Podcast
Questions and Answers
What is a recommended action before prescribing antibiotics in cases involving children aged 2-12 with ear infections?
What is a recommended action before prescribing antibiotics in cases involving children aged 2-12 with ear infections?
- Wait 2-3 days (correct)
- Administer benzocaine ear drops
- Perform myringotomy immediately
- Prescribe lidocaine immediately
Which of the following is a characteristic of children likely to exhibit ear infection symptoms?
Which of the following is a characteristic of children likely to exhibit ear infection symptoms?
- Regularly breastfed
- Have a history of upper respiratory infections (correct)
- Older than 3 years
- Undergo cleft lip/palate surgery
What is the proper method for pulling the pinna back in children under 3 years of age during an ear examination?
What is the proper method for pulling the pinna back in children under 3 years of age during an ear examination?
- Pull straight up
- Pull sideways
- Pull down and back (correct)
- Pull forward and down
Which topical anesthetic is NOT mentioned for ear procedures in the provided content?
Which topical anesthetic is NOT mentioned for ear procedures in the provided content?
In managing an ear infection, which of the following conditions should NOT be present?
In managing an ear infection, which of the following conditions should NOT be present?
During which season do ear infections appear more likely, based on the provided information?
During which season do ear infections appear more likely, based on the provided information?
What is the expected timeframe for management actions in treating ear infections before the need for intervention?
What is the expected timeframe for management actions in treating ear infections before the need for intervention?
Which of the following is NOT considered a therapeutic procedure for ear infections in children aged 2-12?
Which of the following is NOT considered a therapeutic procedure for ear infections in children aged 2-12?
Which of the following is NOT a risk factor for otitis media?
Which of the following is NOT a risk factor for otitis media?
What is a common physical exam finding in a patient with otitis media?
What is a common physical exam finding in a patient with otitis media?
Which prevention strategy is recommended for otitis media?
Which prevention strategy is recommended for otitis media?
When is antibiotic therapy typically indicated for otitis media?
When is antibiotic therapy typically indicated for otitis media?
What is the typical age range most affected by acute otitis media?
What is the typical age range most affected by acute otitis media?
What characteristic appearance might the tympanic membrane have during the physical exam of otitis media?
What characteristic appearance might the tympanic membrane have during the physical exam of otitis media?
Which of the following organisms is NOT commonly associated with epiglottitis?
Which of the following organisms is NOT commonly associated with epiglottitis?
What is a classic sign of epiglottitis that helps to differentiate it from other respiratory conditions?
What is a classic sign of epiglottitis that helps to differentiate it from other respiratory conditions?
What possible complication can occur if otitis media is not treated appropriately?
What possible complication can occur if otitis media is not treated appropriately?
What is the peak age range for the occurrence of bronchiolitis?
What is the peak age range for the occurrence of bronchiolitis?
What is a common method used to visualize the tympanic membrane during diagnosis of otitis media?
What is a common method used to visualize the tympanic membrane during diagnosis of otitis media?
Which of the following symptoms is characteristic of bronchiolitis?
Which of the following symptoms is characteristic of bronchiolitis?
Which of these treatments is commonly applied for bronchiolitis symptoms?
Which of these treatments is commonly applied for bronchiolitis symptoms?
During what months do RSV infections typically peak in the Southeastern United States?
During what months do RSV infections typically peak in the Southeastern United States?
What position does a child with epiglottitis typically prefer?
What position does a child with epiglottitis typically prefer?
Which intervention is a key preventive measure against respiratory illnesses?
Which intervention is a key preventive measure against respiratory illnesses?
What is the primary goal of asthma treatment?
What is the primary goal of asthma treatment?
Which of the following is a common trigger for asthma?
Which of the following is a common trigger for asthma?
What characterizes status asthmaticus?
What characterizes status asthmaticus?
Which type of medication is specifically used as a rescue inhaler for asthma?
Which type of medication is specifically used as a rescue inhaler for asthma?
How can asthma be effectively managed from a preventive standpoint?
How can asthma be effectively managed from a preventive standpoint?
Which of the following medications is classified as a long-acting beta-2 agonist?
Which of the following medications is classified as a long-acting beta-2 agonist?
What complication can arise from status asthmaticus?
What complication can arise from status asthmaticus?
What symptoms signify an asthma exacerbation?
What symptoms signify an asthma exacerbation?
What is the primary genetic inheritance pattern of cystic fibrosis?
What is the primary genetic inheritance pattern of cystic fibrosis?
What does the CFTR gene regulate in relation to cystic fibrosis?
What does the CFTR gene regulate in relation to cystic fibrosis?
Which symptom is most indicative of cystic fibrosis in children?
Which symptom is most indicative of cystic fibrosis in children?
How does thick mucus in cystic fibrosis patients affect their lungs?
How does thick mucus in cystic fibrosis patients affect their lungs?
What does the sweat chloride test measure in diagnosing cystic fibrosis?
What does the sweat chloride test measure in diagnosing cystic fibrosis?
