PEDS Modules 2: Oxygenation

Notes

  • Focus on asthma, bronchiolitis, cystic fibrosis, CROUP

    • Respiraotry System

      • Infants:

        • Nose breathers, produce very luttle mycys, more susceptible to infection

      • Newbrons: Very small nasal passage, more prone to obstruction

      • Thraot increase risk for airways

        • Infants tongues largers in relation to oropharynx

        • Children have enlarge tonsillar and adenoid tissues

      • Bifurcaiton of trachea at level fo the third thoracic vertebra: improtant when suctioning or intubating children

      • Narrower bronchi and bronchioles are increase risk for aspiration

      • Hypoxemia: Low oxygenation of the blood

      • Hypoxia: Tissues not having enough blood

    • Inspect and Observe

      • Anxiety restlessness

      • Color: Pallor, cyanosis

      • Hydration

      • Clubbing

      • Breathing sound

      • Adentitious breaths souds

        • Wheezing ( asthma or viral infections

        • Rales ( Pneomnia

      • Rate and depth of respriation: Tachypnea

      • Respiratory effort

      • Nose and oral cavity

      • Nasal flaring

        • One sign of respirtory distress

      • Cough and other airway noises: stridor

    • Common medical treatment

      • Cool humidified oxygen

      • Peak flow meter

      • Cool humidity ( addition of moisture to insrpured air)

      • Suctions

      • Chest physiotherpay and post postural drainage

      • Saline gargles or lavage

      • Mucolytic agesnt

      • Chest tubs

      • Bronchosopcy

      • Peak Expiratory flow

    • Laboratory and diagnostic test

      • Pulse ox, chest radiogrpahy, blood gases, nasal pharyngeal washing, rapid strep testing via throat swab, sputum culture, WBC

  • Asthma

    • Obstructive inflammatory disorder characterize by airway hyperrespnsive airway, edema, narrowing and inflammation

      • Categorize as mild, moderate, severe

    • Triggers: cold air, smoke, viral infection, stress, pet dander, excercise, pollution, fragrances, mold, chlorine in pools

    • Common meds

      • Albuteral Levabutorls: short acting beta 2 adrenergic agnosit

      • Formoterol Salmetrol: long acting beta 2 adrengric agnosit

      • Beclomethasone, fluticasone, budesonide, metasone: Inhaled corticosteroids

      • Montelukast, zafirluakast: leukotreinece modiferie

      • Prednisone: Oral corticosteriod

  • Cystic Fibrosis

    • Gene mutation in the cystic fibrosis transmembrane conductance regulator

    • Pancreas, intrahepatic bile ducts, intestinal glands, gallbladder, and submaxillary glands become obstructed by viscous mucus and eosinophilic material

    • Pancreatic enzme activitiy is lost and malabsorption of fats, proteins, and carbohydrates occur, resutling in poor growth and lare maladarous stools

    • Therapuetic managemnts: pancreatic enzymes and supplemntal

  • Broncholitis

    • An acute inflmmatory process of broncioles and small bronchi

    • Caused by viral infection RDV

      • Symptoms: Clear runny nose, pharyngitis, low grade fever, cough followed a wheeze , poor feeding, respirotry distress, tachypnea, retraction, grunting and period of apnea

    • Theraputic management: Supplemental oxygen, cool humidifeird, nsaal or nasopharyngeal suction, IV and oral hydration, inhaled bronchodilatory therapy

Powerpoint