Podcast
Questions and Answers
Which of the following is a characteristic of a newborn's respiratory system that increases their susceptibility to respiratory infections?
Which of the following is a characteristic of a newborn's respiratory system that increases their susceptibility to respiratory infections?
- Stronger immune system
- Lack of surfactant (correct)
- Greater surface area for gas exchange in the alveoli
- Larger trachea and lower airway compared to adults
What is the normal respiratory rate for a toddler/preschooler?
What is the normal respiratory rate for a toddler/preschooler?
- 30-35 breaths per minute
- 20-30 breaths per minute (correct)
- 18-20 breaths per minute
- 16-20 breaths per minute
What type of retractions are observed near the trachea in a child experiencing severe respiratory distress?
What type of retractions are observed near the trachea in a child experiencing severe respiratory distress?
- Intercostal retractions
- Substernal retractions
- Suprasternal retractions (correct)
- All of the above
What is the term for difficulty breathing?
What is the term for difficulty breathing?
Which of the following is NOT a characteristic of infant respiratory anatomy?
Which of the following is NOT a characteristic of infant respiratory anatomy?
What is the color of nasal discharge that is typically associated with an allergy rather than an infection?
What is the color of nasal discharge that is typically associated with an allergy rather than an infection?
What type of cough is associated with asthma?
What type of cough is associated with asthma?
What is the medical term for breathing too fast?
What is the medical term for breathing too fast?
Which of the following is NOT a common clinical manifestation of bacterial pneumonia in children?
Which of the following is NOT a common clinical manifestation of bacterial pneumonia in children?
A child presents with sudden onset of fever, chills, and a hacking, nonproductive cough. Chest X-ray reveals patchy infiltrates. Which type of pneumonia is most likely?
A child presents with sudden onset of fever, chills, and a hacking, nonproductive cough. Chest X-ray reveals patchy infiltrates. Which type of pneumonia is most likely?
What is the first-line treatment for bacterial pneumonia in children?
What is the first-line treatment for bacterial pneumonia in children?
Which of the following is a common complication of pneumonia in children?
Which of the following is a common complication of pneumonia in children?
Which of the following is a characteristic of viral pneumonia in children?
Which of the following is a characteristic of viral pneumonia in children?
Which of the following diagnostic tools is NOT typically used in the diagnosis of pneumonia in children?
Which of the following diagnostic tools is NOT typically used in the diagnosis of pneumonia in children?
What is the most common causative agent of upper respiratory tract infections in children?
What is the most common causative agent of upper respiratory tract infections in children?
Which type of pneumonia involves inflammation of the terminal bronchioles and nearby lobules?
Which type of pneumonia involves inflammation of the terminal bronchioles and nearby lobules?
What is a common finding on chest X-ray in a child with Mycoplasma pneumoniae?
What is a common finding on chest X-ray in a child with Mycoplasma pneumoniae?
Which of the following is NOT considered a supportive treatment for viral pneumonia in children?
Which of the following is NOT considered a supportive treatment for viral pneumonia in children?
Which of the following is NOT a common laboratory test for respiratory disorders?
Which of the following is NOT a common laboratory test for respiratory disorders?
Which symptom is primarily associated with dysphagia in respiratory complications?
Which symptom is primarily associated with dysphagia in respiratory complications?
What is the primary viral agent responsible for most cases of nasopharyngitis?
What is the primary viral agent responsible for most cases of nasopharyngitis?
In the diagnosis of nasopharyngitis, a throat culture is NOT recommended if which symptom is present?
In the diagnosis of nasopharyngitis, a throat culture is NOT recommended if which symptom is present?
Which treatment is recommended to relieve symptoms of nasopharyngitis in older children?
Which treatment is recommended to relieve symptoms of nasopharyngitis in older children?
What age group is primarily affected by conditions such as croup?
What age group is primarily affected by conditions such as croup?
Which of the following is NOT a clinical manifestation of croup?
Which of the following is NOT a clinical manifestation of croup?
What is a recommended treatment for a child diagnosed with croup?
What is a recommended treatment for a child diagnosed with croup?
Which diagnostic tool is primarily used to assess for narrowing of the airway due to inflammation in croup?
Which diagnostic tool is primarily used to assess for narrowing of the airway due to inflammation in croup?
Which of the following statements about acute epiglottitis is correct?
Which of the following statements about acute epiglottitis is correct?
What defines frequent tonsillitis in a patient?
What defines frequent tonsillitis in a patient?
Which of the following conditions may warrant a tonsillectomy?
Which of the following conditions may warrant a tonsillectomy?
What post-operative care is recommended for a child who has undergone tonsillectomy?
What post-operative care is recommended for a child who has undergone tonsillectomy?
What is a common peak incidence age for otitis media?
What is a common peak incidence age for otitis media?
What is a recommended first-line antibiotic treatment for otitis media in children?
What is a recommended first-line antibiotic treatment for otitis media in children?
Which statement regarding Eustachian tubes in children is accurate?
Which statement regarding Eustachian tubes in children is accurate?
What is a potential complication of croup?
What is a potential complication of croup?
Which of the following behaviors can reduce the risk of recurrent otitis media?
Which of the following behaviors can reduce the risk of recurrent otitis media?
What is a common physical characteristic in a child with epiglottitis?
What is a common physical characteristic in a child with epiglottitis?
Which position might a child with epiglottitis assume to aid their breathing?
Which position might a child with epiglottitis assume to aid their breathing?
What is the most common cause of epiglottitis in children?
What is the most common cause of epiglottitis in children?
What should NOT be done when examining a throat suspected of epiglottitis?
What should NOT be done when examining a throat suspected of epiglottitis?
Which treatment is indicated for a child diagnosed with epiglottitis?
Which treatment is indicated for a child diagnosed with epiglottitis?
What is a distinguishing symptom of epiglottitis compared to croup?
What is a distinguishing symptom of epiglottitis compared to croup?
What should be avoided in a child with epiglottitis?
What should be avoided in a child with epiglottitis?
What is the recommended prevention strategy for epiglottitis?
What is the recommended prevention strategy for epiglottitis?
What condition is characterized by inflammation of the lung affecting bronchioles and alveoli?
