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What would you look for in a ABCDEFG assessment of a child experiencing an asthma attack?
- AIRWAY- talking/words or sentences
- BREATHING- RR, effort, access mus, colour, O2 sats, auscultate or wheeze, silent cough.
- CIRCULATION- pulse, BP, cap refill, colour
- DISABILITY- GCS
- EXPOSURE- Temp, chest wall recession
- FLUID- Dehydration
- GLUCOSE- BSL
What receptors are triggered in the smooth muscles during a asthma attack? What triggers it?
The Alpha 1 receptors are triggered in the smooth muscles cells during an asthma attack. These are triggered by pollen, cigarette and other smoke, dust and pet dander.
The E in the ABC should stand for what when assessing a pregnant woman?
- Look for bleeding, especially vaginal bleeding.
- Look for fetal movements and HR
What are the changes that the gastrointestinal system undergoes during pregnancy?
- Nausea (Due to increased progesterone)
- Heartburn or reflux (Due to oesphagus being displaced and the stomach crowded by uterus.
- Constipation (Water being absorbed from GI Tract and an increase in intravascualr vol which equals a decrease in mobilitiy.
During pregnancy what changes occur in the respiratory system?
- Increased tidal volume (the normal vol.air displaced between normal inhalation and exhalation when extra effort ISNT applied).
- Decreased residual vol (vol. air still remaining in lungs after most forcible exertion.
- NOTE- RR stays the same
What are the anatomical changes that occur during pregnancy?
- The reproductive orgrans increase vascular size
- Increase in breast size
- Increase in uterus size
- Increase in anterior abdomen size
- Weight gain
What is the receptor that relaxes the smooth muscles of the bronchioles? What medication triggers this?
The receptors that relaxes the smooth muscles are the beta 2 receptors while this can be triggered by Beta Agnotists aka Fast acting inhalers such as Salbutamol
What are the three factors that cause narrowing of the bronchioles during an asthma attack?
- Muscular contraction of the smooth muscle cells in the wall of the airway
- Oedema of the walls mediated by histamine
- Increased mucus secretion
When assessing Circulation for Kids, what are the anatomical differences?
- The CO, its 2X that of adult
- Bradycardia is terminal <35 start CPR
- Decreased blood vol
- Small and difficult veins for peripheral access
- Increased HR taht decreases with age
- Lower BP, increases with age,
- Tachycardia is the first sign of CV compensation
- SO, look for tachycardia, low UO, pulses, cap refill and temp.
What are nursing considerations regarding pregnant women?
- Positioning- left lateral is best, supine (back) causes the uterus to compress the vena cava and can cause a decrease in CO, fainting, dizziness and falls.
- Bleeding, could be normal (increased vascularity vagina and cervix) or miscarriage (usually before 12 weeks)
- Falls risks; from low BP or low PVR
What are the anatomical differences in the AIRWAY for kids?
- Small nostrils
- Big tognues (obstruction issues)
- Short trachea (obstruction, keep head in neutral position as over extension can cause trachea obstruction.
- Stridor, partial upper airway obstruction
- Hypoxia, v. late sign of a/way obstruction
The G of the ABC should include the following assessments for pregnant women?
- Gestational diabetes, the insulin receptors not wokring properly due ot the pregnany hormones
- Increased size of fetus, delivery difficulties
- Baby may have low blood sugar at birth