Extra Week: Respiratory Illnesses & Disorders

● Epiglottitis
○ Bacterial form of croup, inflammation of the epiglottis
○ Common in children 2-8 years old
○ Assessment
■ High fever, sore, red, inflamed throat, absence of spontaneous cough,
dysphonia, dysphagia, dyspnea, agitation, retractions, inspiratory stridor,
tachycardia, tachypnea
○ Interventions
■ Maintain patent airway, assess respiratory status & breath sounds, monitor
pulse ox, maintain NPO, administer analgesics and antipyretics,
administer corticosteroids to decrease inflammation and throat edema,
nebulized epinephrine may be prescribed, provide cool mist oxygen
therapy
● Laryngotracheobronchiti
○ Inflammation of the larynx, trachea, and bronchi
○ Most common type of croup, may be viral or bacterial
○ Common in children younger than 5 years old
○ Assessment
■ Stage 1:
● Low grade fever, hoarseness, seal bark and brassy cough,
inspiratory stridor, fear, irritability & restlessness
■ Stage 2:
● Continuous respiratory stridor, retraction, use of accessory
muscles, crackles and wheezing, labored respiration
■ Stage 3:
● Continued restlessness, anxiety, pallor, diaphoresis, tachypnea,
signs of anoxia and hypercapnia
■ Stage 4:
● Intermittent cyanosis progressing to permanent cyanosis, apneic
episodes progressing to cessation of breathing
○ Interventions
■ Maintain patent airway, elevate HOB & provide rest, increase fluid intake
or IV fluids, analgesics, avoiding cough or cold medicines, administer
corticosteroids or nebulized epinephrine, antibiotics for bacterial infection
● Bronchitis
○ Inflammation of the trachea and bronchi
○ Associated with an upper respiratory infection, mild disorder, typically viral
○ Assessment
 ■ Fever, dry, hacking, nonproductive cough that is worse at night and
becomes productive in 2-3 days
○ Interventions
■ Treat symptoms as necessary, Monitor for respiratory distress, provide
cool humidified air, increase fluid intake, administer antipyretics, cough
suppressant
● Brochiolitis and Respiratory Syncytial Virus (RSV)
○ Brochiolitis inflammation of the bronchioles that causes a thick mucus that
occludes bronchial tubes and small bronchi
○ RSV causes acute viral infection and is a common cause of bronchiolitis
○ Assessment (RSV)
■ Initial
● rhinorrhea, eye or ear drainage, pharyngitis, coughing, sneezing,
wheezing, intermittent fever
■ Manifestations as disease progresses
● Increased coughing and wheezing, signs of air hunger, tachypnea,
retractions, periods of cyanosis
■ Manifestations of severe illness
● Tachypnea more than 70 breaths/min, decreased breath sounds and
poor air exchange, listlessness, apneic episodes
● Pneumonia
○ Inflammation of the pulmonary parenchyma or alveoli or both, can be caused by a
virus or bacteria
○ Assessment
■ Acute or insidious onset
■ Symptoms range from: mild fever, slight cough, and malaise to high fever,
severe cough and diaphoresis
■ Non Productive or productive cough, wheezes or fine crackles
○ Interventions
■ Symptomatic treatment
■ Administer oxygen with cool humidified air, increase fluid intake,
antipyretics, antibiotics for bacterial pneumonia
● Asthma
○ Chronic inflammatory disease of the airways
○ Assessment
■ Episodes of dyspnea, wheezing, breathlessness, chest tightness, and cough
○ Interventions
■ Meds:
● Rescue medications - short acting Beta agonists, anticholinergics,
systemic corticosteroids
 ● Long-term control meds:
○ Corticosteroids, anti allergy meds, nonsteroidal
antiinflammatory drugs, long acting BEta agonists,
leukotriene modifiers, monoclonal antibody
● nebulizer , metered dose inhaler
■ Avoid allergens, premedicate for exercise if need me, breathing exercises,
avoiding individuals with a respiratory infections, encourage adequate
rest, sleep, and well-balanced diet
● Cystic fibrosis
○ Chronic multisystem disorder characterized by exocrine gland dysfunction
○ Abnormally thick, tenacious, and copious mucus that obstructs small passageways
of the affected organs, particularly in the respiratory, gastrointestinal, and
reproductive systems
○ Assessment
■ Respiratory system
● Mucus in the airway, wheezing, cough, dyspnea, cyanosis,
clubbing of the fingers & toes, barrel chest, repeated episodes of
bronchitis & pneumonia
■ GI
● Intestinal obstruction: pain, abdominal distention, nausea,
vomiting, frothy and foul-smelling stools, malnutrition
■ Integumentary
● high concentrations of sodium and chloride in sweat are noted,
skin tastes salty (infants, when kissed), dehydration and electrolyte
imbalance
■ Reproductive
● Delayed puberty in girls, fertility can be inhibited, males are
usually sterile (but not impotent)
○ Interventions for respiratory system
■ Preventing and treating pulmonary infection by improving aeration,
removing secretions and administering antibiotics
■ Monitor respiratory status
■ Chest physiotherapy, mucus clearing, hand-held percussors or vest device
■ Bronchodilator meds
■ Oxygen for acute epidsodes