NSG 3600
EXAM 2 STUDY GUIDE
Nursing Practice – Children’s Health
Galen College of Nursing
, Exam #2 Study Guide
https://quizlet.com/414753995/peds-exam-2-flash-cards/
Normal Pediatric Vital Signs
Respiratory=> WHEN CHILD’S HEALTH IS GOING DOWN IT US USUALLY RESP. CAUSE!!
● Differences in Size, Structure, and Function of the Child’s Respiratory System
●
● Upper respiratory tract
○ Nose, pharynx, larynx, upper trachea
○ Acute nasopharyngitis (common cold), pharyngitis, tonsillitis, influenza, otitis media, infectious
mononucleosis, Pertussis
○ Croup syndromes: acute epiglottitis, LTB, spasmodic laryngitis, tracheitis
○ Others � foreign body aspiration
○ Prolonged inspiratory phase = upper airway obstruction
■ Croup/ foreign body
● Lower respiratory tract
○ Lower trachea, bronchi and bronchioles, alveoli
○ Bronchitis, RSV/bronchiolitis, pneumonia, asthma, cystic fibrosis
■ Cartilaginous support not fully developed until adolescence
■ Constriction of airways
■ Prolonged expiratory phase = asthma
● Respiratory Assessment
, ○ NORMAL=> Inspiratory phase slightly longer or equal to expiratory phase
● Respiratory Distress
○ Grunting = impending respiratory failure
■ PEEP: positive pressure to keep the lungs open
■ Patient is going into respiratory failure
○ Severe retractions
○ Diminished or absent breath sounds
○ Apnea or gasping respirations
○ Poor systemic perfusion / mottling
○ Tachycardia to bradycardia ***
○ Decrease oxygen saturations (note wave form and correlating heart rate)
■ Heart rate and pulse rate should match each other
○
■ RAT first and later BED
● Know what this look likes in peds: FINES
● Beware if the retractions are higher , the more serious the respiratory problem is
becoming
○ FIRST SIGN OF HYPOXIA IS ALTERED LOC!!!
○ Tx of Resp. Distress
■ Stimulate the infant / child - remember crying or activity will help mobilize secretions
and expand lungs
■ Have the older child sit up take deep breaths and cough
■ Chest percussion to loosen secretions
■ Give oxygen
■ Assess if interventions work
● Call for help if you need it – pull the emergency cord – yell for help
● Croup Syndrome (Upper Resp. Infection) (p.746)
, ○ Croup: Croup syndromes affect larynx, trachea, & bronchi; a general term applied to a symptom
complex characterized by
■ hoarseness, a “barking” or “brassy” cough, inspiratory stridor, drooling, and varying
degrees of respiratory distress resulting from swelling or obstruction in the larynx
region
■ Types=> Epiglottitis ( MOST SEVRE/ EMERGENGY), laryngitis, laryngotracheobronchitis
(LTB), tracheitis (MOST COMMON).
○ Care:
■ Home:
● Cool mist – can instruct parents to open freezer door or take outside if cool.
● Fluids
■ Hospital
● Nebulizer treatments with epinephrine/steroid inhalant
● IV fluids if not taking PO fluids
○ Conditions Part of Croup Syndrome
● Epiglottitis: a type of croup syndrome caused by a BACTERIA; a serious obstructive
inflammatory process (inflammation of epiglottis)... (epiglottis is a flap in the throat
that keeps food from entering the windpipe and the lungs) (p. 747)
○ True pediatric emergency!
■ Rapidly progress to severe respiratory distress
○ Clinical Manifestations:
■ Increased pulse
■ Restlessness/irritable
■ Retractions
■ Anxiety increased
■ Inspiratory stridor
■ ***Drooling****TQQQ
■ Sore throat
■ Pain when swallowing
■ Fever
■ Insists on sitting upright (tripoding)
■ Thick/muffled voice
■ Red & inflamed throat
■ Distinctive large, cherry red, edematous epiglottis
○ Treatment:
■ Decrease anxiety*** TQ
■ ***Don’t examine throat!***TQ
○ Don’t put anything in through may close off airway completely**
■ Position for comfort
■ Trach tray or endotracheal tube available ****TQ
■ Humidified oxygen***TQ
■ No oral fluids=> NPO!