What condition is characterized by inflammation of the lung affecting bronchioles and alveoli?
What is a key sign of bronchiolitis in children?
What is a key sign of bronchiolitis in children?
A child presents with a persistent cough, fever greater than 101.5°F, and use of accessory muscles. These symptoms are indicative of which condition?
A child presents with a persistent cough, fever greater than 101.5°F, and use of accessory muscles. These symptoms are indicative of which condition?
Which laboratory test is used to assess for cystic fibrosis impacting the respiratory system?
Which laboratory test is used to assess for cystic fibrosis impacting the respiratory system?
Which symptom is least associated with a diagnosis of acute nasopharyngitis?
Which symptom is least associated with a diagnosis of acute nasopharyngitis?
What is the most appropriate first step for treating a 3 month old infant with nasal congestion associated with nasopharyngitis?
What is the most appropriate first step for treating a 3 month old infant with nasal congestion associated with nasopharyngitis?
A throat culture is typically avoided in the diagnosis of nasopharyngitis when which of the following is also present?
A throat culture is typically avoided in the diagnosis of nasopharyngitis when which of the following is also present?
A child presents with a sore throat, fever, and a rash described as small and macular. Palpable cervical nodes are also noted. Which condition is MOST likely?
A child presents with a sore throat, fever, and a rash described as small and macular. Palpable cervical nodes are also noted. Which condition is MOST likely?
A child has been diagnosed with acute pharyngitis. Which finding would MOST clearly indicate a viral, rather than a bacterial, etiology?
A child has been diagnosed with acute pharyngitis. Which finding would MOST clearly indicate a viral, rather than a bacterial, etiology?
A child is evaluated for tonsillitis. Which clinical finding would be MOST concerning for a peritonsillar abscess requiring drainage?
A child is evaluated for tonsillitis. Which clinical finding would be MOST concerning for a peritonsillar abscess requiring drainage?
A throat culture is ordered for a child suspected of having tonsillitis. Which of the following is a primary reason for obtaining a throat culture?
A throat culture is ordered for a child suspected of having tonsillitis. Which of the following is a primary reason for obtaining a throat culture?
A child is diagnosed with bacterial tonsillitis and is prescribed penicillin. Which of the following is an appropriate nursing education point for this child and their caregivers?
A child is diagnosed with bacterial tonsillitis and is prescribed penicillin. Which of the following is an appropriate nursing education point for this child and their caregivers?
A child presents with nasal congestion, sore throat, and mild fever lasting for 5 days. According to the text, what is the MOST appropriate initial nursing intervention?
A child presents with nasal congestion, sore throat, and mild fever lasting for 5 days. According to the text, what is the MOST appropriate initial nursing intervention?
If tonsillitis is NOT treated promptly, which of the following complications is MOST serious?
If tonsillitis is NOT treated promptly, which of the following complications is MOST serious?
During a physical assessment of a child with a suspected upper respiratory infection, which diagnostic procedure helps identify the presence of infection in multiple sites?
During a physical assessment of a child with a suspected upper respiratory infection, which diagnostic procedure helps identify the presence of infection in multiple sites?
A child with suspected tonsillitis is being evaluated. Palpation of the neck reveals enlarged lymph nodes. Which of the following statements best explains the significance of this finding?
A child with suspected tonsillitis is being evaluated. Palpation of the neck reveals enlarged lymph nodes. Which of the following statements best explains the significance of this finding?
Which of the following is the PRIMARY indication for a tonsillectomy?
Which of the following is the PRIMARY indication for a tonsillectomy?
Which clinical manifestation is specifically associated with inflammation in the larynx in croup?
Which clinical manifestation is specifically associated with inflammation in the larynx in croup?
What is a common diagnostic tool for diagnosing croup in children?
What is a common diagnostic tool for diagnosing croup in children?
Which treatment is NOT recommended for children diagnosed with croup?
Which treatment is NOT recommended for children diagnosed with croup?
What symptom might indicate that respiratory distress is worsening in a child at night?
What symptom might indicate that respiratory distress is worsening in a child at night?
What age group is primarily affected by acute epiglottitis?
What age group is primarily affected by acute epiglottitis?
What type of pneumonia is characterized by patchy infiltrates on a chest X-ray and is often associated with children older than 5 years?
What type of pneumonia is characterized by patchy infiltrates on a chest X-ray and is often associated with children older than 5 years?
Which symptom is most indicative of bacterial pneumonia rather than viral pneumonia?
Which symptom is most indicative of bacterial pneumonia rather than viral pneumonia?
What is the first-line treatment for atypical pneumonia caused by Mycoplasma pneumoniae?
What is the first-line treatment for atypical pneumonia caused by Mycoplasma pneumoniae?
Which diagnostic tool is least useful for diagnosing viral pneumonia?
Which diagnostic tool is least useful for diagnosing viral pneumonia?
What is a common complication of pneumonia that may occur due to infection?
What is a common complication of pneumonia that may occur due to infection?
Which set of symptoms is most associated with viral pneumonia in children?
Which set of symptoms is most associated with viral pneumonia in children?
What is considered frequent tonsillitis in a patient?
What is considered frequent tonsillitis in a patient?
What respiratory examination finding is expected with a lung infiltrate?
What respiratory examination finding is expected with a lung infiltrate?
In which pneumonia type is a productive cough most prevalent?
In which pneumonia type is a productive cough most prevalent?
Which of the following is a common reason for performing a tonsillectomy?
Which of the following is a common reason for performing a tonsillectomy?
Which of the following is a key aspect of management in viral pneumonia?
Which of the following is a key aspect of management in viral pneumonia?
In post-operative care for tonsillectomy, which of the following should be closely monitored?
In post-operative care for tonsillectomy, which of the following should be closely monitored?
Which antibiotic is recommended as a first-line treatment for otitis media in children?
Which antibiotic is recommended as a first-line treatment for otitis media in children?
Which characteristic differentiates lobar pneumonia from bronchopneumonia?
Which characteristic differentiates lobar pneumonia from bronchopneumonia?
What is a key characteristic of Eustachian tubes in children under three months of age?
What is a key characteristic of Eustachian tubes in children under three months of age?
