NUR340 PEDS 👨‍👩‍👧‍👦 > Unit 2 > Flashcards

Unit 2 Flashcards

(53 cards)

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1
Q

What are the key differences between a Child’s vs. Adults respiratory system?

A

• Younger = smaller airway
• Airway is shorter and narrower
• ⬆️ airway resistance

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2
Q

Newborns are _________ breathers. _________ breathing doesn’t begin until 3 - 4 months of age.

A
  1. Nose breathers
  2. Mouth breathing

(That’s why nasal cannulas are used)

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3
Q

Signs of Respiratory Distress

A

• Restlessness 😵‍💫
• Tachycardia
• Tachypnea 😮‍💨
• Diaphoresis 💧

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4
Q

What are the compensatory mechanisms for Respiratory Distress infants?

A

• Grunting (keep alveoli open)

• Retractions (assist ventilation)

• Head bobbing
(assist with ventilation)

• Nasal flaring
(increase air passages)

• Hyperextension of head and neck (open airway)

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5
Q

When does Apnea become worrisome?

A

• 20+ seconds
• increased frequency
• color changes in skin

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6
Q

What are the signs of Epiglottitis?

A

• Tripod position
• High fever
• Cherry red epiglottis
• Thumbs Sign ⛪️

3 D’s:
•Dysphasia (difficulty swallowing)
• Dysphonia (hoarseness)
• Drooling

⚠️ RAPID ONSET ⚠️

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7
Q

What is the treatment for Epiglottitis?

A

• Keep calm, no crying
• EndoTrach tube
• Antibiotics

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8
Q

What is Croup?

A

Viral infection of upper airway 🧬🫁

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9
Q

What are the two types of Croup? 🦭

A

• LTB (Laryngotracheobronchitis)
- 6M to 6Y
- Slow progression 🐌
- barking cough, low fever, dyspnea

• Spasmodic Laryngitis
- 3M to 3Y
- Sudden onset 🐆
- barking cough, afebrile

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10
Q

How do you treat both types of Croup? 🦭

A

• LTB: Steroids, nebulizer epinephrine

• Spasmotic: cool mist, self limiting

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11
Q

Explain Pneumonia

A

• Bacterial or Viral infection in lower lungs

• fever, cough, tacypnea, N/V, Abdominal pain

• tx: antibiotics, cough & deep breathe, hydration

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12
Q

Explain bronchiolitis r/t RSV

A

• bronchioles die, accumulate, and obstruct
• Cough, rhinorrhea, congestion

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13
Q

What is the dire treatment for RSV

A

Palivizumab
• monoclonal antibody
• for pts with cardiopulmonary disease, preterm babies

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14
Q

Explain bronchitis

A

• inflammation of trachea, bronchi, bronchioles
• viral or allergens
• chest pain, thick sputum
• tx: humidity

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15
Q

Explain Cystic Fibrosis

A

• genetic disorder that affect mucus cells and salt glands

• signs: steatorrhea, tachypnea, thick-sticky mucus, wheezing, recurrent pneumonia, infertility, short lifespan

Diagnosed: sweat chloride test

Treatment: pancreatic enzyme replacement, mucolytics

Diet: high protein, calorie, fat

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16
Q

Explain tonsillitis

A

• viral or bacterial

Signs: pain, redness, Dysphasia, drainage, hypertrophy (swelling)

Diagnosis: throat swab

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17
Q

Normal Resps, Pulse, & BP for 3 Years - 6 Years

A

Resps: 20 - 25

Pulse: 70 - 115

BP: 110-95 / 75-60

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18
Q

Describe Ductus Venosus, Foramen Ovale, and Ductus Arteriosus

A

Ductus Venosus: delivers O2 from the Placenta ➡️ IVC ➡️ Right Atrium 🔴

Foramen Ovale: allows blood to flow from Right Atrium ➡️ Left Atrium to support increased blood needs 🔴

Ductus Arteriosus: directs majority of blood (that would go to underdeveloped lungs 🏚) through aorta to the body to support rapid growth 🔴

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19
Q

What happens to the Ductus Venosus, the Foramen Ovale, and the Ductus Arteriosus after birth?

A

DV: constricts and closes
FO: closes, blood flow reverses
DA: closes 2 - 5 days after birth

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20
Q

📈 cardiac workload = _______ cardiac output

A

📉 decreased

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21
Q

Normal Resps, Pulse, & BP for 0 - 3Months

A

Resps: 30 - 60

Pulse: 110 - 160

BP: 85-65 / 55-45

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22
Q

Normal Resps, Pulse and BP for 1 - 3 Years

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A

Resps: 20 - 30

Pulse: 80 - 125

BP: 105-90 / 70 - 55

23
Q

Tachycardia in children always indicates ________, which leads to ________

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A

Compensation, Bradycardia
(heart powering down)

24
Q

What cardiac defects cause increased pulmonary blood flow? ⬆️🫁

Study These Flashcards
A

• Atrial-Septal Defect (ASD)
• Ventricular-Septal Defect (VSD)
• Patent Ductus Arteriosis (PDA)
• AV Canal

