Pediatric Respiratory System & Maternity Chapter 40

Aminophylline is what kind of medication(1)? Tonsillitis usually also occurs with? Why is aspirin not given to adolescents? what does this cause (3)? Otitis Media usally occurs during what season? Occurs higher in girls or boys? Decreases with _____ and _____. OM is treated with (2):

A bronchodilator. Pharyngitis Because of the risk of Reye's syndrome / Brain swelling, confusion, and liver damage. Winter months / Boys / Age and weight / Watch and Weight, Severe cases getting AB (amoxicillin)

Which family member would be restricted from the room of an infant receiving ribavirin? Why? What are some conditions (5), and locations (1) that affect pediatric resistance to illnesses? Most respiratory illnesses are common during what seasons(2)? Such as? Mycoplasma infections occur mostly during (2): Asthmatic bronchitis typically occurs during (2):

Any pregnant female ////// Ribavirin is classified as a category X drug, signaling a high risk for teratogenicity. Immune system (Imm compromised), Allergies, Asthma, Cardiac anomalies, Cystic Fibrosis, Daycare Winter & Spring / Respiratory Syncytial Virus (RSV) Fall and Winter Winter & Spring

CF also affects _____ and _____. What kind of genetic trait is it? What is the change of getting it? First thing that is noticed as a newborn with CF? Treatement (2)? What are the causes of CF (2)? This leads to _______ _______ of the airway.

Blacks and Asians. Autosomal recessive trait / 1:4 chance Meconium ileus / Enema, or worst case = surgery Causes abnormal mucous secretions, and pancreatic degeneration / Mechanical obstruction

Pertussis/Whooping cough is caused by what bacteria? Mainly occurs in children who have not been _______. What precautions? Foreign body aspiration usually occurs between ages __ - __. This presents with what sudden manifestations(2)? Removed with what procedures (2)? Aspiration Pneumonia is a risk for children with? Also occurs with children born with/as (2):

Bordatella pertussis / Immunized / Droplet precautions. 1-3 yrs old / Sudden Inspiratory wheezes or cough Bronchoscopy or Endoscopy Feeding difficulties / Cleft Palate, Preemies

In CF PT's with GI issues, thick secretions block _______ which prevent pancreatic enzymes from reaching the _______. This causes impared digestion and absorption of _______ and _______. Pancreatic endocrine function is initially _______, however pancreatic _______ eventually occurs leading to _______ _______. The liver becomes affected leading to multilobular biliary cirrhosis, this is caused by? CF electrolyte & serum imbalances are (3)? What is some respiratory management for PT's with CF(6)?

Ducts, Duodenum / Fat (steatorrhea) and Protein (azotorrhea). Unchanged, Fibrosis, Diabetes Mellitus. Biliary obstruction Hyponatremic + Hypochloremic alkalosis, and Hypoalbuminemia CPT, Bronchodilator meds, Forced Expiration, Tx of Pulm infect, Home IV AB, Aerosol AB.

A child has a high fever, is anxious, drooling, is breathing by sitting up and leaning forward with the mouth open and the tongue out and has difficulty speaking. The nurse recognizes these symptoms as those seen with which disorder? Which age range has the highest rate of infection? Bacterial or viral? After the age of 5, which type of infections increase (2)? What is pertussis known as? Caused by (Bac, Vir, Fung inf.)_______ _______ that leads to an _______ of airways that causes (2)?

Epiglottitis Toddler and preschool ages / Viral Mycoplasma pneumonia and B-strep infections Whooping cough / Bacterial infection / Inflammation / Narrowing and Impaired gas exchange.

What is croup? Caused by? Most respiratory infections are caused by what organism type? and strand? Also caused by what other organism type? Strands(4)? What can be said about age and immunity? How are infants immune? When do they start loosing this immunity?

Infections of the epiglottis, and larynx / Viral infection Viruses, RSV // Bacteria, Group A Beta streptococcus, Staphylococcus, mycoplasm pneumococci, Heamophilus influenza Immunity increases with age. Infants are immune through maternal AB / This begins to decrease and infection rate increase beginning at 3-6 months depending on if the child is breastfed or formula fed.

How does Acute LTB manifest / present(6)? LTB can progress to(3): LTB is managed by maintaining(4): ASL refers to? Also known as (2)?

Inspiratory stridor, Suprasternal retractions, Barking/Seal like cough, Respiratory distress, hypoxia. Respiratory acidosis, Respiratory arrest, and death. Airway, Hydration (IV or PO), Humidity w/cool mist, and Nebulizer treatements Acute Spasmodic Laryngitis / Smasmodic and midnight croup.

