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Pediatric FALL 2025
Sabrina Arocho
PPT 3 Study Guide
RESPIRATORY
● Vocab
○ Alveoli: small sacs where oxygen-carbon dioxide exchange takes place
○ Atlectasis: collapse of lung
○ Barrel of chest: anteroposterior diameter of chest is increased giving a rounded
appearance, caused by air-trapped and hyperinflaction of alveoli
○ clubbing: increasing rounding of nails- indicative of prolonged hypoxia
○ hypercapnia: excessive carbon dioxide in blood
○ Peak expiratory flow rate: maximum amount of air that can be forcibly exhaled
○ surfactant: phospholipid produced by alveoli that reduces surface tension of fluids
and also aids in lung expansion
○ sweet test: non-invasive diagnostic test performed to measure sodium and
chloride concentration. Obtained from forearm.>60meq/L is diagnostic for cystic
fibrosis
● Diagnostic Tests
○ CHest XRay
■ 2D visualization of size and shape of airway, lungs, heart, diaphragm, and
rib cage
■ lead apron may be required
○ CT
■ contrast medium may be used therefore child may need to be NPO 3-4
hours prior
■ requires complete immobilization and possible sedation
○ Bronchoscopy
■ a scope is used to directly visualize tranchea and bronchi, lesions can be
located and sized and secretions or foreign body can be cleared
■ Preprocedural
● informed consent needed!
● child NPO
● administer sedative and observe for respiratory for depression
■ Post op
● Keep NPO until gag reflex returns
● position flat
● expect blood-streaked sputum for several hours
○ Pulmonary Function test
, 2
■ 5-6 years old is able to follow commands and cooperate
■ Peak expiratory flow rate - using spirometer
○ Sputum Culture
■ young children through nasal or gastric washing to obtain sample
○ Arterial Blood Gas
■ Collected in a heparinized syringe, placed in ice and transported to lab
STAT
● Cystic Fibrosis
○ multisystem disorder of exocrine glands resulting in viscosity of secretions
obstructs passageways of these organs thus prohibiting function
○ inherited as an autosomal recessive trait on chromosome 7
○ diagnosis occurs during infancy and early childhood most prominently in
Caucasian
○ complications
■ pulmonary dysfunction is greatest threat
■ pancreatic ducts become clogged and prevent insulin release
■ small intestines are unable to absorb fats and proteins
○ diagnostic assessment
■ Sweat test
■ 72 hours fecal fat
■ CXR
■ Prenatal DNA testing
■ Hx of resp tract infections
■ cough, sputum, clubbing
■ growth chart, nutritional status
○ Nursing Interventions
■ frequent assessment
■ daily weights
■ chest pt
■ high calorie/protein meals
■ administer medications
● nebulizers
● pancreatic enzymes
● insulin to control hyperglycemia
○ Education
■ Infection control
■ Pancrealipase(creon)- given with ALL meals
■ Chest PT done BEFORE Meals and TID -QID
Pediatric FALL 2025
Sabrina Arocho
PPT 3 Study Guide
RESPIRATORY
● Vocab
○ Alveoli: small sacs where oxygen-carbon dioxide exchange takes place
○ Atlectasis: collapse of lung
○ Barrel of chest: anteroposterior diameter of chest is increased giving a rounded
appearance, caused by air-trapped and hyperinflaction of alveoli
○ clubbing: increasing rounding of nails- indicative of prolonged hypoxia
○ hypercapnia: excessive carbon dioxide in blood
○ Peak expiratory flow rate: maximum amount of air that can be forcibly exhaled
○ surfactant: phospholipid produced by alveoli that reduces surface tension of fluids
and also aids in lung expansion
○ sweet test: non-invasive diagnostic test performed to measure sodium and
chloride concentration. Obtained from forearm.>60meq/L is diagnostic for cystic
fibrosis
● Diagnostic Tests
○ CHest XRay
■ 2D visualization of size and shape of airway, lungs, heart, diaphragm, and
rib cage
■ lead apron may be required
○ CT
■ contrast medium may be used therefore child may need to be NPO 3-4
hours prior
■ requires complete immobilization and possible sedation
○ Bronchoscopy
■ a scope is used to directly visualize tranchea and bronchi, lesions can be
located and sized and secretions or foreign body can be cleared
■ Preprocedural
● informed consent needed!
● child NPO
● administer sedative and observe for respiratory for depression
■ Post op
● Keep NPO until gag reflex returns
● position flat
● expect blood-streaked sputum for several hours
○ Pulmonary Function test
, 2
■ 5-6 years old is able to follow commands and cooperate
■ Peak expiratory flow rate - using spirometer
○ Sputum Culture
■ young children through nasal or gastric washing to obtain sample
○ Arterial Blood Gas
■ Collected in a heparinized syringe, placed in ice and transported to lab
STAT
● Cystic Fibrosis
○ multisystem disorder of exocrine glands resulting in viscosity of secretions
obstructs passageways of these organs thus prohibiting function
○ inherited as an autosomal recessive trait on chromosome 7
○ diagnosis occurs during infancy and early childhood most prominently in
Caucasian
○ complications
■ pulmonary dysfunction is greatest threat
■ pancreatic ducts become clogged and prevent insulin release
■ small intestines are unable to absorb fats and proteins
○ diagnostic assessment
■ Sweat test
■ 72 hours fecal fat
■ CXR
■ Prenatal DNA testing
■ Hx of resp tract infections
■ cough, sputum, clubbing
■ growth chart, nutritional status
○ Nursing Interventions
■ frequent assessment
■ daily weights
■ chest pt
■ high calorie/protein meals
■ administer medications
● nebulizers
● pancreatic enzymes
● insulin to control hyperglycemia
○ Education
■ Infection control
■ Pancrealipase(creon)- given with ALL meals
■ Chest PT done BEFORE Meals and TID -QID
