Pulmonary Disorders
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| show | 2 in 10 children are affected by some type of pulmonary alteration
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| More children are sick with ___ & ___ problmes? | show 🗑
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| show | exacerbation
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| If the house is closed up then what is the child allergic too? | show 🗑
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| What is one of the most frequent reasons for visits to health care providers? | show 🗑
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| What is the most frequent reason for absenteeism in school? | show 🗑
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| show | Intrinsic: 1. The child airways might be smaller 2. Defect in trachea, it could collapse 3. Congenittal Heart defect
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| What are some extrinsic factors of pulmonary disorders? | show 🗑
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| What is one of the most common foods that children aspirate? | show 🗑
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| What are some differences that children have in the pulmonary system compared to adults? | show 🗑
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| If a child has abdominal distention what will they have problems with? | show 🗑
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| How do babies in their 1st 3 weeks breath? | show 🗑
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| show | FALSE THEY NEED TO BE Admitted to the hospital
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| show | An easier time aspirating
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| T/F In children the cartilage trachea & bronchi are well developed? | show 🗑
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| Coughing is not well developed until what age? | show 🗑
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| Since kids don't develope a cough until age 6 they swallow their secretions. They do have a productive cough, but will NOT be able to cough in the sputum cup. What do you do if u need a specimen? | show 🗑
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| show | A child will stop breathing before u see cardiac abnormalities
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| If a child stop breathing what happens to their heart rate? | show 🗑
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| What is the most common arrhythmias in kids and what is it related to? | show 🗑
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| show | True
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| show | 95-100%
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| show | Children with pulmonary disorders
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| show | Newborn babies have an irregular breathing pattern
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| In Newborns it is common for their breathing to pause up to ___ seconds? | show 🗑
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| If a child has ___ the ribs are pliable. The sternum will go in, and in dent. The intercostals between each rib will go in. | show 🗑
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| Restlessness>listlessness; Tachypnea; Tachycardia; Diaphoresis; Dec. striodr or wheezing; Retractions w/o clinical imporvement; respiratory distress are all all cardinal signs of? | show 🗑
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| show | You will put babies in an open radiator (in a hood) so they can very carefully gauge the oxygen they are recieving
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| Don't put a 2 year old on a nasal cannula w/o ____? | show 🗑
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| What is the highest setting you can put a 2 year old on with a nasal cannula? | show 🗑
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| When do you want to use a mask on 2yrs old pts? | show 🗑
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| show | More in winter, especially with asthma
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| show | Asthma
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| show | True - example born with small airways
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| T/F extrinsic factors that cause pediatric pulmonary disorders are things found in the environment. | show 🗑
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| show | abdominal
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| Infants breath primarly through their nose the first ____ weeks | show 🗑
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| show | six
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| show | five to six months
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| ____ is higher in child and easier to aspirate. | show 🗑
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| Cough not well developed until ____ years old. Don’t cough out mucus like adult. | show 🗑
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| pediatric pulmonary disorders are more common in children due to their immature immune system and Increased exposure to different ____ around other kids | show 🗑
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| show | False - After a child stops breathing, cardiac problems appear which is opposite from adults
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| ____ is a deformity of the fingers and fingernails that is associated with a number of diseases, mostly of the heart and lungs. | show 🗑
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| Chest shape of children with pulmonary disorders includes ____ around potions of the ribs and barrel chest | show 🗑
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| show | Stridor
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| show | True
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| show | exhalation
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| show | inhalation
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| show | 20
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| A newborn with oxygen distress can have up to ____ liters of oxygen but at this level can cause problems with ____. | show 🗑
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| show | Restlessness, tachypnea, tachycardia, diaphoresis, decreased stridor or wheezing due to total obstruction, retractions without clinical improvement
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| ____ is a chronic lung disorder that is most common among children who were born prematurely, with low birthweights and who received prolonged mechanical ventilation to treat respiratory distress syndrome. It has inflammation &scarring in the lungs | show 🗑
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| show | Bronchopulmonary Dysplasia (BPD)
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| Bonchopulmonary Dysplasia (BPD) etiology ____ babies per year US, 9 out of 10 are less than ____ grams and less than ____ weeks gestation | show 🗑
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| show | more than 28 days
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| show | Recurrent respiratory infection, delays in growth and development and abnormal persistent lung function in absence of O2 administration
