Ch. 25 - Respiratory

Common cold is also known as

Acute Coryza

5. Which are signs/symptoms of epiglottitis? (Select all that apply.) o Child sits up and leans forward o Drooling because of difficulty in swallowing o Anxious with croaking on respiration o Edematous tongue and swollen lips

Child sits up and leans forward o Drooling because of difficulty in swallowing o Anxious with croaking on respiration All of these are signs/symptoms of epiglottitis, except the edematous tongue and swollen lips. These are signs of an anaphylactic reaction

1. What is the primary symptom in croup? o Dysphagia o Cough o Fever o Pain

Cough Croup is a general term applied to a number of conditions whose chief symptom is a barking (croupy) cough.

The teaching plan for the use of a dry powder inhaler for the treatment of asthma should include the warning to rinse the mouth after inhaling the powder. What does this prevent? a. Discoloration of tooth enamel b. Halitosis c. Irritation of oral membranes d. Candidiasis

Inhalant powders can cause candidiasis (yeast) infection of the mouth.

What is the best choice for fluid replacement that the nurse can offer a child who has just had a tonsillectomy? a. A popsicle b. Chocolate milk c. Orange juice d. Cola drink

a. A popsicle Small amounts of clear liquids can be offered to the child. Synthetic fruit juices are not as irritating as natural juices. A popsicle is usually well-tolerated.

What should the nurse explain to the parent of a child with exercise-induced asthma about when to inhale Cromolyn a. Before exercise to prevent attacks b. At the initial onset of the attack c. During the attack to relieve symptoms d. As often as 4 times a day

a. Before exercise to prevent attacks Anti-inflammatory inhalants are taken before exercise to prevent attacks. These drugs can do nothing for the attack in progress. They are meant to be used as prophylactic therapies.

The nurse would observe a child for frequent swallowing after a tonsillectomy and adenoidectomy (T&A). What might this indicate? a. Bleeding from the surgical site b. Pain at the incision area c. Sore throat from postnasal drip d. Potential vomiting

a. Bleeding from the surgical site Hemorrhage is the most common postoperative complication. Blood trickling down the back of the child's throat could cause frequent swallowing.

What will the nurse teach the child with cystic fibrosis to take in order to facilitate digestion and absorption of nutrients a. Pancreatic enzymes b. Water-soluble minerals c. Fat-soluble vitamins d. Salt supplements

a. Pancreatic enzymes An oral pancreatic enzyme is given to the child with every meal and with snacks to replace the pancreatic enzymes that the child's body cannot produce.

The nurse is caring for a toddler with acute laryngotracheobronchitis. Which assessment finding would indicate the child is experiencing increased respiratory obstruction? a. Restlessness b. Tachycardia c. Brassy cough d. Expiratory wheezing

a. Restlessness Restlessness is a primary sign of increased respiratory obstruction.

The nurse offers a variety of fluids to a 5-year-old asthmatic child to compensate for the fluid loss through dyspnea. Which fluids are most appropriate? a. Room temperature water b. Carbonated beverages c. Iced fruit juice d. Cold milk

a. Room temperature water Room temperature fluids are the best. Carbonated and iced beverages increase spasm. Milk stimulates mucus production.

The parents of a 3-month-old infant with cystic fibrosis (CF) want to know how their child got this disease, because no one in either of their families has CF. What is the nurse's best response based on the understanding of CF? a. Only one parent carries the CF gene. b. Both parents are carriers of the CF gene. c. The inheritance pattern is multifactorial. d. The result is probably a genetic mutation.

b. Both parents are carriers of the CF gene. Cystic fibrosis is an inherited disease. Both parents must be carriers of the CF gene for the child to have the disease.

An infant is hospitalized with RSV bronchiolitis. What is the priority nursing diagnosis? a. Fatigue related to increased work of breathing b. Ineffective breathing pattern related to airway inflammation and increased secretions c. Risk for fluid volume deficit related to tachypnea and decreased oral intake d. Fear and/or anxiety related to dyspnea and hospitalization

b. Ineffective breathing pattern related to airway inflammation and increased secretions An ineffective breathing pattern is the priority nursing diagnosis for an infant hospitalized with RSV infection.

What will the nurse tell parents of a child with a positive throat culture for group A hemolytic streptococcus that the treatment is most likely to be? a. Acetaminophen and plenty of fluids b. Oral penicillin for 10 days c. Penicillin until his sore throat is gone d. Streptococcus immunization

b. Oral penicillin for 10 days When a throat culture is positive for group A beta-hemolytic streptococcus, penicillin is administered for 10 days even if symptoms are alleviated before the medication is finished.

When auscultating breath sounds of an infant with respiratory syncytial virus, which assessment would the nurse immediately report? a. Respiration rate decrease from 40 to 32 breaths/min b. Heart rate decrease from 110 to 100 beats/min c. "Quiet chest" from previous assessment of wheezing d. Oxygen saturation of 90%

c. "Quiet chest" from previous assessment of wheezing A "quiet chest" after assessment of wheezing indicates occlusion of air pathways and impending respiratory arrest. All other options are within normal range for infants undergoing oxygen administration.

Which statement indicates that the child's parents understand how to perform respiratory therapy? a. "We do her postural drainage before the aerosol therapy." b. "We give her respiratory treatments when she is coughing a lot." c. "We give the aerosol followed by postural drainage before meals." d. "She needs respiratory therapy every day when she has an infection."

c. "We give the aerosol followed by postural drainage before meals." Postural drainage for the child with CF is done following nebulization. Therapy is best scheduled before meals or at least 1 hour after eating to prevent vomiting.

