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Increase in mycroplasma pneumonia seen in what age?
>5
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What age group has few respiratory problems?
<3 mo
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What age does respiratory infection rate increase?
3-6 months
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Age groups that have a high rate of viral infection?
Toddler and preschool
-
Structural issues that effect respirtory alterations in peds...
- Smaller airway
- Smaller oral cavity
- Large tonggue
- Nose breathers
- Eustation tube straight, wider, short
- Right bronchi straight
- less alveolar area for gas exchange
- Rapid growth, tonsils and adnoids
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Problem children have with poor lung exchange.
Can't cough enough mucus due to less muscles
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Medical history that affects respiratory alterations
- LBW
- Prematurity
- Use of vents
-
Diagnostics for respirtory
- CBC
- ABGs
- Sputum C/S
- Sputum for acid-fast bacilli (TB)
- Throat C/S
- Pulmonary function (for asthma)
- Chest xray
- Oximetry
- Bronchoscopy
-
Common cold
Nasopharyngitis
-
-
-
Non-aspiritn analgesics
nasopharyngitis
-
Antipyretics
Nasopharyngitis
-
Saline nose gtts q 3-4 hrs
nasopharyngitis
-
hydration
nasopharyngitis
-
Is tonsillitis viral or bacterial?
Viral
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What virus causes tonsillitis and pharyngitis
GABHS
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Hw to inspect tonsillitis
Inspect throat (red, exudate)
-
Englarged cervical nodes indicates what?
Tonsillitis and phayrngitis
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Is fever associated with tonsillitis and pharangitis?
Yes
-
Nasal congestion, mouth breating and dry mucous membranes are all associated with what?
Tonsillitis and Pharyngitis
-
Associated with a strep-headache
Strep
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Pain, N, V, D associated with?
Strep
-
How do you diagnose Strep?
Throat culture or rapid strep test
-
Tx for strep
Antibiotics and releive symtpoms
-
Can cause rhematic fever
Strep
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Rhematic fever has effect on what?
Heart
-
What position after post-op tonsillectomy
Side position
-
What should you not do post tonsillectomy?
Don't cough or blow nose
-
What drinks should you avoid post op tonsillectomy
Encourage non carb, no acidid liquids
-
Avoid using straws post what surgery?
Tonsillectomy
-
Pain reliever post tonsillectomy
Acetaminophen
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Cool humidifier used post op which surgery?
Tonsillectomy
-
How long does tonsillectomy take to heal?
3 weeks
-
Risk of swallowing blood post op....
tonsillectomy
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Otitits media is inflammation of...
otitis media
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Cause of otitis media
Pathogens enter throug heustatcian tube
-
Tx of otitis media
antibiotics and analgesics
-
Family teaching to prevent otitis media
- ABiottle position
- Finish antibiotics
- 2nd hand smoking
- Keep up vaccines
-
Which vaccine helps prevent otitis media?
H Influennza pneumococcal
-
Often the cause of otitis media
H influencza
-
What is otitis media with effusion?
Fluein in the ear
-
Asymptomatic OME
Otitis media with effusion
-
Chronic otitis media may cause
Speech delay
-
-
associated with cyanosis
Marked pallor
Hypotonia
Bradycardia
Apnea
-
ALTE
- Apparent life threatening event
- Near term or term > 37 weeks
-
-
-
Head at midline, neck neutral
apnea
-
Meds to treat apnea
theophylline, aminophylline, methyl.xanthines, caffeine
-
how should you stop the caffiene treatment for apnea
gradual
-
Leading cause of death between 1 mo to 1 year
SIDS
-
90% of SIDS occurs before ___
6 months
-
Risk factors for SIDS
- LBS
- Prematurity
- Multiple birth
- Gender
- Age
- Season
- Passive smoke
- sleeping with others
- prone position
-
Position babies should sleep
Supine
-
Race found in SIDS
2-3 x american indian, african americans
-
Croups is caused by virus or bacteria
Larynotracheobronchitis - viral, most serious
-
Epiglotitis and trachea swelling
Croups
-
-
-
-
-
-
-
tx 02 with humidity for what?
