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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers
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26 - The Child with Respiratory Dysfunction

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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers | Registered Nurse (RN) School Study Aid

26 - The Child with Respiratory Dysfunction
34 Picmonics to Learn | 1 hr 6 mins
Tonsillitis
Cause
Bacterial or Viral Inflammation
Assessment
Sore Throat
Dysphagia
Interventions
Throat Culture
Antibiotics
Tonsillectomy
Considerations
Often Streptococcus
Monitor for Acute Glomerulonephritis
Monitor for Rheumatic Heart Disease
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3 mins
Tonsillectomy
Indications
Recurrent Tonsillitis
Considerations
Saline Gargles
Ice Chips
Monitor for Bleeding
Within 24 Hours
After 5-7 days
Soft Foods
Do Not Cough, Clear Throat, or Blow Nose
Do Not Use Straws
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2 mins
Codeine
Mechanism
Opioid Receptor Agonist
Indications
Mild to Moderate Pain
Cough Suppressant
Side Effects
Sedation
Constipation
Miosis
Considerations
Close Monitoring When Breast Feeding
Often Combined with Non-Opioids
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2 mins
Infectious Mononucleosis
Mechanism
Herpes-like Viral Infection
Signs and Symptoms
Fatigue
Fever
Sore Throat
Head and Body Aches
Hepatomegaly and Splenomegaly
Swollen Lymph Nodes in Neck and Armpits
Rash
Considerations
Suppressed Immune Response
Positive Monospot
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2 mins
Influenza
Assessment
High Fever
Cough
Headache
Muscle Aches
Chills
Intervention
Vaccination
Drug Therapy
Zanamivir (Relenza)
Oseltamivir (Tamiflu)
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2 mins
Otitis Media Assessment
Red or Bulging Tympanic Membrane
Ear Pain
Pulling at Ear
Fever
Upper Respiratory Infection
Considerations
More Common in Young Children
Eustachian Tube Narrower
Conductive Hearing Loss
Smoking Increases Risk
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2 mins
Otitis Media Interventions
Antipyretics
Analgesics
Antibiotics
Irrigation
Position on Affected Side
Myringotomy
Tympanostomy Tube
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2 mins
Croup (Laryngotracheobronchitis)
Mechanism
Parainfluenza Virus
Assessment
3 Months to 3 Years
Nighttime
Barking Seal Cough
Inspiratory Stridor
Interventions
Cool Humidified Air
Dexamethasone
Racemic Epinephrine
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2 mins
Epiglottitis Assessment
Cause/Mechanism
Haemophilus Influenzae
Assessment
Drooling
Fever
Stridor
Restlessness
Dyspnea
Cough
Tripod Position
Considerations
Emergency Treatment
Do Not Examine Throat
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2 mins
Chronic Bronchitis Assessment
Clinical Findings
Chronic Productive Cough
> 3 Months for 2 Years
Increased Mucus Production
Dyspnea
Cyanosis
Wheezes
Complications
Right Side Heart Failure
Jugular Venous Distention (JVD)
Peripheral Edema
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2 mins
Chronic Bronchitis Interventions
Tripod Position
Humidified Oxygen
Pursed Lip Breathing
Increase Fluid Intake
ABGs
Early Detection of Exacerbation
Considerations
Lowest O2 Therapy
Assisted Ventilation
Increased Infection Risk
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2 mins
Pneumonia Assessment
Risk Factors
Older Adult
Immunocompromised
Long Term Care
Assessment
Shortness of Breath (SOB)
Hypoxemia
Cough and Sputum Production
Wheezing or Crackles
Fever
Pleuritic Pain
Diagnosis
Chest X-ray
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2 mins
Pneumonia Intervention
Interventions
Humidified Oxygen
Deep Breathing Exercises
Position of Comfort
Increase Fluid Intake
Manage Fever
Medications
Antibiotics
Mucolytics
Expectorants
Considerations
Pneumococcal Vaccine
Sepsis
Acute Respiratory Failure (ARF)
Prevention Education
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2 mins
Tuberculosis Assessment
Etiology
Airborne Droplet
Assessment
3 Week Productive Cough
Night Sweats
Chest Pain
Fever
Weight Loss
Fatigue
Diagnosis
Chest X-Ray
Blood Tests
Mantoux Skin Test
3 Positive Sputum Tests
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1 min
Tuberculosis Skin Mantoux Test (PPD)
Delayed Hypersensitivity (Cell Mediated Response)
Intradermal Injection
Read 48-72 hours
Positive Results
≥ 5 mm Induration
Immunosuppressed
≥ 10 mm Induration
High Risk Patients
≥ 15 mm Induration
Considerations
Chest X-Ray
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3 mins
Tuberculosis Intervention
Hospital Care
Airborne Isolation
Drug Therapy
Combination Drug Therapy (RIPE)
6-12 Months
Considerations
DOT
BCG Vaccination
Medication Education
3 Negative Sputum Specimens
Infection Control
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2 mins
Acute Respiratory Distress Syndrome (ARDS) Assessment
Cause
Damaged Alveolar-Capillary Membrane
Assessment
Restlessness
Dyspnea
Refractory Hypoxemia
Decreased PaO2
Diffuse Pulmonary Infiltrates
Atelectasis
Pulmonary Hypertension
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2 mins
