Chapter 25 The Child with a Respiratory Disorder
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Questions and Answers

Which type of receptors can sense oxygen concentration in the blood and signal the brainstem to modify respiration?

  • Mechanoreceptors
  • Chemoreceptors (correct)
  • Photoreceptors
  • Baroreceptors

Why should routine immunizations be delayed after a child receives antiviral medications?

  • Antiviral medications affect the integrity of immunizations. (correct)
  • Antiviral medications directly reduce the immune response.
  • Antiviral treatments improve vaccine efficacy.
  • Antiviral medications can cause increased inflammation.

What class of medications are Accolate and Zyflo, and what are their primary functions?

  • Beta-agonists that cause vasodilation
  • Antihistamines that decrease mucus production
  • Leukotriene modifiers that block inflammation and provide bronchodilation (correct)
  • Corticosteroids that suppress immune responses

What is one of the roles of chemoreceptors in respiratory physiology?

<p>They sense oxygen levels and help control respiration. (C)</p> Signup and view all the answers

Which of the following statements about leukotriene modifiers is true?

<p>They block the inflammatory response and can provide bronchodilation. (B)</p> Signup and view all the answers

What is the recommended treatment for a child with a positive throat culture for group A hemolytic streptococcus?

<p>Oral penicillin for 10 days (B)</p> Signup and view all the answers

Which initial intervention should a nurse recommend for a child experiencing laryngeal spasm?

<p>Take the child to the bathroom and turn on a hot shower (D)</p> Signup and view all the answers

What might frequent swallowing indicate in a child after a tonsillectomy and adenoidectomy?

<p>Bleeding from the surgical site (C)</p> Signup and view all the answers

Which fluid replacement option is best for a child who has just undergone a tonsillectomy?

<p>A popsicle (B)</p> Signup and view all the answers

What finding while auscultating an infant with respiratory syncytial virus should be reported immediately?

<p>Quiet chest from previous assessment of wheezing (B)</p> Signup and view all the answers

When assessing a child hospitalized for an acute asthma attack, what classic sign should the nurse expect to auscultate?

<p>Expiratory wheezing (D)</p> Signup and view all the answers

Which action should the nurse prioritize when caring for a child with a suspected laryngeal spasm?

<p>Create a high-humidity environment (B)</p> Signup and view all the answers

What assessment finding following a tonsillectomy may indicate early signs of a complication?

<p>Frequent swallowing (D)</p> Signup and view all the answers

What is the primary dietary recommendation for children with cystic fibrosis?

<p>High-protein, high-calorie diet (D)</p> Signup and view all the answers

What is the best approach to prevent bronchopulmonary dysplasia in newborns?

<p>Prevention of preterm birth (C)</p> Signup and view all the answers

Which of the following signs are NOT included in the allergic salute associated with chronic allergy?

<p>Productive cough (D)</p> Signup and view all the answers

Which types of sports should be encouraged for children with asthma?

<p>Swimming and gymnastics (B)</p> Signup and view all the answers

What symptom is associated with meconium ileus in a newborn?

<p>Abdominal distension (A)</p> Signup and view all the answers

Which of the following behaviors is appropriate to include when teaching pursed-lip breathing?

<p>Inhale deeply through the nose (C)</p> Signup and view all the answers

In caring for a toddler with pneumonia, which action should be prioritized?

<p>Consider the child's age and developmental level (A)</p> Signup and view all the answers

What symptom might lead a nurse to suspect sinusitis in a first-grade student?

<p>Evidence of a cold for over 10 days (D)</p> Signup and view all the answers

What sign might alert a nurse to the presence of epiglottitis in a child?

<p>Restlessness and drooling (D)</p> Signup and view all the answers

Which of the following should be discouraged for children with asthma?

<p>Playing with stuffed toys (C)</p> Signup and view all the answers

Which of these indicates a need for asthma action plan review?

<p>Increased emergency room visits due to asthma (B)</p> Signup and view all the answers

What is a crucial aspect of nutrition management for children with cystic fibrosis?

<p>Add pancreatic enzyme powder with non-fat food (B)</p> Signup and view all the answers

What is a significant nursing intervention for a child undergoing treatment for bronchopulmonary dysplasia?