■ IV fluids
EXAM 2 STUDY GUIDE
Nursing Practice – Children’s Health
Galen College of Nursing
, Exam #2 Study Guide
https://quizlet.com/414753995/peds-exam-2-flash-cards/
Normal Pediatric Vital Signs
Respiratory=> WHEN CHILD’S HEALTH IS GOING DOWN IT US USUALLY RESP. CAUSE!!
● Differences in Size, Structure, and Function of the Child’s Respiratory System
●
● Upper respiratory tract
○ Nose, pharynx, larynx, upper trachea
○ Acute nasopharyngitis (common cold), pharyngitis, tonsillitis, influenza, otitis media, infectious
mononucleosis, Pertussis
○ Croup syndromes: acute epiglottitis, LTB, spasmodic laryngitis, tracheitis
○ Others � foreign body aspiration
○ Prolonged inspiratory phase = upper airway obstruction
■ Croup/ foreign body
● Lower respiratory tract
○ Lower trachea, bronchi and bronchioles, alveoli
○ Bronchitis, RSV/bronchiolitis, pneumonia, asthma, cystic fibrosis
■ Cartilaginous support not fully developed until adolescence
■ Constriction of airways
■ Prolonged expiratory phase = asthma
● Respiratory Assessment
, ○ NORMAL=> Inspiratory phase slightly longer or equal to expiratory phase
● Respiratory Distress
○ Grunting = impending respiratory failure
■ PEEP: positive pressure to keep the lungs open
■ Patient is going into respiratory failure
○ Severe retractions
○ Diminished or absent breath sounds
○ Apnea or gasping respirations
○ Poor systemic perfusion / mottling
○ Tachycardia to bradycardia ***
○ Decrease oxygen saturations (note wave form and correlating heart rate)
■ Heart rate and pulse rate should match each other
○
■ RAT first and later BED
● Know what this look likes in peds: FINES
● Beware if the retractions are higher , the more serious the respiratory problem is
becoming
○ FIRST SIGN OF HYPOXIA IS ALTERED LOC!!!
○ Tx of Resp. Distress
■ Stimulate the infant / child - remember crying or activity will help mobilize secretions
and expand lungs
■ Have the older child sit up take deep breaths and cough
■ Chest percussion to loosen secretions
■ Give oxygen
■ Assess if interventions work
● Call for help if you need it – pull the emergency cord – yell for help
● Croup Syndrome (Upper Resp. Infection) (p.746)
, ○ Croup: Croup syndromes affect larynx, trachea, & bronchi; a general term applied to a symptom
complex characterized by
■ hoarseness, a “barking” or “brassy” cough, inspiratory stridor, drooling, and varying
degrees of respiratory distress resulting from swelling or obstruction in the larynx
region
■ Types=> Epiglottitis ( MOST SEVRE/ EMERGENGY), laryngitis, laryngotracheobronchitis
(LTB), tracheitis (MOST COMMON).
○ Care:
■ Home:
● Cool mist – can instruct parents to open freezer door or take outside if cool.
● Fluids
■ Hospital
● Nebulizer treatments with epinephrine/steroid inhalant
● IV fluids if not taking PO fluids
○ Conditions Part of Croup Syndrome
● Epiglottitis: a type of croup syndrome caused by a BACTERIA; a serious obstructive
inflammatory process (inflammation of epiglottis)... (epiglottis is a flap in the throat
that keeps food from entering the windpipe and the lungs) (p. 747)
○ True pediatric emergency!
■ Rapidly progress to severe respiratory distress
○ Clinical Manifestations:
■ Increased pulse
■ Restlessness/irritable
■ Retractions
■ Anxiety increased
■ Inspiratory stridor
■ ***Drooling****TQQQ
■ Sore throat
■ Pain when swallowing
■ Fever
■ Insists on sitting upright (tripoding)
■ Thick/muffled voice
■ Red & inflamed throat
■ Distinctive large, cherry red, edematous epiglottis
○ Treatment:
■ Decrease anxiety*** TQ
■ ***Don’t examine throat!***TQ
○ Don’t put anything in through may close off airway completely**
■ Position for comfort
■ Trach tray or endotracheal tube available ****TQ
■ Humidified oxygen***TQ
■ No oral fluids=> NPO!
■ IV fluids
