The child with a respiratory disorder #2

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Questions and Answers

What is the main reason toddlers have increased immunity and experience fewer respiratory tract infections as they age?

Repeated exposure to organisms causes increased immunity. (correct)

Secondary infections frequently occur after viral illnesses.

Viral organisms are more prevalent in the population.

The amount of lymphoid tissue decreases.

Which term is used to describe labored breathing in a child?

Orthopnea

Dyspnea (correct)

Hypopnea

Tachypnea

Why are cool-mist vaporizers preferred over steam vaporizers for treating respiratory infections in children?

They dry respiratory secretions.

They are more expensive.

They are safer. (correct)

They are less effective.

Which condition is characterized by difficulty breathing except when in an upright position?

Orthopnea Signup and view all the answers

What is the role of lymphoid tissue in the respiratory system of toddlers as they grow older?

It plays a role in immune response. Signup and view all the answers

Which statement about the prevalence of viral organisms among older children is accurate?

Older children can better resist invading organisms. Signup and view all the answers

In the treatment of respiratory conditions, what is the main purpose of using decongestant nose drops in a 10-month-old infant?

To relieve nasal congestion. Signup and view all the answers

What is a common misconception regarding the effects of steam vaporizers compared to cool-mist vaporizers?

Steam vaporizers dry respiratory secretions. Signup and view all the answers

In the context of respiratory failure, what indicates metabolic acidosis?

pH less than 7.35 and CO2 low Signup and view all the answers

What is indicated by a pH of 7.48 and CO2 of 33?

Respiratory alkalosis Signup and view all the answers

Which instruction is incorrect for using a peak expiratory flowmeter?

Perform the reading at irregular times. Signup and view all the answers

How often should the pulse oximetry status of a child receiving oxygen be monitored in acute asthma?

Continuous Signup and view all the answers

What induration size on a TST indicates a positive result for an HIV positive adolescent?

5 mm Signup and view all the answers

Which of the following correctly describes metabolic alkalosis?

pH greater than 7.45 and CO2 low Signup and view all the answers

If a child has an acute asthma episode, what is the primary concern when providing care?

Providing continuous oxygen monitoring Signup and view all the answers

When using the peak expiratory flowmeter, how many readings should be taken to ensure accuracy?

Three readings with a 30-second pause Signup and view all the answers

What does acidosis indicate regarding pH and CO2 levels?

pH less than 7.35, CO2 greater than 45 Signup and view all the answers

What is the impact of performing the peak flowmeter readings incorrectly?

Misinterpretation of asthma severity Signup and view all the answers

What is a recommended duration for using vasoconstrictive nose drops to avoid rebound congestion?

No more than 3 days Signup and view all the answers

What is the most appropriate nursing intervention for an infant with a fever and upper respiratory infection?

Give small amounts of fluids frequently Signup and view all the answers

When should a parent notify a healthcare professional for an infant with nasopharyngitis?

If the infant shows signs of an earache Signup and view all the answers

Under what condition can a child diagnosed with acute streptococcal pharyngitis return to school?

After 24 hours of antibiotic treatment Signup and view all the answers

What medication might reduce symptoms if administered early for influenza type A?

Amantadine hydrochloride Signup and view all the answers

How does chronic otitis media with effusion (OME) differ from acute otitis media (AOM)?

It is characterized by a feeling of fullness in the ear Signup and view all the answers

What statement indicates that parents understand how to prevent childhood otitis media?

We will keep immunizations up to date Signup and view all the answers

What should parents do if their child experiences irritability during a viral illness?

Provide comfort measures Signup and view all the answers

Parents should avoid which action to reduce the risk of otitis media in infants?

Propping bottles during feeds Signup and view all the answers

Which symptom in a child is indicative of a potential complication from sedation after surgery?

Difficulty waking up Signup and view all the answers

What is a common recommendation for managing an infant's illness accompanied by a fever?

Monitor fluid intake closely Signup and view all the answers

When treating a child with influenza, which treatment option is NOT recommended?

Use of aspirin for fever reduction Signup and view all the answers

Which of the following is a critical monitoring point when treating a child with an upper respiratory infection?

Monitoring for signs of dehydration Signup and view all the answers

Which drug is NOT part of the standard therapy for tuberculosis (TB)?

Amoxicillin Signup and view all the answers

What symptom suggests a complete airway obstruction in a toddler?

