Pediatric Respiratory
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RespiratoryAlterationsinChildren.pptxRespiratory Alterations in Children Kathleen Dennis, MSN, RN
Objectives
Identify factors that lead to respiratory tract infections in infants & children
Compare the effects of different respiratory infections observed in infants & children
Describe post operative care of a child with a tonsillectomy
Formulate the care for a patient with croup
Identify priorities of caring for a infant with RSV
Describe various measures to relieve symptoms of asthma
Describe physiologic effects of CF on GI & pulmonary systems
Formulate a care plan for a child with CF
List major signs of respiratory distress in children
Pediatric Respiratory Assessment
How do you perform a respiratory assessment on an infant or child?
What are some physical differences between the airway & respiratory tract of a pediatric patient compared to an adult?
What are some behavioral signs of difficulty breathing in the pediatric population?
What are some signs the pediatric patient is having respiratory distress?
Respiratory Infections
What are some factors that influence respiratory tract infections?
What are the key infectious agents in respiratory infections?
How does age, size, resistance play a role in monitoring a child’s respiratory status?
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Upper Respiratory Infection (URI)
What are the most common URIs?
Treatments?
What causes most URIs?
What are the clinical manifestations (CM) of URIs?
How would you encourage parents to manage URIs at home?
Early signs of respiratory complications
Influenza
How is it transmitted?
What are the S&S?
How is it treated?
How is it prevented?
What are the complications?
Why do we worry about the Flu in pediatrics?
Retractions
Tonsillitis
What is the function of the tonsils?
What are the indications for removing the tonsils &/or Adenoids?
List the key points you would include in the teaching plan for a patient that has had a tonsillectomy
Infectious Mononucleosis (Mono)
What causes Mono?
Who is most at risk?
What are the clinical manifestations?
What is the treatment?
Long term concerns?
Croup
What is croup?
What causes croup?
Who is at greatest risk?
How is it treated?
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Acute Epiglottitis
What is the cause?
What are the S & S?
What are the nursing considerations?
Nursing Management of Epiglottis
Do not attempt to visualize the throat.
Do not leave the child unattended.
Do not place the child in a supine position.
Provide 100% oxygen in the least invasive manner.
If complete airway occlusion occurs, tracheostomy may be necessary.
Ensure emergency equipment is available
https://www.youtube.com/watch?v=TxDf3DHGGuE
Youtube resp disorders
https://www.youtube.com/watch?v=TxDf3DHGGuE
Respiratory Syncytial Virus & Bronchiolitis
When does it occur?
What are the S & S?
What is the pathophysiology?
How is it diagnosed?
How is it treated?
How is it prevented?
What are the nursing considerations?
Bronchiolitis
Pneumonia (PNA)
What is pneumonia?
How is pneumonia classified?
How does age play a role?
What is the difference between viral & bacterial pna? Difference in tx?
What is the best way to prevent pna?
Nursing considerations
Pertussis (Whooping Cough)
What causes Pertussis?
What are the S & S?
What is the treatment?
What is the best form of prevention?
Otitis Media (OM)
What causes OM?
Why review OM in respiratory material?
Why does OM affect the pediatric population?
What are the clinical manifestations of OM?
How do we treat OM?
How do we prevent OM?
What are complications of OM?
What are some risk factors for OM?
Asthma
What is asthma?
What causes the airway obstruction?
Asthma dx are based on symptoms & classified in one of four categories
Intermittent
Mild persistent
Moderate persistent
Severe persistent
Check your knowledge
What are the 3 cornerstones of drug therapy of asthma?
Is the problem with air trapping related to inhalation or exhalation?
In pediatrics, how would you describe the step wise approach to classifying the severity of asthma for your patient?
Asthma Assessment
Subjective data
Objective data
Risk Factors
Triggers
Nursing care management
Asthma Medications
What are the medications used to treat asthma?
Why are there multiple drug categories to treat asthma?
Metered Dose Inhaler (MDI) with Spacer
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Health Maintenance & Promotion
What are the goals of asthma treatment?
What are 5 key points you would share with parents regarding health maintenance & promotion teaching for asthmatics?
Complications of Asthma
Status Asthmaticus
Nursing Actions
Respiratory Failure
Nursing Actions
Cystic Fibrosis (CF)
What is CF?
How is CF diagnosed?
What are the clinical manifestations?
Pathophysiology of CF
Characterized by several clinical features
What are they?
Autosomal Recessive Inheritance
Respiratory presentation of CF
What are the respiratory symptoms of CF?
What are the infectious pathogens we are most concerned about?
How do we provide optimal respiratory management of the CF patient?
Gastrointestinal Tract & CF
How does CF affect the GI tract?
What complications occur from GI involvement?
How are the GI symptoms managed in CF?
Endocrine Management & CF
How is the endocrine system affected in the CF patient?
What are the key element to that management?
Reproductive Considerations
How does CF affect male reproduction?
How does CF affect female reproduction?
Nursing Considerations r/t CF
Respiratory considerations
ways to optimize function
GI considerations
ways to prevent malabsorption
Client education
Educate to prevent complications
Complications
Resp
GI
Endocrine
Treatment Goals for CF
What are the treatment goals for CF?
What is the prognosis for the CF patient?
Sudden Infant Death Syndrome (SIDS) p 601
Sudden Infant Death Syndrome (SIDS): unexplained death, usually during sleep, of a seemingly healthy infant. AKA: crib death
SIDS is the third leading cause of infant mortality. Increased incidence in the winter months
Accounts for 40-50% of all deaths between 1 month and 1 year
Etiology: UNKNOWN
Lower incidence in breast fed babies & infants put to sleep with a pacifier
SIDS con’t
Risk Factors:
Maternal smoking
Co-sleeping
Prone sleeping (highest risk)
Heart arrhythmias
Soft bedding
Over-heating (thermal stress)
LBW or preterm babies
SIDS con’t
Nursing Care Management
Educating families about the risk of prone sleeping position (or side lying position) in infants from birth-6 mos (prone position has the highest risk of SIDS occurring)
Educating about using appropriate bedding surfaces
Avoid overheating the infant while sleeping (thermal stress)
Many people are concerned that if an infant is on it’s back it will aspirate emesis or mucous. Studies fail to show in increase in infant death from this position
Babies should be placed on their back when they go to sleep
