Why are children at increased risk for airway obstruction related to the throat?
• Infants’ tongues are larger in relation to the oropharynx. • Children have enlarged tonsillar and adenoid tissue.
Why are infants and younger children more likely to deteriorate quickly from a respiratory illness?
Infants and younger children are more likely to deteriorate quickly from a respiratory illness.
What are characteristics of the infant nose?
• Obligated nose breathers • Produce very little mucus • More susceptible to infections • Sinuses are not developed
What are characteristics of newborn nasal anatomy?
• Very small nasal passages • More prone to obstruction • Breathe through nose until at least 4 weeks of age • Nares must be patent to breathe during feeding • When crying, only breathe through mouth
What intervention may help relieve congestion before feeding an infant?
Using a bulb syringe prior to bottle-feeding or breastfeeding may relieve congestion enough to allow the infant to suck more efficiently.
How does the pediatric respiratory system differ from adults?
• Obligated nasal breathers until 6 weeks • Short neck • Smaller, shorter, narrower airways • More susceptible to airway obstruction and respiratory distress • Tongue is larger in proportion to the mouth • Pediatric trachea is much more pliable
Compared to adults, what respiratory differences exist in infants?
• Nasal passages are narrower • Larynx is more funnel shaped • Trachea and chest wall are more compliant • Bronchi and bronchioles are shorter and narrower • Alveoli are significantly fewer in number • Respiratory rate is fast (decreases as the child matures)
How does the airway lumen differ in infants and children compared to adults?
Airway lumen is smaller in infants and children than in adults.
What happens when edema, mucus, or bronchospasm is present in a child’s airway?
• Capacity for air passage is greatly diminished. • A small reduction in airway diameter results in an exponential increase in resistance to airflow. • Increased work of breathing occurs.
How does the larynx differ between adults/teens and infants/children under 10 years?
• Adults/teens: larynx shaped like a cylinder and uniform in width. • Infants/children under 10: cartilage is underdeveloped and the larynx is funnel shaped.
Why does the position of the infant larynx increase aspiration risk?
The larynx is higher in the neck, increasing risk of aspiration.
What is congenital laryngomalacia?
• Laryngeal structure weaker than normal • Greater collapse on inspiration
What occurs in congenital laryngomalacia during inspiration?
Inward collapse of the airway when air is drawn into the lungs.
What is the most common symptom of congenital laryngomalacia?
Noisy breathing (stridor), often worse when the infant is on their back or crying.
What are key points about congenital laryngomalacia?
• Inspiratory stridor may intensify with certain positions. • Suprasternal retractions may be present without other signs of respiratory distress. • Generally a benign condition that improves as cartilage matures and usually disappears by age 1 year. • Parents may recognize changes in stridor; worsening symptoms should be evaluated early.
How is the nursing process applied to respiratory disorders?
• General concepts of the nursing process apply to respiratory disorders. • Care is individualized based on understanding of respiratory disorders and specifics for the particular child.
What behaviors may be observed in a child with respiratory distress?
Anxiety and restlessness.
What color changes may indicate respiratory concerns?
Pallor or cyanosis. Blue hands/feet in newborns (acrocyanosis) is normal.
Why is hydration status important in infants with respiratory illness?
• Nasal congestion interferes with ability to suck effectively. • A child with respiratory illness is at risk for dehydration.
What is clubbing?
Result of increased capillary growth as the body attempts to supply more oxygen to distal body cells.
How is hydration status assessed in infants?
• Palpate fontanels for sunken appearance • Assess oral mucosa for color and moisture • Note skin turgor, presence of tears, and adequacy of urine output
Why may children with respiratory illness have difficulty drinking fluids?
• Pain from sore throat or mouth lesions may prevent drinking. • Tachypnea and increased work of breathing interfere with safe ingestion of fluids.
What is tachypnea?
Increased respiratory rate for age.
Why is tachypnea important in infants and children?
• Often the first sign of respiratory illness. • Can interfere with the ability to safely ingest fluids.