Croup
-
Nebulized racemic epinepherine used to tx
Croup
-
Fluids/hydration, rest, and antipyretics tx
Croup
-
Tx of croup with infection
antibiotics
-
Bacterial invasion of strep, staph, or Haemophilus influenza
Epiglottitis
-
Life-threatening
Epiglottis
-
Rapidly obstructs trachea
Epiglottis
-
-
-
-
Frog like croaking
Epiglottitis
-
Vever lethargy and distressed respritation with inspriatory stridor
Epiglottitis
-
Usually previously healthy then quickly very ill
Epiglottitis
-
-
How to dx Epiglottitis
Lateral neck radiograph
-
Tongue blade Epiglottitis
Will shut the airway down!
-
Dry, hacking cough, non productive
Bronchitis, inflammation of trachea and bronchi
-
Pain, fever, humidity and hydration
Bronchitis, inflammation of trachea and bronchi
-
Avoid 2nd hand smoke
Bronchitis, inflammation of trachea and bronchi
-
Lasts 5-10 days
Bronchitis, inflammation of trachea and bronchi
-
Most common cause of bronchiolitis and pneumonida
RSV
-
Contagious and more common in winter
RS
-
Begins as URI
Bronchiolitis/RSV
-
02 humidified, vent CPAP tx
RSV/ bronchiolitis
-
Hydration and IV fluids important
RSV/ Bronchiolitis
-
Postural drainiage/chest physiotherapy
RSV/Bronchiolitis
-
Bronchodilators, nebulized epi
RSV, Bronchiolitis
-
Tx of briovirin by aerosal
BAronchiolitis/RSV
-
Prophylactic Synagis (paliviumab)
Tx for high risk RSV
-
How is Synagis given
IM or Respiratory, IV given <2 years, high risk NICU
-
Bacterial pneuonia what age
>5 yo,
-
Abrupt and follows URI
Bacterial pneumonia
-
Chest pain and meningeial sx
Baccterial Pneumonia
-
Viral Pneumonia is also called
RSV
-
Viral Pneumonia seen in what age
Small children, and you tx sx
-
SX of pneumia
Respiratory distress and CHest pain!
-
Symptomatic supportive care for Pneumonia
Analgesics, antipyretics, hydrate, enc. couphing, antibiotics if bacterial. Hosp: 02, IVGs, Chest pain
-
Contagious, HA, Soare throat, cough, fever, runny nose, aches, chills, fatigue, vomiting
H1N1
-
High risk for H1n1
<5 yo, or premature
-
h1n1 remains alive on an object for
2-8 hrs
-
Tx/prevention H1N1
Tamiflue, Relenza
-
3 factors contributing to obstruction in asthma
- 1.) Inflammation and edema of mucus membranes
- 2.) Accumulation of tenacious secretions from mucus glands
- 3.) Smooth muscle spasm of bronchi and bronchioles
-
Non productive at onset, but leads to productive cough
Asthma
-
Inspiratory wheeze indicative of high risk respiratory problem and...
Cardiac arrest
-
PEFR
Reveals severity of asthma
-
-
-
-
-
Asthma mild intermittent
No daily meds needed. <2 days per week, < 2 nights per month
-
Astma mild persistent
- >2 /week but < 1x/day, >2 nights/month
- Low doese corticosteroidswith nebulizer or MDI
Alternative tx: Cromolyn, or leukotriene
-
Asthma moderate persistent
- >1 night/week
- Low dose corticosteroids
- long acting beta2 antaganists
- Alternative tx:
- low dose inhaled corticosteroids and either leukotreine receptor antagonist or theophylline.