Which statement about croup is correct?
Which statement about croup is correct?
Which treatment is NOT recommended for managing a child diagnosed with croup?
Which treatment is NOT recommended for managing a child diagnosed with croup?
What complication is associated with untreated or recurrent otitis media?
What complication is associated with untreated or recurrent otitis media?
What is a common posture assumed by a child with epiglottitis to facilitate breathing?
What is a common posture assumed by a child with epiglottitis to facilitate breathing?
Which of the following symptoms is typically absent in a child with epiglottitis but present in croup?
Which of the following symptoms is typically absent in a child with epiglottitis but present in croup?
What is the initial critical step in the management of a child suspected of having epiglottitis?
What is the initial critical step in the management of a child suspected of having epiglottitis?
Which medication is commonly administered as part of the treatment protocol for epiglottitis?
Which medication is commonly administered as part of the treatment protocol for epiglottitis?
What is a key clinical feature of epiglottitis that distinguishes it from other respiratory conditions?
What is a key clinical feature of epiglottitis that distinguishes it from other respiratory conditions?
How should a child suspected of epiglottitis be positioned while waiting for medical intervention?
How should a child suspected of epiglottitis be positioned while waiting for medical intervention?
What is a primary cause of epiglottitis in children?
What is a primary cause of epiglottitis in children?
What sign indicates a potential airway compromise in a child with epiglottitis?
What sign indicates a potential airway compromise in a child with epiglottitis?
Which of the following is NOT a recommended treatment for epiglottitis?
Which of the following is NOT a recommended treatment for epiglottitis?
In what age range is epiglottitis most commonly observed?
In what age range is epiglottitis most commonly observed?
What is a common clinical manifestation of croup in children aged 3 months to 3 years?
What is a common clinical manifestation of croup in children aged 3 months to 3 years?
Which of the following diagnostic tools is commonly used to assess narrowing of the airway in croup?
Which of the following diagnostic tools is commonly used to assess narrowing of the airway in croup?
What is the recommended immediate treatment for a child diagnosed with croup exhibiting severe symptoms?
What is the recommended immediate treatment for a child diagnosed with croup exhibiting severe symptoms?
What symptom is commonly associated with respiratory distress in children experiencing croup?
What symptom is commonly associated with respiratory distress in children experiencing croup?
Which complication is most commonly associated with the need for a tonsillectomy?
Which complication is most commonly associated with the need for a tonsillectomy?
Which medication should be avoided post-tonsillectomy to differentiate bleeding from red dye?
Which medication should be avoided post-tonsillectomy to differentiate bleeding from red dye?
When is otitis media most likely to occur based on age?
When is otitis media most likely to occur based on age?
What is the recommended dose of standard antibiotics for a child with otitis media?
What is the recommended dose of standard antibiotics for a child with otitis media?
Which characteristic of Eustachian tubes in children contributes to an increased incidence of otitis media?
Which characteristic of Eustachian tubes in children contributes to an increased incidence of otitis media?
What behavior can help reduce the risk of recurrent otitis media?
What behavior can help reduce the risk of recurrent otitis media?
What is a common symptom of croup?
What is a common symptom of croup?
What is a common characteristic of bacterial pneumonia compared to viral pneumonia?
What is a common characteristic of bacterial pneumonia compared to viral pneumonia?
Which type of pneumonia is primarily identified by patchy infiltrates on a chest X-ray?
Which type of pneumonia is primarily identified by patchy infiltrates on a chest X-ray?
What is a major complication associated with pneumonia?
What is a major complication associated with pneumonia?
Which of the following laboratory findings is typically associated with bacterial pneumonia?
Which of the following laboratory findings is typically associated with bacterial pneumonia?
Which symptom is less likely to be associated with a viral pneumonia infection?
Which symptom is less likely to be associated with a viral pneumonia infection?
In a child with atypical pneumonia, what symptom might they exhibit?
In a child with atypical pneumonia, what symptom might they exhibit?
Why is promoting pneumococcal immunization important?
Why is promoting pneumococcal immunization important?
Which treatment option is primarily focused on symptom relief for viral pneumonia?
Which treatment option is primarily focused on symptom relief for viral pneumonia?
What can be a sign of respiratory distress in children with pneumonia?
What can be a sign of respiratory distress in children with pneumonia?
Which of the following symptoms, if present in a young child, would least likely suggest a diagnosis of acute nasopharyngitis?
Which of the following symptoms, if present in a young child, would least likely suggest a diagnosis of acute nasopharyngitis?
A child presents with a barking cough, hoarseness, and inspiratory stridor. These symptoms are most likely indicative of which of the following conditions?
A child presents with a barking cough, hoarseness, and inspiratory stridor. These symptoms are most likely indicative of which of the following conditions?
A newborn infant presents with respiratory distress, including nasal flaring and retractions. The most appropriate initial step in management should be:
A newborn infant presents with respiratory distress, including nasal flaring and retractions. The most appropriate initial step in management should be:
What are the three main types of retractions observed in children with respiratory distress?
What are the three main types of retractions observed in children with respiratory distress?
Which of the following is a recommended intervention for a child with nasopharyngitis, specifically for older children and adolescents?
Which of the following is a recommended intervention for a child with nasopharyngitis, specifically for older children and adolescents?
Which of the following is NOT a characteristic of a newborn's respiratory system?
Which of the following is NOT a characteristic of a newborn's respiratory system?
A child with a history of frequent tonsillitis episodes who experiences significant difficulty swallowing, and whose tonsils are repeatedly enlarged, may benefit from which of the following interventions?
A child with a history of frequent tonsillitis episodes who experiences significant difficulty swallowing, and whose tonsils are repeatedly enlarged, may benefit from which of the following interventions?
Which of the following is a TRUE statement regarding the presence of a cough in a child with a respiratory infection?
Which of the following is a TRUE statement regarding the presence of a cough in a child with a respiratory infection?
What is the primary concern associated with retractions in a child with respiratory distress?
What is the primary concern associated with retractions in a child with respiratory distress?
Why is a baby's airway more susceptible to obstruction?
Why is a baby's airway more susceptible to obstruction?
What does "tachypneic" mean in the context of a child's respiratory rate?
