MED 2059 - Exam 2 Review.

MED 2059 Exam # 2
Topics to Review
DISORDERS:
I. Respiratory System Disorders
a. Discuss croup, its causes, pathophysiology, clinical manifestations, complications, treatment, and
nursing interventions
Croup: Weakness in airway walls
Causes:
▪ Viral(more common) or congenital cause
▪ If viral, due to parainfluenza virus
Manifestations:
▪ Inspiratory stridor
▪ Symptoms lessen when infant is placed prone or propped in side-lying position
▪ Usually clears spontaneously as child grows and muscle strengthen
Treatment:
Humidified air
b. Discuss epiglottitis, its causes, pathophysiology, clinical manifestations, complications, treatment,
and nursing interventions
Epiglottis: swelling of the tissues above the vocal chords
Cause:
▪ H. influenzae type B (bacterial)needs IV antibiotics
Clinical manifestation
▪ Rapid, progressive, and life threatening
▪ Most often seen in children 3 to 6 years of age
▪ Respiratory distress, tripod position, increased RR, stridor, muffled voiced/hoarse voice, drooling
Interventions:
▪ DO NOT attempt to examine the mouth using a tongue depressorlaryngospasm
c. Discuss tonsilitis, its causes, pathophysiology, clinical manifestations, complications, treatment, and
nursing interventions after surgeries
Treatment:
▪ IV antibiotics
Tonsilititis: Made of lymph tissue and are part of the body's defense against infection
Manifestastions: Difficulty swallowing and breathing
Treatment: cool mist vaporizer, salt-water gargles, throat lozenges(if age-appropriate), cool liquid diet,
acetaminophen, increase oral fluid intake
Tonsillectomy: Tonsillectomy done only is persistent airway obstruction or difficulty breathing occurs
▪ Watch out for bleeding ; increased swallowing, high pulse rate, low BP, increased PR,
hematemesis, hemoptysis(coughing up blood)
▪ Clearing throatremoval of suturesbleeding

, d. Discuss RSV (bronchiolitis), its causes, pathophysiology, clinical manifestations,
complications, treatment, and nursing interventions
RSV (bronchiolitis):
▪ Spread by direct contact with respiratory secretionplace in
▪ Survives more than 6 hours on countertops, tissues, and bars of soap
▪ Incubation approximately 4 days
Pathophysiology:
▪ Causes cells to rupture and move to the airwaysbronchoconstrictionincreased secretions to excrete
DX:
▪ ELISA test nasal secretions
MGT:

▪ Humidified O2, increase IV fluid intake, suction the secretions PRN, give synagis (palivizumab)
e. Discuss asthma, its causes, pathophysiology, clinical manifestations, complications, treatment,
medications, and nursing interventions
Asthma:
Infants:
▪ Decreased smooth muscle of an infant’s airway
▪ Prescence of increased mucus glands in the bronchi
▪ Normally narrow lumen of the normal airway
▪ Lack of muscle elasticity in the airway
▪ Fatigue-prone and overworked diaphragmatic muscle on which infant respirations depend
Cause:
▪ Most common cause is second-hand
smoke Manifestations:
▪ Expiratory wheeze due to obstruction
▪ Signs of air hunger, such as flaring of the nostrils, and use of accessory muscles may be evident;
orthopnea appears
▪ Coughs and wheezes and has difficulty breathing, particularly during expiration
MGT:

▪ Salbutamol during asthma attack
▪ Albuterolwatchout for tachycardia and insomnia
▪ Bronchodilator first , followed by antiinflammation
▪ Steroid inhalerrinse mouth afterwards to prevent oral thrush
▪ Effective therapyno more wheezing, no more retractions
▪ Assess severity of conditionability to talk
▪ Routine immunization
▪ Pulmonary function test for older children
▪ Identify triggers and control allergens
Complications:
Status Asthmaticus:
▪ ICU admission, supplemental oxygen, IV medications, and frequent vital signs are essential