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