What does "tachypneic" mean in the context of a child's respiratory rate?
Which of these conditions are associated with a wheezing sound upon inspiration?
Which of these conditions are associated with a wheezing sound upon inspiration?
What is the primary reason why infants and young children are more vulnerable to respiratory infections?
What is the primary reason why infants and young children are more vulnerable to respiratory infections?
Which of the following statements about the clinical manifestations of epiglottitis is true?
Which of the following statements about the clinical manifestations of epiglottitis is true?
Which of the following is NOT a method of managing a child diagnosed with epiglottitis?
Which of the following is NOT a method of managing a child diagnosed with epiglottitis?
In the comparison between croup and epiglottitis, which of the following statements is accurate?
In the comparison between croup and epiglottitis, which of the following statements is accurate?
What is the primary causative agent of epiglottitis in children?
What is the primary causative agent of epiglottitis in children?
Which of these interventions is critical for a child with epiglottitis before reaching the hospital?
Which of these interventions is critical for a child with epiglottitis before reaching the hospital?
Which of the following conditions requires hospitalization and possible mechanical ventilation?
Which of the following conditions requires hospitalization and possible mechanical ventilation?
What is a major clinical feature that differentiates bronchiolitis from epiglottitis?
What is a major clinical feature that differentiates bronchiolitis from epiglottitis?
What is a critical step in the treatment of epiglottitis?
What is a critical step in the treatment of epiglottitis?
Which emotional state is commonly observed in a child with epiglottitis?
Which emotional state is commonly observed in a child with epiglottitis?
What is the primary preventive measure against epiglottitis?
What is the primary preventive measure against epiglottitis?
Flashcards
Persistent cough
Persistent cough
A continuous cough that may indicate respiratory issues.
Acute Pharyngitis
Acute Pharyngitis
Inflammation of the throat, commonly known as strep throat.
Common Cold
Common Cold
Virally caused illness characterized by nasal congestion and sneezing.
Sweat chloride test
Sweat chloride test
A test used to diagnose cystic fibrosis by measuring sweat electrolyte levels.
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Dysphagia
Dysphagia
Difficulty swallowing, often a symptom in respiratory complications.
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Infant Trachea Size
Infant Trachea Size
The trachea of an infant is half the size compared to an adult's.
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Nose Breathers
Nose Breathers
Infants primarily breathe through their nose, making them prone to obstruction.
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Alveolar Surface
Alveolar Surface
Infants have limited alveolar surface area for gas exchange.
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Respiratory Rates by Age
Respiratory Rates by Age
Normal respiratory rates decrease with age: Infant 30-35/min, Toddler 20-30/min, School-ager 18-20/min, Adolescent 16-20/min.
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Tachypnea
Tachypnea
Rapid breathing; common in respiratory infections (40-100/min).
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Retractions
Retractions
Inward movement of chest wall tissues during inspiration, indicating respiratory distress.
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Temperature Elevation
Temperature Elevation
A sign of potential infection; can spike at night.
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Sputum Color
Sputum Color
The color of sputum can indicate illness: clear (allergy), yellow (infection).
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Incidence of Croup
Incidence of Croup
Most common in children aged 3 months to 3 years, especially in winter.
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Key Symptoms of Croup
Key Symptoms of Croup
Includes hoarseness, barking cough, stridor, retractions, and low-grade fever.
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Croup Diagnosis
Croup Diagnosis
Diagnosis is made via chest x-ray, neck x-ray, and WBC differential.
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Croup Treatment
Croup Treatment
Treatment includes nebulized epinephrine, corticosteroids, fluids, and rest.
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Acute Epiglottitis
Acute Epiglottitis
A medical emergency involving swelling of the epiglottis, commonly in children 2-7 years.
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Frequent Tonsillitis
Frequent Tonsillitis
Defined as at least seven episodes in a year, five in two years, or three in three years.
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Tonsillectomy Indications
Tonsillectomy Indications
Surgical removal of tonsils due to complications like obstructive sleep apnea or swallowing difficulty.
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Post-op Monitoring
Post-op Monitoring
Monitor for frequent swallowing, bleeding, and infection after tonsillectomy.
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Cool Liquid Recommendations
Cool Liquid Recommendations
Post-op patients should have cool, non-acidic, non-carbonated drinks; avoid red liquids.
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Otitis Media
Otitis Media
Inflammation of the middle ear; can be acute or chronic with or without fluid buildup.
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Eustachian Tube Anatomy
Eustachian Tube Anatomy
Children's tubes are shorter and wider, increasing infection risk.
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Croup
Croup
A viral infection causing swelling in the larynx, trachea, and bronchi, leading to breathing difficulties.
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Antibiotic Administration
Antibiotic Administration
Ensure the full course of antibiotics is given for 10 days to prevent recurrence of ear infections.
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Pneumonia
Pneumonia
Inflammation of the lungs affecting gas exchange.
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Lobar pneumonia
Lobar pneumonia
A type of pneumonia affecting one or more lobes of the lung.
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Bronchopneumonia
Bronchopneumonia
Infection of terminal bronchioles and nearby lobules in the lungs.
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Interstitial pneumonia
Interstitial pneumonia
Affects the alveolar walls and surrounding lung tissue.
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Viral pneumonia symptoms
Viral pneumonia symptoms
Mild fever, nonproductive cough, wheezing, resolves in days.
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Bacterial pneumonia symptoms
Bacterial pneumonia symptoms
High fever, productive cough, chest pain, respiratory distress.
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Mycoplasma pneumonia
Mycoplasma pneumonia
Atypical pneumonia common in children, causes patchy infiltrates.
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Sputum culture
Sputum culture
A test to identify bacteria in respiratory secretions.
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Supportive care treatment
Supportive care treatment
Treatment for viral pneumonia focusing on fluids and rest.
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Multisystem Inflammatory Syndrome (MIS-C)
Multisystem Inflammatory Syndrome (MIS-C)
Condition in children causing inflammation across various body parts.
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Epiglottitis
Epiglottitis
Inflammation of the epiglottis, can block the airway.
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High fever in epiglottitis
High fever in epiglottitis
Patients often present with high fever (>102º F) and toxic appearance.