<p>Monitor the child for signs of respiratory distress (D)</p> Signup and view all the answers

Which of the following is a common sign of meconium ileus in newborns?

<p>Enlarged abdomen (C)</p> Signup and view all the answers

What is the most comfortable position for a child experiencing an acute asthma attack to maximize breathing efforts?

<p>Sitting upright with arms resting on a table (D)</p> Signup and view all the answers

When should a child with exercise-induced asthma inhale Cromolyn?

<p>Before exercise to prevent attacks (A)</p> Signup and view all the answers

To effectively clear nasal passages in an infant with a cold, what method is recommended?

<p>Removing secretions with a bulb syringe (A)</p> Signup and view all the answers

What should parents of a child with cystic fibrosis understand about the inheritance of the disease?

<p>Both parents must be carriers of the CF gene (A)</p> Signup and view all the answers

Which fluid is most appropriate to offer a 5-year-old asthmatic child to compensate for fluid loss due to dyspnea?

<p>Room temperature water (B)</p> Signup and view all the answers

What is a primary nursing diagnosis for an infant hospitalized with RSV bronchiolitis?

<p>Ineffective breathing pattern related to airway inflammation (B)</p> Signup and view all the answers

What teaching should be included regarding the use of a dry powder inhaler for asthma?

<p>Rinse the mouth after inhaling the powder to prevent irritation (A)</p> Signup and view all the answers

What is the highest risk period for pulmonary edema in a smoke inhalation injury patient?

<p>72 hours after exposure (B)</p> Signup and view all the answers

What indicates that a child's parents understand how to perform respiratory therapy correctly?

<p>Postural drainage is done before aerosol therapy (C)</p> Signup and view all the answers

When should pancreatic enzymes be administered to a child with cystic fibrosis?

<p>With every meal and snack (B)</p> Signup and view all the answers

Which symptom indicates the child with laryngotracheobronchitis is experiencing increased respiratory obstruction?

<p>Restlessness (A)</p> Signup and view all the answers

What should be avoided when providing fluids to an asthmatic child to prevent increased bronchospasm?

<p>Carbonated drinks (A)</p> Signup and view all the answers

What significant education should a nurse provide to prevent sudden infant death syndrome (SIDS)?

<p>Place infants on their backs or sides for sleep (A)</p> Signup and view all the answers

Flashcards

Group A strep throat treatment

10 days of oral penicillin, even if symptoms improve.

Laryngeal spasm intervention

High humidity environment, like a hot shower.

Post-tonsillectomy/adenoidectomy swallowing

Frequent swallowing may indicate bleeding.

Post-tonsillectomy fluid

Offer clear liquids, like popsicles, initially.

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RSV quiet chest

Quiet chest after wheezing suggests airway occlusion.

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Asthma attack breath sound

Expect expiratory wheezing.

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Infant respiration rate decrease

Normal change; usually not a cause for immediate concern.

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Infant heart rate decrease

Normal change; usually not a cause for immediate concern.

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Wheezing in Asthma

A whistling sound during breathing, especially when exhaling, caused by narrowed airways in an asthma attack.

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Positioning for Asthma

Place the child with arms resting on the overbed table to aid breathing.

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Cromolyn for Exercise-Induced Asthma

A preventative medication taken before exercise to reduce asthma symptoms.

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Cystic Fibrosis Inheritance

Both parents must carry the CF gene for the child to inherit the condition.

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Respiratory Treatments for CF

Nebulization (aerosol therapy) should be followed by postural drainage, ideally before meals.

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Pancreatic Enzymes for CF

Oral pancreatic enzymes are given with every meal and snack to aid digestion and absorption.

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Clearing Infant Nostrils

Use a bulb syringe to remove nasal secretions after instilling saline drops.

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Fluids for Asthma

Offer room temperature water to a child with asthma to prevent extra irritation.

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Theophylline Toxicity

Signs include stomachache, tachycardia, and sweating.

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Preventing SIDS

Place infants on their backs or sides for safe sleep.

