Peds 24 - Respiratory

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tiffanydawnn
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23715
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Peds 24 - Respiratory
Updated:
2010-06-15 20:30:21
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nursing pediatrics peds respiratory
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Peds Unit 24 - Respiratory Disorders
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  1. Respiratory Development
    • 2-4 weeks: laryngotracheal groove
    • 7th week: diaphragm
    • 24-28 weeks: aveoli and capillaries
    • 24 weeks: lethicin and sphingomyelin production begins
    • 35 weeks: lungs fully mature (assessed with amnio)
  2. Normal Respirations
    • Infant: 30-50
    • One year: 20-40
    • 6 years: 12-20

    • Use abd muscles until 3 yrs
    • Breathe through nose up
    • Sternal/intercostals retractions indicate resp. distress
    • Small bronchial tree - edema/spasms cause distress
  3. Ventilation
    • Medulla - respiratory center
    • Intercostals and diaphragm used to breathe
    • Intercostals, phrenic, and vagus nerves assist
  4. Nasopharyngitis
    • Inflammation and edema of membranes in URT
    • Most common respiratory disorder
    • Caused by rhinovirus or corona virus
    • Spread by sneezing, coughing, direct contact
    • Age, health, nutrition contribute
  5. Nasopharyngitis S/S
    • fever (up to 104 - febrile seizures)
    • nasal discharge - clear then purulent
    • irritability
    • sore throat
    • HA
    • fatigue
    • general discomfort
    • vomiting
    • diarrhea
    • contagious prior to symptoms + 8 hrs after
  6. Nasopharyngitis Complications
    • bronchitis
    • pneumonitis
    • otitis media
    • febrile seizures
    • secondary bacterial infection
  7. Nasopharyngitis Treatment
    • rest
    • clear airway (saline drops, suction)
    • increase fluids
    • ibuprofen/acetaminophen for fever
    • vaseline for nasal irritation
    • cool air humidifier
    • patient teaching - cover mouth/nose, handwashing
  8. Pharyngitis
    • inflammation of the throat or pharynx
    • affects 5-15 year olds
    • 80% viral, 20% strep
    • < 3 usually caused by flu
  9. Pharyngitis S/S
    • fever
    • malaise
    • dysphagia
    • anorexia
    • if viral - conjunctivitis, rhinitis, cough, hoarseness
    • gradual onset - lasts 5 days
  10. Strep Throat
    • fever and dysphagia > 1 week
    • C&S
    • anti-infective (PCN or erythromycin)
    • teach compliance
    • gargle with salt water
  11. Sinusitis
    • inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection
    • ethmoid and macillary sinuses most often infected
  12. Sinusitis S/S
    • URT > 10 days
    • day cough
    • halitosis
  13. Sinusitis Rx
    • anti-infectives
    • teach compliance
  14. Croup
    • inflammation and narrowing of the larynx (voice box) and the trachea (windpipe) caused by an infection
    • barking cough and inspiratory stridor
  15. Types of Croup
    • spasmodic laryngitis - virus, allergy, GERD, psychological
    • laryngotracheobronchitis - virus
  16. Spasmodic Laryngitis S/S
    • sudden onset
    • barking cough
    • resp. distress
    • anxiety
    • lasts several hours at night, morning OK
  17. Spasmodic Laryngitis Rx
    • high humidity
    • increase fluids
  18. Laryngotracheobronchitis S/S
    • preceded by URI
    • barking cough
    • stridor
    • resp. distress
    • cyanosis
    • restlessness
    • anxiety
    • hypoxia
    • tachycardia
  19. Laryngotracheobronchitis Rx
    • high humidity
    • vaporizer (clean daily)
    • mist/croupette tent
    • increase fluids/IV
    • space care
    • VS, O2 sats q 2-4 hours
    • O2 therapy
    • steroids
    • nebs w/ epinephrine
  20. Epiglottitis
    • inflammation of the epiglottis
    • swelling above vocal cords, narrowed airway
    • caused by Hemophilus influenza type b (Hib)
    • affects 3-6 year olds
    • give H. Influenza B vaccine
  21. Epiglottitis S/S
    • rapid onset - emergency
    • leans forward w. mouth open
    • drooling
    • difficulty swallowing
    • elevated temp
    • anxious
    • beefy red epiglottis
    • restlessness
    • croaking on inspiration
  22. Epiglottitis Rx
    • tracheostomy or endotracheal tube
    • O2
    • anti-infectives
    • IV fluids
    • VS, O2 sat q 2-4 hrs
    • space care
  23. Bronchitis
    • inflammation of the mucous membranes of the bronchi
    • children under 4
    • many organisms
    • poor nutrition, allergies, chronic RTI
  24. Bronchitis S/S
    • hacking cough preceded by URI or cold
    • purulent sputum (children under 7 may swallow)
  25. Bronchitis Rx
    • cough suppressant
    • antihistamines
    • expectorants
    • steroids
    • bronchodilators
  26. Bronchiolitis
    • inflammation of the bronchioles (viral
    • 6 mos - 2 years
  27. Bronchiolitis S/S
    • URI or cold
    • fever
    • clear nasal discharge
    • wheezing
    • cough/resp. distress
    • apneic periods
  28. Bronchiolitis Rx
    • treat symptoms
    • elevate HOB
    • IVs
    • I&O
    • increased humidity
    • nebs w. bronchodilators
    • VS, O2 sats q 2-4 hrs
  29. Respiratory Synctival Virus (RSV)
    • causes respiratory tract infections
    • 50% of bronchitis cases
    • babies can become seriously ill
    • spread by direct contact (not airborne), survives for > 6 hours
    • 4 day incubation period
  30. RSV Dx
    • test secretions for RSV antigens
    • symptoms
  31. RSV S/S
    • low grade fever
    • shallow, rapid respirations
    • harsh cough
    • expiratory wheeze
    • rales, ronchi
    • resp. distress
    • fatigue
    • irritability
    • anorexia
    • restlessness
    • cyanosis
    • hypoxia
  32. RSV Rx
    • semi-fowler's
    • IV fluids
    • I&O - urine output 1-2 ml/kg/hr
    • high humidity
    • rest
    • adequate nutrition
    • ribavirin (aerosol mist - no pregnant women)
    • contact isolation
    • hand washing
    • liquid soap
    • daily weight
    • O2 therapy
    • VS, O2 sats

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