Pediatric Nursing - Respiratory

Peak Flow Meter - How often should a patient use their peak-flow meter?

Peak flow meters should be used regularly to check how well the asthma is being controlled • every morning, before taking asthma medications • during asthma symptoms or an asthma attack • after taking medication for an asthma attack • other times recommended by your physician

A 3-year-old boy in respiratory distress is treated in the emergency department. A diagnosis of acute spasmodic laryngitis (spasmodic croup) is made. At the time of discharge, the mother asks how to handle another attack at home. What should the nurse recommend?

Placing him near a cool-mist humidifier

A toddler who was admitted in acute respiratory distress is now resting quietly. The parents tell the nurse that they must leave. What should the nurse suggest that the parents do?

Plan to visit the child as frequently as possible

A 6-year-old child with acute spasmodic bronchitis who is receiving humidified air removes the mask, and while bathing the child the nurse notes increasing respiratory distress. What is the most appropriate nursing intervention?

Stopping the bath and replacing the mask

A school-aged child with cystic fibrosis has recurrent episodes of bronchitis, and the parents ask the nurse why this happens. What reason should the nurse include in the reply?

Tenacious secretions that obstruct the respiratory tract provide a favorable medium for growth of bacteria.

The parents of a school-aged child with cystic fibrosis tell the nurse that they have changed to generic pancreatic enzymes because of money issues. An appropriate response by the nurse is:

"Generic enzymes are not as effective as the brand-name one. This is something you need to discuss with your healthcare provider."

Peak Flow Meter - How would you explain how to use a peak-flow meter to a patient?

1. Stand up or sit up straight. 2. Make sure the indicator is at the bottom of the meter (zero). 3. Take a deep breath in, filling the lungs completely. 4. Place the mouthpiece in your mouth; lightly bite with your teeth and close your lips on it. Be sure your tongue is away from the mouthpiece. 5. Blast the air out as hard and as fast as possible in a single blow. 6. Remove the meter from your mouth. 7. Record the number that appears on the meter and then repeat steps one through seven two times. 8. Record the highest of the three readings in an asthma diary. This reading is your peak expiratory flow (PEF).

nurse in the pediatric clinic determines that the pancreatic enzyme replacement being taken by a child with cystic fibrosis is inadequate. What clinical finding supports this conclusion?

Abdominal cramping

An 8-year-old child with a history of asthma is brought to the emergency department because of respiratory distress. The nurse immediately places the child in a bed with the head of the bed elevated and administers oxygen by means of a facemask. The health care provider performs a physical assessment, writes prescriptions, and admits the child to the pediatric unit. Which instruction should the nurse carry out first?

Administer the nebulizer treatment.

Peak Flow Meter - What is a patient's "personal best", and how would they find it?

The "personal best" peak expiratory flow is the highest peak flow number you can achieve over a two- to three-week period when asthma is under good control. Good control means you feel good and do not have any symptoms. The personal best PEF is the number to which all other peak flow readings you obtain will be compared. To find the personal best peak flow number, take peak flow readings: • Twice a day for two to three weeks • At the same time in the morning and in the evening • Before taking a short-acting beta2 agonist for quick relief • As instructed by your doctor or nurse

The parents of a 12-year-old boy with cystic fibrosis (CF) ask the nurse why he needs a glucose tolerance test. What information should the nurse consider before replying?

Pancreatic scarring predisposes the child to diabetes.

Who would use a peak-flow meter? Explain why a patient would use a peak-flow meter?

Patients with asthma are advised to use a peak- flow meter. A peak flow meter allows you to measure day- to- day changes in your breathing. Using a peak flow meter can help you: -Track the control of your asthma over time - Show how well your treatment is working - Recognize signs of a flare- up before symptoms appear - Know what steps to take when you have signs of an asthma flare- up - Decide when to call your doctor or get emergency care

The nurse is caring for a school-aged child with cystic fibrosis. Which pathophysiological factor has the greatest impact on the child's health status and is of priority in the care plan?

Extremely thick mucus causes obstructed airways.

A 6-month-old infant is brought to the emergency department in severe respiratory distress. A diagnosis of respiratory syncytial virus (RSV) infection is made and the infant is admitted to the pediatric unit. What should be included in the nursing plan of care?

Maintain standard and contact precautions.

A nurse is caring for a toddler in acute respiratory distress precipitated by laryngotracheobronchitis. The child has a temperature of 103° F (39.4° C). What is the priority nursing intervention?

Monitoring respiratory status continuously

An adolescent is admitted to the hospital in respiratory distress, and the health care provider orders oxygen at 40% by way of a Venturi mask. The instructions for the Venturi mask indicate that delivery of 4 L/min equals 24% to 28% oxygen, delivery of 8 L/min equals 35% to 40% oxygen, and 12 L/min equals 50% to 60% oxygen. Mark where the ball of the flow meter should be raised to deliver the percentage of oxygen ordered by the health care provider.

The ball of the oxygen flowmeter should be set at 8 L/min to deliver 40% oxygen through the Venturi mask.

A nurse is caring for several school-aged children with cystic fibrosis. Why does the nurse anticipate that these children will probably be small and underdeveloped for their age?

These children digest little food because pancreatic enzymes are blocked.

A 30-month-old toddler is brought to the emergency department in acute respiratory distress, and a diagnosis of laryngotracheobronchitis (viral croup) is made. What is the most important equipment for the nurse to have available when the child is admitted to the pediatric unit?

Tracheotomy set

A nurse is reinforcing previous learning about cystic fibrosis and its treatment with a 9-year-old child. What is the most suitable information for a child of this age?

Your mucus is thick because of the way your mucous glands work."

Which assessment finding(s) should the nurse expect when caring for a child with cystic fibrosis? (Select all that apply.) A. Steatorrhea B. Obesity C. Foul-smelling stools D. Delayed growth E. Pulmonary congestion

a, c, d, e (A, C, D, and E, are all common assessment findings in the client with cystic fibrosis. Weight loss, not weight gain, is associated with cystic fibrosis, B.)

Peak Flow Meter - What are the zones, and what should a patient do if they get a reading in each zone?

• Green: 80 to 100 percent of your personal best peak flow measurement; asthma is under control. • Yellow: 50 to 79 percent of your personal best peak flow measurement; asthma is getting worse; you may need to use quick-relief medications or other medication, as directed by your physician. • Red: below 50 percent of your personal best peak flow measurement; medical alert, take quick-relief medication and seek medical help immediately

Peak Flow Meter - Describe the different parts of a peak-flow meter.

• case/cover • lung function indicator • zone indicators • mouthpiece