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71 Cards in this Set

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The most common infection problems in infants and children
respiratory
infants and children less than three years old have an immature ________ ________, therefore are at greater risk for developing respiratory infections
immune system
the respiratory tract continuously grows and develops until what age
around 12 years old
in relation to an adult airway, described a child's airway
shorter and narrower, and the tangle of the main stem bronchi is more acute
while the airway is still developing
the smaller oral cavity and a larger tongue, smaller nares and nasopharynx, long floppy epiglottis, larger amount of soft tissue, fewer alveoli, and more compliant chest wall
all of these underdeveloped features put the infant and child at greater risk for?
Obstruction of the airway
respiratory assessment begins with a general assessment
how does the patient look? Alert? Restless or irritable? Skin color?
When auscultating the chest for breath sounds, do they sound ________?
clear, coarse, wheezy, crackly, stridor?
What is the cough producing?
What's the quality, is it dry, wet, brassy, barking? Is the effort strong, weak, or absent?
Another key area of the respiratory assessment
vital signs… what's the temperature, heart rate, respiratory rate, blood pressure
early signs of respiratory distress
tachypnea, tachycardia, retractions, nasal flaring, grunting, stridor or wheezing, mottled color, changes in responsiveness, hypoxemia
late signs of respiratory distress
poor air entry, weak cry, apnea or gasping, deterioration in systemic perfusion, bradycardia
tonsillitis/pharyngitis is usually ________, unless a strep test is positive
viral
symptoms of viral tonsillitis include
sore throat, fever and malaise, and swollen lymph nodes
strep throat is caused by the group A strep bacteria... classic symptoms include
fever, red sore throat, exudative tonsils, palatal petechiae, and swollen sub mandibular lymph nodes
if red sandpaper rash develops, this is a sign that strep has progressed to ________ ________.
scarlet fever
treatment of strep throat is usually this antibiotic ________
penicillin
school-age children must be on ________ for 24 hours before they can return to school
antibiotics
indications for tonsillectomy
frequent strep infections, hypertrophy obstructing breathing and/or eating, i.e. sleep apnea
frequent ________ can indicate excessive bleeding postop
swallowing
after a tonsillectomy is important to teach the patient to
be careful using straws, and avoid blowing nose and coughing
what will most likely happen if excessive blood is swallowed?
Emesis, a.k.a. they're going to blow chunks!
Otitis externa is an external ear infection, also known as ________
swimmers ear
swimmers ear is caused by normal ear flora under the conditions of excessive wetness or ________.
dryness
treatment of swimmers ear includes
keeping it dry and clean, analgesics, otic drops-polymyxin or neomycin and corticosteroids
otitis media with effusion or OME is the presence of fluid in the middle ear WITHOUT what?
Signs of acute infection
acute otitis media or AOM is sudden onset, tympanic memory is bulging and erythemic with otalgia… it has two possible causes
viral or bacterial
what is the usual initial treatment for AOM
if no other complications, watchful waiting for 24 to 72 hours
treatment for chronic OME
steroids, tympanostomy tubes
strong recommendations for prevention of otitis
breast-feeding for least six months, and avoiding daycare
softer recommendations for prevention of otitis
no bottles in bed, avoid or decrease pacifier use after six months, and avoid secondhand smoke
what is a life-threatening condition that causes swelling of the epiglottis and surrounding tissue, which can result in total occlusion?
Acute epiglottitis
Acute epiglottitis has a characteristic appearance of an edematous, Cherry red epiglottis, and what four cardinal signs/symptoms are present? Hint- the fourth Ds
drooling, dysphagia, dysphonia, distressed inspiratory effort… they will possibly a tripod position
Laryngotracheobronchitis or LTB is usually seen in children less than _______ years of age, and is caused by a _______ infection. characterized by a ______ cough.