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Priority Intervention for RSV Bronchiolitis

Focus on ineffective breathing pattern due to airway inflammation and increased secretions.

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Increased Respiratory Obstruction in Laryngotracheobronchitis

Restlessness is a key sign of worsening airway obstruction.

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Mouth Rinse After Dry Powder Inhaler

Rinse the mouth to prevent candidiasis (yeast) infection.

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Smoke Inhalation Pulmonary Edema

Pulmonary edema can appear up to 72 hours after smoke inhalation injury.

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Cystic Fibrosis Care

Provide chest physiotherapy before meals to clear airways.

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Chemoreceptors and Respiration

Chemoreceptors, located in the blood vessels and brain, monitor oxygen levels. When oxygen is low, they signal the brainstem to increase breathing rate and depth to deliver more oxygen to the body.

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Antiviral Medications and Immunizations

After receiving antiviral medications, like those used for respiratory syncytial virus (RSV), routine immunizations should be delayed for a few months. This is because the antivirals can temporarily weaken the body's immune response.

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What are leukotriene modifiers?

Leukotriene modifiers are medications used to treat asthma. They block the release of leukotrienes, chemicals that cause inflammation and bronchoconstriction (narrowing of the airways).

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How do leukotriene modifiers work?

Leukotriene modifiers have two main actions: they block the inflammatory response, reducing swelling and irritation in the airways, and they also provide bronchodilation, opening up the airways to ease breathing.

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What are some examples of leukotriene modifiers?

Some examples of leukotriene modifiers include Accolate (montelukast) and Zyflo (zileuton).

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Bronchopulmonary Dysplasia (BPD)

A condition where the walls of the tiny air sacs in the lungs thicken and become stiff, making it difficult to breathe. This usually happens in premature babies who need oxygen and ventilation for a long time.

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Allergic Salute

A cluster of signs that indicate a child has chronic allergies, including mouth breathing, a crease across the nose, dark circles under the eyes, and red eyes.

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Asthma-Friendly Sports

Sports that involve short bursts of energy, like swimming, gymnastics, and baseball, are better suited for asthmatic children.

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Meconium Ileus

A blockage in the newborn's small intestines caused by thick, sticky meconium. Signs include a swollen belly, vomiting, and no bowel movements.

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Pursed-Lip Breathing

A technique to help manage asthma symptoms by slowing down breathing and keeping airways open. Inhale deeply through the nose and exhale slowly through pursed lips.

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Bed Rest for Toddlers

For toddlers, bed rest doesn't mean complete inactivity. Provide age-appropriate play activities that promote minimal movement.

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Sinusitis in Children

Inflammation of the sinuses, often presenting as a prolonged cold, tooth pain, dark circles under the eyes, and bad breath.

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Epiglottitis

A serious infection of the epiglottis, the flap at the back of the throat that controls breathing. Symptoms include drooling, a hoarse cough, and difficulty breathing.

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Asthma Triggers to Avoid

Things that can trigger asthma attacks include stuffed toys, dust mites, and pets. Some physical activities, like basketball, can also be triggering.

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Cystic Fibrosis Diet

Children with CF need a high-protein, high-calorie diet to maintain adequate nutrition. Pancreatic enzymes should be taken with meals to aid in digestion.

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Chest Physiotherapy

A technique used to help clear mucus from the lungs. Should be done between meals to minimize discomfort.

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Daily Weight Monitoring

Children with cystic fibrosis should be weighed daily to monitor for weight loss or gain, which can be indicators of disease progression or treatment effectiveness.

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H. influenzae type B

A bacterium that can cause serious infections, including epiglottitis, meningitis, and pneumonia. Vaccines are available to prevent these illnesses.

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Study Notes

Group A Hemolytic Streptococcus Throat Culture

  • Positive throat culture requires 10 days of oral penicillin treatment, even if symptoms resolve before the medication is finished.

Laryngeal Spasm in Children

  • High humidity environment (e.g., hot shower) is crucial to manage laryngeal spasm, as humidity liquefies secretions.

Post-Tonsillectomy/Adenoidectomy (T&A) Care

  • Frequent swallowing post-T&A may indicate bleeding.
  • Offer small amounts of clear liquids, like popsicles, to reduce irritation.

