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NB's Alterations in Oxygenation (Ventilation) Keyboard Shortcuts by

Nursing care of newborn's with alteration on oxygen ventilation.

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.
 

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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