Aspiration
Inhalation of a foreign object into the airway occurs most frequently in infants and toddlers |
Signs & Symptoms |
• Choking, hard, forceful coughing |
• Increased respiratory difficulty (stridor) |
Management |
• Subdiaphragmatic thrusts (Heimlich Maneuver) |
• Stand behind the child & place fist under diaphramgm |
• upside down with finger inside mouth, trust the back |
Status Asthmaticus
Recurrent diffuse, obstructive pulmonary disease process caused by airway inflammation and hyperreactivity. Occurs when children fail to respond |
Clinical Manifestation |
• Wheezing changes as disease progresses |
• Inspiratory & expiratory wheeze: airways obstructed |
• Little air movement heard (tight): complete obstruction |
• Retractions, hr & rr elevated, cyanosis, hypoxia |
• Prolonged expiratory phase |
Pathophysiology |
Smooth muscle spasm to mucosal edema leading to mucosal plugging causing obstruction, air trapping leading to hypoxemia |
Nursing Care |
• Aerosol administration of a bronchodilator (albuterol) |
• IV corticosteroids to reduce symptoms |
• O2 by face mask or nasal prongs |
• IV infusion for hydration |
• Monitor I &O : measure the specific gravity of urine |
• In severe attacks, ET intubation & mech. ve |
Diagnostic Tests |
• Chest radiography: detect foreign body, infiltration |
• Lab test: evaluate degree of acidosis & infection |
• Spirometry: to assess severity of disease |
• Pulse oximetry: reveals the low oxygen sat level. |
Extreme emergency because a child may die of heart failure caused by the combination of: exhaustion, atelectasis, respiratory acidosis from bronchial plugging.
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Cystic Fibrosis
is a chronic, progressive, and frequently fatal. Caused by abnormality of chromosome 7 CFTR gene. genetic disease of the body's mucus glands. life span of 30 yrs |
CF affects |
Respiratory |
Increased mucus secretions |
Digestive |
Decreased pancreatic enzymes |
Sweat glands |
increase salt in sweat |
Reproductive |
Infertility |
Clinical Manifestation |
• productive cough, wheezing, hyperinflation of lungs |
• Clubbing of extremities, fat soluble deficiencies |
• Malnutrition, steatorrhea, strong salt in perspiration. |
Treatments |
• Preventing and controlling lung infections |
• Loosening and removing mucus from the lungs |
• Preventing and treating intestinal blockage |
• Providing adequate nutrition |
Medications |
• Antibiotics (gentamycin) |
• Mucus thinning drugs: cough up mucus |
• Bronchodilators: help keep the airways open |
• Oral pancreatic enzymes: help absorb nutrients |
Tests and Diagnosis |
Sweat test |
sweat saltier than normal |
Genetic test |
defect on chromosome 7 |
Imaging test |
Damage to lungs or intestines |
Function test |
How much air, how fast, how well |
Sputum culture |
Analyzed bacteria |
Organ func. |
health of pancreas and liver |
Laryngotracheobronchitis (Croup)
Pathophysiology |
• viral infection of parainfluenza or H.influenza causes swelling of the laynx, trachea, and large bronchi. |
• Swelling due to infiltration of WBC causes airway obstruction thus, increased work of breathing. (stridor) |
Signs & Symptoms |
• Barking cough ( inspiratory stridor ) |
• Marked retractions, temp is mildly elevated |
• Marked retractions, hoarseness |
• Difficulty breathing worsen at night |
Nursing Care |
• Assess airway obstruction by elev. respi status |
• Provide warm, moist envi. & give 02 for hypoxia |
• Corticosteroid (dexamethasone or epinephrine |
• IV therapy to keep child hydrated |
• Keep emergency equipment (tracheostomy, intubation) |
Health Teachings |
• bath with hot water to produce steam |
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