Peds - Ch. 18

______________ is a short-acting beta-adrenergic agonist that acts as a bronchodilator

Albuterol

For a child diagnosed with asthma, using a stepwise approach, rank the order in which the nurse should administer medications

Albuterol as needed Low-dose inhaled corticosteroid Medium-dose inhaled corticosteroid Medium-dose inhaled corticosteroid and salmeterol

drug used to prevent or reduce fever

Antipyretic

What is the course of treatment that the nurse would expect for a patient with a streptococcus infection?

Antipyretic (for fever) Analgesic (for pain) Antibiotic (for bacterial infection)

the collapse of part or all of a lung, is caused by a blockage of the air passages (bronchus or bronchioles) or by pressure on the lung

Atelectasis

Term for the genetic tendency to develop allergic diseases such as allergic rhinitis, asthma and atopic dermatitis (eczema). It is typically associated with heightened immune responses to common allergens, especially inhaled allergens and food allergens clubbing

Atopy

During your assessment of a patient with croup, what is most likely to be seen?

Barking Seal Cough Croup is classically identified by a loud seal-like barking cough due to inflammation of all of the airways Inspiratory Stridor Constriction of the airways due to inflammation causes decreased airway diameter. This causes a loud high pitched inspiratory stridor. Children without stridor are often treated at home

___________________ are anti-inflammatory drugs used to control severe or chronic cases of asthma

Corticosteroids

Term for an acute inflammatory contagious disease involving the upper respiratory tract: a : common cold

Coryza

a medical procedure that makes a real-time video of the movements inside a part of the body by passing x-rays through the body over a period of time

Fluoroscopy

When do symptoms of croup most likely present?

Nighttime Symptoms usually present with sudden onset at night

Which method would the nurse most likely use to give medications to treat the pancreatic involvement seen in CF

Open capsule and sprinkle on food Pancreatic enzymes should be administered at all meals and snacks to promote adequate digestion and absorption of nutrients.

What nursing diagnosis would best apply to a child with allergic rhinitis?

Pain related to sinus edema and headache

What is the most common cause of croup?

Parainfluenza virus inflammation of these airways is also caused by adenovirus, RSV, influenza A&B, and mycoplasma pneumoniae

PEFR

Peak expiratory flow rate

_________________ is air around or outside the lung. It may result from chest trauma, excess pressure on the lungs or a lung disease, such as COPD

Pneumothorax

Risk factors for pneumonia include ...

Prematurity Attending day care

What laboratory/diagnostic tool would likely have been used to diagnose a child with asthma?

Pulmonary functions test

A specialized type of epinephrine named for its chemical properties is given in an aerosolized form. This medication is indicated for stridor or airway constriction due to inflammation, except epiglotti

Racemic Epinephrine

What are 3 interventions most likely associated with croup?

Racemic Epinephrine Dexamethasone Cool Humidified Air

____________ are crackling sounds heard on auscultation when the alveoli become fluid filled

Rales

an autoimmune disease that occurs as a reaction to a group A beta-hemolytic streptococcal infection, specifically, a pharyngitis.

Rheumatic fever

Term for runny nose thin, mostly clear nasal discharge

Rhinorrhea

____________ is a snoring sound heard throughout the lung field when inflammation occurs

Rhonchi

___________ is a high-pitched, readily audible inspiration noise that indicates an upper airway obstruction

Stridor

A 2-year-old toddler is seen for acute laryngotracheobronchitis. What observation would lead the nurse to suspect airway occlusion?

The respiratory rate is gradually increasing

A ________ ________ provides 24% to 50% oxygen concentration

Venturi mask

Tuberculosis screening is recommended annually for children in high-risk situations or communities, including the following:

a family in which there is an active case of TB Native American children children who recently immigrated from Central or South America, the Caribbean, Africa, Asia, or the Middle East Other high-risk children are those infected with HIV, those who are homeless or live in overcrowded conditions, and those immunosuppressed from any cause

Many children with _______ _______ develop sinus headaches from edema of the upper airway

allergic rhinitis

a diagnosis associated with a group of symptoms affecting the nose known as hay fever

allergic rhinitis

Term for an enlargement of the terminal phalanx of the finger, resulting in a change in the angle of the nail to the fingertip a bulbous enlargement of the connective tissue in the distal phalanges of the fingers and toes

clubbing

Treatments are aimed at decreasing inflammation and __________________________ has long been used as a treatment, although its effectiveness has not been completely scientifically documented

cool humidified air

Dextromethorphan suppresses what?