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Tripod position
Tripod position
A posture of leaning forward to facilitate breathing, often seen in epiglottitis.
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Drooling
Drooling
Inability to swallow secretions due to inflammation in epiglottitis.
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Croup vs. Epiglottitis
Croup vs. Epiglottitis
Croup is viral in younger kids; Epiglottitis is bacterial in older children.
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Bacterial Infection (HIB)
Bacterial Infection (HIB)
Haemophilus influenzae type B is the primary cause of epiglottitis.
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Airway compromise
Airway compromise
Swelling can occlude trachea, blocking airflow within minutes.
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Treatment for Epiglottitis
Treatment for Epiglottitis
Involves hospitalization, stabilization, IV antibiotics, and possibly intubation.
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RSV Prevention
RSV Prevention
Synagis (Palivizumab) is an antibody injection used to prevent RSV in high-risk children.
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Respiratory Complications
Respiratory Complications
Conditions like dysphagia and persistent cough that indicate respiratory issues.
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Chest X-ray
Chest X-ray
An imaging test used to rule out infections such as pneumonia.
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Gastric Washings for AFB
Gastric Washings for AFB
A test procedure to detect tuberculosis by examining gastric contents.
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Common Cold Manifestations
Common Cold Manifestations
Symptoms include nasal stuffiness, sneezing, and low-grade fever.
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Treatment for Nasopharyngitis
Treatment for Nasopharyngitis
Includes antipyretics, saline drops, and encouraging fluid intake.
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Acute Pharyngitis Signs
Acute Pharyngitis Signs
Symptoms include sore throat and possible fever, often due to strep.
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Tonsillitis Causes
Tonsillitis Causes
Inflammation of tonsils, primarily caused by Group A strep.
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Symptoms of Tonsillitis
Symptoms of Tonsillitis
Includes severe sore throat, difficulty swallowing, fever, and enlarged tonsils.
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Tonsillitis Diagnosis
Tonsillitis Diagnosis
Conduct throat examination, check for swelling, and throat culture.
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Treatment for Viral Tonsillitis
Treatment for Viral Tonsillitis
Includes warm saline gargles, analgesics, and hydration.
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Antibiotic Options for Strep
Antibiotic Options for Strep
Penicillin, Amoxicillin, and Erythromycin are common treatments.
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Major Complications of Strep
Major Complications of Strep
Potential complications include glomerulonephritis, meningitis, and rheumatic fever.
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Presence of Purulent Matter
Presence of Purulent Matter
Indicates possible bacterial infection in tonsils or throat.
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Chronic Tonsillitis
Chronic Tonsillitis
Frequent episodes requiring tonsillectomy if unresponsive to treatment.
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Differential Diagnosis
Differential Diagnosis
Includes infectious mononucleosis and epiglottitis among others.
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Epiglottitis Symptoms
Epiglottitis Symptoms
High fever, sore throat, difficulty swallowing, drooling due to inflamed epiglottis.
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Tonsillectomy Complications
Tonsillectomy Complications
May involve obstructive sleep apnea, breathing, or swallowing difficulties.
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Frequent Tonsillitis Criteria
Frequent Tonsillitis Criteria
Defined as seven episodes in one year, five in two years, or three in three years.
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Causes of Epiglottitis
Causes of Epiglottitis
Primarily caused by bacterial infection, especially Haemophilus influenzae type B.
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Myringotomy Purpose
Myringotomy Purpose
Facilitates drainage and ventilation of the middle ear during otitis media.
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Drooling in Epiglottitis
Drooling in Epiglottitis
Inability to swallow secretions due to swollen epiglottis, leading to drooling.
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Rapid Decompensation
Rapid Decompensation
Epiglottitis can lead to quick airway blockage; immediate emergency care is crucial.
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Signs of Middle Ear Infection
Signs of Middle Ear Infection
Includes fever and signs of otitis media, such as ear pain.
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High-Risk Age for Epiglottitis
High-Risk Age for Epiglottitis
Most common in children aged 2-7 years.
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Post-op Tonsillectomy Care
Post-op Tonsillectomy Care
Monitor for frequent swallowing, bleeding, and infection after surgery.
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Contraindicated Throat Exam
Contraindicated Throat Exam
Examining the throat in suspected epiglottitis can worsen airway obstruction.
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Acute vs Chronic Otitis Media
Acute vs Chronic Otitis Media
Acute is sudden and painful; chronic lasts longer with less severity.
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Cool Liquid Recommendations Post-op
Cool Liquid Recommendations Post-op
Patients should have non-acidic, non-carbonated, cool drinks; avoid red liquids.
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Antibiotic Treatment for Epiglottitis
Antibiotic Treatment for Epiglottitis
IV antibiotics for 3 days followed by oral for 7-10 days are standard.
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Emergency Response
Emergency Response
Hospitalization and possible intubation are necessary for severe cases of epiglottitis.
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Croup Symptoms
Croup Symptoms
Includes hoarseness, barking cough, stridor, and retractions.
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Comparison of Croup and Epiglottitis
Comparison of Croup and Epiglottitis
Croup is viral and affects younger kids; epiglottitis is bacterial and affects older ones.
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Pneumonia symptoms
Pneumonia symptoms
Inflammation of the lungs causing cough, fever, and difficulty breathing.
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Viral pneumonia
Viral pneumonia
Mild pneumonia with low-grade fever, nonproductive cough, and resolves in 5-7 days.
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Bacterial pneumonia
Bacterial pneumonia
Severe pneumonia with high fever, productive cough, and respiratory distress.
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Diagnosis methods
Diagnosis methods
Includes sputum culture, CXR, WBC count for distinguishing pneumonia types.
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Supportive care
Supportive care
Treatment for viral pneumonia involving fluids and rest.
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Signs of Respiratory Complications
Signs of Respiratory Complications
Symptoms that indicate possible respiratory issues, such as fever and persistent cough.
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Common Cold Causes
Common Cold Causes
Most commonly caused by viruses such as rhinovirus, adenovirus, and RSV.
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Chest X-ray Purpose
Chest X-ray Purpose
Used to rule out respiratory infections like pneumonia by imaging the lungs.
