Asthma
The core of asthma management.
What is prevention of inflammation?
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 1438
In emphysema, chronic hyperinflation leads to this.
What is a "barrel chest" or increased A-P diameter of chest?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 606
Risk factors for the development of aspiration pneumonia. (Name at least 4.)
What are:
Nasogastric/orogastric feeding tube placement; endotracheal tube placement; stroke (CVA), dysphagia or depressed cough reflex; alcohol intoxication; general anesthetic, opioid or sedative use; advanced age; Gastroesophageal reflux disease (GERD); feeding infants on their back?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 535
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 1432
True or false: RSV is mainly treated with antibiotics.
What is false?
Management of RSV focuses on supportive treatment. RSV is a VIRUS which is not treated with antiBIOTICS.
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 1428
Classic signs of TEF and atresia.
What are the 3 Cs (choking, coughing cyanosis)?
Other symptoms include copious frothy sputum, abdominal distension, drooling and apnea.
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 909
The three most common symptoms of asthma.
What are cough, dyspnea, and wheezing?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 633
Pulmonary function tests that measure specific lung volumes and rates; may be measured before and after bronchodilator administration.
What is spirometry?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 606
Signs and symptoms of aspiration pneumonia. (List at least 5.)
What are:
Cough, fever, pleuritic pain, tachypnea, dyspnea, orthopnea, crackles or diminished breath sounds, decreased oxygen saturation, respiratory acidosis, elevated WBCs, predisposing condition for aspiration?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 537
Hospitalization is required for children with these RSV symptoms.
What are tachypnea, significant retractions, poor oral intake and lethargy?
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 1428
True or false: Tracheoesophageal fistula presents with symptoms soon after birth.
What is true?
The pathologic process began en utero and the newborn will show symptoms of aspiration and impaired ventilation soon after birth.
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 909
Hypoxemia, hypocapnia and respiratory alkalosis.
What are initial ABG findings during an acute asthma attack?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 633
True or False: Weight loss is an uncommon result of COPD.
What is false?
1. The dyspnea that accompanies COPD interferes with eating.
2. BREATHING all on its own requires a lot of energy in the COPD patient.
The COPD patient requires extra calories that are easy to take in and won't take a lot of work to chew. Just eating can exhaust the COPD patient. Nutrition is extremely important as the disease process advances.
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 618
Antibiotic treatment for aspiration pneumonia.
What are clindamycin and/or a fluoroquinolone?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 537
Table 19-3
The method of RSV spread.
What is through contact with respiratory droplets or secretions?
In the hospital, this requires the patient be on CONTACT and DROPLET isolation. At home, special precautions should be taken to prevent the spread to any other children living in the house.
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 1428-1429
Diagnostics used for confirmation of TEF.
What are x-rays, ultrasounds, or MRI?
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 910
Complications of asthma.
What are status asthmaticus, respiratory failure, pneumonia, and atelectasis?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 634
Common ABG finding in the COPD patient.
What is respiratory acidosis with hypoxemia?
What are symptoms of respiratory acidosis?
What is the treatment?
Important teaching for parents to prevent aspiration in their young child.
What are:
Keep toxic substances such as lighter fluid, solvents, and hydrocarbons out of reach of young children. Toddlers and preschoolers cannot distinguish safe from unsafe fluids due to their developmental stage.
Avoid oily nose drops and oil-based vitamins or home remedies to avoid lipid aspiration into the lungs.
Avoid oral feedings if the infant’s respiratory rate is 60 or greater to minimize the risk of aspiration of the feeding.
Discourage parents from “force-feeding” in the event of poor oral intake or severe illness to minimize the risk of aspiration of the feeding.
Position infants and ill children on their right side after feeding to minimize the risk of aspirating emesis or regurgitated feeding.
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 1432
Teaching Guidelines 40.3
In RSV, blood gases may reflect these findings.
What are hypoxemia and carbon dioxide retention?
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 1429
Essential nursing interventions for the pre-operative TEF patient. (List at least 3.)
What are:
Initiate nothing by mouth (NPO) status.
Elevate the head of the bed 30 to 45 degrees to prevent reflux and aspiration.
Monitor hydration status and fluid and electrolyte balance; administer and monitor parenteral IV fluid infusions.
Assess and maintain the patency of the orogastric tube; monitor the functioning of the tube, which is attached to low continuous suction; and avoid irrigation of the tube to prevent aspiration.
Have oxygen and suctioning equipment readily available should the newborn experience respiratory distress.
Assist with diagnostic studies to rule out other anomalies.
Use comfort measures to minimize crying and prevent respiratory distress; provide nonnutritive sucking.
Inform the parents about the rationales for the aspiration prevention measures.
Document frequent observations of the newborn’s condition.
Initiate nothing by mouth (NPO) status.
Elevate the head of the bed 30 to 45 degrees to prevent reflux and aspiration.
Monitor hydration status and fluid and electrolyte balance; administer and monitor parenteral IV fluid infusions.
Assess and maintain the patency of the orogastric tube; monitor the functioning of the tube, which is attached to low continuous suction; and avoid irrigation of the tube to prevent aspiration.
Have oxygen and suctioning equipment readily available should the newborn experience respiratory distress.
Assist with diagnostic studies to rule out other anomalies.
Use comfort measures to minimize crying and prevent respiratory distress; provide nonnutritive sucking.
Inform the parents about the rationales for the aspiration prevention measures.
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 910
Albuterol, levalbuterol, and pirbuterol.
What are short acting beta agonists that are used for relief of acute symptoms and prevention of exercise induced asthma?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 634
True or False? The goal for oxygen therapy is the lowest liter flow needed to maintain oxygen saturations greater than 95%.
What is false?
Greater than 90%.
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 614
Invasive procedure done to determine the cause of pneumonia and to obtain a sample of lung tissue.
What is a bronchoscopy?
Overbaugh, Janice L. Hinkle, Kerry H. Cheever, K. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. (15th Edition). pg. 5375
Positive identification of RSV is found via this method.
What are nasal-pharyngeal washings?
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 1429
Administer these things until the esophageal anastomosis is intact and patent.
What are TPN and antibiotics?
Ricci, Susan, et al. Maternity and Pediatric Nursing. (4th Edition). pg. 910
Oral feeds usually being a week after surgery.