Chapter 18 Nursing Care of the Child With an Alteration in Gas Exchange/Respiratory Disorder
A worried mother calls the nurse and tells her that her son has developed a horrible croup cough and is having trouble breathing. What would be the best intervention for the nurse to recommend to the mother
Run a hot shower to fill the bathroom with steam and have the boy stay there One emergency method of relieving croup symptoms is for a parent to run the shower or hot water tap in a bathroom until the room fills with steam, then keep the child in this warm, moist environment as this relaxes the airway tissues and widens the bronchi lumens. If this does not relieve symptoms, parents should bring the child to an emergency department for further evaluation and care. Caution parents not to give cough syrup routinely to children as many produce little effect and the risk of overdose, incorrect dosing, and adverse events is greater than the benefit of the syrup. An analgesic might help alleviate pain due to inflammation and irritation of the throat from coughing, but it is not the priority intervention in this case. Drinking would likely be painful for this child and would not provide lasting benefit.
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?
Sweat sodium chloride test Sweat sodium chloride tests are used for determining the diagnosis of cystic fibrosis. Purified protein derivative tests are used to detect TB. Blood culture and sensitivity is done to determine the causative agent as well as the anti-infective needed to treat an infection. Pulmonary function tests are diagnostic tools for the child with asthma and indicate the amount of obstruction in the bronchial airways, especially in the smallest airways of the lungs.
The nurse is admitting a child who is experiencing an asthma attack. Which clinical manifestation would likely be noted in this child?
Wheezing The onset of an attack can be very abrupt or can progress over several days, as evidenced by a dry hacking cough, wheezing (the sound of expired air being pushed through obstructed bronchioles), and difficulty breathing. Chest retractions can be seen when there is severe respiratory distress. Hoarseness is most commonly seen with illness such as laryngitis. Circumoral cyanosis is seen with children with poor perfusion, such as a child with a congenital heart defect.
The nurse is caring for a 5-year-old girl who shows signs and symptoms of epiglottitis. The nurse recognizes a common complication of the disorder is for the child to:
be at risk for respiratory distress If the airway becomes completely occluded due to epiglottitis, respiratory distress may lead to respiratory arrest and death. Aseptic meningitis is a complication of infectious mononucleosis, resulting in nuchal rigidity; acute otitis media resulting in ear pain is a complication of influenza; and children with pneumonia are at risk for pneumothorax.
What is a complication of cystic fibrosis?
pneumothorax Cystic fibrosis (CF) is a genetic disorder causing thickened tenacious secretions of the sweat glands, gastrointestinal tract, pancreas, respiratory tract and exocrine tissues. The treatment is aimed at minimizing pulmonary complications, maximizing lung function, preventing infection, and facilitating growth. A pneumothorax is a complication of CF. A rupture of the subpleural blebs through the visceral pleura takes place. There is also a high reoccurrence rate and incidence increases with age. Crohn disease is a gastrointestinal disorder that is not associated with cystic fibrosis. Urinary tract infection and kidney disease are also not associated with CF. Most of the problems and complications associated with CF relate to the respiratory system, the gastrointestinal system, and infectious disorders.
