates and postneonatal infants
Respiratory control abnormality
Obstructive sleep apnea syndrome
Apnea in preterm infants!
Secondary to specific etiology (immaturity of cardiorespirator or neurologic function or dysfunction associated with acquried disease
Apnea in term neonates and postneonatal infants!
Secondary to specific etiology
Apnea of Infancy
Respiratory control abnormality!
Obstructive sleep apnea syndrome!
Secondary to anatomic disorders of the upper airway and neuromuscular disease
Etiology of infants with apnea!
Central nervous disease
What things are monitored during a sleep study?
Respiration effort and air flow
Factors predisposing to obstructive sleep apnea in children!
Enlarged tonsils and adenoids
Cleft or high arched palate
Chronic nasal congestion
Clinicals features associated with sleep apnea!
Failure to thrive
What is an ALTE?
An episode of apnea, color change, and hypotonia that the observer believes to be life threathing to the infant and for which some intervention is felt to be requried
What is the risk for CF in each pregnancy?
Elevated sweat chloride
What are the GI complications of CF?
Don not produce lipase
What are the pulmonary complications of CF?
What else can be done besides regular CPT to move secreations with CF?
What are the symptoms that make you supect CF?
Frequent thisk sputum production
Reccurent respiratory infections
Breaks down DNA
What sweat chloride is diagnostic for CF?
Greater than 60
Know CPT positions!!!
Look them up!
Early ABG's with CF!
Early PFTs with CF!
Decrease FEF 25-75
Early CXR with CF!
Late ABG's with CF!
Late PFTs with CF!
Late CXR wtih CF!
List three symptoms that indicate a tune up is needed with CF?
Increased sputum production
What causes the cells to sickle in sickle cell disease?
Rapid temperature changes
What body systems are affected with sickle cell disease?
What are the pulmonary effects of sickle cell disease?
Acute chest syndrome
Pulmonary vascular injury
Sickle cell chronic lung disease
What are the treatment options for ACS?
Red blood cell tranfusions
Aerosolized beta agonist
Which lobe is often affected with foreign object aspiration?
Right middle lobe bronchi
What are the factors that determine the severity of presentation?
The location of impaction
The degree of airway obstruction
Can an esophageal aspiration give respiratory symptoms?
Explain how an expiratory CXR may help with the diagnosis of foreign body aspiration?
It will detect asymmetric lung hyperinflation that can result from a ball valve effect of foreign material localized in a major bronchus
According to the PALS guidelines, what symptoms suggest that immediate intervention is need with foregin body aspiration?
Inability to speal or cry audible
Weak ineffective cough
High pitched sound or no sound during inhalation
Universal chocking sign
Why didnt more albuterol help rachel?
She needed something else!
What is the rule of two?
Children should be accompanied with a friend if they are short of breath?
6 steps to control asthma?
Intial assessment and diagnosis
: managing asthma long term
Controls of factors contributing to asthma severity
Periodic assessment and monitoring
Education for partnership in asthma care
Managing asthma exacerbation
A trait or disease that is passed down threw families
What organism infects CF patients?
What symptoms of ACS overlap with pneumonia?
Why does recurrent pneumonia suggest the presence of an FOA?
If its something like metal it will get over looks and you will continue to get pneumonia in the same exact spot even after treatment
The development of respiratory failure: Phase 1
The patient develops mild hypoxemia secondary to V/Q imbalance.
The patient has a slightly increased RR
The development of respiratory failure: Phase 2
Worsening hypoxemia will stimulate the chemoreceptors to increase breathing.
An increase in RR and Vt will result in increases alveolar ventilation.
This will stabilize the O2 status but will result in hyperventilation
The patient is working hard and is compensating for the problem
The development of respiratory failure: Phase 3
The respiratory muscles are fatigueing
Respiratory pattern of tired muscles is increased RR and decreased Vt.
Alveolar ventilation is decreased
The patient is working hard but not doing as well
The PaO2 starts to fall anf the PaCO2 starts to climb and this is impending respiratory failure
The development of respiratory failure: Phase 4
The fatigue increases and RR begins to fall
Vt is still reduced RR reduces
MV decreases and PaCO2 is greater than normal
Hypoventilation results with worsening hypoxemia
The minute volume is not enough for adequate gas exchange
The patient is now in respiratory failure
Where do you find the narrowest portion of the pediatric airway that may compromise endotracheal intubation?
Irreversible dilation of the bronchial tree
What combination of pneumonia to causative pathagen is incorrect?
What signs suggest ACS in a patient with sickle cell disease?
The major culprit for VAP appears to be what?
The incidence of asthma has done what over the past 10 years?
When educating a patient or family member it is always essential to remeber to...
Ask open ended questions
What is the purpose of a spacer?
To slow aerosol velocity
To minimize particle impaction in the oropharynx
To enhance deposition in the lower respiratory tract
Omalizumab is generally dosed for patients with IgE levels between...
30 and 700
What is the best way to manage cockroaches?
Triggers to airflow obstruction include?
Aspirin and nonsteriods antiinflammatory drugs
What are the five components of asthma?
The increased production in the viscous airway secretions of a patient with CF are caused by all of the following except!
Decreased ciliary function
Patients with severe chronic forms of CF should only be given oxygen to maintain saturations between 90% to 95% why?
To elimante CO2 retention
To preserve hypoxic drive
Today, the median survival rate for CF is about...
The most common upper airway problems encountered by children with CF include...
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Prenatal and pediactric
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