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Flashcards in Test-2 Respiratory Deck (84)
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1
Q

Breathing remains primarily nasal until

A

5-6 months of age

2
Q

Infants normally breathe with an

A

Irregular rhythm

3
Q

Children breathe

A

Abdominally and diaphragmatically

4
Q

Chest radiograph

X ray

A

See respiratory disease in lungs

5
Q

CT scan

A

See tumors and large masses

6
Q

Bronchoscopy

A

Biopsy of lung tissue/lesion, remove foreign tissue

7
Q

Laryngoscopy

A

Direct view of larynx . Diagnosis of stridor

8
Q

PULMONARY function testing

A

Spirometer direct measure of vital capacity and expiratory flow rate

9
Q

Sputum cultures

A

Isolate pathogens

10
Q

Transcutaneous monitoring

A

Electrode used to detect O2 and co2 concentrations

11
Q

Cystic fibrosis

A

Inherited progressive autosomal recessive disorder affecting cells that produce mucous, sweat and digestive juices

12
Q

People with cystic fibrosis

A

Have inherited two copies of the defective CF gene-one from each parent

13
Q

Cystic fibrosis cause

A

Gene changes. Protein that regulates movement of salt in and out of cells

14
Q

Cystic fibrosis results

A

Abnormal accumulation of thick, sticky mucus. Leads to obstruction in pancreas, respiratory, GI and GU systems

15
Q

Cystic fibrosis in the respiratory system

A
Chronic infection, inflammation, bronchispasms
Impaired has exchange
Hypoxia
Increased vascular resistance 
Heart pumps harder
CHF
16
Q

Cystic fibrosis early manifestation

A

Wheezing
Dry, non productive cough
Frequent respiratory infections

17
Q

Cystic fibrosis late manifestations

A

Digital clubbing
Barrel chest
Nasal polyps

18
Q

Cystic fibrosis digestive system pancreas

A

Mucus prevents release of digestive enzymes that allow body to break down food
Diabetes type 1
Bowel obstruction
Poor absorption of proteins, cholesterol, fats

19
Q

Cystic fibrosis digestive

Bowel

A
Fecal impaction
Intussusception 
Meconium ileus in newborn
Recap prolapse
Steatorrhea
Growth retardation
Delayed bone age
20
Q

Cystic fibrosis physical manifestations

A

Protuberant abdomen
Wasted buttocks
Thin extremities

21
Q

Chaotic fibrosis and skin

A

Parent may report salty taste when kissing infant
Xerostoma
Increased sodium and chloride in sweat

22
Q

Cystic fibrosis reproductive system

A

Males are sterile

Females- fertility problems

23
Q

Cystic fibrosis Dx and tests

A
DNA screenings 
Family history
Clinical signs
Pilocarpine lontophoresis (sweat test) 
Measures Na and Cl 
> 60mEq/l is diagnostic
24
Q

Additional tests for cystic fibrosis

A
72 hour fecal fat
Liver function 
Fasting glucose
Chest X ray
Sputum
PULMONARY function
25
Q

Cystic fibrosis goal

A

Prevent and treat lung infection
Nutritional
Adaptation to disease

26
Q

Cystic fibrosis therapy

A

Segmental percussion and postural drainage
Excercise
Vitamin supplement a d e k
Antibiotics
Steroids PRN
Pancreatic enzymes( adjusted with stool fat)

27
Q

Cystic fibrosis nursing care

A

Respiratory assessment every shift and PRN
Weight/ height
Malabsorption?
Calodrie intake?
Stools? Pain, blood in stool comstipation?

