Describe:
Epiglottitis
(Immediate complication)
An infection of the epiglottis which can be caused by Influenza type B or Strept.
There is a high risk of airway obstruction.
What are the characteristic signs and symptoms of epiglottitis?
- sore, red, and inflamed throat, pain with swallowing
- muffled voice, dysphagia, dyspnea, and drooling
- tripod positioning to attempt to widen airway
What are the priority interventions for epiglottitis?
- maintain patent airway
- possible intubation with ventilator
How is epiglottitis prevented?
Get vaccinated for influenza type B (Hib).
Should anything be placed in the mouth with a child suspected of epiglottitis?
Never place anything in the mouth with epiglottitis. That includes tongue depressors, spoons, forks, culture swabs, or taking an oral temperature.
Describe:
Croup (laryngotracheobronchitis)
Inflammation of the larynx, trachea, and bronchi caused by an infection.
What is the characteristic symptom of croup (laryngotracheobronchitis)?
Barking cough.
What are the precautions If a child (or any client) has respiratory symptoms such as coughing?
Place in isolation or have them wear a mask if isolation isn’t possible.
What are the general interventions for a client that has a respiratory infection?
- maintain a patent airway
- give oxygen if needed
- encourage fluid intake or IV fluids to prevent dehydration
- administer antibiotics and steroids
- isolation precautions
Describe:
Status asthmaticus
(Immediate complication)
A severe asthma attack that doesn’t respond to inhalers.
Intubation and ventilator may be needed.
Describe:
Cystic fibrosis
A genetic disorder that affects the lungs and digestive system. The body produces thick and sticky mucus that can clog the lungs and obstruct the pancreas.
Life span is early 40’s.
What are the respiratory symptoms of cystic fibrosis?
From increased mucus in the lungs:
- dyspnea
- cyanosis
- wheezing and cough
Symptoms are similar to COPD.
What are the gastrointestinal symptoms of cystic fibrosis?
Due to mucus clogging up the ducts and enzymes aren’t able to break down foods:
- meconium ileus (in newborns)
- intestinal obstruction
- frothy and foul-smelling stools
What are the interventions for respiratory symptoms with cystic fibrosis?
Focus on removing thick secretions and improving oxygenation:
- chest physiotherapy
- special vest that oscillates to remove secretions
- nebulizers, steroids, and oxygen
What is the last resort treatment for cystic fibrosis?
Lung transplant.
What are the interventions for gastrointestinal symptoms of cystic fibrosis?
Focus on replacing pancreatic enzymes to digest food:
- high calorie and high protein diet to meet energy needs
- administer pancreatic enzymes before meals: pancrelipase, pancreatin
What position are infants placed in for sleeping in order to prevent sudden infant death syndrome (SIDS)?
Place in a supine position (on back) when sleeping.
What are the risk factors for sudden infant death syndrome (SIDS)?
- soft bedding
- overheating
- cosleeping
- mother who smokes
- tobacco smoke