What is a common non-biological trait observed in children with cystic fibrosis?
What is a common non-biological trait observed in children with cystic fibrosis?
What role does the CFTR protein play in epithelial cells?
What role does the CFTR protein play in epithelial cells?
What is the current standard method for diagnosing cystic fibrosis?
What is the current standard method for diagnosing cystic fibrosis?
What is a significant sign that indicates respiratory failure is imminent?
What is a significant sign that indicates respiratory failure is imminent?
Which of the following treatments is crucial for anaphylactic shock management?
Which of the following treatments is crucial for anaphylactic shock management?
What common respiratory symptom may accompany hypoventilation?
What common respiratory symptom may accompany hypoventilation?
What is the main reason for cardiac failure in young children related to respiratory health?
What is the main reason for cardiac failure in young children related to respiratory health?
Which of the following signs is NOT typically associated with anaphylactic shock?
Which of the following signs is NOT typically associated with anaphylactic shock?
What is a characteristic of babies' airways at birth?
What is a characteristic of babies' airways at birth?
What is indicated by nasal flaring during respiratory assessment?
What is indicated by nasal flaring during respiratory assessment?
What is one of the implications of underdeveloped lungs in infants?
What is one of the implications of underdeveloped lungs in infants?
How does the development of chest muscles in infants affect their breathing?
How does the development of chest muscles in infants affect their breathing?
What behavior might indicate that a baby is struggling to breathe?
What behavior might indicate that a baby is struggling to breathe?
How do babies primarily breathe in the first few months of life?
How do babies primarily breathe in the first few months of life?
What does a higher respiratory rate in infants suggest?
What does a higher respiratory rate in infants suggest?
What does the presence of grunting in a baby typically indicate?
What does the presence of grunting in a baby typically indicate?
What is a common presenting sign of acute spasmodic laryngitis?
What is a common presenting sign of acute spasmodic laryngitis?
In children with laryngotracheitis, which procedure is contraindicated due to the risk of laryngospasms?
In children with laryngotracheitis, which procedure is contraindicated due to the risk of laryngospasms?
What treatment method is recommended to help manage symptoms of croup?
What treatment method is recommended to help manage symptoms of croup?
Which of the following correctly identifies a sign of epiglottitis in children?
Which of the following correctly identifies a sign of epiglottitis in children?
Which characteristic is associated with croup syndromes worsening at night?
Which characteristic is associated with croup syndromes worsening at night?
What is a critical intervention for managing a child experiencing severe symptoms of epiglottitis?
What is a critical intervention for managing a child experiencing severe symptoms of epiglottitis?
What symptom might indicate a serious complication if otitis media is not appropriately treated?
What symptom might indicate a serious complication if otitis media is not appropriately treated?
Which type of airway illness is categorized under croup syndromes?
Which type of airway illness is categorized under croup syndromes?
What is the primary effect of a defective CFTR protein in cystic fibrosis?
What is the primary effect of a defective CFTR protein in cystic fibrosis?
Which of the following is a common method for assessing sweat electrolyte levels in cystic fibrosis?
Which of the following is a common method for assessing sweat electrolyte levels in cystic fibrosis?
What is the significance of early diagnosis in cystic fibrosis?
What is the significance of early diagnosis in cystic fibrosis?
How does thick mucus in patients with cystic fibrosis impact the lungs?
How does thick mucus in patients with cystic fibrosis impact the lungs?
What is a key characteristic of cystic fibrosis as an 'orphan disease'?
What is a key characteristic of cystic fibrosis as an 'orphan disease'?
Which statement is true regarding the inheritance pattern of cystic fibrosis?
Which statement is true regarding the inheritance pattern of cystic fibrosis?
What should be emphasized when teaching about asthma exacerbation prevention?
What should be emphasized when teaching about asthma exacerbation prevention?
What happens to the sweat chloride levels in patients with cystic fibrosis compared to non-affected individuals?
What happens to the sweat chloride levels in patients with cystic fibrosis compared to non-affected individuals?
Which symptom would indicate the need for immediate airway assessment after a tonsillectomy?
Which symptom would indicate the need for immediate airway assessment after a tonsillectomy?
What is a common postoperative complication to monitor for after a tonsillectomy?
What is a common postoperative complication to monitor for after a tonsillectomy?
What is a recommended hydration method for patients after a tonsillectomy, assuming the gag reflex has returned?
What is a recommended hydration method for patients after a tonsillectomy, assuming the gag reflex has returned?
Which practice should be avoided to prevent complications after a tonsillectomy?
Which practice should be avoided to prevent complications after a tonsillectomy?
What type of medication should be administered to manage fever after a tonsillectomy?
What type of medication should be administered to manage fever after a tonsillectomy?
Why should red liquids be avoided after a tonsillectomy?
Why should red liquids be avoided after a tonsillectomy?
What should be assessed if a patient exhibits bright red emesis following a tonsillectomy?
What should be assessed if a patient exhibits bright red emesis following a tonsillectomy?
