Respiratory Knowledge Check
1. Anatomic Differences in Pediatric Airways
• Narrower trachea and bronchi (4 mm diameter at birth vs. 18–20 mm in adults).
• Higher tracheal bifurcation (T3 vs. T6 in adults).
• Epiglottis is long, floppy, and higher in the neck, increasing risk of obstruction.
• Smaller nares and increased soft tissue lead to greater airway resistance.
• Immature cartilage (thyroid, cricoid, tracheal) can collapse more easily with neck flexion.
• Fewer alveoli at birth (20–50 million vs. 300 million by 8 years).
• Children under 6 years are primarily abdominal breathers .
2. Signs and Symptoms of Respiratory Distress
• Tachypnea or abnormal respiratory rate.
• Retractions (intercostal, subcostal, suprasternal).
• Nasal flaring.
• Head bobbing (infants).
• Grunting, wheezing, or stridor.
• Cyanosis (late sign).
• Restlessness or lethargy due to hypoxia .
3. General Nursing Management of Respiratory Disorders
• Maintain airway patency and position (e.g., elevate head of bed).
• Promote adequate oxygenation (suction, chest PT, humidification, CPAP as prescribed).
• Monitor vitals, SpO₂, and ABGs.
• Prevent infection (hand hygiene, isolation if needed).
• Ensure proper nutrition and hydration.
• Educate families on triggers, medications, and when to seek emergency care .
4. Cystic Fibrosis (CF)
a. What is it?
, • A genetic (autosomal recessive) disorder of exocrine glands, causing thick mucus obstructing
respiratory and GI tracts .
b. Diagnostics:
• Newborn screening, sweat chloride test (>60 mEq/L), genetic testing.
c. Clinical Manifestations:
• Respiratory: Chronic cough, thick mucus, frequent infections, wheezing.
• GI: Pancreatic enzyme insufficiency, steatorrhea (fatty stools), poor growth, vitamin
malabsorption .
d. Therapeutic Management:
• Airway clearance (chest physiotherapy, oscillating vests).
• Inhaled bronchodilators, mucolytics (dornase alfa).
• Pancreatic enzyme supplements and high-calorie diet.
• Antibiotics for infections.
e. Patient Education:
• Daily airway clearance, infection prevention, high-protein/high-calorie diet.
• Adherence to enzymes and vitamins (A, D, E, K).
• Genetic counseling for families.
5. Pharyngitis
a. Causes:
• Mostly viral (adenovirus), but 25% are bacterial (Group A strep) .
b. Diagnostics:
• Throat culture or rapid antigen test .
c. Clinical Manifestations:
• Abrupt onset sore throat, fever, swollen tonsils with exudate, cervical lymphadenopathy,
headache, abdominal pain .
d. Treatment:
• Supportive care for viral causes.
• Penicillin (or amoxicillin) for strep infections .
e. Patient Education:
• Complete antibiotics course.
1. Anatomic Differences in Pediatric Airways
• Narrower trachea and bronchi (4 mm diameter at birth vs. 18–20 mm in adults).
• Higher tracheal bifurcation (T3 vs. T6 in adults).
• Epiglottis is long, floppy, and higher in the neck, increasing risk of obstruction.
• Smaller nares and increased soft tissue lead to greater airway resistance.
• Immature cartilage (thyroid, cricoid, tracheal) can collapse more easily with neck flexion.
• Fewer alveoli at birth (20–50 million vs. 300 million by 8 years).
• Children under 6 years are primarily abdominal breathers .
2. Signs and Symptoms of Respiratory Distress
• Tachypnea or abnormal respiratory rate.
• Retractions (intercostal, subcostal, suprasternal).
• Nasal flaring.
• Head bobbing (infants).
• Grunting, wheezing, or stridor.
• Cyanosis (late sign).
• Restlessness or lethargy due to hypoxia .
3. General Nursing Management of Respiratory Disorders
• Maintain airway patency and position (e.g., elevate head of bed).
• Promote adequate oxygenation (suction, chest PT, humidification, CPAP as prescribed).
• Monitor vitals, SpO₂, and ABGs.
• Prevent infection (hand hygiene, isolation if needed).
• Ensure proper nutrition and hydration.
• Educate families on triggers, medications, and when to seek emergency care .
4. Cystic Fibrosis (CF)
a. What is it?
, • A genetic (autosomal recessive) disorder of exocrine glands, causing thick mucus obstructing
respiratory and GI tracts .
b. Diagnostics:
• Newborn screening, sweat chloride test (>60 mEq/L), genetic testing.
c. Clinical Manifestations:
• Respiratory: Chronic cough, thick mucus, frequent infections, wheezing.
• GI: Pancreatic enzyme insufficiency, steatorrhea (fatty stools), poor growth, vitamin
malabsorption .
d. Therapeutic Management:
• Airway clearance (chest physiotherapy, oscillating vests).
• Inhaled bronchodilators, mucolytics (dornase alfa).
• Pancreatic enzyme supplements and high-calorie diet.
• Antibiotics for infections.
e. Patient Education:
• Daily airway clearance, infection prevention, high-protein/high-calorie diet.
• Adherence to enzymes and vitamins (A, D, E, K).
• Genetic counseling for families.
5. Pharyngitis
a. Causes:
• Mostly viral (adenovirus), but 25% are bacterial (Group A strep) .
b. Diagnostics:
• Throat culture or rapid antigen test .
c. Clinical Manifestations:
• Abrupt onset sore throat, fever, swollen tonsils with exudate, cervical lymphadenopathy,
headache, abdominal pain .
d. Treatment:
• Supportive care for viral causes.
• Penicillin (or amoxicillin) for strep infections .
e. Patient Education:
• Complete antibiotics course.