coughs

Acute laryngotracheobronchitis is also know as _________

croup

Steroid medications like _______________________ are given to decrease inflammatory processes of tissues in the body as treatments are aimed to decrease inflammation

dexamethasone

the sweat chloride test is indicated for what use?

diagnose cystic fibrosis

A hospitalized child suddenly begins reporting "my chest hurts," is tachypneic, and has tachycardia. The nurse auscultates the lung sounds and finds absent breath sounds on one side. After notifying the health care provider, what action would the nurse take first?

prepare for chest tube insertion A pneumothorax is a collection of air in the pleural space. Trapped air consumes space in the pleural cavity causing a partial or complete collapse. The priority symptom a nurse would assess is the decreased or absent lung sounds on the affected side.

Term for crackling sounds an abnormal rattling sound heard when examining unhealthy lungs with a stethoscope

rales

What are the three signs of major respiratory distress and occlusion?

respiratory rate (tachypnea) retractions nasal flaring

Acute bronchiolitis is most often caused by what type of virus?

respiratory syncytial virus

An infant exposed to second- or thirdhand smoke is at risk for developing RSV

respiratory syncytial virus (RSV) RSV season runs from September through April Infants are susceptible to RSV much more than older children

What is usually used for the assessment of cystic fibrosis?

sputum culture sweat chloride test

The respiratory tract grows and changes until the child is about what age?

12 years of age

Term for an abnormally low concentration of oxygen in the blood

Hypoxemia

Term for condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level

Hypoxia

What measure at home could help a child with an upper respiratory infection breathe more easily?

Increasing room humidity

What age ranges are best linked to croup?

3 Months to 3 Years The age of onset of this disorder is after 3 months of age but usually before 3 years

The child with cystic fibrosis would not have respiratory distress unless ...

ill with respiratory infection

What type of environment helps prevent respiratory secretions from drying and becoming difficult to raise?

A moist environment

What is one complication that may occur with CF?

A pneumothorax is a complication of CF

_______________ is a high-pitched sound heard on auscultation, usually on expiration

A wheeze

Oxygen can be delivered up to ________ via nasal cannula

4 liters

Newborns are obligatory nose breathers until at least what age?

4 weeks of age

What is usually used for the assessment of asthma to check for hyperventilation

A chest x-ray

drug acting to relieve pain

Analgesic

are used to help decrease wheezing and exercise-induced asthma attacks

Mast cell stabilizers A bronchodilator often is given to open up the airways just before the mast cell stabilizer is used

fluoroscopy is used to identify what?

masses or abscesses as with pneumonia

PaO2

partial pressure of oxygen

The allergens that usually cause ___________________ are pollens or molds rather than foods or drugs

allergic rhinitis (hay fever) Over-the-counter or prescription allergy medications may help provide relief for these clients when taken

Viruses are often spread in which manner?

between groups of people in close contact like crowds

Inflammation and swelling of the epiglottis and surrounding structures are common in children ages 2 to 7 years. The child will attempt to improve his/her airway by doing what?

sitting forward and extending the neck forward with the jaw up, in a "sniffing position" (tripod position).

What is the most common debilitating disease of childhood among those of European descent?

Cystic fibrosis Medical advances in recent years have greatly increased the length and quality of life for affected children, with median age for survival being the late 30s.

A _______ _______ ________ is used to assist with mobilization of secretions for older children and adolescents with cystic fibrosis

flutter valve device

The child with epiglottitis is very anxious and prefers to breathe by sitting ...

forward with the neck extended

describe the shape of the larynx in infants

funnel In infants and children (younger than the age of 10 years)

Pancreatic enzymes may be given by which method?

given by opening the capsule and sprinkling the medication on the child's food the child with cystic fibrosis has an infection, IV medications may be given, but this is not on a daily basis

streptococcus is what type of infection

any type of infection caused by the group of bacteria Streptococcus

Children who are considered high risk and could benefit from the influenza vaccine are:

immunocompromised have a chronic pulmonary disease have had a congenital abnormality chronic renal or metabolic disease sickle-cell disease HIV any type of neurological disorder (seizures)

A ___________ _____________ ________ provides 50% to 60% oxygen concentration

partial rebreather mask

an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body. It affects the cells that produce mucus, sweat and digestive juices.