Which sign suggests a potential infection post-tonsillectomy?
Which sign suggests a potential infection post-tonsillectomy?
What is the primary purpose of analgesics like tetracaine lozenges after a tonsillectomy?
What is the primary purpose of analgesics like tetracaine lozenges after a tonsillectomy?
Which assessment finding would indicate excess pallor in a post-tonsillectomy patient that requires attention?
Which assessment finding would indicate excess pallor in a post-tonsillectomy patient that requires attention?
What symptom is often reported alongside febrile status post-tonsillectomy?
What symptom is often reported alongside febrile status post-tonsillectomy?
Which dietary option is preferable for patients recovering from a tonsillectomy?
Which dietary option is preferable for patients recovering from a tonsillectomy?
What is a critical post-operative recommendation for patients to avoid complications?
What is a critical post-operative recommendation for patients to avoid complications?
What is an expected finding during assessment of a patient post-tonsillectomy?
What is an expected finding during assessment of a patient post-tonsillectomy?
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Study Notes
Respiratory Assessment In Children
- Children have underdeveloped respiratory systems with smaller airways and fewer alveoli at birth.
- Airways are more narrow which leads to retractions
- Chest muscles are less developed which leads to retractions
- Respiratory rate is higher in children
- Eustachian tubes are shorter and more horizontal.
- Children are obligate nose breathers for their first few months.
- Babies breathe only through their nose, even if congested.
Respiratory Assessment Findings in Children
- Respiratory rate: count for a full minute
- Color: Babies can appear grey/green with darker skin.
- Effort: nasal flaring, grunting, head bobbing.
- Auscultation: wet or dry, assess for wheezing
- Cough: indicates a problem and needs to be investigated
- Behavior: anxiety is indicative of distress.
Treatment and Post-Op Care for Pediatric Respiratory Issues
- Treatment depends on the specific issue, but may include supportive care, medication, and surgery.
Post-Operative Care
- Assess airway, vitals, and bleeding and redness. Rest, warm fluids, and supportive care are recommended for recovery.
- Encourage fluids after the return of the gag reflex.
- Avoid red liquids, milk-based products, throat clearing, coughing, nose blowing, and strenuous activities.
Child vs Adult Anatomy: Otitis Media
- The anatomy of children is different from adults.
- Ear tubes are often inserted to treat otitis media. These will fall out on their own around 12-18 months.
Croup Syndromes
- Croup is a broad classification of upper airway illnesses that result from swelling of the epiglottis and larynx.
- Types of croup include:
- Spasmodic laryngitis
- Laryngotracheitis/laryngotracheobronchitis (LTB)
- Bacterial tracheitis
- Epiglottitis
- Symptoms worsen at night and include tachypnea, inspiratory stridor, and seal-like barking cough.
- Diagnosis is made by clinical presentation, and throat cultures and visual inspection should be avoided as they can cause laryngospasms.
- Humidified oxygen and cool mist are recommended for treatment.
Epiglottitis
- Epiglottitis is a medical emergency.
- It is likely that the child will need immediate intubation.
Asthma
- Triggers play a role in exacerbating asthma.
- Short- and long-acting medications are used to treat asthma.
- Education on asthma exacerbation prevention should be provided to patients and caregivers.
Cystic Fibrosis
- Cystic Fibrosis is an autosomal recessive genetic disease.
- It is characterized by dysfunction of the transmembrane conductance regulator (CFTR) protein, which regulates the hydration of epithelial cells.
- This leads to thick mucus buildup in the lungs, digestive tract, sweat glands, and reproductive system.
- Early diagnosis is possible through newborn screening, but it is not a definitive diagnosis.
- Individuals with CF may experience progressive illness, which worsens over time.
Genetic Inheritance of CF
- The CF gene is inherited from both parents.
Increased Sweat Electrolytes in CF
- The sweat chloride test is the gold standard for diagnosing CF.
- Sodium and chloride levels will be 2-5 times greater than in controls.
- Parents may be able to taste the salt when they kiss their child.
Pathophysiology of CF
- The CF gene directs the body's epithelial cells to produce a defective form of a protein.
- The defective protein disrupts the balance of salt and water needed to maintain normal mucus. This results in thick, sticky mucus that is difficult to move.
- Thick mucus blocks airways, leading to respiratory infections.
- It also blocks pancreatic channels, preventing the release of essential enzymes needed for digestion.
- Respiratory failure occurs when the body's oxygen needs exceed actual intake.
Nursing Role in Identifying Respiratory Distress
- Assessment findings should be monitored and escalated appropriately.
- Support children during respiratory distress to prevent respiratory failure.
- Respiratory failure is the main cause of cardiac failure in young children.
Anaphylactic Shock
- Anaphylactic shock is a severe allergic systemic reaction.
- Assess patients for signs of airway compromise, poor perfusion, and changes in consciousness.
- Administer epinephrine, antihistamines, and support airway and circulation.
- Transfer to the intensive care unit (ICU).
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