28
Q

Cystic fibrosis interventions

A
Airway
Infection 
Nutrition growth
Excercise
Emotional
Home care
29
Q

Acquired respiratory health problems

A

Asthma
Apnea
SIDS

30
Q

Asthma - reactive airway disease

A

Genetics and environment
Decreased elastic lung recoil
Pro e to airway obstruction
Flexible rib cage, underdeveloped chest muscles lead to exhaustion

31
Q

Asthma pathophysiology

A

Increased airway responsiveness to stimuli
Inflammation and EDEMA of mucus membranes
Bronchospasm
Hypoventilation indicates worsening condition

32
Q

Asthma clinical manifestations

A

Wheezing
Hypoxia signs
Worsening symptoms after child goes to bed

33
Q

Asthma diagnosis

A
Good response to nebulizer 
Strong family Hx of asthma or allergies
PULMONARY function tests 
Peak expiratory flow rate 
X ray
34
Q

Intermittent asthma

A

Symptoms < twice a week
Rx SABA albuterol
15 minutes before exercise

35
Q

Mild persistent asthma

A

Symptoms > twice per week but < once per day, 1-4 nighttime symptoms/ month

36
Q

Mild persistent asthma Rx

A

Beclomethasone by MDI > 5 yo
Budesonide- nebulizer for younger children
SABA used to relieve Sx

37
Q

Moderate asthma

A

Daily symptoms, bronchodilator used daily, sleep disturbance greater than once per week

38
Q

Moderate asthma Rx

A

Same as mild

May add LABA for children > 5 yo

39
Q

Severe persistent asthma

A

Symptoms all day, sleep disturbance

Rx corticosteroids
LABD daily
Leukotriene blockers

40
Q

Asthma therapy

A

Apply dust proof covers on pillows mattress
Over humidify rooms
Wood/ tile floors
Peak flow meter can detect start of attack

41
Q

Asthma in the hospital

A
Cardiopulmonary status q 15-30 minutes until condition improves 
Humidified O2
IV fluids Rxs 
NPO status; monitor I&amp;O
Rest
42
Q

Apnea

A

Cessation of breathing for 20 seconds or more cyanosis bradycardia
Often seen in premature infants

43
Q

Apnea manifestations

A

Apparent life threatening events
Observer may relate infant would have died without intervention
Occur most often in 37 weeks or greater while sleeping eating or awake

44
Q

Apnea: nursing

A

Continuous heart/ respiration monitoring
If apnea observed, record time, duration, skin color, HR and O2 sat
Set monitor alarm for respiration pause >15 seconds
Gently tap foot or trunk
Resuscitative equipment ready

45
Q

SIDS

A
Unknown cause
2-4 months of age
Winter and spring 
Prematurity
Soft bedding
Sleeping in prime position 
Maternal smoking 
Sibling died from SIDS 
LBW, poor
46
Q

SIDS manifestations

A

Silent death

47
Q

SIDS nursing considerations

A

Pacifier to sleep

On back

48
Q

Croup

A

General term applied to a broad classification of upper airway illness result from swelling of the epiglottis and larynx

49
Q

Croup cause

A

Parainfluenza virus

50
Q

Types of croup

A
Laryngotracheobronchitis
6 months- 6 years
More female, winter 
Acute spasmodic- 1-3 yo, anxious child, hereditary 
Bacterial tracheitis- 
Epiglottitis- unique
51
Q

Epiglottitis

A

Medical emergency!!!!!!!
Acute inflammation of epiglottis and surrounding tissue
Rapid onset
Complete airway obstruction

52
Q

Epiglottitis cause

A

H influenzae

53
Q
Affects 3-7 yo girls and boys equally 
Hib vaccine ( vaccine failure, atypical organism)
A

Epiglottitis

54
Q

Epiglottitis assessment

A
4 Ds 
Dyspnea
Dysphagia
Drooling
Distress 
DO NOT assess throat!!!!!! May cause complete obstruction
55
Q

Croup manifestations

A
Barking cough
Worse at night
Inspiratory stridor 
Accessory muscles
Frightened
Agitation
Cyanosis
56
Q

Epiglottitis manifestations

A
Abrupt onset
Rapid
Tripod position. 
Chin thrust, mouth open 
Fever 102-104
Tacky
Hypoxia symptoms
57
Q

