Summary NCLEX Respiratory Review

Peds:
Acute Epiglottitis

Patho

●​ caused by HIB- is preventable from vaccination
●​ present very suddenly

Clinical Manifestations

●​ sudden fever
●​ sore throat
●​ restless
●​ anxious
●​ agitated
●​ Tripod position- resp distress
○​ 4 D's
■​ drooling
■​ dysphonia
■​ dysphagia
■​ distress
■​ retractions, stridor, nasal flaring

Nursing Interventions

●​ AIRWAY
●​ intubation or trach
●​ watch cardiac and pulse ox
●​ IV abx
●​ NPO
●​ IV fluids
●​ nothing in the mouth- no swabbing, tongue depressors or oral temps
○​ causes laryngeal spasm

Asthma

Risk Factors

●​ Meds: beta blockers (causes bronchospasm) + aspirin

Clinical Features

●​ chest tightness
○​ DIB
○​ wheezing
○​ cough
●​ Mod - Severe
○​ resp distress
■​ tachypnea

, ■​ retractions
■​ hypoxemia
○​ diminished or absent lung sounds

Diagnosis

●​ spirometry
○​ not good during exacerbation
●​ ABG
○​ increased CO2 and decreased O2

Nursing Interventions

●​ high fowler or tripod position
●​ o2 if sat <90
●​ bronchodilators
○​ albuterol
○​ anticholinergics
■​ dry up mucus
■​ ipratropium
●​ corticosteroids

Client Teaching

●​ peak flow meter + inhaled spacer use
●​ avoid allergens

Bronchiolitis and RSV

Patho

●​ inflammation of bronchioles -> thick secretions -> bronchiole obstruction
●​ droplet transmission

Clinical Features

●​ Initial Stage
○​ rhinorrhea
○​ cough
○​ pharyngitis
●​ extra lung sounds
●​ may need hospital at 3-5 days
○​ hypoxia
○​ retractions
○​ tachypnea

Nursing Interventions

●​ mod -> severe
○​ contact + droplet precautions
●​ IV fluids