Pediatrics - Respiratory Med. Guide

Pediatrics - Respiratory Med. Guide - Pediatrics Child...

Info iconThis preview shows pages 1–3. Sign up to view the full content.

View Full Document Right Arrow Icon
Pediatrics – Child Health Nursing Medications Used for Symptomatic Treatment of Laryngotracheobronchitis Medication Action/Indication Nursing Considerations Beta-agonists and beta- adrenergics (eg, albuterol, racemic epinephrine): aerosolized through face mask Rapid-acting bronchodilator, decreases brochial and tracheal secretions and mucosal edema, used to decrease symptoms of moderate to severe respiratory distress; and constriction of subglottic mucosa and submucosal capillaries. Used until dexamethasone begins working. Provides only temporary relief; improvement in 30 minutes which lasts about 2 hours, it gives time for the steroid to work; the child may experience tachycardia (160- 200 beats/min) and hypertension; dizziness, headache, and nausea may necessitate stopping medication; reduces the need for artifical airway;. Corticosteroids (eg, dexamethasone): IM, PO, Nebulized budesonide Antiinflammatory, used to decrease edema; has a long half life of 36-54 hours The child may experience cardiovascular symptoms (hypertension): requires close observation for individual response; children less frequently need emergency airways; stridor resolves faster Nursing Assessment of Child With Respiratory Difficulty Nursing Action Rationale Assess heart rate and respiratory rate Tachypnea and tachycardia indicate increasing respiratory effort What is the child’s position? (sitting, prone, or supine) Upright or semi-Fowler’s promotes airway patency; the child’s change to a more upright position may signal increased distress Assess overall quality of respiratory effort: Determine inspiratory and expiratory breath sounds, ability to speak, and presence of stridor, cough, retractions, nasal flaring, cyanosis Reflects overall adequacy of airway and respiratory function Initiate stridor severity assessment (Table 25-6) continue scoring every 30 minutes or more frequently if distress increases; initiate nursing actions appropriate for croup score Provides consistent and objective and assessment data with score for future comparison Attach cardiorespiratory monitor and pulse oximeter Provides continuous assessment data as part of ongoing physiologic monitoring 1
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Clinical Therapy for Bronchiolitis Collaborative Care Rationale Cardiorespiratory monitor and pulse oximeter Enable provider to follow course and assess need for specific therapies Humidified oxygen therapy by hood or face tent, mask or nasal cannula Delivery method chosen based upon desired concentration of oxygen, degree of humidity, and child’s response Intubation and assisted ventilation (PEEP/CPAP) Used when the child becomes too fatigued to breathe effectively Hydration with intravenous or oral fluids Provider must consider insensible fluid loss, decreased intake, the child’s current electrolyte and hydration status, and risk for pulmonary edema Postural drainage and chest physiotherapy Helps to further loosen and mobilize trapped mucus Systemic medications Symptomatic treatment may include
Background image of page 2
Image of page 3
This is the end of the preview. Sign up to access the rest of the document.

This note was uploaded on 05/04/2008 for the course NURS 220 taught by Professor Dewitt during the Spring '08 term at Lady of the Lake.

Page1 / 7

Pediatrics - Respiratory Med. Guide - Pediatrics Child...

This preview shows document pages 1 - 3. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online