Croup Dx

A

Symptoms
Croup score
O2 status

58
Q

Epiglottitis Dx

A

Exam of throat
Only do when intubating
Increased WBC
Lateral neck radiograph

59
Q

Croup therapy

A
Humidity
Increase fluids
Antipyretics 
IV fluid
IV antibiotics
Racemic epinephrine 
Possible intubation
60
Q

Epiglottitis therapy

A

Intubation
Fluids
Antibiotics

61
Q

Bronchiolitis

A

Inflammation of bronchioles
Winter, spring
RSV 80% of cases
Inadequate hand washing

62
Q

Bronchiolitis transmission

A

Live on paper up 1 hour
No porous surfaces up to 6 hours
Not airborne
Younger than 2 months hospitalized

63
Q

Bronchiolitis pathophysiology

A

Upper respiratory infection (rsv)
EDEMA , mucus, cellular debris, obstruct bronchioles
Bronchioles constrict during expiration, cause hyperinflation of lungs
Atelectasis
Hypoxemia

64
Q

Bronchiolitis manifestations

A
URI for days
Tachypnea
Wheezing, crackles, rhonchi 
Intercostal retractions 
Cyanosis
65
Q

Bronchiolitis Dx

A

Chest X ray

Enzyme immunosorbent assay of nasal secretions

66
Q

Bronchiolitis therapy

A
At home, fluids, rest
Hospitalized:
Cool, humidified O2 if says <90
IV fluids
Assess repiratory status q 1-2 hrs
67
Q

Bronchiolitis Rx

A

Palivizumab (synagis) IM Q month during RSV season used to reduce hospitalization of premature infants or children with heart/lung issues

68
Q

Pneumonia

A

Infection of lung parenchyma

Bacterial, viral, aspiration, chemical

69
Q

Pneumonia manifestations

A
Fever
Cough
Tachypnea
Rhonchi, crackles, wheeze
Retractions
Nasal flaring
Chest pain
Cyanosis pallor
Irritable
Anorexia
Vomiting diarrhea
70
Q

Pneumonia Dx

A

X ray
Blood culture
Gram stain and culture of sputum

71
Q

Pneumonia at home

A

Acetaminophen
Cool mist humidifier
Warm fluids
No smoking

72
Q

Otitis media

A

Otitis media= effusion of middle ear

Otitis media with effusion= fluid behind tympanic membrane without signs of infection

73
Q

Otitis media causes

A

Streptococcus pneumonia
Haemophilus influenzae
Nora Ella catarrhalis
Allergies

74
Q

Otitis media manifestations

A

May start with symptoms of upper respiratory infection

75
Q

Otitis media Dx

A

Hx
Pneumatic otoscopy
Typanometry

76
Q

Otitis therapy

A

Prophylactic antibiotics for child with 3 or more distinct episodes in 6 months for four in one year

Myringotomy with tympanostomy tube persistent for more than 3 months associated with hearing loss

77
Q

Foreign body aspiration

A

Normally less than 3 years
Leading cause of death under 1 year
Usually lodge in right main bronchus

78
Q

Foreign body aspiration manifestations

A
Hoarseness
Croup cough
Wheezing stridor 
Cyanosis
Dysphagia 
Dypnea
79
Q

Foreign body aspiration Dx

A

Fluoroscopy and chest X ray

80
Q

Tonsillitis

A

Inflammation and infection of palatine tonsil

81
Q

Adenoiditis

A

Inflammation and infection of pharyngeal tonsils

82
Q

Pharyngitis-tonsillitis causes

A

Adenoviruses
Coronaviruses
Enteroviruses
Tonsillitis- group A beta-hemolytic streptococcus

83
Q

Pharyngitis- tonsillitis manifestations

A

Throat culture- bacterial or viral

84
Q

Pharyngitis -tonsillitis therapy

A

Symptoms
Cool, bland diet
Pain
Rest