Respiratory Syncytial Virus (RSV) Assessment

  • A quiet chest after wheezing indicates a serious concern (potential respiratory arrest) and requires immediate reporting.
  • Other signs (decreased RR, decreased HR, O2 sat of 90%) are not immediate concerns.

Acute Asthma Attack Assessment and Management

  • Expiratory wheezing is a classic sign of an acute asthma attack.
  • Position the child upright with arms supported on the overbed table for optimal breathing efforts.
  • Avoid carbonated beverages.

Exercise-Induced Asthma

  • Inhaled cromolyn is used before exercise to prevent attacks, not during or after.

Cystic Fibrosis (CF) Inheritance

  • CF requires both parents to carry the CF gene.

Respiratory Therapy for CF

  • Postural drainage after nebulization for CF patients.
  • Schedule treatments before meals or one hour after meals to avoid vomiting.

CF Nutritional Considerations

  • Pancreatic enzymes are crucial for nutrient digestion and absorption in CF patients.

Infant Nasal Congestion Relief

  • Use a bulb syringe to clear nasal secretions.

Fluid Management for Asthmatic Children

  • Room temperature water is the most suitable choice for fluid replenishment to avoid inducing spasms.

Theophylline Toxicity

  • Symptoms like stomach ache, tachycardia, and profuse sweating suggest theophylline toxicity.

Sudden Infant Death Syndrome (SIDS) Prevention

  • Place infants on their backs or sides to sleep on a firm mattress to prevent SIDS.

RSV Bronchiolitis Priority Nursing Diagnosis

  • Ineffective breathing pattern related to airway inflammation and increased secretions is the primary concern in RSV bronchiolitis.

Acute Laryngotracheobronchitis (LTB) Assessment

  • Restlessness is an indicator of increasing respiratory obstruction in LTB.

Dry Powder Inhaler Use

  • Rinse the mouth after using a dry powder inhaler to prevent candidiasis.

Smoke Inhalation Injury

  • Pulmonary edema risk is highest in the first 72 hours following a smoke inhalation injury.

Cystic Fibrosis Care Planning

  • Ensure a high-protein, high-calorie diet.

Bronchopulmonary Dysplasia (BPD) Prevention

  • Prevention of premature birth is the key to preventing BPD.

Allergic Salute Signs

  • The allergic salute includes features like mouth breathing, transverse nasal crease, dark circles, and reddened conjunctiva.

Sports Recommendations for Asthmatic Children

  • Suitable sports for children with asthma include swimming, gymnastics, and baseball (avoid prolonged exertion).

Meconium Ileus Newborn Assessment

  • Abdominal distention, vomiting, and absence of stool are signs of meconium ileus.

Pursed-Lip Breathing Technique

  • Inhale deeply through the nose with mouth closed.
  • Exhale through the mouth in a controlled manner, not forced.
  • Exhalation should be longer than inhalation.

Toddler with Pneumonia Care

  • Tailor bed rest to the toddler's age and developmental level, focusing on light play activities.

Sinusitis in Children

  • Possible symptoms include tooth pain, a cold lasting two weeks, periorbital swelling, and bad breath (halitosis).

Epiglottitis Assessment

  • Infants with epiglottitis may exhibit restlessness, an edematous epiglottis, drooling, and a preference for sitting up.

Asthma Prevention Measures

  • Discourage stuffed toys and basketball, and encourage pet ownership (certain types).

Chemoreceptors in Respiration

  • Chemoreceptors sense blood oxygen and signal the brain to adjust breathing.

RSV Immunization Deferral

  • Routine immunizations are delayed for 9 months (post antiviral treatment) to prevent vaccine interference.

Leukotriene Modifiers

  • Leukotriene modifiers block inflammation and enhance bronchodilation.

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Test your knowledge on the management of throat and respiratory conditions in children. This quiz covers critical topics such as Group A Streptococcus treatment, laryngeal spasm, post-tonsillectomy care, respiratory syncytial virus assessment, and acute asthma management. Assess your understanding of key signs and interventions in pediatric respiratory care.

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