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Key Symptom of Epiglottitis
Key Symptom of Epiglottitis
High fever and difficulty swallowing are primary indicators of inflamed epiglottis.
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Limited Alveolar Surface
Limited Alveolar Surface
Infants have a smaller surface area in their lungs for gas exchange.
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Chest Expansion in Newborns
Chest Expansion in Newborns
Newborns experience poor chest expansion and decreased lung volume.
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Immature Immune System
Immature Immune System
Infants have an underdeveloped immune system, raising infection risk.
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Frequent Tonsillitis Definition
Frequent Tonsillitis Definition
Defined as at least seven episodes in a year, five in two years, or three in three years.
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Otitis Media Types
Otitis Media Types
Inflammation of the middle ear, can be acute, chronic, infectious, or non-infectious.
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Signs of Otitis Media
Signs of Otitis Media
Includes fever and signs of infection like ear pain, especially in children.
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Croup Incidence
Croup Incidence
Most common in children aged 3 months to 3 years, particularly during winter months.
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Signs of Respiratory Distress
Signs of Respiratory Distress
Symptoms include anxiety, tachypnea, retractions, and cyanosis in severe cases.
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Diagnosis of pneumonia
Diagnosis of pneumonia
Involves sputum culture, CXR to check for consolidations, and WBC count.
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Complications of pneumonia
Complications of pneumonia
Include pleural effusion and abnormal breath sounds over infiltrates.
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Supportive care for viral pneumonia
Supportive care for viral pneumonia
Involves fluids, rest, and sometimes oxygen therapy; antibiotics are not used.
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Epiglottitis Causes
Epiglottitis Causes
Bacterial infection primarily caused by Haemophilus influenzae type B.
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Signs of Epiglottitis
Signs of Epiglottitis
Includes high fever, extreme sore throat, drooling, and absence of cough.
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Emergency Response for Epiglottitis
Emergency Response for Epiglottitis
Immediate hospitalization and possible intubation required for airway obstruction.
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Hospitalization Treatment
Hospitalization Treatment
Includes IV antibiotics, corticosteroids, and keeping the child NPO.
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Bacterial vs Viral Infections
Bacterial vs Viral Infections
Epiglottitis is a bacterial infection, while croup is viral.
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Clinical Manifestations of Epiglottitis
Clinical Manifestations of Epiglottitis
Manifestations include toxic appearance, high fever, and anxious demeanor.
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Anatomical Differences
- Infant's trachea and lower airway are half the size of an adult's.
- Infants are primarily nose breathers, making them more susceptible to airway obstruction.
- Newborns have a limited alveolar surface area for gas exchange.
- Poor chest expansion and decreased lung volume occur during expiration in newborns.
- Immature immune systems and a lack of surfactant increase susceptibility to respiratory infections.
- Infants have greater metabolic and oxygen demands.
Bifurcation in Infants
- Bifurcation in infants is larger than in adults.
- Trachea in infants is smaller than in adults.
Respiratory Assessment of Infants and Children
-
Normal respiratory rates vary by age:
- Infants (30-35 breaths/min)
- Toddlers/Preschoolers (20-30 breaths/min)
- School-agers (18-20 breaths/min)
- Adolescents (16-20 breaths/min)
-
Assess respiratory rate, depth, and rhythm on the chest.
-
Check for tachypnea (rapid breathing) which can indicate respiratory infections (40-100 breaths/min).
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Note the ease of respirations.
-
Assess for dyspnea (difficulty breathing).
Retractions
- Retractions are inward movements of soft tissues in the chest wall during inhalation.
- They indicate increased respiratory effort and are a sign of impending respiratory failure.
- Respiratory infections often cause dyspnea and retractions.
- Intercostal retractions occur around the ribs.
- Substernal retractions are seen on the sides of the sternum.
- Suprasternal retractions are evident near the trachea in severe respiratory distress.
Caring for a Child With a Respiratory Infection
- Monitor temperature (can spike at night).
- Observe nasal discharge (clear, yellow, or green).
- Assess for presence of cough (moist, dry, productive, or non-productive).
- Note pain location (chest, muscles used for coughing - anterior or posterior).
- Look for sputum color and frequency of swallowing.
- Check for presence of wheezing or stridor (during inspiration or expiration).
- Evaluate odor of breath.
Early Manifestations of Respiratory Complications
- Dysphagia (difficulty swallowing)
- Use of accessory muscles
- Listlessness
- Persistent cough
- Earache
- Fever greater than 101.5°F
Common Laboratory Tests for Respiratory Diseases
- Chest X-ray (rule out infections like pneumonia)
- Fluorescent antibody testing
- Gastric washings for AFB
- Pulmonary Function Tests (peak expiratory flow rate)
- Rapid flu, rapid strep tests
- Sweat chloride test (cystic fibrosis)
Acute Infectious Respiratory Disorders
- Common cold (acute nasopharyngitis)
- Strep throat (acute pharyngitis)
- Tonsillitis
- Otitis media
- Acute laryngitis
- Croup syndromes
- Acute epiglottitis
- Bronchiolitis & RSV
- Pneumonia
- Bronchitis
Common Pediatric Respiratory Disorders
- Nasopharyngitis ("common cold")
- Causative agents: rhinovirus, adenovirus, influenza, RSV, parainfluenza viruses.
- Can include: nasal stuffiness, sneezing, nasal discharge, coughing, sore throat, low-grade fever, irritability, poor feeding, vomiting, and diarrhea.
Nasopharyngitis (Diagnosis and Treatment)
- Diagnosis, usually afebrile and normal WBC count. RADT if sore throat is the main complaint.
- Treatment: antipyretics, non-aspirin analgesics, saline nose drops/suctioning; encourage fluid intake to prevent dehydration. Cough suppressants and decongestant nasal drops can be used for older children only.
Acute Pharyngitis
- Often called "sore throat."
- Can be Group A strep (15-30% of cases).
- Look for exudate, white patches, secretions, palpable cervical nodes, scarlatiniform rash (redness in small macular rash)
- Treatment involves nursing care (education on gargles), completing antibiotic therapy (Penicillin or Cephalexin if allergic to PCN), hydration, and pain relief.
