Terms in this set (95)
Which parts of the lower resp tract are able to constrict?
the bronchi and bronchioles
at what age do viral infections become less frequent?
A noninvasive pulse oximeter (oxygen saturation) measurement should be performed on all children as part of the routine physical assessment.
When might a child not have a fever with a respiratory tract infection?
under 28 days
Meningeal signs without infection of the meninges that often accompanies respiratory tract infection
When hydrating a child, what is the preferred drink?
pedialyte for young and infant.
gatorade for older children
method of assessing output in nonhospitalized infants and toddlers
Counting the number of wet diapers in a 24-hour period
Who experiences worse symptoms with nasopharyngitis?
infants and young children
What are two possible complications of nasopharyngitis?
otitis media and pneumonia (less common)
Fancy name for strep throat
possible complications of strep throat
rheumatic fever and glomerulonephritis
acute rheumatic fever
an inflammatory disease of the heart, joints, and central nervous system
What causes scarlet fever?
strain of group A streptococcus.
What is the characteristic sign of scarlet fever?
erythematous sandpaper-like rash
which lymph nodes get swollen in strep throat?
The usual culprit for pharyngitis is...
DOC for strep throat
penicillin for 10 days
Children with temperature tend to prefer ______ activities
If an antibiotic injection is required, it must be administered deep into...
a large muscle mass (e.g., the vastus lateralis or ventrogluteal muscle)
Which symptoms are more suggestive of a viral cause of strep throat?
nasal discharge, conjunctivitis, hoarse, cough, diarrhea, mouth ulcers, stomatitis
Never administer penicillin G procaine or penicillin G benzathine suspensions intravenously; they may cause embolism or toxic reaction with ensuing death in minutes. Instead, administer these medications deep into the muscle tissue to decrease localized reactions and pain
When, after beginning antibiotic therapy, are children no longer contagious?
Waldeyer tonsillar ring
a mass of lymphoid tissue encircling the nasopharynx and oropharynx
Which tonsils are removed during a tonsillectomy ?
Which tonsils are not part of the Waldeyer ring?
surgical removal of the adenoids
When can you remove tonsils?
not until after 3-4 years of age because of the problem of excessive blood loss in young children and the possibility of regrowth or hypertrophy of lymphoid tissue
True or False:
It is important to get the child to cough after a tonsillectomy and adenoidectomy to avoid aspiration
They shouldnt cough or do anything to upset the incision site
True or False:
Coughing or vomiting up blood is normal after a T&A
Also why you don't want to give red or brown fluids to these children.
What are other food/drink items the child cannot have after a T&A?
straw (messes with the site).
dairy/pudding (coats the mouth and may cause child to clear throat).
spicy or citrus foods.
The most obvious early sign of bleeding is the child's continuous swallowing of the trickling blood. While the child is sleeping, note the frequency of swallowing. If continuous bleeding is suspected, notify the surgeon immediately
True or False:
A cream colored membrane on the tonsils bed post op is a sign of infection
Its totally normal
What do you do if the patient has objectionable mouth odor and slight ear pain with a low-grade fever?
Thats normal for the first few days, but if it persist, they need to see a doctor
When can they resume activity after a T&A?
Who is more likely to get infectious mononucleosis?
What is the main cause of infectious mononucleosis?
epstein barr virus
If you give a patient antibiotics for infectious mononucleosis, what will happen?
they will get a macular rash over the trunk
What test is often done to diagnose infectious mononucleosis?
the spot test (mono spot)
Advise the family to seek medical evaluation of the child or adolescent if: • Breathing becomes difficult
• Severe abdominal pain develops
• Sore throat pain is so severe that the child is unable to eat or drink
• Respiratory stridor is observed
Which type of influenza is not included in the flu vaccine?
Major changes that occur at intervals of usually 5 to 10 years
minor variations within the same subtypes
How is influenza spread?
direct contact/large droplet
When is the flu most contagious?
24 hours before and after symptom onset
the spread of a new disease to which the population has little or no immunity and that spreads rapidly from human to human.
What is the greatest possible complication of the flu
the development of a secondary infection
An inflammation of the middle ear without reference to etiology or pathogenesis
Acute otitis media
An inflammation of the middle ear space with a rapid onset of the signs and symptoms of acute infection—namely, fever and otalgia (ear pain).
eardrum will be red.
