Respiratory Dysfunction

what time of year do most ear infections (Otitis Media) occur?

winter months

what are some environmental factors that could contribute to OM?

smokers in house, living with a lot of people, just had RSV or flu.socioeconomic status.

infants who are breast fed have a lower incidence of getting OM. t or f?

TRUE

an inflammation of the middle ear space with a rapid onset of s&s. fever and ear pain. bulging tympanic membrane.

acute otitis media (AOM)

an inflammation of middle ear. no pain or fever. rhinitis. cough. diarrhea may be present.

Otitis Media (OM)

fluid in the middle ear without s&s of acute infection. air bubbles.

Otitis Media with effusion (OME)

what is the clinical term for "earache

ostalgia

what signs would you see in an older child who has had chronic ear infections throught life?

maybe some hearing loss, tinnitus, difficulty communicating/speech issues

under what age should the child always be treated for OM?

under 6 months bc of immune system cannot fight yet

what would you give for an ear infection that wont clear?

Rocefin injection

what are some common antibx tx's for OM?

Amoxicillin or Omnicef

how long should you wait after the onset of OM before giving antibx?

72 hours as long as they are over 6mo

during the 72 hours you are waiting to give antibx for OM, what should you do for pain?

Tylenol AND motrin

the watchful waiting approach for children under age 2 is not recommended if they are showing signs of ear pain/OM. t or f?

TRUE

what is myringotomy?

surgical incision to relieve pressure on ear drum from pus/infection. provides drainage.

what do tubes do for ear infections?

allows for drainage of fluid. which promotes hearing and prevents scar formation

what is the principal cause of mono?

Epstein Barr virus

early signs of Mono?

HA, malaise, fatigue, chills, low grade fever, loss of appetite

why should a teenage who just recieved the dx of mono not play contact sports?

cannot play contact sports for 2 to 3 months because of risk of rupturing the spleen

what is the test for determining Mono?

blood test (spot test or Mono spot)

what type of tx is given for mono?

no specific tx. symptomatic, rest.

how long does mono fatigue usually last?

2 to 4 weeks

characterized by hoarsing, barking cough. inspiratory stridor and varying resp distress.

croup

croup can affect what parts of the body?

larnyx trachea and bronchi

what is the most common cause of croup?

viruses

steeple sign and swollen airway are associated with wht?

Croup

sore throat, pain, tripod pos, retractions, inspiratory stridor, swelling of epiglottis, mild hypoxia, chin out, mouth open, protruding tongue, drooling of saliva bc swallowng hurts

acute epiglottis

what is the therapeutic managment for these pts with epiglottis swelling?

mechanical intubation

what should you never do with a child that has suspected acute epiglottis?

Check the childs throat with a tongue depressor unless they are mechanically intubated

what are the 3 clinical observations that are predictable of acute epiglottis?

spontaneous cough, drooling, agitation

what is the tx for acute epiglottis?

humidified epinephrine

what is the tx for acute laryngitis?

fluids, humidified air

what is the chief complaint for acute laryngitis?

hoarseness

what is the most common of the croup syndromes?

(LTB) laryngotracheobronchitis

LTB generally affects which age group?

less than 5yo

gradual onset of low-grade fever, and the parents often report that the child went to bed and later awoke with a barky, brassy cough. Inflammation of the mucosa lining the larynx and trachea causes a narrowing of the airway. When the airway is significant

LTB

classic barking or seal-like cough and acute stridor after several days of rhinitis.

LTB

what is the main tx for LTB stage II and up?

Nebulizer treatments of Epi or steroids

what is the most important nursing function for pt with LTB?

continuous, vigilant observation and accurate assessment of respiratory status

acute spasmodic laryngitis happens when?

at night aka midnight croup

what is the tx for acute spasmodic laryngitis?

steroids PO, shower steam, night air thats cool

what is infection of the mucosa of the upper trachea?

bacterial tracheitis

thick, purulent, tracheal secretions is assoc with what infection?

bacterial tracheitis

what is the tx for bacterial tracheitis?

antipyretics, antibx, could require intubation, humidified o2

a 4yr comes to the ED with sore throat, difficulty swallowing, and suspected dx of epiglottis. your initial assessment should NOT include what?

throat culture

what is the causative agent of bronchitis?

viral

CM's dry hacking cough, worse at night, become productive in 2 to 3 days. Treatment is symptomatic.

Bronchitis

most common reason for infant hospitalization for infants under 1yr

RSV

how do you diagnose RSV?

nasal swab

what is the tx for RSV?

symptom management

do you give albuterol or steroids to RSV pt?

NO

what does Palivizumab do?

given monthly to infants as prohylaxis of RSV in high risk infants only.

rhinnorrhea, low grade fever, maybe some conjucitvitis, irritability, and maybe some resp distress signs

RSV

with bacterial pneumonia, what is the tx?

antibx

with bacterial pneumonia what does child appear like?

very ill, fever, malaise, cough, chest pain

what is the tx of viral pneumonia?

symptomatic

how do we treat pneumonia caused by mycoplasma bacteria?

Zithromax or cephlosporin in school age child

what is education to send home with parents for care of pneumonia?

antibx if necessary, antipyretics, fluids, bed rest, antitussives, contact isolation.