Tonsillitis
- Tonsils are lymphoid tissues in the oropharynx protecting from invading organisms.
- Inflammation or infection of the palatine tonsils can cause peritonsillar abscess (swollen, enlarged, purulent matter).
- Causative agent: Group A beta-hemolytic streptococci (GABHS).
- Potential complications (if untreated): otitis media, scarlet fever, suppurative infection of tissues, glomerulonephritis, meningitis, and rheumatic fever.
Clinical Manifestations of Tonsillitis
- Sore throat and difficulty swallowing
- Fever
- Nasal congestion
- Pain and headache
- Nausea and vomiting
- Diarrhea
- Enlarged tonsils and adenoids
- Kissing tonsils (3+ or 4+)
- Halitosis (bad breath)
- Purulent drainage
Diagnosis of Tonsillitis
- Examine throat, ears, and nose using an otoscope.
- Check for scarlatina (a rash).
- Palpate the neck for enlarged lymph nodes.
- Listen to breath sounds bilaterally.
- Check for splenomegaly (enlarged spleen).
- Perform CBC and throat culture.
Differential Diagnoses
- Acute tonsillitis
- Infectious mononucleosis
- Epiglottitis
- Peritonsillar abscess
- Retropharyngeal abscess
- Diphtheria
- HIV infection
Treatment of Tonsillitis
- Antipyretics and non-aspirin analgesics (for viral tonsillitis).
- Antibiotics for bacterial tonsillitis.
- Tonsillectomy may be considered for recurring or chronic cases, especially when antibiotic treatment isn't effective.
- Adenoidectomy may be needed if both tonsils and adenoids are affected.
Treatment - Antibiotic Therapy
- Treatment options depend on confirming Group A beta-hemolytic streptococcus infections with antigen testing or throat culture.
- Primary options include penicillin V potassium (dosage depends on child's weight and age).
- Secondary options (if allergic to PCN): azithromycin, clarithromycin, erythromycin.
Treatment - Surgery (outpatient)
- Tonsillectomy may be performed for frequent, chronic or bacterial tonsillitis that doesn't respond to antibiotics
- Indications for tonsillectomy: At least 7 episodes in the preceding year; At least 5 episodes a year in the past two years; At least 3 episodes a year in the past three years.
- Potential complications of tonsillitis that warrant tonsillectomy: obstructive sleep apnea, breathing difficulty, trouble swallowing (particularly solid foods), and abscess that doesn't improve with antibiotics.
Patient Education (Post-op)
- Assess for frequent swallowing (early sign of bleeding).
- Monitor for bleeding (from the nose or throat).
- Advise children not to cough or blow their nose (to avoid causing trauma).
- Offer crushed ice and sips of water as first means of controlling bleeding; ice/sips of water are for controlling bleeding and decreasing facial swelling.
- Provide cool (non-carbonated, non-acidic) liquids (avoid red drinks and foods as they can be mistaken for blood).
- Promote cool humidification.
- Administer acetaminophen for pain relief. Administer an ice collar for pain relief, especially to the neck
Otitis Media
- Inflammation of the middle ear.
- Can be acute, chronic, infectious, or noninfectious.
- Fluid may build up in the middle ear (effusion), sometimes clear or pus-like (purulent).
- Peak incidence: 6–12 months, winter months.
- Eustachian tubes are wider, shorter, and straighter in children under 3 years; fluid drainage may be inadequate.
- Common causes: Viral infections, Streptococcus pneumoniae, Haemophilus influenzae (often precipitated by influenza or RSV), which causes respiratory infection along with the OM infection.
- Eustachian tube dysfunction can lead to fluid accumulation in the middle ear, causing hearing impairment.
- Rupture of the tympanic membrane can result from untreated otitis media.
- Facial malformations, like Down Syndrome and cleft lip/palate, can increase vulnerability to OM.
Clinical Manifestations of Otitis Media
- Pain (tugging, pulling).
- Fever.
- Irritability.
- Diarrhea and vomiting.
- Symptoms of URI (common cold).
- Complications: hearing loss, or speech delays due to frequent ear infections.
Diagnosis of Otitis Media
- Otoscopic examination (inspection with otoscope).
- Pneumatic otoscopic assessment (evaluating tympanic membrane movement with air).
Differential Diagnoses of Otitis Media
- Acute Otitis Media
- Myringitis
- Mastoiditis
- Cholesteatoma
Treatment of Otitis Media
- Initial: wait-and-see approach (especially if viral).
- Oral antibiotics (10 days) if bacterial.
- Secondary options if allergic to penicillin: Cefdinir, Cefuroxime axetil.
- Myringotomy with tympanostomy tube insertion (in certain cases).
Patient Education (Otitis Media)
- Teach parents how to administer antibiotic therapy for the full course.
- Educate parents on monitoring fever and other OM symptoms.
- Inform parents that secondary smoke exposure can cause recurrent OM infections.
- Encourage breastfeeding because breast milk provides good drainage to the ear.
- Possible temporary or permanent hearing loss.
Croup (Laryngotracheobronchitis)
- Viral infection of the larynx, trachea, and large bronchi.
- Swelling of the mucosa and muscle spasms in the upper airway.
- Peak incidence: children 3 months to 3 years of age.
- Common causes: parainfluenza viruses, influenza viruses, RSV, adenoviruses, commonly occurs in winter months,
- Rare cases may require hospitalization.
Clinical Manifestations of Croup
- Hoarseness (laryngeal swelling)
- Barking cough (laryngeal swelling and inflammation)
- Inspiratory stridor (narrowing of the glottic area)
- Suprasternal retractions
- Anxiety and air hunger
- Nasal drainage
- Sore throat and rhinorrhea
- Low-grade fever
- Tachycardia and tachypnea
- Wheezing
- Fatigue
- Pallor or cyanosis
- Lateral neck X-ray (may reveal narrowing)
Diagnosis & Treatment of Croup
- Diagnosis: CXR, neck X-ray, WBC count with differential
- Treatment: Nebulized racemic epinephrine, one dose of corticosteroids (dexamethasone), fluids, rest, cool mist (avoid steamy showers).
