NUR 4445 Respiratory Dysfunction
1. Pediatric Respiratory System
Answer
Respiratory dysfunction is the primary cause of hospitalization in children
-Also primary cause of cardiopulmonary failure
Respiratory system grows until age 12 years Consume more oxygen due to increase metabolic
rate Short neck, can result in an occluded airway
2. Correcting Airway Dysfunction
Answer
"Sniffing position"
Attempting to get neck straight to optimize child's ability to breathe
3. Retractions
Answer
Pulling musculature in their chest wall
We lose it, but the COPD patients get it back
4. Anatomy and Physiology that make children more at risk for respiratory dysfunction
Answer
Small airways (trachea, lower airway)
Fewer alveoli
Nose, pharynx, & nasopharynx are also smaller Infants are nose breathers (until 4-6 months)
Chest wall is soft & pliable
Poorly developed respiratory muscles Immature immune system
,Hand-to-mouth activity
Close contact with other children Preterm babies lack surfactant Decreased oxygen stores
5. Assessment
Answer
Color
Respiratory Effort Vital Signs
Upper respiratory Auscultation
Feeding pattern & presence of emesis
Behavior
6. Color
Answer
Pale or cyanosis, especially periorbital
7. Respiratory Effort
Answer
Retractions, nasal flaring Cough, sputum (color & consistency)
Position of the child
8. Vital Signs
Answer
Respiratory rate, heart rate, oxygen saturation, temp
We start to intervene when we see cyanosis
-Central or oral cyanosis - not good!!
-Children of color- look at mucous membranes or ears to look for cyanosis
, Patients can maintain adequate oxygenation between 90-95% as long as their RR is WNL and
the patient is still, quiet, with no cyanosis.
9. Upper respiratory
Answer
Rhinorrhea - color, consistency
Nasal passage patency Hoarse voice, sore throat Oral cavity & pharynx
-Make sure they aren't foaming ’ means they are not breathing through nose and not swallowing
the spit in their mouth
Crying is good, crying releases moisture and secretions ALWAYS INSPECT FIRST!!
10. Auscultation
Answer
Best auscultation is with a pediatric stethoscope because it fo- cuses on the small airways
-Can hear the spaces much better
Airflow in and out Breath sounds
Abnormal sounds in which part of the lung
11. Feeding pattern & presence of emesis
Answer
Feeding well or poor
-Find out when they ate last ’ can choke on food or liquids
-Often choke with breastfeeding if the baby has poor latching
Emesis all mucous
12. Behavior
Answer
Anxiety or restlessness, altered level of consciousness
1. Pediatric Respiratory System
Answer
Respiratory dysfunction is the primary cause of hospitalization in children
-Also primary cause of cardiopulmonary failure
Respiratory system grows until age 12 years Consume more oxygen due to increase metabolic
rate Short neck, can result in an occluded airway
2. Correcting Airway Dysfunction
Answer
"Sniffing position"
Attempting to get neck straight to optimize child's ability to breathe
3. Retractions
Answer
Pulling musculature in their chest wall
We lose it, but the COPD patients get it back
4. Anatomy and Physiology that make children more at risk for respiratory dysfunction
Answer
Small airways (trachea, lower airway)
Fewer alveoli
Nose, pharynx, & nasopharynx are also smaller Infants are nose breathers (until 4-6 months)
Chest wall is soft & pliable
Poorly developed respiratory muscles Immature immune system
,Hand-to-mouth activity
Close contact with other children Preterm babies lack surfactant Decreased oxygen stores
5. Assessment
Answer
Color
Respiratory Effort Vital Signs
Upper respiratory Auscultation
Feeding pattern & presence of emesis
Behavior
6. Color
Answer
Pale or cyanosis, especially periorbital
7. Respiratory Effort
Answer
Retractions, nasal flaring Cough, sputum (color & consistency)
Position of the child
8. Vital Signs
Answer
Respiratory rate, heart rate, oxygen saturation, temp
We start to intervene when we see cyanosis
-Central or oral cyanosis - not good!!
-Children of color- look at mucous membranes or ears to look for cyanosis
, Patients can maintain adequate oxygenation between 90-95% as long as their RR is WNL and
the patient is still, quiet, with no cyanosis.
9. Upper respiratory
Answer
Rhinorrhea - color, consistency
Nasal passage patency Hoarse voice, sore throat Oral cavity & pharynx
-Make sure they aren't foaming ’ means they are not breathing through nose and not swallowing
the spit in their mouth
Crying is good, crying releases moisture and secretions ALWAYS INSPECT FIRST!!
10. Auscultation
Answer
Best auscultation is with a pediatric stethoscope because it fo- cuses on the small airways
-Can hear the spaces much better
Airflow in and out Breath sounds
Abnormal sounds in which part of the lung
11. Feeding pattern & presence of emesis
Answer
Feeding well or poor
-Find out when they ate last ’ can choke on food or liquids
-Often choke with breastfeeding if the baby has poor latching
Emesis all mucous
12. Behavior
Answer
Anxiety or restlessness, altered level of consciousness