Otitis media with effusion
Fluid in the middle ear space without symptoms of acute infection.
eardrum will be orange.
a surgical incision of the eardrum, may be necessary to alleviate the severe pain of AOM
Which pain reliever is better for night and why?
ibuprofen because it has a longer duration (6 hours)
How can you prevent skin irritation from exudate drainage from an eardrum surgery?
zinc oxide or petroleum jelly (diaper rash stuff)
If the tymphanostomy tube falls out, what should the parents do?
just call the doctor, but this is a common occurrence
Otitis media peaks in ______ whereas otitis externa peaks in _______
What is a good way to prevent otitis externa after swimming?
50/50 vinegar and alcohol in the ear for 5 minutes after swimming
a general term applied to a group of symptoms characterized by hoarseness, a resonant cough described as "barking" or "brassy" (croupy), varying degrees of inspiratory stridor, and varying degrees of respiratory distress resulting from swelling or obstruction in the region of the larynx and subglottic airway
Four types of croup infections
acute spasmodic laryngitis.
Children with epiglottitis usually _______, in contrast to children with LTB, who ________
look worse than they sound, has bacterial causes and progresses rapidly.
sound worse than they look, has viral causes and has a slow progression.
Which is worse: LTB or epiglottitis?
epiglottitis. Its a medical emergency
Three clinical observations that are predictive of epiglottitis are absence of spontaneous cough, presence of drooling, and agitation
Throat inspection should only be performed when immediate endotracheal intubation or an emergency tracheotomy can be performed if needed
Most common cause of epiglottitis?
HiB --> vaccine is a good preventative measure
Nurses who suspect epiglottitis should not attempt to visualize the epiglottis directly with a tongue depressor or take a throat culture but should have the child seen by the primary care provider immediately. Resuscitation equipment and suction should be immediately available and ready at the child's bedside
What is the chief complaint of acute laryngitis?
What therapy can provide comfort for children with croup?
cool mist therapy
What is heliox?
a mix of oxygen and helium that reduces airway turbulence
Children with severe respiratory distress (traditionally, a respiratory rate >60 breaths/min for infants) should not be given anything by mouth to prevent aspiration and increased work of breathing
Early signs of impending airway obstruction include increased pulse and respiratory rate; substernal, suprasternal, and intercostal retractions; nasal flaring; and increased restlessness
What is one of the main characteristics of acute spasmodic laryngitis?
paroxysmal attacks of laryngeal obstruction that occur chiefly at night
an inflammation of the large airways (trachea and bronchi) that is frequently associated with a URI
Chronic bronchitis may be associated with...
tobacco or marijuana use
Where does bronchiolitis have max impact?
the bronchiolar level
medicine used to prevent RSV
palivizumab. It is usually only given to small children at high risk and is given once a month
($1200 per dose. wtf)
All or a large segment of one or more pulmonary lobes is involved. When both lungs are affected, it is known as bilateral or double pneumonia
Begins in the terminal bronchioles, which become clogged with mucopurulent exudate to form consolidated patches in nearby lobules; also called lobular pneumonia
Inflammatory process more or less confined within the alveolar walls (interstitium) and the peribronchial and interlobular tissues
Which pneumonia occurs more frequently?
atypical pneumonia is usually caused by...
What kind of fever does pneumonia usually present with?
very high fever
You should suspect staph pneumonia if you see...
conjunctivitis or furuncles
When could pneumonia lead to hospitalization?
if pleural effusion or empyema occur -
What is the best way to lie after a thoracentesis?
good lung up! affected side down
What is the most common manifestation of pertussis in infants?
apnea- the cough may not appear until after 6 months of age
Who has the highest rate of TB?
What med requires screening for TB before use?
TNF-alpha (for inflammatory bowel disease or arthritis)
Things that could cause a TB false-negative
Live virus vaccine in the past few weeks.
Corticosteroids/ immunosuppresive agents.
when TB becomes systemic
LTBI (latent tuberculosis infection)
indicates infection in a person who has a positive TST, no physical findings of disease, and normal chest radiograph findings
M bovis may be resistant to which drug?
When would surgery be required for TB?
to remove the source of infection in tissues that are inaccessible to antimicrobial therapy or that are destroyed by the disease.
When would a child be in isolation in the hospital?
if they have a positive sputum culture
What kind of masks do nurses need to wear when caring for a TB patient?
Who would get the BCG vaccine?
people at high risk for continuous exposure or exposure to resistant strains
How much protection does BCG give you?
Why does BCG suck?
its very painful