Cystic fibrosis (CF)

describe the shape of the larynx in teenagers and adults

cylindrical and fairly uniform in width

What is usually used for the assessment of pneumonia?

fluoroscopy sputum culture

Which medication would the nurse most likely give a pt with pneumonia to help reduce the viscosity of the child's secretions?

guaifenesin An expectorant

A _________________ _________ provides 95% oxygen concentration:

nonrebreather (face) mask

An ______________ ___________ provides up to 80% to 90% oxygen concentration, used for infants only

oxygen hood

Term for gas exchange The exchange of air between the lungs and the atmosphere so that oxygen can be exchanged for carbon dioxide in the alveoli

ventilation

the state of being thick, sticky, and semifluid in consistency

viscosity

Term for effort or labor associated with respiration

work of breathing

A positive reaction to the __________________________ indicates the child has been exposed to tuberculosis or has developed antibodies to the foreign products of the tuberculosis organism

interferon-gamma release assay (IGRA)

A sputum culture is indicated to assess which respiratory issues?

pneumonia cystic fibrosis tuberculosis

_______________ is the most common complication of a tonsillectomy

Hemorrhage (an escape of blood from a ruptured blood vessel)

If a pt with cystic fibrosis has bouts of diarrhea or constipation, what may need to be changed?

dosage of pancreatic enzymes may need to be adjusted

a leaf-shaped flap in the throat that prevents food and water from entering the windpipe and the lungs

epiglottis

Stridor, tachycardia, and the rapid onset are classical signs of ________________

epiglottitis

s/s of tonsillitis

fever sore throat dysphagia (difficulty swallowing) hypertrophied tonsils erythema of the pharynx

A chest x-ray is usually ordered for the assessment of ___________to check for hyperventilation

asthma

Being a triplet is a factor for _____________

bronchiolitis Caused by a viral infection

A child with a positive reaction to a TB testing needs a follow-up _____________

chest x-ray

Term for collection of inflammatory cells, cellular debris, and foreign organisms an abnormal substance that accumulates gradually within cells or body tissues

infiltrates

During an acute asthma attack the child may lose a great quantity of fluid through the _____________ ________ and may have poor oral intake because of coughing and vomiting.

respiratory tract Theophylline administration also has a diuretic effect, which compounds the problem. Get Weights

Term for bobbing of the head with each breath the inward pulling of soft tissues with respiration

retractions

Adverse reactions of albuterol, a bronchodilator, include...

tachycardia, nervousness, tremors, hyperactivity, malaise, palpitations, increased appetite, hypokalemia, and muscle cramps

Term for increased respiratory rate for age abnormally rapid breathing

tachypnea

The diameter of the infant and child's trachea is about the size of...

the child's little finger

Bleeding late postoperatively can occur when ...

the clots dissolve and new tissue is not yet present

The child with ___________ may have a fever of 101°F (38.4°C) or higher, a sore throat, often with dysphagia (difficulty swallowing), hypertrophied tonsils, and erythema of the pharynx.

tonsillitis

Term for incision in trachea to permit breathing a hole that surgeons make through the front of the neck and into the windpipe

tracheostomy

Babies are nose breathers for how long?

until at least 4 weeks of life Newborns breathe through their mouths only while crying.

Acute bronchiolitis is caused by a ...

viral infection

Term for a high-pitched sound that usually occurs on expiration, results from obstruction in the lower trachea or bronchioles

wheezing

The student nurse is collecting data on a child diagnosed with cystic fibrosis and notes the child has a barrel chest and clubbing of the fingers. In explaining this manifestation of the disease, the staff nurse explains the cause of this symptom to be:

chronic lack of oxygen

Term for a bluish discoloration of the skin resulting from poor circulation or inadequate oxygenation of the blood

cyanosis

Placing an infant with heart failure in a ___________ __________ position reduces the pressure of the abdominal contents against the chest and allows for better lung expansion

semi-Fowler

Term for a high-pitched, readily audible inspiratory noise, is a sign of upper airway obstruction

stridor