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| Managment of Bronchopulmonary Dysplasia (BPD) includes: maintain adequate arterial blood gases with administration of oxygen and to avoid ____ of the disease. | show 🗑
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| Managment of Bronchopulmonary Dysplasia (BPD) includes: ____steroid therapy, oral ____, ____dilators | show 🗑
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| show | RSV season. RSV
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| show | Increase calories without increasing fluid due to possible fluid overload
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| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): ____ detection of problems (especially signs of further respiratory compromise & overhydration and underhydration) Make sure not ____ | show 🗑
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| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD):• Providing periods of ____. | show 🗑
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| show | suctioning - and avoid unless necessary bc makes child irritable and causes bronciospasms
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| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): • Control & evaluation of ____ from respiratory support | show 🗑
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| show | Feeding evaluation & techniques – increase about ¼ more calories than needed for weight
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| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): Increase Fi____, and promote non-nutritional _____ when not eating give pacifier so they can learn to ____. | show 🗑
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| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): • Decrease environmental ____ so the baby can rest. | show 🗑
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| show | swaddle
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| One of the nursing intervention of Bronchopulmonary Dysplasia (BPD): while feeding ____ head of bed | show 🗑
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| show | consistency of caretakers and parental involvement and teaching
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| show | Home assessment and family support and follow-up
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| Teaching plan for home care of BPD include: | show 🗑
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| Inflammation of the palatine tonsils (lymphoid tissue) | show 🗑
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| show | True - bacterial is redder and more swollen
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| viral pharyngitis is self limiting just treat ____ with Tylenol for discomfort. | show 🗑
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| With tonsillitis, obtain a throat culture to test for ___. If have it treat with antibiotics | show 🗑
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| show | six
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| show | four
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| Two nursing interventions for tonsillitis | show 🗑
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| show | side or stomach (prone)
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| Nursing condideration for tonsillectomy:swallowing frequently is a classic sign of ____. An infection can cause ____ a week or two later. | show 🗑
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| Nursing condideration for tonsillectomy: diet - depends on doctor, regular food may cause ____, give liquids then ____ food. | show 🗑
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| Name the 4 croup syndromes | show 🗑
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| show | Hemophilus influenzae Type B (there is a vaccine), acute epiglottitis
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| show | 1-8 years
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| No spontaneous cough, drolling on one side (can't swallow secretions) and agitation are the three cardinal signs of | show 🗑
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| T/F sever expiratory stridor is seen in epiglottitis | show 🗑
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| show | epiglottitis
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| medical management of epiglottitis includes endotracheal intubation or ____ | show 🗑
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| Antibiotic given for epiglottitis to decrease swelling so child can be intibated | show 🗑
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| Which croupe syndrome shows a "thumb sign" when x-rayed | show 🗑
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| What medication is given to a child over 4 years who has come in contact with epiglottitis | show 🗑
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| show | Acute Laryngotracheobronchitis (LTB)
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| Acute Laryngotracheobronchitis (LTB) etiology between ____ months and ____ years | show 🗑
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| show | Croup
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| show | Parainfluenza virus type 1 (also RSV, adenovirus)
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| Acute Laryngotracheobronchitis (LTB) takes 1 - ___ days to develope | show 🗑
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| show | Harsh, barky cough
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| show | low grade fever, hoarse voice, mild inspiratory stridor and mild to moderate respiratory failure
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| Medical management of MILD Acute Laryngotracheobronchitis (LTB) | show 🗑
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| show | coll air vaporizer and encourage fluids
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| Medical management of SEVERE Acute Laryngotracheobronchitis (LTB) | show 🗑
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| Non medical management of SEVERE Acute Laryngotracheobronchitis (LTB) | show 🗑
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| Acute Laryngotracheobronchitis (LTB) x-ray shows subglottic narrowing also called "____" | show 🗑
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| One of the nursing interventions for Acute Laryngotracheobronchitis (LTB) include: continuous assessment of____ status | show 🗑
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| show | secondary infections such as an ear infection
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| One of the nursing interventions for Acute Laryngotracheobronchitis (LTB) include:have ____ equipment near and keep calm | show 🗑
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| One of the nursing interventions for Acute Laryngotracheobronchitis (LTB) include:IV therapy - be take in nutrition ____ if respiratory rate is less than 60 per minute | show 🗑
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| One of the croup syndromes that include paroxysmal attacks of laryngeal obstruction that occur chiefly at night (mild) wake up with barking cough. Keep the child calm and after a few hours the sx go away If not they go to hospital and treated like LTB. | show 🗑
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| show | Acute Spasmodic Larngitis (ASL) occurs in children usually between 1 to 3 years of age with history previous attacks & history of allergies.