What classic sign would the nurse, auscultating the breath sounds of a child hospitalized for an acute asthma attack, expect to find? a. Fine crackles b. Coarse rhonchi c. Expiratory wheezing d. Decreased breath sounds at lung bases

c. Expiratory wheezing The child experiencing an acute asthma attack wheezes as air moves in and out of the narrowed airways. The expiratory wheeze is most pronounced.

The first child of a couple is being treated for bronchopulmonary dysplasia (BPD). They ask how to prevent this from happening with the child they are currently expecting. What will the nurse explain as the best way to prevent BPD? a. Maternal intake of folic acid b. Exercise c. Prevention of preterm birth d. Provision of oxygen therapy to the newborn

c. Prevention of preterm birth Bronchopulmonary dysplasia (BPD) is a fibrosis, or thickening, of the alveolar walls and the bronchiolar epithelium. It occurs in premature infants (less than 32 weeks) who have abnormal or arrested lung development and receive ventilation and oxygen for more than 28 days to survive. Respiratory distress in the newborn is the major reason why oxygen and ventilators are used for prolonged periods. The main cause of respiratory distress in the newborn is prematurity. Therefore the prevention of preterm births is the best way to prevent BPD.

How would the nurse advise a mother to clear the nostrils when her infant has a cold? a. Clear the nasal passages after the infant has a feeding. b. Use over-the-counter nose drops to clear passages. c. Remove nasal secretions with a bulb syringe. d. Instill saline nose drops after clearing away secretions.

c. Remove nasal secretions with a bulb syringe. The nasal passages can be cleared by instilling a few drops of saline into the nose and then suctioning the secretions with a bulb syringe.

Which initial intervention will the nurse suggest to the parents of a child experiencing laryngeal spasm? a. Take the child outside in the cool air. b. Bring the child directly to the emergency department. c. Take the child to the bathroom and turn on a hot shower. d. Have the child drink plenty of fluids.

c. Take the child to the bathroom and turn on a hot shower. The child experiencing laryngeal spasm should be placed in a high-humidity environment, such as the bathroom with a hot shower running. The humidity liquefies secretions and reduces spasm.

The nurse is caring for a 3-year-old who suffered a smoke inhalation injury. How long is this patient at the highest risk for pulmonary edema after exposure? a. 2 hours b. 4 hours c. 18 hours d. 72 hours

d. 72 hours Pulmonary edema appears in a child with smoke inhalation injury 6 to 72 hours after exposure.

The asthmatic child who has been taking theophylline complains of stomachache and tachycardia and is sweating profusely. What does the nurse recognize as the cause of these symptoms? a. Severe asthma attack b. Allergic response to theophylline c. Onset of bronchitis d. Drug toxicity

d. Drug toxicity The symptoms described are the signs of theophylline toxicity.

Which is the most appropriate nursing action when planning care for a child with cystic fibrosis? a. Provide chest physiotherapy before meals every day. b. Assess weight monthly. c. Administer pancrease with protein food at mealtime. d. Ensure high-protein, high-calorie diet.

d. Ensure high-protein, high-calorie diet. The maintenance of adequate nutrition is essential. The diet is high in protein and calories. Chest physiotherapy should be done between meals. Pancreatic enzyme powder should be given with applesauce or other nonstarch, nonfat, nonprotein food. Children with cystic fibrosis should be weighed daily.

The nurse is planning to teach parents about preventing sudden infant death syndrome (SIDS). What significant information would the nurse include? a. Wrapping the infant snugly for rest periods b. Positioning the infant prone for sleep c. Sitting the infant up in an infant seat d. Placing infants on their backs or sides for sleep

d. Placing infants on their backs or sides for sleep The American Academy of Pediatrics recommends that all healthy infants be placed in the supine or side-lying position on a firm mattress to prevent SIDS.

What is the best intervention for the nurse caring for a child experiencing an acute asthma attack? a. Offer plenty of fluids, particularly carbonated beverages. b. Place the child in a humidified cool mist tent with oxygen. c. Administer sedatives as ordered to decrease anxiety. d. Position the child with arms resting on the overbed table

d. Position the child with arms resting on the overbed table. This position is comfortable and allows maximum use of the accessory muscles for breathing. Sedatives would mask symptoms of increasing air hunger. Carbonated beverages are contraindicated in persons with dyspnea.

3. What type of isolation precaution is for infants infected with respiratory syncytial virus (RSV)? o Airborne o Contact o Standard o Depends on if the child has a cough

o Contact RSV is spread through direct contact of secretions, so contact isolations are appropriate. Standard precautions apply to all patients. This isolation is not dependent on the occurrence of a cough.

4. Which symptoms are manifested with chronic respiratory distress? (Select all that apply.) o Productive cough o Failure to thrive o Irritability o Pupil constriction o Retractions

o Failure to thrive o Irritability o Retractions Symptoms of chronic respiratory distress include wheezing, retractions, cyanosis on exertion, use of accessory respiratory muscles, clubbing of the fingers, failure to thrive, and irritability caused by hypoxia.

2. A nurse is caring for a 7-year-old patient immediately after a tonsillectomy. What is the best position for this patient? o High Fowler's o Partly on the back and partly on the side o Partly on the side and partly on the abdomen Correct o Supine

o Partly on the side and partly on the abdomen To facilitate drainage immediately after surgery, the child is placed partly on the side and partly on the abdomen, with the knee of the uppermost leg flexed to hold the position.

Cystic fibrosis is a _______________ system disease. o respiratory o endocrine o gastrointestinal o multi

o multi Cystic fibrosis is considered a multisystem disease because the thick, viscid secretions affect the respiratory system, digestive system, skin, and reproductive system. REF: Page