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ATI Pediatrics-MJ > Ch. 19: CF > Flashcards

Ch. 19: CF Flashcards

1
Q

CF is a respiratory disorder that results from inheriting a ____

A

Mutated gene

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2
Q

What is CF characterized by?

A
  • Mucus glands that secrete an increase in the quantity of thick, tenacious mucous–> Leads to mechanical obstruction of organs
  • Increase in organic and enzymatic constituents in the saliva
  • Increase in Na and Cl in sweat
  • CNS abnormalities
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3
Q

One of the things CF is characterized by is mucus glands that recreate an increase in the quantity of thick, tenacious mucous, which leads to obstruction of organs. What organs are affected?

A 
Pancreas
Lungs
Liver
S. Intestine
Reproductive system
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4
Q

One or both biological parents carry the recessive trait for CF?

A

BOTH

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5
Q

Physical assessment findings:

______ at birth manifested as distention of the abdomen, vomiting, and inability to pass stool

A

Meconium ileus

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6
Q

Physical assessment: Respiratory

What are the early signs?

A

Wheezing

Dry, non-productive cough

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7
Q

Physical assessment: Respiratory

What are the increased involvement signs?

A

Dyspnea
Paroxysmal cough
Mucus plugs and atelectasis on xray

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8
Q

Physical assessment: Respiratory

What are the advanced involvement signs?

A

Cyanosis
Barrel-shaped chest
Clubbing of fingers and toes
Multiple episodes of bronchitis or bronchopneumonia

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9
Q

Physical assessment: GI

What kind of stools?

A

Large, loose, fatty, sticky, foul-smelling

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10
Q

Physical assessment: GI

What are the early signs for appetite? late?

A

Early: Voracious appetite
Late: Loss of appetite

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11
Q

Physical assessment: GI

Do they gain weight easily?

A

No–failure to gain weight; weight loss

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12
Q

Physical assessment: GI

How are their growth patterns? What type of abdomen, arms, and legs?

A

Growth pattern= delayed

Arms and legs= thin

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13
Q

Physical assessment: GI

Deficiency of what?

A

Fat soluble vitamins

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14
Q

Physical assessment: GI

What kind of blood problems?

A

Anemia

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15
Q

Physical assessment: Integumentary

How are the sweat, tears, and saliva?

A

Abnormally salty

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16
Q

Physical assessment: Endocrine and reproductive

What goes on here?

A
  • Viscous cervical mucus

- Decreased/absent sperm

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17
Q

How is CF diagnosed?

A

Sweat chloride test

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18
Q

What is a sweat chloride test?

A

A special device that stimulates sweat production

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19
Q

How many sites need to have sweat collected for it to be an adequate sample for the sweat test?

A

Sweat from 2 different sites

20
Q

Sweat chloride test: Expected reference range is the presence of chloride less than ____

A

40 mEq/L

21
Q

**Sweat chloride test: What is the diagnostic confirmation for CF?

A

Normal= 40 mEq/L

CF= Chloride greater than 60 mEq/L for infants less than 3 months of age & greater than 40 mEq/L for all others

22
Q

Why would a chest x ray be done?

A

May indicate atelectasis and obstructive emphysema

23
Q

Why would an abdominal x ray be done?

A

Detect meconium ileus

24
Q

Lab tests: What are we testing for detection of infection?

A
  • Pseudomonas aeruginosa
  • Haem influenzae
  • Burkholderia cepacia
  • S. aureus
  • E. Coli
  • Klebsiella pneumonia
25
Q

What 2 types of infection need contact isolation?

A

B. cepacia and P. aeruginosa

26
Q

For pulmonary management for CF, one nurse care is to perform chest physiotherapy (CPT) with postural drainage as prescribed. When should we avoid doing CPT?

A

Before and after meals

27
Q

For pulmonary management for CF. one nurse care is to perform airway clearance therapy. What do we use to do this and how many times a day do we do this?

A

Use flutter mucus clearance device

Twice daily

28
Q

Pulmonary management. We should encourage physical exercise. Ex?

A

Stationary bike

29
Q

GI management. What kind of diet? How many meals a day?

A

Diet: well balanced, high in PROTEIN and CALORIES

3 meals a day with snacks

30
Q

GI management. What do we administer as prescribed 30 min within eating?

A

Pancreatic enzymes

31
Q

GI management: What vitamins may we give (as prescribed)?

A

Multivitamins; vit. A, D, E and K

32
Q

GI management. What if the child is constipated?

A

Give GoLYTELY (polythylene-glycol electrolyte solution)

33
Q

Medications. What med decreases the viscosity of mucus and improves lung function?

A

Dornase alfa

34
Q

Dornase alfa is administered ____

A

1x a day

35
Q

If a client is taking ipratropium bromide (cholinergic antagonists), what should we observe for and what should we do with client education?

A

Observe: Dry mouth

Client education: Wait 5 min between ipratropium bromide and other inhaled meds

36
Q

If the client is taking albuterol, what do we monitor the child for?

A

Tremors and tachycardia

37
Q

What should we teach the client about fluticasone propionate/salmeterol?

A

Rinse mouth after taking that

38
Q

What are some common antibiotics given? How are they administered?

A

Tobramycin
Ticarcillin
Gentamicin

Administered through IV or aerosol

39
Q

If we are giving the child with CF pancreatic enzymes, what should we be monitoring? Explain.

A

Adequate dosing

Loose, fatty stool= increase dose
Constipated= decrease dose

40
Q

How do we give the pancreatic enzymes?

A

In a capsule with all meals and snacks (remember earlier, give within 30 min of eating)

41
Q

Pancreatic enzymes–is it okay if the client swallows capsule whole? Is it okay if they sprinkle capsules on food?

A

Yes to both

42
Q

Care after discharge. What should we emphasize?

A

Need for up-to-date immunizations and a yearly influenza vaccine

43
Q

A nurse is caring for a child who is suspected of having CF. Which of the following tests should the nurse prepare to administer to confirm the diagnosis?

A. Sweat chloride
B. Pulmonary function test
C. Arterial blood gases
D. Chest percussion

A

A

44
Q

A nurse is admitting a child who has CF. Which of the following meds should the nurse anticipate including in the plan of care? (SATA)

A. Tobramycin
B. Solu-medrom
C. Fat-soluble vitamins 
D. Albuterol
E. Dornase alfa
A

A, C, D, E

45
Q

A nurse is caring for a child who has CF. Which of the following are expected findings? (SATA)

A. Wheezing
B. Clubbing of fingers and toes
C. Barrel-shaped chest
D. Thin, watery mucus
E. Rapid growth spurts
A

A, B, C

46
Q

A nurse is planning care of child who has CF. Which of the following interventions should she include in plan of care?

A. Provide a low calorie, low protein diet
B. Administer pancreatic enzymes with meals and snacks
C. Promote an increase in fluids after 1800
D. Restrict physical activity

A

B

ATI Pediatrics-MJ (41 decks)

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