Peds respiratory

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Sejune
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41638
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Peds respiratory
Updated:
2010-10-12 13:10:36
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Peds respiratory nursing
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Peds respiratory nursing
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  1. Increase in mycroplasma pneumonia seen in what age?
    >5
  2. What age group has few respiratory problems?
    <3 mo
  3. What age does respiratory infection rate increase?
    3-6 months
  4. Age groups that have a high rate of viral infection?
    Toddler and preschool
  5. Structural issues that effect respirtory alterations in peds...
    • Smaller airway
    • Smaller oral cavity
    • Large tonggue
    • Nose breathers
    • Eustation tube straight, wider, short
    • Right bronchi straight
    • less alveolar area for gas exchange
    • Rapid growth, tonsils and adnoids
  6. Problem children have with poor lung exchange.
    Can't cough enough mucus due to less muscles
  7. Medical history that affects respiratory alterations
    • LBW
    • Prematurity
    • Use of vents
  8. Diagnostics for respirtory
    • CBC
    • ABGs
    • Sputum C/S
    • Sputum for acid-fast bacilli (TB)
    • Throat C/S
    • Pulmonary function (for asthma)
    • Chest xray
    • Oximetry
    • Bronchoscopy
  9. Common cold
    Nasopharyngitis
  10. Malaise
    Nasopharyngitis
  11. Viral
    Nasopharyngitis
  12. Non-aspiritn analgesics
    nasopharyngitis
  13. Antipyretics
    Nasopharyngitis
  14. Saline nose gtts q 3-4 hrs
    nasopharyngitis
  15. hydration
    nasopharyngitis
  16. Is tonsillitis viral or bacterial?
    Viral
  17. What virus causes tonsillitis and pharyngitis
    GABHS
  18. Hw to inspect tonsillitis
    Inspect throat (red, exudate)
  19. Englarged cervical nodes indicates what?
    Tonsillitis and phayrngitis
  20. Is fever associated with tonsillitis and pharangitis?
    Yes
  21. Nasal congestion, mouth breating and dry mucous membranes are all associated with what?
    Tonsillitis and Pharyngitis
  22. Associated with a strep-headache
    Strep
  23. Pain, N, V, D associated with?
    Strep
  24. How do you diagnose Strep?
    Throat culture or rapid strep test
  25. Tx for strep
    Antibiotics and releive symtpoms
  26. Can cause rhematic fever
    Strep
  27. Rhematic fever has effect on what?
    Heart
  28. What position after post-op tonsillectomy
    Side position
  29. What should you not do post tonsillectomy?
    Don't cough or blow nose
  30. What drinks should you avoid post op tonsillectomy
    Encourage non carb, no acidid liquids
  31. Avoid using straws post what surgery?
    Tonsillectomy
  32. Pain reliever post tonsillectomy
    Acetaminophen
  33. Cool humidifier used post op which surgery?
    Tonsillectomy
  34. How long does tonsillectomy take to heal?
    3 weeks
  35. Risk of swallowing blood post op....
    tonsillectomy
  36. Otitits media is inflammation of...
    otitis media
  37. Cause of otitis media
    Pathogens enter throug heustatcian tube
  38. Tx of otitis media
    antibiotics and analgesics
  39. Family teaching to prevent otitis media
    • ABiottle position
    • Finish antibiotics
    • 2nd hand smoking
    • Keep up vaccines
  40. Which vaccine helps prevent otitis media?
    H Influennza pneumococcal
  41. Often the cause of otitis media
    H influencza
  42. What is otitis media with effusion?
    Fluein in the ear
  43. Asymptomatic OME
    Otitis media with effusion
  44. Chronic otitis media may cause
    Speech delay
  45. Apnea lasts
    >20
  46. associated with cyanosis
    Marked pallor
    Hypotonia
    Bradycardia
    Apnea
  47. ALTE
    • Apparent life threatening event
    • Near term or term > 37 weeks
  48. Tx of apnea
    Foot tap
  49. 50% has no cause
    Apnea
  50. Head at midline, neck neutral
    apnea
  51. Meds to treat apnea
    theophylline, aminophylline, methyl.xanthines, caffeine
