Week 1 Flashcards

Question

LRTI: Bronchiolitis

Answer 1

Bronchiolar Inflammation * affects infants / babies * widespread lung inflammation * increased WOB, respiratory distress * Viral illness – very common in winter Clinical features * Bronchospasm * Respiratory distress * Coryzal symptoms * Lethargy and poor feeding CXR * Patchy areas of collapse and consolidation on CXR Auscultation * widespread insp crackles and exp wheeze +/- audible stridor

Answer 2

- Disease process in peripheral airspaces * Central airways usually clear - Various organisms typically affect different ages of kids Clinical features * Pyrexia * Dry cough * Tachypnoea * Loss of appetite * Increased WOB * Consolidation on CXR * Phases * Consolidation * Harsh breath sounds * Resolution * Crackles, moist cough Management: - In sputum retention - percussion, positioning, PEP and FET will aid AC

Answer 3

- Whooping cough - highly contagious but vaccine available - Very dangerous in children under 6 months or respiratory compromised - Paroxysmal cough - Thick tenacious sputum - Patchy collapse and consolidaition on CXR Management * VIP to remove secretions * May need to ventilate and paralyse to stop paroxysmal cough * Minimal handling - position for V/Q mismatch * Physio C/I in acute stages – coughing * Subacute phase: ACT if mucus plugging, don’t demand cough

Answer 4

- Chronic inflammatory process * Wheezing * Breathlessness * Cough - Increased smooth muscle responsiveness * Variable triggers; Pollens, dust mites, tobacco smoke, food, exercise - Airway obstruction from mucous plugging - Inflammation and narrowing of the airways - Links with anxiety in adolescence

Answer 5

Abnormal and chronic dilation of the bronchi leading to bronchial obstruction causing chronic collapse and secretion retention in distal areas. Acute exacerbations lead to URTI and LRTI Signs and symptoms: * Asymptomatic when not exacerbated, cough productive of sputum daily +/- restricted ADL’s * Characterized by exacerbations... * increased sputum, * haemoptysis, * SOB, * decreased ex tolerance, * fevers Management - AB therapy - Monitoring - Secretion clearance ACBT, manual techniques, mucolytics, FET, OPEP/PEP - Exercise

Answer 6

Genetic multisystem disorder characterised by disturbances in fluid and electrolyte across epithelial surfaces. Effects more seen in respiratory and digestive systems (progressive) with... - Excessive thickened mucous - Poor clearance, retained secretions and infection - Widespread lung involvement - Chronic disease with acute exacerbations - Deterioration with age Neonates present with abdominal distension, vomiting and failure to pass meconium

Answer 7

Person centred - Listening to what they want - Respecting their autonomy - Centre of decision making Family centred - Considering the family when treating a child - Strain can be placed on families when child has high treatment needs - Empowers the patient and their families and fosters independence - Allows them to make decisions respecting their values, beliefs and cultural backgrounds

Answer 8

- Engaging through play, also acts as a good distraction - Approach your interactions with children with the same level of enthusiasm that the child displays and children will generally co-operate - Crying can be a normal response - Your direct interaction with the child will shape their perceptions of their environment and the people around them as a whole - Have a calm approach and address child by their name - Build rapport to make them feel comfortable - Assume a position at eye level - Using age appropriate language - Clear simple explanation of what you are going to do - Try and give them a special job or a choice that really isn't a choice (red or blue PEP device?) - Ensure environment is calming and non-intimidating - Be aware of the developmental stage of the child - Allow children to express concerns and fears and to ask questions - Older children can talk without parents present if that makes them more comfortable - Encourage participation from caregivers

Answer 9

- Some kids will not want to be examined so when this is the case it is best for you to work quickly and save your conversation for after physical exam - Distraction can help intervention go more smoothly and encourage participation in treatment - Using visual cues like happy or sad faces for children who cannot communicate well - Ask parents how they learn what their child is thinking and feeling and work from the same cues and nonverbal approaches they use for communication

Answer 10

- In general, a minor (less than 18 years) requires consent from a parent or guardian before treatment can commence, with the exception of an emergency or where treatment is of a minor nature. - However, in Australia, there are legislative provisions and common law principles that recognise the developing competency of adolescents to make decisions regarding their own medical treatment - Gillick competent child - Judgment about a minor's competence involves consideration of... 1. their ability to understand the issues and circumstances 2. their maturity and degree of autonomy 3. the type and sensitivity of the information to be disclosed 4. the age of the minor 5. the complexity and nature of the treatment (e.g. elective, therapeutic or emergency). - If a child is consider a mature minor they consent to their medical procedures and are entitled to the same confidentiality as adults.

Week 1 Flashcards

(34 cards)