1Gas Exchange- O2 into the cells, CO2 out of the cells
Exemplars-
TEF (Tracheoesophageal Fistula)
Aspiration Pneumonia
RSV
Asthma
COPD
Tracheal Esophageal Fistula- (pediatric and newborn)
An abnormal communication between the trachea and the esophagus. A fistula is when two
tubes are combined. Atresia is the abnormality with the esophagus with a blind pouch
4 main types-
Type a- esophagus ends in a blind pouch not the stomach. When the pt breathes their stomach
fills up with air
Type b- where both portions end in a blind pouch, no fistula
Type c- one segment but its very narrow so they cant eat
Type d- fistula connects esophagus to the trachea
Patho- doesn’t happen alone. Would have kidney, heart and GI abnormalities
Happens early in fetal development
Risk factors-
polyhydramnios - huge risk factor. Too much amniotic fluid in utero because the baby can't
swallow the amniotic fluid. First sign they have this disorder
Idiopathic disorder- no clear cause
Three Cs- coughing, choking and cyanosis. Lots of frothy sputum in nose and mouth, excessive
drooling, abdominal distension
Auscultation- rattling respirations, wet lungs, increases risk for pneumonitis and atelectasis.
Ultrasound.
Once confirmed you get reading for surgery (anastomosis- connecting the ends of the tubes
together)
Aspiration pneumonia- food or fluid in the lungs
Typically bacterial, pt with impaired swallowing and decreased LOC pts, anything that
decreases coughing reflex
Common pathogens- staph a, streptococcal, gram neg bacilli
, Clinical assessment/ diagnosis-
Bronchopneumonia (streptococcus)- chills, rapid onset fever, pleuritic chest pain (stabbing when
breathing in), Tachypnea, use of accessory muscles, orthopnea
Blood cultures, sputum cultures, good history, listen to lungs
interventions- antibiotics, position,rest,hydrate,symptom manage
RSV- respiratory synctival virus- can breathe in but cant breathe out
Pathophysiology- highly contagious through contact with secretions or particles on objects.
Invades nasal pharynx into the lower respiratory tract
Mucus plugging- obstruction of airways
Lung hyperinflation, Atelectasis, hypoxemia, hypercapnia,
human metapneumovirus
Risk factors- young age, premature babies, day care attendance, chronic lung disease,
congenital heart disease, boys are more likely
Clinical manifestations/assessment- appearance, color, air hunger, cyanosis, resp distress,
coughing, audible wheezing, listless (uninterested in surroundings), listen to the lungs, quiet
lungs is complete obstruction
Diagnostics- pulse oximetry, chest x-ray, blood gases,nasal pharyngeal washings,
***rRT-PCR (nasal swab test) best one.
Therapeutic management- focuses on supportive treatment
Supplemental oxygen, nasal and or nasopharyngeal suctioning, oral or IV hydration, inhaled
bronchodilator therapy
Nursing management- maintain patent airway,promote adequate gas exchange, reduce risk for
infection, parent education
Prevention med-nirsemivab
RSV bronchitis- frequency and severity of the disease decrease with increasing age
Asthma- reversible. Chronic airway inflammation
There can be asthma and COPD overlap, smokers are at a higher risk
4 Types
Intermittent asthma
Mild persistent
Moderate persistent
Severe persistent
Exemplars-
TEF (Tracheoesophageal Fistula)
Aspiration Pneumonia
RSV
Asthma
COPD
Tracheal Esophageal Fistula- (pediatric and newborn)
An abnormal communication between the trachea and the esophagus. A fistula is when two
tubes are combined. Atresia is the abnormality with the esophagus with a blind pouch
4 main types-
Type a- esophagus ends in a blind pouch not the stomach. When the pt breathes their stomach
fills up with air
Type b- where both portions end in a blind pouch, no fistula
Type c- one segment but its very narrow so they cant eat
Type d- fistula connects esophagus to the trachea
Patho- doesn’t happen alone. Would have kidney, heart and GI abnormalities
Happens early in fetal development
Risk factors-
polyhydramnios - huge risk factor. Too much amniotic fluid in utero because the baby can't
swallow the amniotic fluid. First sign they have this disorder
Idiopathic disorder- no clear cause
Three Cs- coughing, choking and cyanosis. Lots of frothy sputum in nose and mouth, excessive
drooling, abdominal distension
Auscultation- rattling respirations, wet lungs, increases risk for pneumonitis and atelectasis.
Ultrasound.
Once confirmed you get reading for surgery (anastomosis- connecting the ends of the tubes
together)
Aspiration pneumonia- food or fluid in the lungs
Typically bacterial, pt with impaired swallowing and decreased LOC pts, anything that
decreases coughing reflex
Common pathogens- staph a, streptococcal, gram neg bacilli
, Clinical assessment/ diagnosis-
Bronchopneumonia (streptococcus)- chills, rapid onset fever, pleuritic chest pain (stabbing when
breathing in), Tachypnea, use of accessory muscles, orthopnea
Blood cultures, sputum cultures, good history, listen to lungs
interventions- antibiotics, position,rest,hydrate,symptom manage
RSV- respiratory synctival virus- can breathe in but cant breathe out
Pathophysiology- highly contagious through contact with secretions or particles on objects.
Invades nasal pharynx into the lower respiratory tract
Mucus plugging- obstruction of airways
Lung hyperinflation, Atelectasis, hypoxemia, hypercapnia,
human metapneumovirus
Risk factors- young age, premature babies, day care attendance, chronic lung disease,
congenital heart disease, boys are more likely
Clinical manifestations/assessment- appearance, color, air hunger, cyanosis, resp distress,
coughing, audible wheezing, listless (uninterested in surroundings), listen to the lungs, quiet
lungs is complete obstruction
Diagnostics- pulse oximetry, chest x-ray, blood gases,nasal pharyngeal washings,
***rRT-PCR (nasal swab test) best one.
Therapeutic management- focuses on supportive treatment
Supplemental oxygen, nasal and or nasopharyngeal suctioning, oral or IV hydration, inhaled
bronchodilator therapy
Nursing management- maintain patent airway,promote adequate gas exchange, reduce risk for
infection, parent education
Prevention med-nirsemivab
RSV bronchitis- frequency and severity of the disease decrease with increasing age
Asthma- reversible. Chronic airway inflammation
There can be asthma and COPD overlap, smokers are at a higher risk
4 Types
Intermittent asthma
Mild persistent
Moderate persistent
Severe persistent
