Respiratory P2

barrel chest clubbing sinusitis cor pulmonale

4 Respiratory issues with CF

7

Cystic fibrosis deals with the genes located on the long arm of chromosome _____

between t3-t5

Where does the trachea bifuracte

cricoid ring

Where is the narrowest point of the throat for the child

methylprednisone

Which IV steroid would you use for status ashtmaitcus

intermittent moderate mild severe

Label as (Intermittent, mild, moderate, severe asthma) for asthma less than 2 days a week daily greater than 2 days a week but not daily throughout the day

20 seconds

Apena Absence of breathing for longer than ________ seconds that can be accompanied by bradycardia

IV steroids IV mag sulfate IV terubutaline IV epinpehrine

4 IV meds used for status asthmaticus

thick mucus diabetes and hyperglycemia

Pancreas secretes what with CF what related to blood sugar happens later in life with CF

ARDS

•mechanical ventilation, ECMO, nitric oxide This manages what

IV

route for racemic epi

RR increaisng

A 2-year-old toddler is seen for acute laryngotracheobronchitis. What observation would lead the nurse to suspect airway occlusion? The toddler states being tired and wanting to sleep. The respiratory rate is gradually increasing. The cough is becoming harsher. The nasal discharge is increasing.

acute life threatening event

•Can present in the form of an ___________________ in which the infant or child exhibits some combination of apnea, color change, muscle tone alteration, coughing, or gagging

read

•Cystic fibrosis transmembrane conductance regulator (CFTR) mutation results in problems in exocrine glands

symptoms of CF

- salty skin - recurrent URI - increased appetite - poor weight gain - bulky stools - clubbing + barrel chest = later signs

admin the bronchodilator first

A 3-year-old child with asthma and a respiratory tract infection is prescribed an antibiotic and a bronchodilator. The nurse notes the following during assessment: oral temperature 100.2°F (37.9°C), respirations 52 breaths/minute, heart rate 90 beats/minute, O2 saturation 95% on room air. Which action will the nurse take first? Administer the bronchodilator via a nebulizer. Give the antibiotic as prescribed. Apply oxygen at 2 liters via a nasal cannula. Apply a cardiac monitor to the child.

funnel

A group of nursing students are reviewing information about variations in the anatomy of a child's respiratory tract structures in comparison to adults. The students demonstrate an understanding of the information when they describe the shape of the larynx in infants as: funnel. cylindrical. oval. spherical.

Shellfish

After teaching the parents of an 8-year-old girl with asthma about common allergens their child should avoid, the nurse determines that the parents need additional teaching when they identify what as a common allergen for asthma? shellfish indoor molds pet dander dust mites

19

Children with asthma should be seen every 3-6 months to gauge asthma compliance. Asthma Control Test Score of _______ or greater typically means adequate symptom control.

At night

Cough for asthma is typically during what part of the day

wheeze stridor

If asucultating lungs and mouth sound- _____ If ausculating and sound is just mouth- _____

read

Educate on proper medication administration, and age-appropriate use of MDI with spacer and nebulizer machine

vagal

Intubation or suction can cause ________ nerve stimulation with bradycardia initiated

inahlable steroid

Fluticasone is what mediaton

antibiotics

For exacerbation of CF we may inhale

highest reading

For peak flow •Repeat three times and record the __________

15 minutes

How long before excersise should the kid get the inhaler

inspiratory stridor is the upper airway wheeze is lower airway

Inspiratory stridor is which part of the airway Wheeze is which part of the airway

intermittent moderate severe mild

Label as (Intermittent, mild, moderate, severe asthma) less than 2 days a week daily severeal times a day greater than 2 days a week but not daily

CF

Most common respiratory illness among caucasian children

0 1-2 times a month 3-4 times a month greatert than 1 a week

Night time awakenings for the different asthmas classifications intermittent mild moderate severe

leukotriene modifiers inhaled corticosteroids long acting bronchodilators

Three typical maintance medications used for asthma

Respiratory system

Sometimes stomach pain can indicate malfunction of which body system in child

tearing edema

Symptoms of allergic rhinitis red rimmed _______ eyes mild eyelid _______

note any frequent swallowing

Upon providing discharge instructions home after a tonsillectomy and adenoidectomy, which is most important? Provide acetaminophen for pain. Note any frequent swallowing. Allow the child an age-appropriate, quiet plan. Stress regular fluid consumption.