BT may be a complication of: Bacterial tracheitis presents with _______, _______ secretions that result in _______ _______. Therapeutic management of BT consists of the following (4): What structures are considered the reactive portion of the respiratory tract(2)? What is not fully developed until adolescence?

LTB (Laryngotracheobronchitis) Thick, purulent / Respiratory distress Humidified oxygen, Antipyretics, Antibiotics, and possibly intubation Bronchi & Bronchioles Cartilaginous support

Which measure/medication would be most effective in aiding bronchodilation in a child with laryngotracheobronchitis? How does it work? What components are part of the upper respiratory tract(2)? What components are part of the lower respiratory tract(3)? Can infections spread? What happens if a child has 5 cases of tonsillitis within 1 year?

Racemic epinephrine is an alpha adrenergic agent // It works on the mucosal vasoconstriction to reduce the edema. Nose, Pharynx Bronchi, Bronchioles, Trachea Yes, infections can spread. They must be refered to a ENT specialist to see if they need to be removed.

What is a definitive test for cystic fibrosis? Croup can present with the following sounds(2) while Froglike croaking sound is caused by (1). Croup can affect which respiratory structures:(4) Acute epiglottitis manifests as (6): When auscultating, how does it sound?

Sweat chloride = CF+ patients have high levels of Chloride in their sweat. Barking cough, inspiratory stridor / Epiglottitis Epiglottitis, Laryngitis, Laryngotracheobronchitis, Tracheitis. Sore throat, Pain, Retrating, Tripod positioning, Mild hypoxia, and Distress. Inspiritory stridor.

Most reliable test for CF? What is elevated(2)? By how much? CF causes an increase in organic/enzymatic constituents of ______. Also causes abnormalitites of the ______ system. Stagnation of _______ and _______ _______ result in destruction of lung tissue since secretions are difficult to expectorate. This causes an obstruction of the _______ /_______. Since CF leads to a decrease in O2 and CO2 exchange, this results in (7):

Sweat chloride test / Na and Cl will be 2-5 times greater. Saliva / ANS Mucous & bacterial colonization / Bronchi/bronchioles Hypoxia, Hypercapnea, Resp. acidosis, Pulmonary Increased HTN, Cor pulmonale (RSHF), Resp. Failure, Death

An 8-year-old with cystic fibrosis has had a noted decline on the growth chart. Which nursing intervention is best for maintaining adequate nutrition (2)? What generalized manifestations often present in young children(10)? Absence of lung sounds when auscultating typically indicates? Nursing Interventions R/T pedi respiratory should include(8):

The best nursing intervention is a high calorie, high protein snack. F/A/V, Diarrhea, Abdominal pain, Cough, Soar throat, Nasal blockage~discharge, Respiratory sounds. Consolidation of pneumonia. Easing respiratory effort (such as humidifying and mist from hot shower), ↓Infection, Rest & Comfort, Nutrition, Fluids, and Family Support/Edu

Acute bronchiolitis is caused by a _______ _______ spread between groups of people in close contact. Do not look into a child's throat with suspected _______ _______ because what happens? What does it require? Acute laryngitis presents with mainly symptoms of: Acute LTB is the most common of the _______ _______ and affects children ages of _______ and _______. What organisms are responsible for Acute LTB (5)?

Viral infection Acute Epiglottitis / The epiglottis closes // Emergency Tracheotomy. Hoarseness Croup Syndromes / 5 and under. RSV, Parainfluenza, Muycoplasma pneumoniae, Influenza A&B

Infectious Pathogen that is found in rotting onions? What is a pathogen that is found in the respiratory system, that cannot be destroyed by alveolar macrophages? What causes inspiratory wheezes (2)? Expiratory wheezes(1)? Gradual progression follows _______ infection and destroys ________ epithelium. infection ultimately spreads to _______ tissues, weakening _______ walls. Chronic hypoxemia causes _______ & _______ of muscle fibers in pulmonary arteries/arterioles which leads to (4): What testing is done for PT's with CF(6)?

→Burkholderia cepacia (found in rotting onions & high AB resistance) →Pseudomonas aeruginosa Foreign body blockage or Croup / Asthma Chronic, Bronchial / Peribronchial tissues, alveolar walls. Contraction & Hypertrophy // Pulmonary hypertention, RSHF, Pneumothorax, Hemoptysis Sweat chloride test, Cx X-ray, PFT, Barium enema, Stool fat/enzyme analysis.

