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