Test Answers on Chapter 25 Flashcard

Ineffective breathing pattern

Frequent swallowing

You should use the inhaler regularly everyday even if you are symptom free.

Have a tracheotomy set at the bed side

~ droplet precautions ~ Contact precautions

Cough

Partly on the side and partly on the abdomen

Contact

Failure to thrive Irritability Retractions

~ Child sits up and leans forward ~ Drooling because of difficulty in swallowing ~ Anxious with croaking on respiration

multi

~ pulmonary insufficiency ~ pulmonary edema ~ bronchopneumonia

S/s - fever, malaise, dysplasia, and anorexia lasting longer than 1 week Dx by throat culture Tx - penicillin for 10 days Complications if not treated are: rheumatic fever, glomerulonephritis, otitis media, mastoiditis, meningitis, Osteomyelitis, and pneumonia.

-Spread by direct contact with respiratory secretions -Survives more than 6 hours on surfaces -Incubation approximately 2-8 days -If hospitalized, place in contact isolation precautions - nurses assigned should not be caring for other infants. Adults with RSV should not care for infants Treatment -Supplemental oxygen -Intravenous hydration -Antiviral medication, such as ribavirin -IV immune globulin (RespiGam)

Congenital laryngeal stridor (laryngomalacia) stridor on inspiration -Symptoms lessen when infant is placed prone or propped in side-lying position -Usually clears spontaneously as child grows and muscles strengthen Spasmodic laryngitis (spasmodic croup) -Sudden onset, usually at night -Characterized by barking, brassy cough and respiratory distress; lasts a few hours -Treatment: increasing humidity and providing fluids Laryngotracheobronchitis -Viral condition manifested by edema, destruction of respiratory cilia, and exudate, resulting in respiratory obstruction -Mild URI followed by barking cough, then stridor develops and leads to respiratory distress; crying and agitation worsen symptoms -Child prefers to be in upright position (orthopnea) Overall Symptoms -grunting sound on expiration (stridor) -Crowing on inspiration - Flaring nares - restlessness and aprehension - decrease in awareness of surroundings -club fingers -rales, rhonchi wheeze - cynosis of nail bed - increase use of accessory muscles of respiration Overall Treatment -Cold water humidifier Helps relieve respiratory distress and laryngeal spasm -If hospitalized, may be placed in a mist tent or croupette -Cool air saturated in microdroplets enter small airway of child, cooling and vasoconstriction occurs, relieving the respiratory obstruction and distress -Opiates are contraindicated, as are sedatives

Spasms of the vocal cords

-Difficulty swallowing and breathing Large android block Nasal passages causing mouth breathing. -Provide cool mist vaporizer, salt-water gargles, throat lozenges, cool liquid diet, acetaminophen -Removal of tonsils and adenoids not recommended if under 3 years of age. Problem will correct itself. -Tonsillectomy done only if persistent airway obstruction or difficulty breathing occurs

-Swelling of the tissues above the vocal cords -Narrows airway inlet -Caused by H. influenzae type B -Can occur in any season -Course is rapid, progressive, and life-threatening -Onset of epiglottitis is abrupt -Child insists on sitting up, leaning forward with mouth open, drools saliva because of difficulty in swallowing -Cough is absent -Examining the throat with a tongue blade could trigger laryngospasms; therefore, a tracheotomy set should be at the bedside before examination of the throat takes place -Treatment of choice is immediate tracheotomy or endotracheal intubation and oxygen -Prevents hypoxia, brain damage, and sudden death -Parenteral antibiotics show dramatic improvements within a few days -Prevention: HIB vaccine beginning at 2 months of age

Nursing Care -With grieving parents, the nurse must convey some important facts -disease cannot be predicted or prevented, and they are not responsible for the child's death -Parents must be given the opportunity to say goodbye to their child -Parents are catapulted into a totally unexpected bereavement that requires numerous explanations to relatives and friends

- "Back to sleep" - For high-risk infants, they may be sent home on an apnea monitor - Parents must be taught CPR -don't let infants sleep in carseat -when in car seat keep chin off chest

-Increased thickness of mucus gland secretions - loss of electrolytes in sweat because of an abnormal chloride movement -Clubbed fingers and toes -meconium ileus in newborns - salty tears, saliva, and sweat - large foul smelling stools -barrel shaped chest - rectal prolapse Dyspnea, wheezing, and cynosis. Child maybe irritable and tire easy. -sweat test is the best diagnostic test Postural drainage to move up and out- done 2 hrs after eating and nebulization.

Powdered are dosed. Rinse mouth after Leukotriene?? Inflammatory reduces mucous.....

Dysrhythmia and tremors

-Maintain -normal pulmonary function and activity level -Prevent chronic s/s as well as exacerbations that require hospital treatment -Prevent adverse responses to medications -Promote self-care and monitoring consistent with developmental level Medication treatment -Bronchodilators -Antiinflammatory drugs -Leukotriene modifiers -Metered-dose inhalers

Purse lips tightly breath in through nose and shape mouth like a whistle blow out slowly. Exhale twice as long as inhalation

House dust Animal dander Wool Feathers Pollen Mold Passive smoking Strong odors Certain food Vigorous physical activity (especially in cold weather) Rapid changes in temperature Emotional upset

- Frequent swallowing while the child is sleeping is an early sign of bleeding after a tonsillectomy -Milk and milk products may coat the throat and cause the child to "clear" the throat, further irritating the operative site