Alterations in Respiratory Status Notes

when dealing with a respiratory infection who are signs and symptoms more generalized for


what is the first sign of respiratory distress in a child


what is the final sign of respiratory distress

stupor, coma

what is a sign that respiratory distress is progressing


During assessment you notice that your 1 year old has a SaO2 of 75%. What should the nurse do first?

Assess the child before responding to what the monitor says.

what is the biggest thing for an oxygen hood

do not take it on and off because you are exposing the baby to room air (21%)

how much oxygen is the child in if using a oxygen hood


how much oxygen is a child getting if using a nasal cannula


what is an oxygen tent

a plastic bubble" can be useful to provide humidity, used in small rural communities, wet and cold.

what is the form of nebulizer for a child? older kids?

a mask, an inhaler

what does a spacer for inhaler do

ensures medication is getting into the lungs

what is a compression vest used for

to clear the lungs on children who have cystic fibrosis

what is the most high tech treatment for ventilation

assisted ventiation

A 4-year old is admitted to the ED with expiratory wheezing, RR of 68, subcostal retractions, and a persistent cough. Which of the following medications should be given first?


what is the normal respiratory rate for 4 year olds

20-28 breaths

what is salmeterol

long acting beta adrenergic

what is beclomethasone


what is pseudoephedrine


The nurse knows that patient teaching has been effective when the 10 year old with asthma says:

My cromolyn won't help if I am having an asthma attack, but it can help prevent one.

when does montelukast need to be taken? why?

. The rationale is that most asthma symptoms are exacerbated in the night and early morning so the peak effect of the drug will be around those times.

Which of the following indicates effectiveness of racemic epinephrine? Select all that apply

Improved work of breathing, absence of croup, relaxed affect

Ease respiratory efforts by:

Deep Breathing (play game)

What is fever?

Children less than 3 months who have a temperature over 100.4 need to be seen by a doctor.
Children ages 3 months to 3 years who have a temperature over 100.4 and acting sick need to be seen by a doctor. If over 102, need to be seen.
Children aged over 3

What age child is at risk for choking on foreign body?

6 months

what can pharyngitis cause

soft tissue swelling

What do we do if we know a child is choking?

If they are coughing, leave them alone! Let them cough. If they are not coughing then do the correct form of the Heimlich.

what accompanies sinusitis

green/yellow snot

what accompanies pharyngitis/tonsillitis

sore throat (throat)

when can a child return to daycare/school after running a fever

24 hours after fever that has not been medicated down.

what is acute spasmodic laryngitis?

take them in a humidified room and it gets better on its own, not really a problem (preschoolers)

what is epiglottitis

serious emergency that happens in 4-10 year olds, high fever develops quickly, intubated, on antibiotics, cannot breathe laying down
Nursing care-keep everyone calm, preparing for intubation

A two week old infant to the unit with suspected RSV. Assessment reveals tachypnea, substernal and subcostal retractions, pulse ox of 88%, and poor muscle tone. An order for 80% oxygen is ordered. Which of the following delivery systems is best for this p

Oxygen Hood

Why don't we immunize all kids for RSV

There a few children who are at high risk for severe problems with RSV (premature, heart disease). It is also very expensive.

Immune Globulin (Respigam)

given if they have RSV


gets to prevent RSV, only for those at high risk, shots begin at RSV season and they need 1 shot for 5 months straight

The charge nurse making assignments for a group of children on a pediatric unit. The nurse should most avoid assigning the same nurse to care for a 2-year-old with respiratory syncytial virus (RSV) and:

A 1-year-old with a heart defect

what does the treatment for pneumonia involve

oxygen, airway clearance, medication, and hydration, diagnosis with an x-ray


typically affects children born premature and on a vent
Ventilation caused the problem, treatment worsens the problem
Turns into a respiratory distress syndrome
High risk for further lung damage
Remain small, they need high calories but less volume due to

When do they start allergic testing?

When allergies become persistent and it affects daily activities


Bronchoconstriction, airway edema, mucus plugging
First sign is clearing the throat
Retractions progressing from intercostal to supraclavicular
Often on multiple types of medications

Which of the following statements by a school age child with asthma leads you to believe that they need more teaching regarding cromolyn (Intal)?

I will use this medication after I exercise if I am having an acute asthma attack.

You know that your teaching has been successful if your client, who is using a beclomethasone (Vanceril) inhaler, states:

I will rinse my mouth after each use of my inhaler

Cystic Fibrosis

Both parents have to have it. There is a 25% a child will be affected every pregnancy.
Exocrine Gland Disfunction- lungs and GI tract are affected the most
Small for age, chronic lung disease
Most boys are sterile and girls are late to develop

The problem of cystic fibrosis is sometimes first noted by the nurse in the newborn nursery because of the infant's:

Abominal distention