Some additional complications of CF caused by GI dysfunction are (8): How does CF affect the reproduction system in females(2)? Males? What kind of diet for those with CF(5)?

↓Salivation, COPD due to infection, Sweat gland dysfunction, Failure to thrive, Weight loss despite appetite, Respiratory deterioration, bowel obstruction, rectal prolapse. Causes delayed puberty (malnutrition) and ↑ cervical mucous / Sterility in males (congenital bilateral absence of the vas deferens). ↑Protein, ↑Calorie, ↓Fat, 150% RDA, Salt supplementation.

Why does clubbing occur? Maximum Liter flow - Nasal Cannula in children? Epiglottitis is most often caused by what organism/strand? CF PT's are deficient in the following vitamins: -what can be done with these PT's to break up chest congestion?

Because of increased capillary growth as the body attempts to supply more oxygen to distal body cells. 4L/min Haemophilus influenzae type b A,D,E,K / Cupping to break up mucous secretions

Does grunting occur on inspiration or expiration? Why is this noise caused? Purpose of this? Grunting might occur with _______ collapse or loss of lung _______, such as in atelectasis. What is a stridor? Inspiration or expiration? It is a sign of: What are retractions? These are documented by the severity of the reaction such as (3):

Expiration / Caused by premature glottic closure / Preserve or increase functional reserve capacity. Alveolar / Volume High pitched noise / Inspiratory / Upper airway obstruction Inward pulling of soft tissues with respiration / mild, moderate, severe

What is meant by Step I, II, III, IV asthma? What is Theophylline? What does it require? Cystic Fibrosis is caused by? Its a disease that involves multiple _______. It is a lethal genetic illness most common amongst _______ children. Approximately __% of the population are symptom free carriers.

I: mild & Intermittent II: mild & persistant III: moderate & persistent IV: severe & persistent Its a bronchodiliator / Requires monitoring of serum levels. An endocrine gland dysfunction / Systems White / 3%

ASL chiefly occurs during what part of the day? Inflammation may be _____ or entirely _____. What medicines are used in nebulizers for therapeutic management of LTB(2)? ASL typically affects children ages __ - __. Bacterial tracheitis is an infection of the ______ of the _______ _______. BT has features that are similar to (2):

Night / Mild or Absent Epinephrine & Steroids. 1 - 3 years of age Mucosa / upper trachea. Croup and Epiglottitis

Bronchitis is also known as? Caused by what organism? Bronchiolitis is caused by what organism? What time of year? What age group? What type of precautions? What is SYNAGIS? What is meant by respiratory failure?

Tracheobronchitis / M. pneumoniae Respiratory Syncytial Virus (RSV) // Winter-Spring // Usually before 2 years of age. Droplet precautions An monthly injection for RSV that helps prevent serious lung complications in children. Inability of respiratory system to maintain adequate oxygenation

Pancreatic enzymes may be given by which method? When are they given? URI (Nasopharyngitis) also known as the common cold can be caused by what kind of viruses(5)? Occurs during what months(1)? Pharyngitis is caused by? and presents with (3)? Why is it taken seriously(4)? Treated with(1) unless its (1). Its most often caused by (V/B/F)? When can the child return back to school or other activities? What should be discarded?

They are sprinkled onto the food. /// Before/with meals. RSV, Rhinovirus, Adenovirus, Influenza, Parainfluenza / Winter months Strep throat / Strawberry tongue, swollen uvula and tonsils / Very contagious, ↑ risk of Acute Rheumatic Fever, Kidney damage and other complications / Narrow spectrum antibiotics unless viral / Most often viral. Cant return back to school for a minimum of 24 hours and without a fever / Toothbrush

CF presents with the following signs/symptoms (8): Adults have a lower consumption rate of oxygen than children, what is it? Why does this happen? Why does pallor occur? Why is it that the abscence of cyanosis is not an accurate indication of severe respiratory involvement?

Wheezing, Dry non-prod cough, Gen obst. emphasysema, Atelectasis, Cyanosis, Clubbed fingers/toes, Repeated Bronchitis and pneumonia. Adults = 3-4L and Children 6-8L // Children have 20million alveoli, adults have 300million alveoli, children require more oxygen. Because of vasoconstriction, the body conserves oxygen for vital functions/organs. Because those with ↓RBC count will not display cyanosis as early as those with an ↑ count.