Inability to speak Signup and view all the answers

Which method is the best way to monitor carbon monoxide poisoning?

Arterial blood gases Signup and view all the answers

What is a common trigger for asthma in infants?

Viral infections Signup and view all the answers

Which statement correctly describes bronchial asthma?

There is heightened airway reactivity. Signup and view all the answers

Which assessment findings are indicative of asthma in a child?

Nonproductive cough and wheezing Signup and view all the answers

Children on long-term inhaled steroids for asthma require frequent assessments primarily to monitor for which condition?

Slowed growth Signup and view all the answers

What is a potential complication of acute respiratory distress syndrome (ARDS) requiring nursing intervention?

Monitoring arterial blood gases Signup and view all the answers

What action should be taken if a child exhibits signs of choking?

Perform abdominal thrusts immediately. Signup and view all the answers

In children with asthma, what is the primary purpose of long-term inhaled steroid therapy?

To prevent asthma attacks. Signup and view all the answers

What is the first step in managing a child suspected of carbon monoxide poisoning?

Administer oxygen immediately. Signup and view all the answers

What breathing symptom can indicate an exacerbation of bronchial asthma?

Loud, wheezing noises Signup and view all the answers

What might indicate that a toddler has a mild respiratory obstruction rather than a complete obstruction?

Loud wheezing sounds Signup and view all the answers

Which signs can differentiate asthma from pneumonia in a pediatric patient?

Nonproductive cough and wheezing Signup and view all the answers

What is the primary reason for administering a full course of antibiotics?

To prevent recurrence of infection with resistant bacteria Signup and view all the answers

What recommendation should be made to prevent otitis media (OM) in children?

Avoid tobacco smoke Signup and view all the answers

What is a significant risk when examining a child with acute epiglottitis using a tongue depressor?

Causing complete airway obstruction Signup and view all the answers

Which type of croup is categorized as a medical emergency?

Epiglottitis Signup and view all the answers

Why should a mother be encouraged to stay at the bedside of a child with acute laryngotracheobronchitis?

To ease anxiety and support respiratory efforts Signup and view all the answers

What symptom is most suggestive of bronchitis in a school-age child?

Worsening cough that becomes productive Signup and view all the answers

How often should children who live in high-prevalence TB regions undergo Mantoux testing?

Periodically based on exposure risk Signup and view all the answers

What is one incorrect method of preventing otitis media?

Encouraging cohabitation with sick children Signup and view all the answers

What is the primary assessment concern when caring for a toddler with laryngotracheobronchitis?

Observing respiratory effort and distress Signup and view all the answers

When a child has an acute infection, symptoms may subside before which action is taken?

Completing the full course of antibiotics Signup and view all the answers

Which is a common early sign of epiglottitis that is misleading and may not indicate urgency?

Sore throat and pain on swallowing Signup and view all the answers

What is a misconception regarding the treatment of epiglottitis?

It can be treated at home if fever is resolved Signup and view all the answers

What is the focus of managing a child with tuberculosis?

Effective pharmacotherapy Signup and view all the answers

What is the primary action of b-adrenergic agonists and methylxanthines during an asthma attack?

Dilate the bronchioles. Signup and view all the answers

Which sport is recommended for children with asthma due to its compatibility with their condition?

Swimming Signup and view all the answers

In treating an acute asthma episode in young children, which medication is typically administered first?

Short-acting b2 agonists Signup and view all the answers

Which statement correctly reflects the genetic implications of cystic fibrosis?

Both parents must be carriers of the defective gene for a child to have cystic fibrosis. Signup and view all the answers

What is the earliest recognizable clinical manifestation of cystic fibrosis?

Meconium ileus Signup and view all the answers

What tests are typically expected for a child being admitted for cystic fibrosis testing?

Sweat chloride test, stool for fat, chest radiograph films Signup and view all the answers

To establish a diagnosis of cystic fibrosis, which test is considered essential?

Sweat chloride test Signup and view all the answers

What condition is necessary for both parents to have for their child to be affected by cystic fibrosis?

Both parents must be carriers. Signup and view all the answers

Which option is NOT considered a diagnostic test for cystic fibrosis?

Bronchoscopy Signup and view all the answers

Which statement about exercise-induced bronchospasm in sports is true for children with asthma?

It is more prominent in endurance sports. Signup and view all the answers

Which of the following is false concerning the characteristics of cystic fibrosis?

