NR 602 QUIZ 3 STUDY GUIDE
Respiratory Infections
- Leading cause of morbidity and mortality in children
- Respiratory failure can develop rapidly with ominous symptoms
- Be able to recognize key respiratory sounds
o Croup cough vs. other coughs *Sound bit croup cough: see
link under Croup*
o Inspiratory stridor *Sound bit:
(https://www.easyauscultation.com/heart-lung-sounds-
details/140/Stridor)
o Wheezing * Sound bit:
(https://www.easyauscultation.com/heart-lung-sounds-
details/71/Wheeze)
- Critical Sign: Tachypnea!
o Respiratory Rates:
Infants (birth to 12 months): 30-53 bpm (RR > 60
requires further evaluation)
Toddlers (1-2 yrs): 22-37 bpm (RR > 40 requires
further evaluation)
Preschool (3-5 yrs): 20-28 bpm
School Age (6-9 yrs): 18-25 bpm
Pre-Adolescent (10-11 yrs): 18-25 bpm
Adolescent (12yrs and older): 12-20 bpm
o Red Flags: Tachypnea +
grunting,
nasal flaring,
use of accessory muscles
- Upper Respiratory Infections are the most common (common cold)
, o Most often Viral
Rhinovirus, Parainfluenza, RSV, Coronavirus, human
metapneumovirus
Self-limiting lasting 7-10days
o Peak: Spring and Winter
o Common Sxs: (gradual onset)
Low grade fever
Nasal Congestion
Sore throat, hoarseness
*Hallmark: Rhinorrhea (clear at first, progresses to
purulent)
Cough/Sneezing
o Clinical Findings:
Conjunctiva: mild injection
Erythematous nasal mucosa with mucus
Erythematous posterior oropharynx
Anterior cervical lymphadenopathy
- Diagnostics:
o ONLY if in doubt of URI: sore throat without drainage or
cough
Rapid antigen detection test (RADT): rapid strep
Throat culture if RADT negative
o Treatment: Supportive Care
Hydration
OTC antipyretics as directed (weight dose)
Normal saline nasal rinse
Topical menthol
NO Antibiotics prophylactically
o Complications: secondary infection
Bacterial infection
, Otitis media
Sinusitis
Asthma exacerbation
- Pharyngitis, Tonsillitis, and Tonsillopharyngitis
o Inflammation of mucosal lining of the throat structures
o Infectious or noninfectious causes
Viral or bacterial
Viral (most common): adenovirus (pharyngitis
primary sx), Epstein-Barr (EBV), herpes simplex
(HSV), cytomegalovirus (CMV), enterovirus,
parainfluenza, HIV
o Upper nasal symptoms, cough and
rhinorrhea, hoarseness, conjunctivitis, rash,
diarrhea
o Occur year round, except adenovirus which
is predominantly summer (contaminated
swimming pools)
Bacterial: GABHS (most common in 5-13 year
olds), gonococcal (15-19 year olds),
Corynebacterium diphtheria (RARE),
Arcanobacterium haemolyticum, Neisseria
gonorrheae(adolescents), Chlamydia trachomatis
(adolescents), Francisella tularensis, Mycoplasma
pneumonia, Group C & G Strep
o GABHS: typically late winter and early
spring
o Acute abrupt onset: sore throat, headache,
nausea, vomiting, abdominal pain, myalgia,
arthralgia, malaise
Respiratory irritants (smoke)
Respiratory Infections
- Leading cause of morbidity and mortality in children
- Respiratory failure can develop rapidly with ominous symptoms
- Be able to recognize key respiratory sounds
o Croup cough vs. other coughs *Sound bit croup cough: see
link under Croup*
o Inspiratory stridor *Sound bit:
(https://www.easyauscultation.com/heart-lung-sounds-
details/140/Stridor)
o Wheezing * Sound bit:
(https://www.easyauscultation.com/heart-lung-sounds-
details/71/Wheeze)
- Critical Sign: Tachypnea!
o Respiratory Rates:
Infants (birth to 12 months): 30-53 bpm (RR > 60
requires further evaluation)
Toddlers (1-2 yrs): 22-37 bpm (RR > 40 requires
further evaluation)
Preschool (3-5 yrs): 20-28 bpm
School Age (6-9 yrs): 18-25 bpm
Pre-Adolescent (10-11 yrs): 18-25 bpm
Adolescent (12yrs and older): 12-20 bpm
o Red Flags: Tachypnea +
grunting,
nasal flaring,
use of accessory muscles
- Upper Respiratory Infections are the most common (common cold)
, o Most often Viral
Rhinovirus, Parainfluenza, RSV, Coronavirus, human
metapneumovirus
Self-limiting lasting 7-10days
o Peak: Spring and Winter
o Common Sxs: (gradual onset)
Low grade fever
Nasal Congestion
Sore throat, hoarseness
*Hallmark: Rhinorrhea (clear at first, progresses to
purulent)
Cough/Sneezing
o Clinical Findings:
Conjunctiva: mild injection
Erythematous nasal mucosa with mucus
Erythematous posterior oropharynx
Anterior cervical lymphadenopathy
- Diagnostics:
o ONLY if in doubt of URI: sore throat without drainage or
cough
Rapid antigen detection test (RADT): rapid strep
Throat culture if RADT negative
o Treatment: Supportive Care
Hydration
OTC antipyretics as directed (weight dose)
Normal saline nasal rinse
Topical menthol
NO Antibiotics prophylactically
o Complications: secondary infection
Bacterial infection
, Otitis media
Sinusitis
Asthma exacerbation
- Pharyngitis, Tonsillitis, and Tonsillopharyngitis
o Inflammation of mucosal lining of the throat structures
o Infectious or noninfectious causes
Viral or bacterial
Viral (most common): adenovirus (pharyngitis
primary sx), Epstein-Barr (EBV), herpes simplex
(HSV), cytomegalovirus (CMV), enterovirus,
parainfluenza, HIV
o Upper nasal symptoms, cough and
rhinorrhea, hoarseness, conjunctivitis, rash,
diarrhea
o Occur year round, except adenovirus which
is predominantly summer (contaminated
swimming pools)
Bacterial: GABHS (most common in 5-13 year
olds), gonococcal (15-19 year olds),
Corynebacterium diphtheria (RARE),
Arcanobacterium haemolyticum, Neisseria
gonorrheae(adolescents), Chlamydia trachomatis
(adolescents), Francisella tularensis, Mycoplasma
pneumonia, Group C & G Strep
o GABHS: typically late winter and early
spring
o Acute abrupt onset: sore throat, headache,
nausea, vomiting, abdominal pain, myalgia,
arthralgia, malaise
Respiratory irritants (smoke)