Neonatal Respiratory Distress Syndrome
Cause/Mechanism
Fetal Lung Immaturity
Lack of Surfactant
Assessment
Respiratory Distress
Nasal Flaring
Retractions
Grunting
Interventions
Surfactant
Oxygen
Mechanical Ventilation
Considerations
Total Parenteral Nutrition (TPN)
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2 mins
Acute Respiratory Distress Syndrome (ARDS) Interventions
Interventions
Closely Monitor Patient
ABG's (Arterial Blood Gases)
Oxygen
Assess for O2 Toxicity
Mechanical Ventilation
PEEP
Assess for Pneumothorax
Permissive Hypercapnia
Considerations
High Mortality Rate
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2 mins
Montelukast (Singulair)
Mechanism
Leukotriene Receptor Blocker
Indications
Allergic Rhinitis
Asthma Prophylaxis
Exercise Induced Bronchospasm
Side Effects
Fatigue
Headache
Mood Changes
Suicidal Thoughts
Considerations
Increased Risk of Churg Strauss
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2 mins
Asthma Assessment
Assessment
Triggers (Cold air, Dander, Dust, Infection, Mold, Pollen, Smoke)
Shortness of Breath (SOB)
Tachypnea and Tachycardia
Wheezing
Diaphoresis
Accessory Muscles
Decreased Pulmonary Function Tests
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2 mins
Asthma Implementation and Education
Medication
Oxygen
Corticosteroids
Ipratropium (Anticholinergic)
Albuterol
Implementation
Inhaler/nebulizer
Pulse Oximetry
Pursed Lip Breathing
Education
Carry Inhaler
Rinse Mouth after Inhaler
Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
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2 mins
Inflammatory Response
Pathogens Infect Tissue
Mast Cells Release Histamine
Histamine Dilates and Increases Capillary Permeability
Macrophages Engulf Pathogens
Macrophage Signals Cells With Cytokines
Responding Neutrophils Cross Capillary Wall
B And T Lymphocytes Arrive At Injury Site
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2 mins
Beta-2 Agonists
Short-term Treatment
Terbutaline
Asthma
Tocolysis
Albuterol
Asthma
Long-term Treatment
Salmeterol
Asthma
Chronic Obstructive Pulmonary Disease (COPD)
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3 mins
Beta Blockers
"-olol" suffix
Mechanism
Decreases Heart Rate and Contractility
Decreases Peripheral Vascular Resistance
Decreases Renin Release
Indications
Hypertension
Heart Failure
Angina Pectoris
Contraindications
Asthma and Heart Block Patients
Nursing Considerations
Assess Blood Pressure and Heart Rate
Masking Signs of Hypoglycemia
Do Not Stop Abruptly
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2 mins
Cromolyn (Mast Cell Stabilizers)
Mechanism
Mast Cell Stabilizer
Indications
Asthma Prophylaxis
Bronchial Inflammation
Allergic Rhinitis
Side Effects
Cough
Bronchospasm
Consideration
Fixed Schedule Administration
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2 mins
Anticholinergics
B.O.AT.S Acronym
Benztropine
Parkinson's Disease
Oxybutynin
Decrease bladder spasms
Atropine
Mydriasis and Cycloplegia
Scopolamine
Motion Sickness
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1 min
Anticholinergics Continued
Drugs
Glycopyrrolate
Reduces Airway Secretions
Ulcer Treatment
Ipratropium
Asthma and C.O.P.D
Dicyclomine
Hyoscyamine
Irritable Bowel Syndrome
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1 min
Magnesium Sulfate
Mechanism
Muscle Relaxant
Indications
Preterm Labor Contractions
Preeclampsia
Side Effects
Warm Feeling
Hypotension
Decreased Deep Tendon Reflexes (DTRS)
Decreased Respiratory Rate
Decreased Urine Output
Paralytic Ileus
Antidote
Calcium Gluconate
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2 mins
Cystic Fibrosis Assessment
Thickened Mucus
Recurrent Pulmonary Infections
Pulmonary Congestion
Pancreatic Insufficiency
Steatorrhea
Fat-Soluble Vitamin Deficiencies
Salty Taste to Skin
Meconium Ileus
Delayed Growth and Poor Weight Gain
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2 mins
Cystic Fibrosis Interventions
Bronchodilators
N-Acetylcysteine (Mucolytics)
Inhaled Hypertonic Saline
Early Antibiotics
Dornase Alfa (Mucolytic Agent)
Postural Drainage with Percussion
Fat Soluble Vitamin Supplements
Pancreatic Enzymes with Every Meal
High Protein, High Calorie Diet
Added Dietary Salt
Glucose Monitoring
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2 mins
Therapeutic Diets
Common Therapeutic Diets
High Fiber
Low Residue (Fiber)
Low Sodium
Low Cholesterol
Diabetic
Renal
Dysphagia
Nursing Considerations
Diet Education
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2 mins
Obstructive Sleep Apnea (OSA)
Cause/Mechanism
Narrowed or Obstructed Air Passage
Assessment
Apnea
Loud Snoring
Startle Response
Daytime Drowsiness
Interventions
Positional Therapy
Oral Appliance
Continuous Positive Airway Pressure (CPAP)
Surgery
Considerations
Weight Loss
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3 mins
Atropine
Mechanism of Action
Muscarinic Antagonist
Indications
Bradycardia
Increased Exocrine Secretions
Smooth Muscle Spasms
Side Effects
Tachycardia
Dry Mouth
Urinary Retention
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2 mins

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