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| Clinical Manifestations of ___ include goes to bed with mild resp sx, sudden barky cougy with noisy inspirations, no fever and sx subside in a few hours | show 🗑
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| show | Home - Hospital
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| Nursing interventions of acute spasmodic layngitis: ____ care and ____ support. | show 🗑
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| Which croup syndrom is an Infection of the mucosa of the upper trachea usually due to staph infection Need to be suctioned due to secretions. | show 🗑
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| show | Staphylococcus aureus - 1 month to 6 years
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| show | URI, croupy cough, stridor, thick purulent secretions, fever, no response to LTB therapy
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| Medical management of bacterial tracheitis (acute tracheitis) includes which antibiotic? Why must the first dose be given while in the hospital? | show 🗑
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| Non medical management of bacterial tracheitis (acute tracheitis) includes | show 🗑
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| show | Bronchiolitis
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| show | Respiratory Syncytial Virus (RSV)
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| Bronchiolitis is most common during ____ and peak incidence is ____ months of age | show 🗑
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| show | 10
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| Bronchiolitis is transmitted through ____ with secreations and found more in what living conditions | show 🗑
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| ____% of bronchiolitis pt develop asthma, and ____% mortality | show 🗑
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| show | URI sx several days with clear nasal drainage and sneezing causing difficulty in feeding, caugh may develop, wheezing, rales, retractions
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| pt are hospitalized with bronchiolitis if respirations are over ____/min and or less than ____ weeks of age or has other chronic resp illnesses | show 🗑
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| Other than Ribarvirin (broad spectrum antiviral agent (controversial tetragenic) ____ medications are available to treat RSV. | show 🗑
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| show | Palivizumab (Synagis) - November
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| show | symptomatic care, HOB elevated, respiratory status, small frequent feedings
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| Highly contagious (direct contact or droplet) acute respiratory infection caused by Bordetella pertussis | show 🗑
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| show | primarily in children under 4 and college aged kids. 30% get from their mother.
