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80 Cards in this Set
- Front
- Back
what are some upper repiratory tract infections?
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sinusitits, thrush, pharyngitis, tonsillitis, croup, epiglottitis
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what are some lower respiratory tract infections?
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tracheitis, pneumonis( bacterial- #1 cause is S. pneumoniae, viral- RSV), asthma
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the most common respiratory pathogens appear in epidemics during which seasons?
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Winter, and srping
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What do you include in a repiratory assessment, and look for?
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Rate- rapid(tachypnea), normal, or slow (bradypnea) for the particular child.
Depth- retraction; hyopnea-shallow and slow; hypernea- increased depth and rate ease- effortless, or labored; orthopnes; flares nares; grunting; wheezing. Rhythm- the variation in rate and depth of respiration. |
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what can bradypnea (slow breathing rate) cause?
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DKA, liver failure, respiratory failure
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what can tachypnea (fast breathing rate) cause?
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heart or lung disease, lung infections, anemia
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what are some repiratory test?
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Plumonary function test, which are non invasive. Also pulse ox, arterial blood gases (done by RT), apnea/bradycardia monitor, chest x-ray, CT scan, MRI, bronchoscopy.
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What is the function for a child in respiratory distress of a bronchoscopy?
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diagnostic or therapeutic (removal of a foreign body)
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What are some post procedure things interventions and complications from a bronchoscopy?
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interventions- giving fluids after gag/swallowing returns.
complications- hemorrhage, respiratory distress |
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infants are obligate ____ breathers?
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Nose. if nose is stuffy they can't breath.
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Infants have ____ airways?
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Small. Throat infections can easily lead down to lungs. Its also narrow and can narrow furthur from edematous mucous membranes and increased production of secretions.
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with URI ______ is a BIG problem, so give _____ of any kind.
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Dehydration, fluids
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nasopharyngitis is also referred to as _____. How would you treat this?
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Common cold. symptomatic treatment.
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You would never give an infant <2 months with a cold an OTC cold remedie becauses it causes _____.
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Vasocontriction
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Infants less than 2 months old are hospitalized with a fever > ____ even with cold symptoms.
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100.4
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For oral rehydration infants should get ____ and older children should get____.
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pedialyte, gatorade
pg 791 |
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the onset of pharyngitis is characterized by?
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headache, fever, and abd pain
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What is prescribed for pharyngitis?
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oral penicillin
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what is the diagnostic method for pharygitis?
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throat culture
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what causes pharygitis?
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group A hemolytic streptococcus. This strep throat can travel to the lungs.
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tonsillitis often occurs with what other URI?
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pharyngitis
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this URI is one of the most prevalent disease of early childhood, whose incidence is higher in the winter months, and mostly occurs in the first 24 months of life.
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otitis media
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shildren living in households with ____ers are more likely to have OM.
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somkers
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a child with OM will have and ear drum that looks like?
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a tympanic membrane with OM reveals a purulent descolored effusion and bulging, full, or reddened membrane
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bottle feeding a baby supine increases the risk for?
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OM. reflux of milk in to the eustachian tubes.
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What is one reason BreastFed babies are at lesss risk for OM?
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The breast milk contains IGA which coats the MM of the eustachian tubes.
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in OM pathogens enter the middle ear from where?
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the throat
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What are some symptoms of OM?
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Mild to severe pain, low grade to high fever, nausea and vomiting.
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what bacterial is the most common cause of OM?
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S. pneumoniae
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what to u treat OM with? and if a pt is <6 months you ____, and if the pt is >2 yrs you _____.
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Amoxicillin initially.
<6 month- must treat >2yrs can watch and wait |
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what are some surgical treatments of OM?
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for recurrent OM:
tympanostomy tube palcement, adenoidectomy |
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nursing considerations for OM
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1. relieving pain, 2. facilitating drainage when possible,3. preventing complications or recurrence
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OM with euffsion is characterized by?
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-fluid in the middle ear w/o infection
-sounds that are muffled, feeling fullness in ear |
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what is treament protocal for OME?
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tympanostomy tube palcement
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OME can significantly impact ____ and delay _____?
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hearing and speech
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what does croup cause?
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laryngeal and tracheal inflammation and swelling causing narrowing of the airway.
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what is croup characterized by?
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a hoarseness, a resonant cough described as "barking" or " brassy". With varying degrees of respiratory distress resulting from sewlling or obstuction in the region of the larynx
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for a pt with croup the nurse should be vigilant in observation of there ____?
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respiratory status. most important. if obstuction is severe enough it can prevent adequate exhalation of CO2 which leads to respiratory acidosis which leads to respiratory failure.
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what are some meds for croup (2)?
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nebulized epinephrine with severe croup- stridor at rest, retractions, or difficulty breathing.