  52. how should you stop the caffiene treatment for apnea
    gradual
  53. Leading cause of death between 1 mo to 1 year
    SIDS
  54. 90% of SIDS occurs before ___
    6 months
  55. Risk factors for SIDS
    • LBS
    • Prematurity
    • Multiple birth
    • Gender
    • Age
    • Season
    • Passive smoke
    • sleeping with others
    • prone position
  56. Position babies should sleep
    Supine
  57. Race found in SIDS
    2-3 x american indian, african americans
  58. Croups is caused by virus or bacteria
    Larynotracheobronchitis - viral, most serious
  59. Epiglotitis and trachea swelling
    Croups
  60. Copius secreations
    Croup
  61. Rhinorrhea
    Croup
  62. Tachypnea
    Croup
  63. ins/exp stridor
    croup
  64. retractions
    croup
  65. decreased 02
    croups
  66. tx 02 with humidity for what?
    Croup
  67. Nebulized racemic epinepherine used to tx
    Croup
  68. Fluids/hydration, rest, and antipyretics tx
    Croup
  69. Tx of croup with infection
    antibiotics
  70. Bacterial invasion of strep, staph, or Haemophilus influenza
    Epiglottitis
  71. Life-threatening
    Epiglottis
  72. Rapidly obstructs trachea
    Epiglottis
  73. Dysphonia
    Epiglottitis
  74. Dysphagia
    Epiglottitis
  75. Drooling
    epiglottis
  76. Frog like croaking
    Epiglottitis
  77. Vever lethargy and distressed respritation with inspriatory stridor
    Epiglottitis
  78. Usually previously healthy then quickly very ill
    Epiglottitis
  79. Tripod
    Tx Epiglottitis
  80. How to dx Epiglottitis
    Lateral neck radiograph
  81. Tongue blade Epiglottitis
    Will shut the airway down!
  82. Dry, hacking cough, non productive
    Bronchitis, inflammation of trachea and bronchi
  83. Pain, fever, humidity and hydration
    Bronchitis, inflammation of trachea and bronchi
  84. Avoid 2nd hand smoke
    Bronchitis, inflammation of trachea and bronchi
  85. Lasts 5-10 days
    Bronchitis, inflammation of trachea and bronchi
  86. Most common cause of bronchiolitis and pneumonida
    RSV
  87. Contagious and more common in winter
    RS
  88. Begins as URI
    Bronchiolitis/RSV
  89. 02 humidified, vent CPAP tx
    RSV/ bronchiolitis
  90. Hydration and IV fluids important
    RSV/ Bronchiolitis
  91. Postural drainiage/chest physiotherapy
    RSV/Bronchiolitis
  92. Bronchodilators, nebulized epi
    RSV, Bronchiolitis
  93. Tx of briovirin by aerosal
    BAronchiolitis/RSV
  94. Prophylactic Synagis (paliviumab)
    Tx for high risk RSV
  95. How is Synagis given
    IM or Respiratory, IV given <2 years, high risk NICU
  96. Bacterial pneuonia what age
    >5 yo,
  97. Abrupt and follows URI
    Bacterial pneumonia
  98. Chest pain and meningeial sx
    Baccterial Pneumonia
  99. Viral Pneumonia is also called
    RSV
  100. Viral Pneumonia seen in what age
    Small children, and you tx sx
  101. SX of pneumia
    Respiratory distress and CHest pain!
  102. Symptomatic supportive care for Pneumonia
    Analgesics, antipyretics, hydrate, enc. couphing, antibiotics if bacterial. Hosp: 02, IVGs, Chest pain
  103. Contagious, HA, Soare throat, cough, fever, runny nose, aches, chills, fatigue, vomiting
    H1N1
  104. High risk for H1n1
    <5 yo, or premature
  105. h1n1 remains alive on an object for
    2-8 hrs
  106. Tx/prevention H1N1
    Tamiflue, Relenza
  107. 3 factors contributing to obstruction in asthma
    • 1.) Inflammation and edema of mucus membranes
    • 2.) Accumulation of tenacious secretions from mucus glands
    • 3.) Smooth muscle spasm of bronchi and bronchioles
  108. Non productive at onset, but leads to productive cough
    Asthma
  109. Inspiratory wheeze indicative of high risk respiratory problem and...
    Cardiac arrest
  110. PEFR
    Reveals severity of asthma
  111. PEFR range
    80-100%
  112. Green PEFR
    80-100
  113. Yellow PEFR
    50-80
  114. Red PEFR
    <50%
  115. Asthma mild intermittent
    No daily meds needed. <2 days per week, < 2 nights per month
  116. Astma mild persistent
    • >2 /week but < 1x/day, >2 nights/month
    • Low doese corticosteroidswith nebulizer or MDI