Bronchodilator and mast cell stabilizer

The caregivers of an 8-year-old bring their child to the pediatrician and report that the child has not had breathing problems before, but since taking up lacrosse the child has been coughing and wheezing at the end of every practice and game. Their friend's child has often been hospitalized for asthma; they are concerned that their child has a similar illness. The nurse knows that because the problems seem to be directly related to exercise, it is likely that the child will be able to be treated with: decreased activity and increased fluids. corticosteroids and leukotriene inhibitors. removal of allergens in the home and school. a bronchodilator and mast cell stabilizers.

control of prevention and inflammation

The management of asthma is focused on ___________

To determine fluids losses

The nurse caring for the child with asthma weighs the child daily. What is the most important reason for doing a daily weight on this child? To determine medication dosages To monitor the child's growth pattern To ensure that the child's food intake is adequate To determine fluid losses

Open capsule and sprinkle on food

The nurse is administering medications to a child with cystic fibrosis. Which method would the nurse most likely use to give medications to treat the pancreatic involvement seen in this disease? Open capsule and sprinkle on food. Shake inhaler and hold close to mouth. Draw up in syringe and administer subcutaneously. Pour in medication cup and have the child drink.

take a picture of the lungs

The nurse is auscultating the lungs of a lethargic, irritable 6-year-old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma? "I'm going to have the respiratory therapist get some of the mucus from your lungs." "I'm going to have this hospital worker take a picture of your lungs." "We're going to go take a look at your lungs to see if there are any sores on them." "I'm going to hold your hand while the phlebotomist gets blood from your arm."

Sweat sodium chloride test

The nurse is caring for a child who has been admitted with a possible diagnosis of cystic fibrosis. Which laboratory/diagnostic tools would most likely be used to help determine the diagnosis of this child? Purified protein derivative test Sweat sodium chloride test Blood culture and sensitivity Pulmonary functions test

fever and labored

The nurse is correct to identify which group of symptoms as present with acute laryngotracheobronchitis? Wheezing and a moist cough Fever and labored respirations Crackles in lung fields with cyanosis Hypoxia with shallow respirations

IV ketamine

This drug is sued for status asmathcius in preperation for intubation in respiratory failure

pacifier

To help prevent SIDS we can use the ______ during bedtime and napping as appropriate

mast cell stabilizing spray leukotriene modifiers

Two treatments for allergic rhinitis?

zero breath blow

Using peak flow •Slide the arrow down to _______ •Stand up straight and take a deep _______ and close the lips tightly around the mouthpiece ___________ hard and fast note the number the arrow moves to

pancreatic gastric acids

WITH CF decreased _________ enzymes and hypersecretion of ____________

20 meg of potassium

What IVF for status asmaticus

like 40

What age do most people survive cf with

larynx

What anatomical structure is higher in the neck for children

we are starting low with medications and then increasing as things get worse

What does a step wise approach mean when it comes to care for the asthma patient

pulmonary function test

What is a PFT

pneumothorax

What is a complication of cystic fibrosis? pneumothorax urinary tract infection kidney disease Crohn disease

fever

What is a symptom of bacterial pharyngitis? fever rhinitis symptoms have gradual onset white blood cell (WBC) count in normal range

pulmonary enzyme to help with CF

What is dornase alfa

intermittnet is more inhaler mild and moderate are goign to be using the fluticasone

What is the difference between mild and intermittent asthma in terms of medication regiment

high calorie and high protein

What kind of diet with CF

fat soluable

What kind of vitamins does someone need with CF

occlusive dressing and clamp

What should be by the bed side for pneumthorax

same time each day

When should the child do peak flow

Nasal congestion

Which clinical manifestation of acute nasopharyngitis is more of a concern for the infant than the older child? Fever Vomiting Nasal congestion Diarrhea

dehydration

With CF Decreased chloride and water secretion into the intestines causing ________

infertility

With CF what happens reproductive organs?

IGE receptors

With allergic rhinitis The allergen binds to specific __________ on the surface of mast cells, releasing chemical mediators of histamine and leukotrienes.

24 hours after antibiotics are started

With pharyngitis when can is the kid considered not contagious and can return to school

read

With the lungs and CF, there is sticky mucous buildup, bacterial infection, and widened airways

Chest Tube

____________ remove air or fluid though a drain inserted into the pleural cavity,

tympany asthma

__________might be percussed with pneumothorax, and hyperresonance might be apparent with _________

atopic dermatitis ashtma allergic rhinitis

atopic triad

Positive end expiratory pressure

coughing or grunting is relative to what ventilatory setting

toothbrush

discard what oral care item post strep

asthma

episodes of breathing difficulty due to narrowed or obstructed airways

mucus blocks the alveoli in the lungs

mucus blocks what in the lungs with CF

PEEP

positive end-expiratory pressure - common mechanical ventilator setting in which airway pressure is maintained above atmospheric pressure

bad ominous sign

realy tachypneic to sleepy means what

shiners crease

symptoms of allergic rhinitis •allergic ________" bluish or grayish cast beneath the eyes an "allergic salute" a transverse nasal _________ between the lower and middle thirds of the nose that results from repeated nose rubbing

atrovent and albuterol

the DUO nebulizer is used in status asthmaticus and is composed of what two meds

needle aspiration or chest tube

two treatments for pneumthroax

intermittent vs persisent

two types of asthma

collection of air in the pleural space

what is a pneumthorax

status asthmaticus

•A severe asthma exacerbation resulting in significant hypoxemia despite vigorous therapeutic efforts

read

•ARDS occurs after a primary insult ( sepsis, viral pneumonia, smoke inhalation, near drowning)

for ARDS

•Alveolar capillary membrane becomes more permeable and pulmonary edema develops

read

•Apnea in newborns might be associated with hypothermia, hypoglycemia, infection or hyperbilirubinemia

central

•Apnea may be _________ which is unrelated to any other causes