Week 1 327 PEDs

What are the differences between croup and epiglottits?

Croup - viral - barking seal-like cough - stridor (inspiratory) - NOT airway emergency - cool mist/humidity - nebulized epinephrine and steroids to treat Epiglottis - bacterial - airway emergency - vaccine preventable - antibiotics and steroids to treat - DON'T ATTEMPT TO VISUALIZE THE THROAT

What are the goals of atraumatic care?

DO NO HARM 1. Prevent or minimize separation from family 2. Promote a sense of control 3. Prevent or minimize bodily injury and pain

Asthma is classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to determine these categories include: A. Pulmonary lung function tests B. Associated allergies C. Frequency of symptoms D. Frequency and severity of exacerbations a. A, C, D b. A, B, C, D c. A d. C, D

a. A, C, D

What's the big deal with bronchiolitis and infants?

younger children are most likely to to end up in the hospital (most concerning for premature babies)

What are some of the roles of the nurse in the area of genetics?

• Applying and integrating genetic knowledge into nursing assessment • Identifying and referring patients who may benefit from genetic information or services • Identifying genetics resources and services to meet patient's needs • Providing care and support before, during, and after providing genetic information and services.

Can bronchiolitis be prevented?

- at risk children can receive vaccinations for this - breastfeeding (especially in premature infants and during flu season)

Provide education to a parent on how to prevent SIDS

- breastfeeding - immunizations - back sleeping - firm bedding - sleep sacks - no co-sleeping - pacifiers

How do the actions of the nurse support atraumatic care goals?

- choices ONLY when they are possible - explain what they will feel, what to expect, and what they can do - don't lie - use language they will understand

Assessing the respiratory status of a child

- level of consciousness - vital signs - skin (color and temp) - upper airway (inspiration) - lower airway inspect for: - nasal flaring - grunting - use of accessory muscles/ retractions - peripheral pulse - capillary refill

Which nursing interventions are needed in the diagnosis of Bronchopulmonary dysplasia?

- nutritional support - O2 assessment - frequent rest periods - promote treatment of infections - medication administration

What cues are consistent with chronic respiratory conditions in childhood?

- poor growth - clubbed fingers - barrel chest - poor color - increased hemoglobin

what are the differences in the airways of infants and toddlers that predispose them to respiratory illnesses/disorders.

- short and narrow upper airway - smaller nares - trachea is shorter - angle of right bronchus is more acute - small oral cavity and large tongue - larynx and glottis are higher in the neck

What cues would make you consider a foreign body aspiration in a child?

- spasmodic coughing or gagging - dyspnea - stridor or hoarseness - no fever or signs of illness - respiratory distress after 15-30 min

What are the similarities between croup and epiglottits?

- sudden onset - primarily in young children - upper airway infection - steroid use

What is the relationship between inflammation and bronchospasm with asthma?

1.Inflammation causes heightened airway responsiveness 2.Bronchospasm causes airflow obstruction 3.Increased mucous production

what is a problem statement

1.Problem identification 2.Background 3.Scope of the problem 4.Consequences of the problem 5.Knowledge gaps 6.Proposed solution

what is a research question?

A Question that can lead to an experiment that attempts to answer the question

What is the mechanism that causes the presentation of Cystic Fibrosis?

Abnormal chloride movement in the chloride channel. Altered function of exocrine glands causes abnormal mucus secretion and obstruction.

what is a research problem

An enigmatic, perplexing, or troubling condition

What is the role of a literature review?

Answering the question: what is the current state of evidence on this research problem?

A 4-year old girl is brought to the emergency department. She has a "froglike" croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should: a. Examine her oral pharynx and report to the physician b. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation c. Make her lie down and rest quietly d. Auscultate her lungs and make preparations for placement in a mist tent.

b. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation

The nurse is preparing staff in-service about atraumatic care for pediatric patients. Which interventions should the nurse include? a. Help the child accept the loss of control associated with hospitalization b. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal. c. Help the child accept that pain is connected with a treatment or procedure d. Prepare the child for separation from parents during hospitalization by reviewing a video

b. Prepare the child before any unfamiliar treatment or procedure by demonstrating on a stuffed animal.

A infant with congenital heart defect is receiving palivizumab (Synagis). The purpose of this is to: a. Prevent secondary bacterial infection b. Prevent respiratory syncytial virus (RSV) infection c. Decrease toxicity of antiviral agents d. Make isolation of the infant unnecessary

b. Prevent respiratory syncytial virus (RSV) infection

What represents the major stressor of hospitalization for children from middle infancy throughout the preschool years? a. Loss of control b. Fear of pain c. Separation anxiety d. Fear of bodily injury

c. Separation anxiety

What is the relationship between dehydration and bronchiolitis?

children with bronchiolitis (RSV) are typically dehydrated

One of the goals for children with asthma is to prevent respiratory infection. This is because respiratory infection: a. Lessens effectiveness of medications b. Encourages exercise-induced asthma c. Increases sensitivity to allergens d. Can trigger an episode or aggravate an asthmatic state

d. Can trigger an episode or aggravate an asthmatic state

Cystic Fibrosis may affect singular or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is: a. Hyperactivity of the sweat glands b. Atrophic changes in the mucosal wall of the intestines c. Hypoactivity of the autonomic nervous system d. Mechanical obstruction caused by increased viscosity of mucous gland secretions

d. Mechanical obstruction caused by increased viscosity of mucous gland secretions

The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37 degrees C. The nurse suspects croup and should recommend: a. Trying over the counter cough medicine and coming to the clinic in the morning if there is no improvement b. Controlling the fever with acetaminophen and calling if the cough gets worse at night c. Admitting to the hospital and observing for impending epiglottitis d. Trying a cool mist vaporizer at night and watching for signs of difficulty breathing

d. Trying a cool mist vaporizer at night and watching for signs of difficulty breathing

In addition to respiratory support, kids with CF need to consume a lot of calories, why?

difficulty digesting and absorbing fat

What are some principles of family centered care?

enabling and empowering - acknowledge the parents expertise in caring for the child - consider the need of all family members - the family is the Childs constant

What is a hypothesis?

expected relationships among the independent and the dependent variable - accepted or rejected

Which babies with bronchiolitis are the most concerning?

premature or those with chronic conditions

What population develops Bronchopulmonary dysplasia and why?

preterm infants - don't make surfactant to lubricate the lungs which damages the alveoli

How does a research question differ between quantitative and qualitative studies?

quantitative studies - expresses relationship between the independent variable and the dependent variable. - can also be descriptive - can be intervention, prognosis, etiology, or descriptive qualitative studies - include phenomenon of interest and the group or population of interest -involve meaning, process, or descriptive questions.