NUR 4445 Respiratory Dysfunction
- Pediatric Respiratory System
Answer Respiratory dysfunction is the primary cause of hospitalization in children
-Also primary cause of cardiopulmonary failure
Respiratory system grows until age 12 years Consume more oxygen due to increase metabolic rate Short neck, can result in an occluded airway
- Correcting Airway Dysfunction
Answer "Sniffing position"
Attempting to get neck straight to optimize child's ability to breathe
- Retractions
Answer Pulling musculature in their chest wall
We lose it, but the COPD patients get it back
- Anatomy and Physiology that make children more at risk for respiratory dysfunction
Answer Small airways (trachea, lower airway) Fewer alveoli Nose, pharynx, & nasopharynx are also smaller Infants are nose breathers (until 4-6 months)
Chest wall is soft & pliable
Poorly developed respiratory muscles Immature immune system 1 / 3
Hand-to-mouth activity
Close contact with other children Preterm babies lack surfactant Decreased oxygen stores
- Assessment
Answer Color
Respiratory Effort Vital Signs Upper respiratory Auscultation Feeding pattern & presence of emesis Behavior
- Color
Answer Pale or cyanosis, especially periorbital
- Respiratory Effort
- Vital Signs
Answer Retractions, nasal flaring Cough, sputum (color & consistency) Position of the child
Answer Respiratory rate, heart rate, oxygen saturation, temp We start to intervene when we see cyanosis
-Central or oral cyanosis - not good!!-Children of color- look at mucous membranes or ears to look for cyanosis 2 / 3
Patients can maintain adequate oxygenation between 90-95% as long as their RR is WNL and the patient is still, quiet, with no cyanosis.
- Upper respiratory
Answer Rhinorrhea - color, consistency
Nasal passage patency Hoarse voice, sore throat Oral cavity & pharynx -Make sure they aren't foaming ’ means they are not breathing through nose and not swallowing the spit in their mouth
Crying is good, crying releases moisture and secretions ALWAYS INSPECT FIRST!!
- Auscultation
Answer Best auscultation is with a pediatric stethoscope because it fo- cuses on the small airways
-Can hear the spaces much better Airflow in and out Breath sounds Abnormal sounds in which part of the lung
- Feeding pattern & presence of emesis
Answer Feeding well or poor
-Find out when they ate last ’ can choke on food or liquids -Often choke with breastfeeding if the baby has poor latching Emesis all mucous
- Behavior
- / 3
Answer Anxiety or restlessness, altered level of consciousness