25
What happens anatomically with an increased pulmonary blood flow cardiac defect? ⬆️🫁
• Oxygenated blood from L side of heart mixes with Deoxygenated blood in R side of heart 🔴🔵 - O2 blood 🔴 pumped through lungs again, instead of being sent to body Manifestations: Failure to Thrive, tachypnea, pulmonary edema, labored breathing, cardiomegaly ⚠️ will NOT see cyanosis ⚠️ (Doesn't affect process of oxygenation)
26
Explain Atrial-Septal Defect (ASD)
• Hole in the septal wall between R & L Atria -🔴 blood from left side of heart flows to right 🔵 and is recycled through lungs again 🔄 - L to R shunting causes ⬆️🫁
27
Explain Ventricular Septal Defect (VSD)
• Hole in septal wall between L & R ventricles -🔴 blood from left side of heart flows to right 🔵 and is recycled through lungs again 🔄 - L to R shunting causes ⬆️🫁
28
PATCH REPLACEMENT
29
Explain Patent Ductus Arteriosis (PDA)
• Ductus Arteriosus fails to close 2 - 5 days after birth 🕳 Tx: Indomethacin NSAID IV (BLOCKS 🚫 prostaglandins that keep the artery open), surgical ligation - blood that should all go through aorta partially goes to lungs ⬆️🫁
30
Explain an AV Canal
• Hole in septal wall and warped valves - partial: ASD, VSD, warped valve - complete: all 4 chambers • surgical repair within 1 year of life 🪡 - 🔴 blood from left side of heart flows to right 🔵 and is recycled through lungs again 🔄 - Left to Right shunting causes ⬆️🫁
31
What cardiac defects cause decreased pulmonary blood flow? ⬇️🫁
• Pulmonic Stenosis • Pulmonary Atresia • Tetralogy of Fallot (4) • Tricuspid Atresia
32
What happens anatomically with a decreased pulmonary blood flow cardiac defect? ⬇️🫁
• 🔵 Deoxygenated blood from Right side of the heart mixes into the Oxygenated Left side 🔴 - blood from R side skips its trip to the lungs and goes straight to the rest of the body 🔵 Manifestations: cyanosis, clubbed fingers, hypoxemia, polycythemia (increased RBC)
33
What cardiac defects cause decreased pulmonary blood flow? ⬇️🫁
• Pulmonic Stenosis • Pulmonary Atresia • Tetralogy of Fallot • Tricuspid Atresia
34
Explain Pulmonic Stenosis
• Narrowed pulmonary Valve - obstruction of blood flow to lungs • Surgical interventions and heart failure management 🪡 -Causes ⬇️🫁
35
Explain Pulmonary Atresia
• Pulmonary Valve is absent, closed, or underdeveloped - proper blood not getting to lungs causes ⬇️🫁 ⚠️PDA must remain open for Supplemental O2 delivery ⚠️ - administer prostaglandins
36
Explain Tetralogy of Fallot
1. Pulmonic Stenosis 2. Right Ventricular Hypertrophy 3. Overriding Aorta 4. VSD • most common cyanotic defect ‼️ • TET spells 😨 • improper blood flow through heart causes ⬇️🫁 • surgical repair 🪡
37
Explain Tricuspid Atresia
• Incomplete Tricuspid valve & Atrial Septal Defect (ASD) - blood cannot get from RA to RV to go to lungs, causing ⬇️🫁 • Prostaglandins immediately
38
What cardiac defects cause Obstruction of blood flow? 🟣
• Coarctation of Aorta • Aortic Stenosis
39
Explain Coarcation of Aorta
• Narrowing of Aorta - high BP in upper extremities (warm & pink), low BP in lower (cold & pale) • surgical repair 🪡
40
Explain Aortic Stenosis
• Narrowing of Aortic valve - exercise restrictions - surgical repair 🪡 - potential endocarditis
41
What defects cause Mixed defects?
• Transposition of Great Arteries • Truncus Arteriosus • Hypoplastic Left Heart
42
What happens anatomically with a mixed blood flow cardiac defect? 🔀
Arteries and veins can be mixed/overlap ⚠️ will see cyanosis ⚠️
43
Explain Hypoplastic Left Heart
• Underdeveloped Left side of heart - VERY low cardiac output -cyanosis, cold hands and feet, lethargy
44
Explain Truncus Arteriosus
• Single great artery with VSD - cyanosis and fatigue - surgical repair 🪡
45
Explain Transposition of Great Arteries
• Arteries connected to the wrong ventricles - 🔵 blood sent to body 🔴 blood sent to lungs -cyanosis, tachypnea • Prostaglandins, Surgery 🪡
46
Define Heart Failure
• Impairment of ventricles -monitor mental status, pulmonary function 🫁, fluid, weight, and kidney function!
47
Heart failure meds:
Cardiac glycosides: makes heart pump stronger ACE Inhibitors: reduce blood pressure Loop Diuretics: relieve congestion Beta blockers: reduce HR and BP
48
DIGOXIN
49
Explain Rheumatic Fever
• autoimmune reaction to A Streptococcus - ages 5 - 15 years Symptoms: chorea, arthralgia, fever, carditis Tx: antibiotics
50
Explain endocarditis
• Infection of endocardium - bacterial vegetation grows in valves, causing dysfunction 🦠 - administer antibiotics • FROM JANE
51
52
Explain Kawasaki Disease
• idiopathic vascular inflammatory disorder - happens < 5years old - most common cause of aquire heart disease 3 stages: acute, subacute, and convalescent Symptoms: fever, strawberry tongue, rash, conjunctivitis Tx: IVIG (no live vaccines for 11 months)
53
Pediatric HTN
• 130+ / 80+
NUR340 PEDS 👨‍👩‍👧‍👦
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