    Alternative tx: Cromolyn, or leukotriene
  117. Asthma moderate persistent
    • >1 night/week
    • Low dose corticosteroids
    • long acting beta2 antaganists

    • Alternative tx:
    • low dose inhaled corticosteroids and either leukotreine receptor antagonist or theophylline.

    • w/reoccuring exacerbations
    • Preferred tx:
    • medium dose inhaled corticosteroids

    • Alternative tx:
    • Medium dose inhaled corticosteroids and iether leukotrien receoptor antagonist or theophylline
  118. Asthma severe persistent
    Continual, Frequent

    • High dose inhaled corticosteroids and long acting beta 2 agaonists and if needed
    • Corticosteroids tablets or syrup long term (2mg/kg/day)
  119. Rescue meds to treat asthma exacerabations
    • Beta 2 antagonists (short acting): Inhaled
    • Beta 2 agonists SQ
    • Corticosteroids-Methylprednisolone IV or Prednisone PO
  120. Use of Corticosteroids- Mythlprenisolone IV or Prednisone PO
    Inflammation/iobstruction

    • Short term therapy
    • 3-10 days
    • -Watch s/e
  121. Albuterol use
    Use spacer and risnse mouth after use
  122. Salmeterol/Severent and Formoterol inhaltion (USE)
    • Relaxes smooth muscle
    • Used at night/exercise, watch SE
  123. SE of Long acting beta2 agonists (salmeterol/serevent and Formoterol)
    Tachycardia
  124. Theophylline po or Aminophylline IV SE
    Nasuea, tremors, tachyucardia
  125. Serum levsls of theophylline or aminoophylline
    >20ug/ml
  126. Adjunct to inhaled steroids for moderate to severe
    Leukotrienes
  127. Take beta agonist 1st, 2nd or 3rd?
    First
  128. ZBeta agaonists function to
    Open bronchi, enhances steroid obstruction
  129. Autosomal recessive disorder
    Cystic fibrosis
  130. Genetic passage of cystic fibrosis
    • 25% offspring will have disease
    • 50% will be carriers
    • 25% will not have it
  131. Secrete thick secreations onto the skin
    Cystic fibrosis
  132. Affects multiple organs, commonly lungs, pancrease, liver and small intestines
    Cystic fibrosis
  133. Diagnostic test for cystic fibrosis
    Sweat test
  134. Sweat test results
    >60mg POS x2
  135. Diagnostic test for cystic fibrosis
    Impaired fat absorption from liver/pancreatic dysfunction - poop floats
  136. Meconium ileus
    Cystic Fibrosis
  137. Salty tasting skin
    Cystic Fibrosis
  138. Profuse sweating
    Cystic Fibrosis
  139. Frequent infection
    Cystic Fibrosis
  140. Wheezing is an assessment finding in what DISORDER
    Cystic Fibrosis
  141. Digital clubbing (chronic)
    Cystic Fibrosis
  142. Steatorrhea and azotorrhea
    Cystic Fibrosis
  143. Mustle wasting - Failure to thrive
    Cystic Fibrosis
  144. Hypoproteinemia
    Cystic Fibrosis
  145. Deficiency of A, D, E , K
    Cystic Fibrosis
  146. Nasal polyps
    Cystic Fibrosis
  147. Recurrent pneumonia or bronchitis
    Cystic Fibrosis
  148. Respiratory infection by pseudomonas
    Cystic Fibrosis
  149. Reproductive effect of Cystic Fibrosis on men
    Steirle males, blockage or absesnes of vas deferense
  150. reproductive effect of Cystic Fibrosis on females
    thick mucous secreations interfere with psassage of sperm
  151. Bronchodilators and adrenergic agonists (aerosols). Use and tx for.
    • Tx for Cystic Fibrosis
    • Opens airway/before chest p/t
  152. Mucolytics (mucomyst) use and tx for
    Cystic Fibrosis, dec viscostiy of secretions
  153. Corticosteroids use and Tx for
    anti-inflammatory decrease lung dis progrogress Cystic Fibrosis
  154. Pancreatic enzymes (viokase)
    tx pancrease def, give with meals,

    High dose IB provin/alt days

    Cystic Fibrosis
  155. Ursodeoxycholate
    given for Cystic Fibrosis, of elevated liver enzymes
  156. Lactulose
    Cystic Fibrosis for distal intestinal obstruction
  157. Iron supplements
    Cystic Fibrosis
  158. Goals for Cystic Fibrosis
    • Maintain respirtory function
    • Prevent/Manage infection
    • Promote Optimal Nutrition and Exercise
    • Prevent instestinal obstruction
  159. Foreing body obstruction usually found where?
    Bronchial
  160. Which long most common site of lower airway obstruction
    Right

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