Term
| What are key points of the respiratory history? |
|
Definition
-child's age
-time of year
-general health status
-OLDCART/PQRST
-fever & timing
-cough
-congestion
-sore throat
-HA
-ear pain
-medications
-exposure to similar s/s
-length of s/s
-appetite
-elimination
-sleep
-activity
-ETS or tobacco and marijuana use
-childcare
-siblings
-travel: part of the world, airplane
-previous respiratory illness
-hospitalizations
-vaccinations: flu, RSV |
|
|
Term
| What vital signs and measurements are taken? |
|
Definition
|
|
Term
| What are age guidelines for RR? |
|
Definition
< 2 mos: < 60
2-12 mos: < 50
1-5 yrs: < 40
6-8 yrs: < 30 |
|
|
Term
| What are components of the physical exam? |
|
Definition
-general appearance
-HEENT
-neck: lymphadenopathy
-chest: adventitious sounds, retractions, flaring
-skin: rashes
-mucous membranes: hydration |
|
|
Term
| What is the most common infective pathogen of URIs? |
|
Definition
|
|
Term
| Children average ___?___ colds/yr with peak incidence during the first ___?___ yrs. |
|
Definition
|
|
Term
| What are s/s of a cold in infants? |
|
Definition
-irritability & restlessness
-fever: 100-102
-occasional GI upset: diarrhea
-changing in eating and sleep patterns
-desire to be held |
|
|
Term
| What are physical findings in a cold? |
|
Definition
-erythematous nasal mucosa
-edematous nasal turbinates
-nasal discharge
-erythematous tonsils and pharynx
-cervical lymphadenopathy |
|
|
Term
| What is the most common serious acute illness of young children and infants? |
|
Definition
|
|
Term
| When is the peak time of year for bronchiolitis? peak age group? |
|
Definition
mid winter to early spring
2-6 month olds |
|
|
Term
| What factors increase severity of bronchiolitis? |
|
Definition
-male
-not breastfed
-low SES: crowded conditions
-group childcare |
|
|
Term
| What are s/s of bronchiolitis? |
|
Definition
initial:
-rhinorrhea
-congestion
-cough
-decreased appetite
-low grade fever
progression:
-increased WOB
-tachypnea
-decreased appetite and poor suck
-decreased activity
-forced expiratory phase
infants, especially premature:
-apnea
-lethargy
-irritability
-poor feeding |
|
|
Term
| What are physical exam findings in bronchiolitis? |
|
Definition
-***wheezing (crackles and decreased breath sounds suggest more severe dz)
-tachypnea
-shallow breathing
-retractions
-nasal flaring
-prolonged expiratory phase
-paroxysmal wheezy cough
-rhinorrhea
-otitis
-conjunctivitis
-pharyngitis
-afebrile or low grade fever
-palpable liver or spleen d/t hyperinflation of lungs |
|
|
Term
| After bronchiolitis, hyperinflation may persist on CXR for ___?___ months. Many children will have permanent airway hyperreactivity. |
|
Definition
|
|
Term
| What are the most common organisms that cause croup/laryngotracheobronchitis? |
|
Definition
1) parainfluenza virus
2) RSV
3) influenza A & B |
|
|
Term
| What is the most common age range for croup? |
|
Definition
|
|
Term
| Females are more affected by croup than males. true/false |
|
Definition
| false- males are more affected |
|
|
Term
|
Definition
-initial URI
-rapid onset of "barky" cough & inspiratory stridor
-afebrile or low grade fever
-NO drooling |
|
|
Term
|
Definition
-nighttime
-agitation, crying |
|
|
Term
| Croup peaks in severity at ___?___ days. |
|
Definition
|
|
Term
| What are physical findings of croup? |
|
Definition
-inspiratory stridor
-barking cough
-dyspnea
-exipiratory stridor, if severe
-low grade fever
-clear chest
-no involvement of lower respiratory tract |
|
|
Term
| What medications are used to treat croup? |
|
Definition
-nebulized racemic or L-epinephrine
-corticosteroids |
|
|
Term
| Chronic bronchitis lasts longer than ___?___ |
|
Definition
|
|
Term
| What are viral causes of bronchitis? |
|
Definition
-parainfluenza
-RSV
-rhinovirus |
|
|
Term
| What are bacterial causes of bronchitis? |
|
Definition
-mycoplasma
-chlamydia
-strep cornynebacterium
-diptheria
-H. flu |
|
|
Term
| What are s/s of bronchitis? |
|
Definition
-initial URI
-dry then productive cough
-sputum: purulunt; swallowing causes nausea
-retrosternal chest pain with coughing
-malaise
-decreased appetite |
|
|
Term
| What are physical findings of bronchitis? |
|
Definition
-brassy cough
-coarse, bronchial breath sounds in periphery
-rhonchi
-tracheal tenderness with palpation |
|
|
Term
| When are abx used in bronchitis? |
|
Definition
-bacterial suspected and cough >10-14 days
-chronic pulmonary dz |
|
|
Term
| What is the peak age for foreign body aspiration? |
|
Definition
|
|
Term
| What are physical findings with foreign body aspiration? |
|
Definition
-unilateral wheezing
-decreased breath sounds: on side of apiration, or bilateral
-persistent cough
-voice changes
-stridor
-dyspnea
-sputum
-emesis
-bronchiectasis
-abscess formation
-recurrent pneumonia
-hemoptysis |
|
|
Term
| What diagnostic tests are used in foreign body aspiration? |
|
Definition
-pulse ox: decreased if significant obstruction
-CXR: only 10-25% of objects aspirated are opaque
-expiratory chest films
-rigid or flexible bronchoscopy |
|
|
Term
| What follow-up care is needed after foreign body aspiration? |
|
Definition
-humidification
-bronchodilators
-anti-inflammatory medications
-CXR after 8 wks |
|
|
Term
|
Definition
|
|
Term
| At what age is pertussis most common and severe? |
|
Definition
|
|
Term
| What is the incubation period for pertussis? |
|
Definition
|
|
Term
| How do infants present with pertussis? |
|
Definition
-short catarrhal stage
-gagging
-gasping
-apneic episodes
-cyanosis |
|
|
Term
| When is pertussis most contagious? |
|
Definition
-catarrhal stage: mild respiratory symptoms
-1st 2 weeks after cough onset |
|
|