Corticosteroids- for inflammation, subglottic edema |
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def of bronchiolitis-RSV
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acute swelling of bronchioles with the lumina filling with exudate and mucus
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what are some s/s of bronchiolitis-RSV
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Wheezing, couging, rhinorrhea, low-grade fever. OM may also be present. in very youn infants apnea may be the first sign.
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what is the diagnostic test for bronchiolitis-RSV?
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antibody testing - ELISA or IFA
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Treatment of bronchiolitis-RSV
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treat symptomatically- high humidity, adequate fluid intake and rest
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a pt in the hospital for bronchiolitis-RSV is on what type of precautions?
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droplet
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s/s of pneumonia
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abrupt onset following a viral UIR
-fever, tachypnea, cough, chest pain, malaise, abd pain |
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bacterial pneumonia treatment
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antibiotic therapy, liberal fluid intake, activity as tolerated with rest, antipyretic for fever
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respiratory dirtress symptoms
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-must be aware pt is getting worst-
- tachypnea - infants >60 -nasal flaring -retraction - substernal, inter costal -cyanosis -accessory muscel use - neck -grunting -collapse of vocal cords with each breath -mental status -restlessness (sometimes all u got) -confusion |
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respiratory dirtress treatments
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-immediate repiratory support w/ o2
-stablize pt -oxygen - meds -albuterol, epinephrine (vasodilators) - if unable to stabilize may need ventilation or intubation |
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respiratory failure causes 5
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1. air way obstruction
-foreign body, CF, increased secretions, asthma, anaphylaxis 2. lund disease -severe pneumonia, asthma, CF, pulmonary edema 3. weakness affecting breathing -drugs, severe obesity, sleep apnea 4. muscle weakness -muscular dystrophy, spinal cord injury 5. Adnormal chest wall |
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what are some durgs (2) to use during respiratory failure?
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corticosteroids and epinephrine
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a pt could have a ____ reaction to epinephrine?
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hypersensitivity-anaphylaxis
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what is the max dose of epi and how often can it be givien?
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0.5 mg, can repeat q 20 min for 4 hours.
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what should you monitor when you give epi?
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hypertension, tachycardia and EKG changes
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what is naloxone (Narcan) used for?
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opiate intoxication -resp. depression
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is naloxone (Narcan) short or long acting?
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very short acting, must repeat q 2-3 min.
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SE of naloxone (Narcan)
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n/v, diaphoresis, tachycardia, hypertension, tremors
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def of asthma
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chronic, reversible inflammatory airway disorder involving mast cells, leukotrienes, eosinophils, characterized by airflow obstruction.
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what are the manifestations of asthma?
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wheezing, breathlessness, chest tightness, and cough esp. at night or in the early morning. also tachypnea, restlessness, anxiety, sweating
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diagnosis of asthma?
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pulmonary function test, serum IgE levels, chest x-ray
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asthma management
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prevention- identify and avoid triggers (key)
-annual influenza immunization b/c asthma gets worst w/ this -desensitization (if stimulas can be avoided) -meds |
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what is the #1 rescue med used to treat symptoms and exacerbations?
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albuterol-short acting
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what is the function of the short acting med albuterol
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dilate smooth muscle, decreasing spasms
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sort acting meds short be used up ___ times a day
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four
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se of short acting meds
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tremors, tachycardia, insomnia, dry mouth, hypertension (cardiac se)
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how is albuterol delivered?
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nebulizer or MDI.
oral not affective |
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for a pt using corticosteroids what should u advise them to do after using the med?
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wash mouth good to prevent trush
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what is the function of the short acting med corticosteroids?
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decrease inflammation to treat airflow obsturction
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corticosteroids should be used in the lowest dose to avoid the SE which are...
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osteoporosis, immune problems, hypertention
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do not take ______ with grapefruit juice.
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prednisolone a corticosteroids
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_______ can be given IV for hospitalized patients (asthma med)
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prednisolone
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long acting asthma meds are used for?
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control or prevention
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for a pt using a long acting asthma med u should advise pt to discontinue their_____ and restart only if acute exacerbation occurs
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rescue bronchodilator
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name one anti-inflammatory agents for control of asthma
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pulmicort- an inhaled corticosteroid, for the prevention of symptoms and suppression, control and reversal of inflammation.
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name one leukotriene modifier use for the control of asthma
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singular
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singulair, a leukotriene modifier, prevents asthma by?
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preventing bonchospasm, mucosal edema and increased secretions caused by the luekotrienes
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exercise induced bronchospasm peak in 5- 10 min after _____ and resolvesin 20-30 min _____.
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after ending axercise and resolves on its own
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what asthma group is used for exercise induced bronchospasm
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long acting agonists- foradil or serevent
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for status asthmaticus improve ventilation by
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using short acting agonists and corticosteroids
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use should re-hydrate status asthmaticus with fluids given at maintenance rate only to avoid what complication?
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pulmonary edema
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for status asthmaticus if they don't improve with short acting agonists or corticosteroids u should admin?
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epinephrine
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