Pediatric Respiratory

what is cystic fibrosis

a genetic disorder that impairs lung function and causes abnormally thick, sticky mucus that plugs the organ ducts in the lungs, pancreas, liver, small intestine, and the reproductive organs

what are some symptoms of cystic fibrosis

1. wheezing

2. coughing

3. dyspnea

4. mucus plug

5. signs of CO2 retention: barrel shaped chest, finger clubbing, cyanosis

6. GI symptoms: meconium ileus at birth, weight loss despite increased appetite, malnourishment, vitamin deficiency, malabsorptive syndrome with chronic diarrhea and frothy stool

how to diagnose cystric fibrosis

1. prenatal genetic testing

2. Sweat chloride test: Sodium and chloride in the sweat will be 2-5 times greater than the normal range

what does the treatment/ respiratory management of cystic fibrosis

1. chest PT 2x daily

2. promote physical exercise

3. bronchodilators

4. dornase alpha - thins the secretions in the respiratory tract

5. mucolytics - thins the secretions

6. antibiotics - for pulmonary infections

7. pancreatic enzymes with meals/snacks to break down and digest food

8. high-protein, high calorie diet, up to 150% more

what is athma

chronic inflammatory disorder of the airways that is intermittent

what could be some triggers of asthma

1. environmental allergens

2. cold air

3. smoke

4. exercise

what are signs and symptoms of asthma

1. SOB

2. wheezing

3. chest tightness

4. anxiety

5. use of accessory muscles

how to diagnose pulmonary testing

• pulmonary function test

• allergy testing to identify potential triggers

what are treatments for asthma

1. o2 if needed

2. bronchodilatoris

   1. short-acting - albuterol (rescue inhaler)

   2. long-acting - salmeterol (used for daily maintenance)

3. inhaled corticosteroids (inhaler)

nursing care of asthma

1. Using the peak flow meter: use it three times and record the highest and pt should be ideally in the green zone.

what is the epiglottis

a flap of cartilages at the top of the larynx that protects the airway when we’re eating to prevent food to go down the airway

what is acute epiglottitis?

the life-threatening inflammation of the epiglottitis

who is more at risk at developing epiglottitis

1. those between the ages two and five

2. those who ever never received their Hib vaccine

what are the 4 D’s - symptoms of epiglottitis

1. dyspnea

2. dysphagia

3. dysphona

4. drooling

what can you NOT do because of epiglottitis

• do not put anything in their mouth - no tongue blade/depressors

• no throat culture/examination

• don’t lie patient on their back

how to treat for epiglottitis

1. intubation and trach set

2. Administer O2 as needed

3. suction as needed

4. monitor for distress

5. relieve fear/anxiety/stress

what is acute LTB (croup)

it’s inflammation of the larynx, trachea, and bronchioles

what’s the telltale signs of croup

stridor, nasal flaring, and a barking cough

what can cause croup

upper respiratory infections such as RSV or flu A+B

what is the treatment for croup

1. cool mist/steam

2. nebulized epinephrine

3. oral steroids (dexamethasone)

4. always sleeping upright

what is tonsilitis

inflammation of the tonsils

what it the cause of pharyngitis/tonsilitis

1. virus

2. strep

what are the signs and symptoms of pharyngitis/tonsilitis

• fever

• sore throat

• enlarged tonsils (if they get too big, it can impair the ariway)

what is the treatment for pharyngitis/tonsilitis

• antibiotics

• antipyretics to help with fever

• chronic tonsilitis → tonsillectomy & adenoidectomy

what is otitis media

a middle ear infection that caused by an URI that causes congestion and inflammation to that ear and that leads to an obstruction of the station tube and the accumulation of fluid in the ear

treatment for otitis media

• acetaminophen/ibuprofen for pain relief

• antibiotics

• if recurrent ear infections → myringotomy (ear tubes)

what are you assessing when completing a respiratory assessment?

1. movement

2. rate

3. rhythm

4. depth

5. quality

6. breath sounds

respiratory irregularities nursing care/interventions include

• chest PT

• supplement O2

• promote hydration / nutrition

• observe for worsening condition

• promote comfort

• saline bullet + suctioning combo

what are the pros of a nasal cannula

• secure on the face

• allows pt to still eat

pros of using an oxygen tent

it’s a tent that goes over the crib to allow air, allowing a cool, wet, environment for movement