Chamberlain College of Nursing - NR 602 NR midterm study guide.

1. Asthma – all levels of severity What are s/s of asthma? • Wheezing Continuous/persistent cough Long expir. phase Diminished breath sounds Signs of resp. distress Tachypnea Retractions Nasal flaring Accessory muscles Apprehension Drowsiness Tachycardia Cyanosis of lips How is asthma dx'd? • O2 sat PFT: -Spirometry -FEV1: normal >75%, mild 60-75%, mod 50-59%, severe <49%. -FVC: normal 80-120%, mild 70-79%, mod 50-69%, severe <50%. What are mild asthma s/s? • Wheezing @ end of expiration or no wheezing No/min intercostal retraction along post. axil. line Slight prolongation of exp. phase Normal aeration in all lung fields Can talk in sentences What are moderate asthma s/s? • Wheezing throughout expiration Intercostal retractions Prolonged expiratory phase Decreased breath sounds at base What are severe asthma s/s? • Use of accessory muscles plus lower rib/suprasternal retractions Nasal flaring Inspir/expir. wheezing or no wheezing heard w/poor air exchange Blepharitis What is blepharitis? Inflammation/infection of the lid margins (chronic problem) What are the two types of blepharitis? • Seborrheic (non-ulcerative) • Ulcerative What can cause seborrheic blepharitis? Irritants (smoke, makeup, chemicals) What are s/s of seborrheic blepharitis? • Chronic inflammation of eyelid • Erythema • Greasy scaling of anterior eyelid • Loss of eyelashes • Seborrheic dermatitis of eyebrows/scalp What usually causes ulcerative blepharitis? • Infection w/staph or strep What are s/s of ulcerative blepharitis? • Itching • Tearing • Recurrent styes • Chalazia • Photophobia • Small ulceration at eyelid margin • Broken/absent eyelashes • Most frequent complaint: ongoing eye irritation, conjunctiva redness What is the treatment for blepharitis? • Clean w/baby shampoo 2-4 times/day • Warm compresses • Lid massage (right after warm massage) How are infected eyelids with blepharitis treated? • Antistaph abx: bacitracin, erythromycin 0.05% x1 wk and quinolone ointments How is blepharitis infection resistant to topical abx treated? • Tetracycline 250mg PO x4 • Doxy 100mg PO x2 Café au lait spot What are cafe au lait spots? • Smooth, regular borders of darkened patch If a child has >5 cafe au lait spots that are >1.5cm, what should be suspected? • Possible Von Recklinghausen's dz (90-100%) LEOPARD syndrome: -Lentigines -Electrographic abnormalities -Ocular hypertelorism -Pulmonary stenosis -Abnormalities of genitalia -Retardation of growth -Deafness In kids <5yo with 5 or more cafe au lait spots of at least 0.5cm, what should be suspected? • Neurofibromatosis What is a rare but diagnostic sign of neurofibromatosis? • Smaller 1-4cm diameter cafe au lait spots in axillae (axillary freckling or Crow's sign)