BROWARD COLLEGE NUR 1310 EXAM 2 OUTLINE 2 PEDS QUESTIONS AND ANSWERS | COMPLETE PEDIATRIC NURSING STUDY GUIDE 2026/2027

BROWARD COLLEGE NUR 1310 EXAM 2 OUTLINE 2 PEDS
QUESTIONS AND ANSWERS |
COMPLETE PEDIATRIC NURSING STUDY GUIDE 2026/2027


UNIT 8: RESPIRATORY DISORDERS

STRUCTURES OF UPPER/LOWER RESPIRATORY TRACT
• UPPER RESPIRATORY TRACT
o Mouth and nose
o Pharynx
o Larynx (voicebox)
▪ Infections of the epiglottis and larynx are categorized as croup syndromes
(respiratory INFECTION/SWELLING OF TRACHEA SYMPTOMS ARE
BARKING COUGH, HOARSE VOICE)
o Upper trachea
• LOWER RESPIRATORY TRACT
o Lower trachea
o Bronchi
o Bronchioles
o Alveoli
• Respiratory infections seldom fall into discrete anatomic areas
o Infections often spread from one structure to another because of the
contiguous nature of the mucous membrane lining the entire tract
o The effect on one area may predominate in any given illness
• Most respiratory infections are caused by viruses (e.g. RSV-RESPIRATORY
SYNTICAL VIRUS)
• RIGHT LUNG HAS THREE LOBES AND LEFT LUNG HAS TWO (the heart shares same space
as left lung).
RESPIRATORY RATES AT REST
• < 1 year = 30-40 breathes/min
• 1-2 = 25-35
• 2-5 = 25-30
• 5-12 = 20-25
• > 12 = 15-20

ASSESSING BREATH SOUNDS
• http://www.youtube.com/watch?v=5JA6D1Mguh0
• http://www.youtube.com/watch?v=t2QE0O_exAQ
• http://www.youtube.com/watch?v=Z1_uKqmPyLA
• HYPOPNEA: breathing that is too shallow
• HYPERPENEA: breathing that is too deep
• ORTHOPNEA: difficulty breathing except in upright position
o Associated with intercostal or substernal retractions
▪ Inspiratory “sinking in” of soft tissues in relation to the cartilaginous

, and bony thorax
• PULSUS PARADOXUS: blood pressure falling with inspiration and rising with expiration

, • HEAD BOBBING: head of sleeping child with sub-occipital area supported on caregiver’s
forearm bobbing forward in synchrony with each inspiration
•
• COUGH (observe characteristics)
o Under what circumstances (night only, on arising)
o Nature of the cough (paroxysmal (sudden and violent), with or
without wheezing, “croupy” or “brassy”
o Frequency of cough
o Association with swallowing or other activity
o Character of cough (moist and dry)
o Productivity
• HALITOSIS: (Term for BAD BREATHE)
o May be associated with some upper airway infections
o More common in mouth breathers

PEDIATRIC DIFFERENCES
• Diameter of airway smaller in young children
o Subject to considerable narrowing from edematous mucous membranes
and increased production of secretions
o Organisms may move rapidly down the shorter respiratory tract of
younger children, causing more extensive involvement
• Eustachian tube shorter
o Allows pathogens easy access to the middle ear
• Daycare attendance and exposure to secondhand smoke increase the likelihood of
infection
• INFANTS especially are prone to fluid and electrolytic deficits during respiratory illness
because a rapid respiratory rate that accompanies such illnesses precludes adequate
oral fluid intake
• Also, the presence of fever increases the total body fluid turnover in infants
• A/P: lateral diameter
o They are equal before age 2
o Ratio is 2:1 starting at age 2
LESS RESISTANCE TO RESPIRATORY INFECTIONS:
• Deficit in immune system (children in general)
o Children between 6 months and 3 years of age react more severely to acute
respiratory tract infections than older children
• Allergies
• Cardiac anomalies
• Cystic fibrosis
• Daycare attendance
• Second-hand smoke
o Smoke outside, not in the house

, SEASONAL VARIATIONS IN RESPIRATORY INFECTION
• Respiratory conditions more common during winter and spring
• Mycoplasma infections aka (PNEUMONIA) OTITIS MEDIA WHICH IS EAR INFECTION
ALSO OCCUR: fall and early winter
• Asthma: more frequent in cold weather, winter and early spring
• RSV (respiratory synctical virus) season: winter and early spring

BRONCHIOLOTIS
• Inflammation of bronchioles
• Viral infection
• Maximum effect at the bronchiolar level
• INCIDENCE
o Common cause for hospitalization < age 1
o More common in children < 2 years
o Peak age: 2-6 months
o Tends to occur in winter and spring
• ETIOLOGY-CAUSE
o Viral: adenovirus, parainfluenza
o Bacteria
o Microplasma AKA PNEUMONIA
o Most common cause: RSV (respiratory synctical virus)

TRANSMISSION/PATHOPHYSIOLOGY OF BRONCHIOLOTIS
• TRANSMISSION
o Person to person from contaminated hands
▪ Virus can live several hours on fomites(door,table,desk etc) and on
hands for 30 minutes
o Nosocomial outbreaks common
• PATHOPHYSIOLOGY
o Viruses invade epithelial cell walls of respiratory tract (RSV produces a fusion of
cell membranes, forming a giant cell) edema, mucus, cellular debris  clogging of
bronchioles  obstruction & irritation, edema & inflammation  increased mucus
and decreased air transport  hyperinflation  impaired gas exchange (patient
can’t exhale well, trapping air in alveoli) increased PaCO2, acidosis
o ALTERNATIVE PATHOPHYSIOLOGY FROM CHART ON NEXT SLIDE:
▪ Upper respiratory infection usually by respiratory syncytial virus (RSV) 
edema, mucus, and cellular debris obstruct bronchioles  bronchioles
constrict during expiration, causing hyperinflation of lungs  atelectasis
(which is complete or partial collapse of lung/lobe) occurs when
obstruction is complete and trapped air is absorbed  normal exchange of
gases impaired  hypoxemia  metabolic acidosis, mild respiratory alkalosis