- w/reoccuring exacerbations
- Preferred tx:
- medium dose inhaled corticosteroids
- Alternative tx:
- Medium dose inhaled corticosteroids and iether leukotrien receoptor antagonist or theophylline
-
Asthma severe persistent
Continual, Frequent
- High dose inhaled corticosteroids and long acting beta 2 agaonists and if needed
- Corticosteroids tablets or syrup long term (2mg/kg/day)
-
Rescue meds to treat asthma exacerabations
- Beta 2 antagonists (short acting): Inhaled
- Beta 2 agonists SQ
- Corticosteroids-Methylprednisolone IV or Prednisone PO
-
Use of Corticosteroids- Mythlprenisolone IV or Prednisone PO
Inflammation/iobstruction
- Short term therapy
- 3-10 days
- -Watch s/e
-
Albuterol use
Use spacer and risnse mouth after use
-
Salmeterol/Severent and Formoterol inhaltion (USE)
- Relaxes smooth muscle
- Used at night/exercise, watch SE
-
SE of Long acting beta2 agonists (salmeterol/serevent and Formoterol)
Tachycardia
-
Theophylline po or Aminophylline IV SE
Nasuea, tremors, tachyucardia
-
Serum levsls of theophylline or aminoophylline
>20ug/ml
-
Adjunct to inhaled steroids for moderate to severe
Leukotrienes
-
Take beta agonist 1st, 2nd or 3rd?
First
-
ZBeta agaonists function to
Open bronchi, enhances steroid obstruction
-
Autosomal recessive disorder
Cystic fibrosis
-
Genetic passage of cystic fibrosis
- 25% offspring will have disease
- 50% will be carriers
- 25% will not have it
-
Secrete thick secreations onto the skin
Cystic fibrosis
-
Affects multiple organs, commonly lungs, pancrease, liver and small intestines
Cystic fibrosis
-
Diagnostic test for cystic fibrosis
Sweat test
-
Sweat test results
>60mg POS x2
-
Diagnostic test for cystic fibrosis
Impaired fat absorption from liver/pancreatic dysfunction - poop floats
-
Meconium ileus
Cystic Fibrosis
-
Salty tasting skin
Cystic Fibrosis
-
Profuse sweating
Cystic Fibrosis
-
Frequent infection
Cystic Fibrosis
-
Wheezing is an assessment finding in what DISORDER
Cystic Fibrosis
-
Digital clubbing (chronic)
Cystic Fibrosis
-
Steatorrhea and azotorrhea
Cystic Fibrosis
-
Mustle wasting - Failure to thrive
Cystic Fibrosis
-
Hypoproteinemia
Cystic Fibrosis
-
Deficiency of A, D, E , K
Cystic Fibrosis
-
Nasal polyps
Cystic Fibrosis
-
Recurrent pneumonia or bronchitis
Cystic Fibrosis
-
Respiratory infection by pseudomonas
Cystic Fibrosis
-
Reproductive effect of Cystic Fibrosis on men
Steirle males, blockage or absesnes of vas deferense
-
reproductive effect of Cystic Fibrosis on females
thick mucous secreations interfere with psassage of sperm
-
Bronchodilators and adrenergic agonists (aerosols). Use and tx for.
- Tx for Cystic Fibrosis
- Opens airway/before chest p/t
-
Mucolytics (mucomyst) use and tx for
Cystic Fibrosis, dec viscostiy of secretions
-
Corticosteroids use and Tx for
anti-inflammatory decrease lung dis progrogress Cystic Fibrosis
-
Pancreatic enzymes (viokase)
tx pancrease def, give with meals,
High dose IB provin/alt days
Cystic Fibrosis
-
Ursodeoxycholate
given for Cystic Fibrosis, of elevated liver enzymes
-
Lactulose
Cystic Fibrosis for distal intestinal obstruction
-
Iron supplements
Cystic Fibrosis
-
Goals for Cystic Fibrosis
- Maintain respirtory function
- Prevent/Manage infection
- Promote Optimal Nutrition and Exercise
- Prevent instestinal obstruction
-
Foreing body obstruction usually found where?
Bronchial
-
Which long most common site of lower airway obstruction
Right
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