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