Respiratory Tutoring.docx - Respiratory Tutoring:...

Respiratory Tutoring: Pediatrics
Respiratory:
 Seasonal variations
o Most common during winter and spring
o Mycoplasma infections more common in fall and winter
o Asthmatic bronchitis more frequent in cold weather
o RSV season considered winter and spring
 Nursing interventions
o Ease respiratory effort
o Fever management
o Promote rest and comfort
o Infection control
o Promote hydration and nutrition
o Family support and teaching
o Prevent spread of infection
o Provide support and plan for home care
 Raise HOB
 Provide humidified air
 Monitor vitals and respiratory quality and effort
 Suction airway
 Provide gentle CPT (Chest percussion and chest physiotherapy)
 Encourage deep breathing
 Administer bronchodilator and any other meds prescribed by PCP
 Aspiration precautions
 Positioning
 Respiratory monitoring surveillance
 Oxygen therapy
 Airway suctioning
 Vital signs monitoring
 Cough enhancement
 Anxiety reduction
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Respiratory Tutoring: Pediatrics
 ********HAND WASHING***********
 s/s of dehydration: pale, dry skin, depressed fontanels, no tears while crying
 Acute epiglottitis
o PATHO: inflammation of the epiglottis occurs caused by bacteria Haemeophilus influenzae or
Streptococcus Pneumoniae
o ASSESSMENTS: (Sudden Onset)
 Tachycardia/Tachypnea
 4 D’S : Dysphagia, Drooling, Dysphonia (cant hear/muffled) , Distressed
 Fever
 cherry red sore throat*****
 Nasal Flaring
 Tripod Positioning: EMERGENCY
o INTERVENTIONS:
 Maintain patent airway
 DO NOT STICK ANYTHING IN THE MOUTH OR LOOK IN MOUTH: can cause
a bronchospasm!!!
 Maintain NPO
 IV antibiotics + IV Fluids
 Administer (analgesics, antipyretics, corticosteroids, nebulized epinephrine, cool mist o2)
 What should be kept at the bedside? TRACH SET
 *Primarily affecting children between the ages of 2 and 8 years old.
 The epiglottis covers the larynx during swallowing to prevent food from entering
the trachea.
 Serious obstructive risk due to inflammatory process
 Kids with Hib Vaccine are less at risk of contracting croup
 Emergency??  YES! IT CAN OBSTRUCT AIRWAYS VERY FAST
 Never leave the child unattended; support the child in position of comfort;
encourage the parents to hug and cuddle child
 Make sure the pt is up to date on all vac
 *********THROAT INSPECTION SHOULD ONLY BE PERFORMED WHEN
IMMEDIATE ENDOTRACHEAL INTUBATION OR AN EMERGENCY
TRACDHEOTOMY CAN BE PERFORMED IF
NEEDED*********************************************

 Nursing Considerations for Epiglottitis
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Respiratory Tutoring: Pediatrics
o Position for comfort
o Decrease anxiety
o No tongue blade
o Keep suction at bedside
o Keep emergency respiratory equipment at bedside
 Croup
o PATHO: inflammation of the larynx, trachea, and bronchi. VIRAL
o ASSESSMENTS: Harsh Barky or Seal-Like Cough , Stridor, retractions, Tachypnea,
restlessness
o INTERVENTION:
 Short-Acting bronchodilator
 Nebulized epinephrine
 Systemic steroids (reduce airway edema and inflammation)-Dexamethasone
 O2: brief exposure to cool night air or cool mist shower
 VIRAL
 COMMON IN INFANT/TODDLER
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o
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