peds resp

upper airway

nose, pharynx, larynx

lower respiratory tract

trachea bronchi, lungs

resp infections classified by…

anatomical location

viruses are…

most common cause of pediatric respiratory infections

0-3 months

protected by maternal antibodies

3-6 months

increased infections

toddlers/preschool

highest infection rates

greater than 5 years

fewer infections, but greater mycoplasma and strep

airway structural factors…

narrower and shorter. leads to increased risk of obstruction and infections

6 months - 3 years have…

more severe reactions to infections than older children

breathing pattern assessment

rate, depth, ease, rhythm

signs of respiratory distress

labored breathing, use of accessory muscles, pulse oximetry

key resp assessment findings

fever, lymphadenopathy, cough, sputum, breath sounds, cyanosis, chest/abd pain, halitosis

wheeze indicates…

lower airway obstruction

stridor indicates…

upper airway obstruction

respiratory nursing care

maintain oxygenation, reduce work of breathing, hydration, promote comfort, reduce fever, infection control

respiratory oxygenation

ensure airway patency, oxygen therapy if needed

how to reduce work of breathing?

positioning, humidified air

nasopharyngitis

viral common cold that involves nose and throat

management of nasopharyngitis

usually home care, antipyretics, fluids, cool-mist humidifier

nasopharyngitis symptoms younger children

fever, irritability, poor feeding, sneezing, mouth breathing, vomiting/diarrhea

nasopharyngitis symptoms older children

dry throat, nasal discharge, sneezing, chills, myalgia, cough

nasopharyngitis red flags

increased work of breathing, not eating, significant GI losses, fever not responding to meds

pharyngitis key points

sore throat, inflamed pharynx, usually viral, can be bacterial, no nasal congestion

management of pharyngitis

usually home care, antibiotics if bacterial

acute streptococcal pharyngitis (strep throat) cause…

group A beta-hemolytic streptococcus

strep throat symptoms

abrupt onset, fever, sore throat, headache, abd pain, tonsillar exudate, strawberry tongue, petechiae, sandpaper rash, tender cervical nodes, red and swollen uvula

strep throat complications

rheumatic fever, acute glomerulonephritis

strep throat nursing care

antibiotics, hydration, swallowing assessment, infection control

escalate strep throat care if…

fever not responding, severe throat pain, worse after 24-48 hours antibiotics, dehydration

tonsilitis

viral or bacterial inflammation of tonsils. often occurs with pharyngitis

symptoms of tonsilitis

red/swollen tonsils, exudate, fever, sore throat, tender lymph nodes, kissing tonsils, difficulty swallowing/breathing, mouth breathing

tonsilitis treatments

supportive care, antibiotics, tonsillectomy/adenoidectomy

tonsillitis red flags

drooling/cannot swallow, dehydration, high fever, airway obstruction, peritonsillar abscess

indications for tonsillectomy and adenoidectomy

recurrent infection, airway obstruction/OSA, abscess, chronic tonsillitis

adenoidectomy specific indications

nasal obstruction, recurrent sinusitis, sleep-disordered breathing

tonsillectomy/adenoidectomy contraindications

cleft palate, acute infection, poor anesthesia risk

otitis media risk factors

daycare, smoke exposure, bottle propping, allergies, cleft palate

causes of otitis media

RSV, streptococcus pneumoniae

resp key nursing takeaways

airway always priority, recognize early signs of resp distress, hydration, most infections viral, parent education