Five, viral, barking
LTB progresses through ____ stages
four
LTB management includes
maintaining airway and adequate gas exchange, nebulized epinephrine, corticosteroids, oxygen administration, Heliox (a mixture of helium and oxygen)
this is an acute viral infection, most commonly caused by RSV, seen typically in the winter months, and rarely in patients over two years old
bronchiolitis- large amounts of thick secretion in a small airway
bronchiolitis management includes
frequent assessment of respiratory status and oxygenation, Heliox, suctioning as needed to clear mucus from the airway, and remember to include parents and care as much as possible to provide education and decrease anxiety
RSV prevention is for at-risk infants under two years of age under two years of age, who meet specific criteria... those criteria:
born prematurely, have a congenital heart disease, or have a chronic lung disease that requires oxygen treatment
pneumonia is inflammation of the lung parenchyma, and may be viral or bacterial… 3mo-5years is usually ________ and 5-12years is usually ________.
pneumococcal, Mycoplasma
how is treatment for pneumonia determined?
Treatment is determined by age due to age specific bacteria or virus
if pneumonia is treated with antibiotics and there is no response after 24 to 48 hours…
cultures will be grown to determine actual cause
chlamydial pneumonia is seen in infants newborn up to the age of ___ weeks, and is passed from infected mother just before or during the birthing process
19
treatment of chlamydial pneumonia is...
a 21 day course of erythromycin
pertussis is also known as…
whooping cough
whooping cough is spread through direct contact and droplet exposure, making it
highly contagious
whooping cough lasts around 4-6 weeks and has the highest incidence in _____ and _____.
spring, summer
prevention of whooping cough with what vaccine?
TDAP
pertussis has three stages:
Catarrhal stage- Coryza, mild cough, lacrimation, low-grade fever. Paroxysmal stage- increasing cough, whoop. Convalescent stage-gradually diminishing symptoms
infants under six months may not present with typical cough
apnea is common in this age group
influenza is a _____ elements
respiratory
pediatric and geriatric patients with influenza have an increased risk for secondary bacterial ________ infection
pneumonia
what is the most prevalent type of influenza? This is the one we’re vaccinated for
type A influenza
what is the protocol for the patient who has never been vaccinated for influenza?
If they are less than nine years old, two doses given at least one month apart
if a patient has an immune deficiency, i.e. there are chemotherapy, what type of flu vaccination should they receive?
Trivalent inactivated
asthma therapy goals
prevent chronic symptoms, reduce the use of the short acting beta agonist (SABA) less than two times a week, maintain normal pulmonary function
cromolyn sodium
a nonsteroidal anti-inflammatory drug that blocks early and late reactions to allergens. Not recommended for first-line preventive therapy
nedocromil sodium
both anti-allergenic and anti-inflammatory properties. For use in children over five years old. Not effective for acute exacerbations.
Acute asthma sympathomimetics
are used for quick relief of acute exacerbations, i.e. terbutaline and albuterol
beta agonist side effects
decreased diastolic and mean arterial pressure, tachycardia, jitteriness, myocardial ischemia
what serious issue can arise from the use of terbutaline?
Hypokalemia
maintenance medications for asthma
corticosteroids, leukotriene modifiers, monoclonal antibodies
status asthmaticus
when a patient does not respond to medication and is a medical emergency that can result in respite for a failure and death… treatment requires establishment and maintenance of adequate airway and oxygenation
cystic fibrosis is an odd and somewhat recessive transmission, meaning that…
it can only be passed to offspring both mother and the father pass their recessive genes
how does cystic fibrosis affect the body?
It is an exocrine dysfunction where there is increased mucus viscosity with multi-system effects-pancreas, lungs, and GI
concurrent with the earliest findings, there is an abnormal transport of chloride
sweat contains 2 to 5 times more sodium and chloride = salt
signs and symptoms of cystic fibrosis
continual weight loss, frequent pulmonary infections, bulky loose stools, inability to absorb fat-soluble vitamins ADEK, and in both males and females an inability to have children
treatment of cystic fibrosis
pancreatic enzymes with all food, water soluble forms of vitamins ADEK, high calorie high protein diet, and may need extra sodium
sudden infant death syndrome, a.k.a. SIDS highest risk are
ages 1 to 3 months, babies with low birth weight, black and Native American
speculated cause of SIDS is...
most likely a pre-existing condition and an initiating event
recommendations for reducing SIDS
supine sleeping, firm surfaces, no smoking during pregnancy or secondhand smoke, baby sleeps in a separate crib, avoid overheating