“Epidoses” of coughing – has apnea event (not breathing) Has to thin out and clear over time – cannot suction o Pertussis: Treatment Oxygen Respiratory support IVF or tube feedings (baby is too sick to eat) Treat with azithromycin (Zpack) Prevent with vaccination (starting in Mom’s 27 th week of pregnancy ) T-DAP vaccination for mom – to help prevent baby from pertussis **Recommended for dads and grandparents too** - think herd immunity til baby can get Asthma o Chronic obstructive inflammatory disorder o Asthma triggers include cold air, pets, dander, smoke, infections, stress, and exercise (viruses – 6-8yr) o Bronchospasm from constriction of smooth muscle o Typically treated with an inhaled steroid and a fast-acting bronchodilator o Can outgrow asthma, but some have life-long o Asthma: Assessment Cough – often worse at night Nasal flaring Retractions Chest Tightness Prolonged expiration Wheezing Peak Flow Meter: measures expiration rate, portable o Asthma: Pulmonary Function Tests Determines degree of pulmonary impairment Done to ensure adequacy of asthma control medications or at initial diagnosis PFTs before and after medication or exposure to stressor Not really reliable until age 5 o Asthma Classification o Basic Asthma Treatment TYPE of MEDICATION EXAMPLE Daily Controller -Oral Leukotrine Modifier Montelukast (Singulair) Daily Controller -Inhaled corticosteroid -Long-Acting Beta 2 Agonist (LABA) Flovent Salmeterol Combo of the two: Advair Quick Relief or “RESCUE” -Short-acting Beta 2 Agonist (SABA) Allbuterol Xopenex Steroids – decrease inflammation (systemic) -Oral or IV corticosteroids Prednisolone Solumedrol o MDIs: The right way! SPACER o Asthma Action Plan Green, Yellow, and Red zones – all specific to patient o Asthma Teaching Discuss Triggers/Avoiding Triggers Signs/Symptoms of Trouble Breathing Using a Peak Flow Meter Medication Use and Side Effects Asthma Action Plan Meds at home, school, other parent’s home o Status Asthmaticus Unrelenting asthma attack despite treatment Respiratory Failure
Continuous nebulizers May need to be intubated with paralysis – hard to wein off ventilator Can be fatal Cystic Fibrosis - 37 o Autosomal recessive disorder of the exocrine glands o Deletion in chromosome 7 at the cystic fibrosis transmembrane regulator (CFTR) o Excessive mucus production o Excessive chloride production by sweat glands o Thick mucus blocks ovarian ducts, vas deferens, pancreatic duct, hepatic duct, and gallbladder duct, lungs o *** Chloride builds up because can’t cross channels = mucus builds up GI Tract, lung tract, reproductive tract, ANY mucus membranes build up Chloride CAN’T go through channels, but SODIUM can – SALTY skin (kiss a baby and tastes like salt) o CF: History 1950s - Children lived to elementary school age.
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- Spring '17
- Mucus, pain scale