Patient Care (Croup)
- Ensure patent airway
- Humidity and supplemental oxygen
- Upright position for ventilation
- Emergency intubation equipment at bedside
- Administer medications
- Informing parents of symptom changes, especially worsening at night, and how to recognize respiratory distress signs.
Acute Epiglottitis
- A type of croup, considered a medical emergency.
- Inflammation and swelling of the epiglottis primarily affecting children aged 2 to 7 years.
- Life-threatening because the swelling blocks the airway and can occlude the trachea within minutes.
- Contraindicated: Examination of the throat (can further compromise the airway).
- Causative agent: Bacterial infection (commonly Haemophilus influenzae type B).
Clinical Manifestations of Acute Epiglottitis
- Sudden onset, previously healthy child. Often sudden illness with high fever (over 102°F).
- Toxic appearance (overall presentation)
- Anxious, fearful
- Mouth open and neck extended (tripod position)
- Drooling (cannot swallow secretions due to inflamed epiglottis)
- Absence of cough
- Extreme sore throat; with cherry-red, swollen epiglottis
- Rapid deterioration/decompensation. Requires immediate ED/OR visit to protect airway
Diagnosis & Treatment of Acute Epiglottitis
- Diagnosis: Hospitalization, CXR, blood cultures, and gases performed in OR.
- Treatment: IV antibiotics (3 days, followed by oral antibiotics 7-10 days); corticosteroids; antipyretics (for fever and sore throat); emotional support; discuss HIB vaccination.
Bronchiolitis
- Inflammation of the bronchioles with edema and excess mucus accumulation.
- Air trapping and atelectasis result from increased airway resistance.
- RSV is the primary causative agent.
- Commonly occurs during winter and spring months, often starting as early as September.
- Peak incidence: 6 months.
- Begins with mild upper respiratory infection (URI), and can progress to hypoxemia and respiratory acidosis due to air trapping and atelectasis.
Clinical Manifestations of Bronchiolitis
- Symptoms of URI (air hunger, congestion, cough, rhinitis)
- Wheezing
- Tachypnea (>70 breaths/min)
- Nasal flaring
- Retractions
- Crackles/rales
- Intermittent cyanosis
- Apneic episodes
- Marked diminished breath sounds.
- Uncomplicated bronchiolitis resolves within 7-10 days.
Diagnosis & Treatment of Bronchiolitis
- Diagnosis: CXR (revealing air trapping and infiltrates), most cases are managed at home with rest, fluids, and fever management.
- Treatment: Supportive care (fluids, rest, adequate oxygen intake, fever control, and monitoring pulse oximetry).
- Possible mechanical ventilation (hospitalization) for cases with respiratory distress or failure.
- Ribavirin (aerosol antiviral medication) can be used in specific cases (high-risk children).
- Synagis or Palivizumab (antibody injections) for prevention in high-risk infants.
Patient Education (Bronchiolitis)
- Teach parents on administering antibiotics and recognizing signs and symptoms of RSV infection.
- Educate parents on monitoring for fever, respiratory distress signs, and how to administer the full course of antibiotics.
- Instruct parents on administering appropriate supportive care, including fluids, rest, and monitoring for signs of respiratory distress or worsening symptoms.
- Teach parents how to recognize signs of respiratory distress (and complications).
Pneumonia
- Lung inflammation affecting bronchioles and alveoli.
- Common causes: Viral infections (RSV, parainfluenza, influenza); bacterial infections (S. Pneumoniae, atypical bacteria like Mycoplasma Pneumoniae).
- Types of Pneumonia:
- Lobar pneumonia (one or more lobes)
- Bronchopneumonia (terminal bronchioles and nearby lobules)
- Interstitial pneumonia (confined to alveolar walls, peribronchial and interlobular tissue).
Clinical Manifestations of Pneumonia
- Fever, cough, crackles (or rales), wheezing, possible transient lobar infiltrates on CXR; symptoms may progress in terms of severity & appearance of symptoms..
- Viral Pneumonia: mild low-grade fever, no productive cough, rhinitis, symptoms last 5-7 days, wheezing, tachypnea, and increased respiratory distress.
- Bacterial Pneumonia: high fever, productive cough, ill appearance, retractions, grunting respirations, chills, chest pain, respiratory distress, restlessness, and anxiety.
- Usually occurs after viral infection
Diagnosis & Treatment of Pneumonia
- Diagnosis: Sputum culture, CXR (patchy infiltrates, consolidation, fluid), arterial blood gases, WBC count.
- Treatment: Supportive care (fluids, rest) and antibiotics if bacterial (often macrolides), acetaminophen or ibuprofen for fever and pain, and oxygen therapy or chest physiotherapy as needed.
Mycoplasma Pneumonia
- Atypical pneumonia.
- Similar to viral pneumonia.
- More common in school-aged children (over 5 years).
- CXR often reveals patchy infiltrates.
- Elevated WBC count.
- Symptoms include: sudden fever, chills, diffuse crackles/wheezes, hacking nonproductive cough, and sore throat.
COVID-19 and Children (MIS-C)
- Condition where different body parts (heart, lungs, kidneys, brain, skin, eyes, and the gastrointestinal organs) become inflamed in children. This inflammation develops due to infection with the COVID-19 virus or exposure to someone infected with the virus.
- Symptoms: fever, abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, feeling extra tired.
- Usually resolves with treatment, but it's important to receive medical attention due to the potential for the condition to be serious and even life-threatening.
Symptoms
- Fever
- Abdominal pain
- Vomiting
- Diarrhea
- Neck pain
- Rash
- Bloodshot eyes
- Feeling extra tired
- Be aware that not all children will have all the same symptoms.
Diffuse, red, patchy rash on torso
Case Study (Infant Follow-up)
- Highest priority: Decreased pulse oximeter saturation (indicating respiratory distress). Increased temperature, increased heart rate, and decreased bowel sounds are also important but less immediately critical.
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Description
Test your knowledge on the respiratory anatomy and common conditions seen in children. This quiz covers characteristics of a newborn's respiratory system, normal respiratory rates for toddlers, and various respiratory issues faced by children. Ensure you understand the clinical manifestations and treatments related to pediatric pneumonia and respiratory distress.