Lecture 6 Respiratory distress/Vaccines

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monica124
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40755
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Lecture 6 Respiratory distress/Vaccines
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2010-10-08 20:36:21
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Respiratory Distress Vaccines
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Lecture 6
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  1. What would you look for in a child in respiratory distress?
    • Dyspnea
    • Tachypnea
    • Retractions
    • Flaring
    • Cyanosis
    • Pallor
    • Restlessness
    • Lethargy
  2. What would you listen in a child in respiratory distress?
    • Inspiratory Stridor
    • Expiratory Grunting
    • Adventitious Sounds
    • Coughing
  3. What would you check for in a child in respiratory distress?
    • Tachycardia
    • Sudden change in behavior
  4. Which are the early signs of impending airway obstruction?
    • Tachycardia
    • Tachypnea
    • Nasal Flaring
    • Intercostal, suprasternal, substernal retractions
    • Increased restless ness
  5. Which are the late signs of impending airway obstruction?
    • Sudden agitation or sudden quietness
    • cyanosis
    • child w sever asthma who suddenly stops wheezing
  6. What protects infants and children from respiratory infections?
    • IgG from the mother
    • hand hygiene
    • HiB vaccine
  7. Antibodies are delivered which provide immediate protection against infection, this does not confer lasting immunity.
    Forms of passive immunity
    • Transplacental - IgG (3rd trimester)
    • Breastfeeding - IgA (Colostrum)
    • Ig Injections - Given to pts. who have recently been exposed to infection
  8. They stimulate antibody production in the host w/o causing clinical disease
    Forms of Active Immunity
    Vaccines
  9. Good Hygiene
    Advice for children and caregivers with respiratory infections:
    • Don't share cups, towels, washcloths
    • Try to avoid children who are well
    • Use tissues and dispose them properly
    • Good handwashing
    • Caregivers - Try not to touch your eyes or nose
  10. How long can RSV survive in the hands?
    For 1 hour
  11. What put infants at risk for respiratory infections?
    • Immature immunity - Children lack of complete Humoral Immunity until 6 yo
    • Prematurity - Baby lacks of IgG
    • Anatomy of the respiratory tract - Airway is short and narrow
    • Inherited conditions - CF
  12. At what age is FBO most common?
    1- 3 yo
  13. Which foods are most dangerous for FBO?
    • Hot dogs
    • Candy
    • Peanut Butter
    • Nuts
    • Popcorn
  14. Intervention for choking?
    Birth to 1 yo
    • 5 back blows
    • 5 chest thrusts
    • If infant becomes unconscious, start CPR
  15. Interventions for choking?
    1 yo and up
    Heimlich Maneuver
  16. Interventions for FBO in the lower airways?
    Endoscopy
  17. FBO, sudden onset of symptoms?
    • Sudden coughing or sudden onset of respt. distress
    • No fever or other symptoms of illness
  18. What are the respiratory symptoms of Cystic Fibrosis?
    • Wheezing
    • Dry, non-productive cough
    • Frequent respiratory infections
  19. What is the diagnostic test for CF?
    Sweat chloride test
  20. What is the tx for CF?
    • CPT (at least 1 hr Before meals)
    • Bronchodilators PRN
    • Antibiotics PRN
  21. Why is Surfactant important?
    • It is a phospholipid produced by the alveoli
    • It peaks at 35 wks gestation
    • It keeps alveoli open and allows for a normal breathing
  22. RDS
    Who is at most risk?
    Signs of RDS?
    • Preterm infants are at most risk
    • Signs:
    • Tachypnea
    • Retractions
    • Expiratory Grunting
    • Nasal Flaring
    • Cyanosis
  23. How can RDS be prevented?
    • Try to prevent preterm deliveries
    • Give the mother dexamethasone (steroids)
    • Give the preterm newborn (<35 wks) surfactant
  24. What is Apnea of prematurity
    • Lack of spontaneous breathing for more than 20 sec.
    • Tactile stimulation may be helpful
    • It can be treated with theophylline or caffeine
  25. What are the signs of Theophylline toxicity?
    • Irritability
    • Tachycardia
    • Nausea
  26. Name 4 respiratory emergencies
    • Status Asthmaticus
    • Laryngotracheobronchitis
    • Epiglotittis
    • Pneumothorax
  27. Define Status asthmaticus
    • Patient with asthma in severe respiratory distress that does not respond to standard treatments
    • Can develop slowly or quickly
    • Often there is an underlying problem (pneumonia)
  28. What is the treatment for status asthmaticus?
    • B2 Agonist (Albuterol, Bronchodilator)
    • Terbutaline (Bronchodilator)
    • Epinephrine (B1 and B2 Agonist, Bronchodilator)
    • Corticosteroids (Anti-inflammatory)
  29. Mention some common asthma triggers
    • Exercise
    • Allergen
    • Stress
    • Bacteria
    • Smoke
  30. Asthma is an inflammatory response that causes:
    • Dyspnea
    • Expiratory wheezing
    • Coughing
    • Thick tenacious mucus
    • Bronchospasm
  31. What are the signs of Epiglottitis?
    • Child wakes up with sore throat and high fever
    • Drooling
    • Agitation
    • Sits in a tripod position
  32. What are the don'ts for Epigottitis or Croup (LTB)?
    • Don't try to open the mouth
    • Don't try to insert any objects or visualize the epiglottis
    • Don't try to get a throat culture

    It may cause a laryngospasm
  33. What are the do's for Epiglottitis and Croup (LTB)?
    Get ready for intubation or tracheostomy
  34. What is the most common causative organism of Epiglottitis?
    HiB (Haemophillius Influenza B )
  35. What is croup?
    • Laryngotracheobronchitis - Inflammation of the larynx and trachea
    • It is caused by a viral infection of the parainfluenza virus
    • It starts slowly as an upper respiratory tract infection and progresses slowly over a period of days
  36. What are the signs of Croup?
    • Toddler starts out with a runny nose
    • then
    • low-grade fever
    • then
    • "barking" cough
    • then
    • Inspiratory stridor
  37. What vaccines are given at 2 mo. of age?
    • HiB - Haemophillius Influenza B - Prevents Epiglottitis
    • Hep B - Prevents Hepatitis B
    • PCV - Pneumococcal Conjugate Vaccine - Prevents Pneumonia
    • DTaP - Diphtheria/Tetanus Toxoids/ Acellular Pertussis
    • IPV - Innactivated Polio Vaccine - Prevents Polio
    • Rotavirus
  38. Name two live vaccines
    Varicella and MMR (Mumps/Measles/Rubella)
  39. When is Varicella vaccine given?
    1 yo
  40. When is MMR given?
    at 1 yr and 4 yrs
  41. When is MMR vaccine contraindicated?
    • In pregnant women
    • Pts. allergic to Neomycin
  42. 4 Points to remember about vaccination:
    • 2 vaccines can be given in the same extremity
    • They can be administered even if the child has:
    • Low grade fever
    • Had recent exposure to an infectious disease
    • Is taking antibiotics
  43. How is Varisella (Chickenpox) spread?
    Direct contact w

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