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| show | 5-21 usually 7-10
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| Pertussis (Whooping Cough) has increased/decreased since 1976 | show 🗑
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| Kids going to college should be re-immunized for ____ | show 🗑
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| show | sneezing, dry hacking cough, lowgrade fever lasts 1 to 2 weeks
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| show | short, rapid cough (maching-gun burst) usually at night followed by sudden inspiratory high pitched "whoop" flushed or cyanotic cheeks bulged eyes and protruded tongue, continue until cough mucus (usually vomits afterwards) lasts 4-6 weeks
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| show | cough gradually decreases in frequency and may be louder at times lasting for several weeks
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| Pertussis three stages usually lasts less than ____ months and ___/___ are hospitalized due to stress | show 🗑
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| Medical management of pertussis includes ____ for 14 days first line, also give _____ for pain and ____ for fever | show 🗑
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| show | bedrest and hospitalization if cant drink or dehydration or respiratory complications
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| A nursing intervention for pertussis includes: ____ during first (catarrhal) stage | show 🗑
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| A nursing intervention for pertussis includes: reduce ____ that may promote paroxysms | show 🗑
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| A nursing intervention for pertussis includes: encourage frequent small amounts of ____, observe signs of ____ obstuction and family ____ | show 🗑
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| ____ includes familial predisposition and exposure to allergen | show 🗑
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| show | 20%
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| Manifestations of allergic rhinitis: | show 🗑
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| show | nasal smear, blood test for total IgE, RAST radioallergosorbent test) (and skin testing
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| Medical management to prevent allergic rhinitis | show 🗑
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| Nursing intervention of allergic rhinitis includes educating pt that allergy shots are not given at home because | show 🗑
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| show | asthma
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| factors that cause asthma include: ____ of airway smooth muscle, ____ of airway mucosa, ____ mucus secretion, ____ cell infliltration of airway walls, and ____ of the airway epithelium | show 🗑
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| show | biochemical, immunologic, endocrine, infectious, autonomic, and psychological factors
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| show | False, as reach adolescent ormones improve and may go yrs then cal be later exposed to a respiratory virus and get asthma again
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| show | 80%
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| T/F Asthma is hereditary due to a specific chromosome | show 🗑
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| Not so ovious asthma triggers | show 🗑
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| #1 reason kids give to an asthma trigger | show 🗑
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| show | lung volume, airway funcation and gas exchange
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| Asthma affects inspiration or expiration | show 🗑
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| show | spirometer - test repeted 2-3 times with average of 2 highest readings recorded
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| the spirometer pulmonary function test measures ___ + ___ = ___ | show 🗑
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| Nursing interventions of spirometer | show 🗑
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| show | Peak Expiratory Fow Rate (PEFR)
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| show | exhale forcefully = highest level, use the highest of 3 readings
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| show | 2 times per day over 2 week period to determin a patient's personal best reading between age 4-6 can do it
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| peak expiratory flow rate (PEFR) green zone is ____-____% personal best, yellow zone is ____ - ____ % personal best and red zone is ____ or less personal best | show 🗑
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| show | PEFR yellow zone start to see sx of nighttime cough, make sure pt is taking meds. red = sx of wheezing, use bronchodilator immediate
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| If use bronchiodiolator more than ____ times a week except for exercize, need preventitive medication | show 🗑
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| show | 2 - 2
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| With mild intermittent asthma, peak efficiency flow is greater than ____ predicted value, and asymptomatic between episodes. | show 🗑
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| show | 2 - 2
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| show | 80% - green zone
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| With moderate persistent asthma, symptoms are more than ____ per week and nighttime symptoms are more than __ per week. | show 🗑
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| With moderate persistent asthma, symptoms and use of bronchodilators are used ____ and episodes affect ____ | show 🗑
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| show | PEF between 60% & 80% - yellow zone
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| With severe persistent asthma, daytime symptoms are ___ episodes and nighttime symptoms are ____? | show 🗑
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| With severe persistent asthma, peak efficience flow is less than ____% with increased variability wich limits activity | show 🗑
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| show | drop peak flow readings, cough, chest tightness, exercise intolerance, wheezing restlessness, and signs of respiratory failure
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| Medical management of asthma includes ____-term control medications and ____-term relief medications | show 🗑
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| show | corticosteriods, leukotriene modifiers, and hyposensitization
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| show | MDI, turbuhaler, diskus inhaler, and nebulization
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| Discharge Teaching Nursing interventions for asthma include identifying ____, ____ control measures, recognizing signs and symptoms of an ____, importance of relaxation & ____, daily ____ readings | show 🗑
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| discharge teaching nursing interventions of asthma include: ___ plan, correct use of med and ____, breathing techniques using ____, importance of ____ care, teaching ____ involved with patient, and ____ groups. | show 🗑
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| show | status asthmaticus
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| show | ER or PICU
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| show | frequent assessment of respiratory status, keep O2 above 90% and keep in High-Fowler position
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| show | inhales aerosolized short-acting B2-agonists, IV corticosteroids (don't overhydrate with IV fluids, and correct acidosis
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| show | cystic fibrosis
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| show | 3.3%
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| show | chloride
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| In the 70's life expectancy was ____ yo, if born recently, life expectancy is ____ yo due to ____ generation antibiotics | show 🗑
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| One of the first signs a newborn has cystic fibrosis is the ____ has not passed in first 2 hours | show 🗑
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| Children with cycstic fibroses are usually ____ due to obstruction of the GI or they have ____ stools with foul odor? | show 🗑
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| show | Need to rule out cystic fibrosis (CF) if a child shows signs of failure to thrive due to having pneumonia more than once or not gaining weight.