CF is inherited as an autosomal dominant trait. Signup and view all the answers

Which medication is NOT indicated for acute asthma exacerbation in children?

Theophylline Signup and view all the answers

What is a potential consequence due to poor digestion in cystic fibrosis?

Intestinal blockage Signup and view all the answers

When should aerosolized bronchodilator medication be administered to a child with cystic fibrosis?

Before chest physiotherapy (CPT) Signup and view all the answers

What is a known adverse effect of recombinant human deoxyribonuclease (DNase) in children?

Voice alterations Signup and view all the answers

What should be considered when administering pancreatic enzymes to a child with cystic fibrosis?

Enzymes can be taken whole or sprinkled on food at meal start Signup and view all the answers

What dietary consideration is important for a child with cystic fibrosis?

Diet should be high in protein and calories Signup and view all the answers

Which pulse is preferred for palpation during CPR in a toddler?

Carotid pulse Signup and view all the answers

Which medication is considered most effective in treating pediatric cardiac arrest?

Epinephrine hydrochloride Signup and view all the answers

When performing CPR on a 5-year-old child, what is the correct ratio of breaths to compressions?

Two breaths to 30 compressions Signup and view all the answers

At what age is the Heimlich maneuver recommended for children experiencing airway obstruction?

1 year Signup and view all the answers

What indicates that a child is still in respiratory acidosis based on blood gas analysis?

pH 7.35, CO2 55 Signup and view all the answers

What is typically an effect of aerosolized bronchodilator medication not commonly recognized?

Decreased airway resistance Signup and view all the answers

Which of the following statements about DNase is true?

It is typically delivered via an aerosolized form Signup and view all the answers

Why should pancreatic enzymes be given at the start of a meal?

To enhance nutrient absorption Signup and view all the answers

Which dietary element should be emphasized for children with cystic fibrosis?

High-protein and calorie-rich foods Signup and view all the answers

What is the primary reason for using the carotid pulse in toddler CPR?

Most central location Signup and view all the answers

Study Notes

Respiratory Dysfunction in Toddlers

Toddlers experience fewer respiratory infections as they age due to increased immunity from repeated exposure to organisms.
Lymphoid tissue increases with age, which is not directly related to immunity from infections.

Labored Breathing

Labored breathing is also known as dyspnea.
Tachypnea is rapid breathing.
Hypopnea is shallow breathing.
Orthopnea is difficulty breathing except when upright.

Cool-Mist vs. Steam Vaporizers

Cool-mist vaporizers are safer for home treatment of childhood respiratory infections than steam vaporizers.
Steam vaporizers are not less expensive than cool-mist vaporizers.
Steam loosens secretions, while cool-mist vaporizers do not dry them.

Decongestant Nose Drops (Toddlers)

Decongestant nose drops, like phenylephrine, should not be used for more than 3 days to prevent rebound congestion.
Drops should be discarded after one illness to prevent bacterial contamination.
Administer drops before feedings are preferable.

Upper Respiratory Infection (URI) and Fever (Infants)

Frequent, small sips of fluids are crucial to prevent dehydration in febrile infants with URI.
Tepid water baths may worsen fever due to shivering.
Food should not be forced, as this may lead to vomiting.
Infants should wear light, loose clothing to prevent chilling.

Nasopharyngitis (Infant)

Parents should notify the health professional if the infant exhibits signs of an earache as this could indicate a secondary bacterial infection.
Fussiness, coughing, and fever are common with viral illnesses and do not typically warrant immediate medical attention.

Acute Streptococcal Pharyngitis (School-Age Child)

Children with acute streptococcal pharyngitis should return to school after 24 hours of antibiotic treatment as they are no longer contagious.
Sore throat may linger after antibiotic treatment.

Influenza

Amantadine hydrochloride is effective in reducing influenza A symptoms when administered within 24–48 hours of onset.
Amantadine is ineffective against influenza B or C.
Aspirin is not recommended for children with influenza as it increases the risk of Reye's syndrome.

Otitis Media with Effusion (OME)

Chronic OME is differentiated from acute otitis media (AOM) by a feeling of fullness in the ear instead of severe pain.

Otitis Media Prevention

Keeping childhood immunizations up-to-date helps prevent otitis media.
Maintaining an upright position during feedings is vital in preventing otitis media.
Breastfeeding exclusively until at least 6 months of age is a recommended prevention method.