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| show | The reporductive system of pt c CF includes a delayed puberty, 90% male and 50% female infertility; resulting in premature birth and LBW...The mother has decreased respiratory status during pregnancy
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| show | high sodium & chloride, diminished protein absorption causes edema
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| T/F there is a newborn screening for diagnosis of cystic fibrosis | show 🗑
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| show | Sweat chloride test - sodium
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| The sweat chloride test needs ____ positive results of ____meq/liter of chloride for diagnosis? | show 🗑
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| show | True - example airborn allergens or food allergies
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| show | fat and enzyme
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| A sputum culture of an infant or child usually shows which type of bacterias | show 🗑
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| A sputum culture of an adolescent with cycstic fibrosis usually shows which bacteria | show 🗑
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| What is the primary treatment goal in the medical mangement of cycstic fibrosis? (Hint: effective ___ clearance with CPT ___ & flutter ____ clearance device) | show 🗑
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| show | Fat soluable vitamins (ADEK)
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| show | pancreatic enzymes
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| show | over 50%
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| pt with cycstic fibrosis have problems absorbing food so they need to increase caloric intake ____% and include ___ & ___? | show 🗑
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| Medical management of pt with cycstic fibrosis includes: wearing a ____ vest, inhaling recombinant human ____ 1X/day, tx of asthma, free water and ____, take ___ for secondary infection, and bronchoscopy to ____ brachial tube mucus? | show 🗑
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| show | False - survival rate is about 50% after 5 years - trying to campaign to get lung transplants before lung function is low
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| nursing inervention for cystic fibrosis includes assessment of ____ & ____ | show 🗑
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| show | oxygen
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| nursing inerventions for pt with cystic fibrosis includes ____ and fluid managment, ____ administration, skin care, education ____ care and ____ support for chld and family | show 🗑
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| ____ is an acute exacerbation of asthma that does not respond to standard treatments of bronchodilators and corticosteroids. Symptoms include ? | show 🗑
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| ___ failure means that O2 can no longer be provided, CO2 can no longer be eliminated, which leads to ___? | show 🗑
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| ____ refer to the visible sinking in of the chest wall with inspiration in a child with respiratory difficulty. | show 🗑
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| show | 1. in the area above the collarbone (supraclavicular) 2. between the ribs (intracostal) 3. below the ribcage (subcostal)
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| ____ are wet, crackly lung noises heard on inspiration which indicate fluid in the air sacs of the lungs. ____ are often indicative of ____. | show 🗑
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| Define Rhinorrhea. | show 🗑
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| ____ is a sudden outburst of emotion or action. It can also be a sudden attack, recurrence, or intensifiaction of a disease. Another definition for it is a spasm or fit; convulsion. | show 🗑
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| show | The person with allergic rhinitis (hay fever) often rubs his/her nose using the index finger. This is the so-called "allergic salute."
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| show | Allergic gape
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| _____ is an abnormal, high-pitched, musical breathing sound caused by a blockage in the throat or voice box (larynx). It is usually heard when ...? | show 🗑
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| show | croupy cough
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| ___ is a form of chronic lung disease that develops in preterm neonates treated with oxygen & positive pressure ventilation. Like Respiratory Distress Syndrome neonates. | show 🗑
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| show | 2L always humidified
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| show | humidified 4L
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| show | 6L humidified
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| When do you not feed a child with respiratory infection or problems orally? | show 🗑
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| show | Look for the GAG REFLEX
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| show | Expect stool color; frequency stool & urine 1st day 2-6 times and after 6-8 at least and 5-25; as milk come in what the stool color will look like
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