Acute Otitis Media (AOM) Treatment

Antibiotic treatment should be completed to prevent antibiotic resistance.
Symptoms may subside before the complete treatment course is concluded.

Acute Epiglottitis

Examining a child with suspected epiglottitis with a tongue depressor can lead to complete airway obstruction and should be avoided if possible.
Immediate intubation capability is necessary if a throat examination is performed.
Stridor is often observed.

Croup

Epiglottitis is a medical emergency.
Laryngitis is a common viral illness in children and adolescents.
Spasmodic croup responds to humidity treatments.

Laryngotracheobronchitis (LTB)

Keeping parents at the hospital bedside is essential to ease anxiety, reducing respiratory distress in the child.

Bronchitis

Bronchitis is indicated by: several days of URI followed by a persistent dry, hacking cough (worse at night), and a productive cough within the past 24 hours.

Tuberculosis (TB) Testing

Periodic testing for TB is recommended for children in high-prevalence regions.

Tuberculosis (TB) Management

Pharmacotherapy is the key intervention in managing childhood TB.

Airway Obstruction

Inability to speak is a critical indication in choking children, requiring immediate lifesaving measures (abdominal thrusts).
Gagging and coughing are less severe and do not necessarily signal a critical blockage.

Acute Respiratory Distress Syndrome (ARDS)

Pulse oximetry monitoring is essential in children with ARDS.
Forcing fluids may be helpful but should be handled with care.

Carbon Monoxide Poisoning

Arterial blood gas monitoring is crucial for evaluating carbon monoxide poisoning.
Immediate supplemental oxygen is absolutely essential, regardless of the child's apparent respiratory distress or other symptoms.

Asthma (Infants)

Viral infections are frequent triggers for asthma in infants.

Asthma

Bronchial asthma involves heightened airway reactivity leading to bronchoconstriction.
Asthma has multiple causes, not just allergic hypersensitivity.

Asthma Assessment

Wheezing and non-productive coughing are common asthma symptoms.

Asthma: Inhaled Steroids

Frequent assessments of growth are crucial in children receiving long-term inhaled steroids to check for slowed growth as a side effect.

Asthma Treatment

Short-acting beta-2 agonists are the initial medication for an acute asthma attack in children.

Cystic Fibrosis (CF) Implications

Both parents usually carry the defective gene if a child has CF.
CF is an autosomal recessive genetic disorder.

Cystic Fibrosis (CF): Early Signs

Meconium ileus is one of the earliest and most notable early signs of CF.
Foul-smelling, frothy, greasy stools are later symptoms.
Recurrent pneumonia and lung infections are also characteristic but later signs of CF.

Cystic Fibrosis (CF) Diagnosis

A sweat chloride test is crucial for diagnosing CF.
Tests like chest radiographs, stool for fat, and stool for trypsin are useful for supporting the diagnosis once CF is suspected.

Cystic Fibrosis (CF) Treatment

Bronchodilators should be administered before chest physiotherapy.
Pancreatic enzymes are typically administered just before meals and snacks.

CF Nutrition

Children with CF need a high-protein, high-calorie, well-balanced diet.

Cardiopulmonary Resuscitation (CPR)

The carotid pulse is usually the most easily palpated in toddlers during CPR.

Childhood Cardiac Arrest

Epinephrine is the most helpful drug in childhood cardiac arrest.

CPR Techniques

Lone-rescuer CPR involves 2 breaths for every 30 chest compressions.

Heimlich Maneuver

The Heimlich maneuver is only appropriate for children over 1 year old.

Respiratory Acidosis

Respiratory acidosis is indicated by a low pH and elevated CO2 levels.

Peak Expiratory Flow Meter Use

Record the highest of three readings; measurement should be taken close to the same time each day with the person sitting comfortably.

Asthma Management

Continuous pulse oximetry monitoring is crucial for children with acute asthma exacerbations experiencing supplemental oxygen.

Tuberculin Skin Test (TST) Results (HIV Positive Patient)

A 5 mm induration on a TST after 48–72 hours is considered positive in children who are HIV positive or have other immunosuppressive conditions.

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Description

This quiz focuses on the various aspects of respiratory dysfunction in toddlers, including common breathing issues, the use of vaporizers, and decongestant treatments. Understand the progression of respiratory health in young children and the best practices for managing respiratory infections.