AIRWAY DISORDERS/RESPIRATORY

Disorder Cause S/Sx Diagnostics Management

1. STREPTOCOCCAL -GAHBS -Inflammation of Throat -swab and culture A. Meds:
PHARYNGITIS -Pain on swallowing throat -Antibiotics (Amox or Pen G) -> Toothbrush
(STREP THROAT) -High grade Fever should be replaced after starting antibiotics
-Headache -Antipiretics
-Swollen lymph nodes B. Diet: Fluids, Soft diet, Avoid Spicy food and
-swollen red tonsils w/ pus acid juices. Gargle with warm water
2. TONSILITIS -viral/bacterial - Inflammation of Palatine A. Meds:
TONSILS -Antibiotics (Amox or Pen G) -> Toothbrush
-Difficulty swallowing should be replaced after starting antibiotics
-Fever, lethargy -Antipiretics
-Mouth breathing B. Surgery
-Halitosis -TONSILECTOMY
-Sleep Apnea -Post Op: WOF BLEEDING (FREQUENT
SwaLLOWing or Clearing of THROAT)
3. FOREIGN BODY ASPIRATION -Inhalation of -CHOCKING, Coughing, -Xray REMOVE OBJECT
foreign objects dyspnea, hoarseness, stridor -Bronchoscopy -HEIMLICH MANNEUVER (>1y.o)
-CYANOSIS, infection-> -Fluoroscopy -5 Back blows/slaps & 5 chest thrusts (<1y.o)
Death
4. EPIGLOTITIS -H.Influenzae -Dysphagia, Dysphonia -CBC (Leukocytosis) A. Meds:
type B -Drooling, Distressed respi -Elevated c reactive -Antibiotics (Chloramphenicol, co-
(Pneumococci, effort CHON amoxiclav,cefotoxime, cefuroxime)
streptococci, -High fever -Culture of epiglottis, -Steroids (DEXAmetahSONE)
staphylococci) -Sore throat -Neck Xray B. EMERGENCY Tx: INTUBATION & preparation
-Inspiratory Stridor of poss tracheostomy
-TRIPOD POSITION C. Nsg Care:
-Moist Air- O2 humidified
-Hydration
-NO VISUAL INSPECTION, INVASIVE
POCEDURE, ANXIETY-PROVOKING activity

5. LARYNGOTRACHEO- -Infectious -Inflammation & Narrowing -CBC A. Meds:

BRONCHITIS CROUP of Larynx, tranchea & -Neck Xray -Oral Steroids (DEXAmethaSONE)
-Parainfluenza bronchi -Epinephrine (via Neb)
-RSV (VIRUS) -Hacking/Barking cough- B. Nsg Care:
-0-5 y.o worse at Night -Monitor V/S, avoid anxiety-> may ET insertion
-1-2 y.o-peak -Hoarse voice, sore throat -STEAM INHALATION (cool mist humidifier or
-fever, n/v, poor appetite hot water steam
6. ASTHMA -Hypersensitivity -Dyspnea, wheezing, -Identify Allergy A. Peak Flow Rate
Response frightened Exhausted -Pulse Oximeter -Green Zone (80-100%): No asthma sx
-Genetics -Peak Flow Meter -YELLOW Zone (50-80%)- contact AP
-RED ZONE (<50%)-> MEDS-> Contact AP
B. Meds:
1. Reliever-> Bronchodilator-> Ventolin/
Albuterole, Theophylline, Comolyn Na)
2. Anti-Inflamatory-> Glucocorticoids (
*Inhalation- Budesonide, fluticasone
*Oral/IV- Hydrocortisone, Dexamethasone
3. Combi Drugs
C. Nsg Care:
-ORTHOPNEIC position
7. STATUS ASTHMATICUS -Progression of -INC HR & RR A. Meds:
attack-> -DEC BREATH SOUNDS -Continue Reliver meds
Unresponsive to (SILENT CHEST) -IV steroids
therapy -Cyanosis B. Emergency Care: ET
-Allergens C. Nsg Care: Asist ET
8. SUDDEN INFANT DEATH -CRIB DEATH -Sudden Death A. Prevention
SYNDROME (SIDS) -1mos-1y.o. -M. Risk Factors-> poor -SUPINE Position
-2-4mos- peaks lifestyle -Avoid exposure to smoke
-Sleeping on -NB Risk Factors: cyanosis, -Own Sleeping environments- NO quilts,
PRONE position tachycardia, resp d/o, blankets, pillows
hypothermia, poor feeding B. Psychological assistance to parents
9. RESPIRATORY DISTRESS -PRETERM at Risk -INC RR, CHEST -ABG A. Surfactant Replacement (ET Tube)
SYNDROME (RDS) RETRACTIONS, EXPIRATORY -XRAY -O2 ventilation
GRUNT -< Lecithin/- -supportive care
-cyanosis, hypothermia Sphingomyelin ratio
(Normal- 2:1)
CARDIOVASCULAR DISORDERS

ACYANOTIC Disorder Cause S/Sx Management

1. ATRIAL SEPTAL -Opening between ATRIA -dyspnea, fatigue, failure to thrive A. Surgery (closure) – 1-3y.o.
DEFECT (ASD) -FO did not close -SPLIT S2 (2nd intercostal space LSB- pulmonic -Dacron Patch
-FEMALES valve) -Open Heart surgery
B. Nsg. Care
-Complications: Left untreated-> endocarditis->
leads to HEART FAILURE
-Post-OP: -Monitor ARRYTHMIA, Administer
Antibiotics
2. VENTRICULAR -Ventricular septum -dyspnea, fatigue, failure to thrive, respi infxn -SAME with ASD
SEPTAL DEFECT (VSD) opening -PANSYSTOLIC MURMUR (L; 2nd ICS)
-MOST COMMON
3. PATENT DUCTUS -Descending Aorta to -CLUBBING, dyspnea, -SAME with ASD
ARTERIOSUS (PDA) pulmo artery -LOUD “MACHINERY MURMUR” (-2nd-3rd ICS)
-Premature
-Maternal rubella
-FEMALES
CYANOTIC Disorder Cause S/Sx Management
1. TETRALOGY OF PROV -dyspnea, fatigue, failure to thrive, systolic murmur A. Surgery (closure) – 1-2y.o.
FALLOT (TOF) -Pulmonary stenosis -Polycythemia, Tet spells- CYANOTIC SPELLS-> -Blalock-Taussig Shunt- Anastomose subclavian
-Right Vent hypertrophy cyanosis during stressful or painful procedures art and pulmo while waiting for reparative
-Overriding Aorta surgery
-Ventricular Septal Defect **Post-op -Monitor Arrythmia, Avoid BP and
Venipuncture in Rt ARM
B. Nsg Care
-Complications: Left untreated-> leads to
THROMBOEMBOLISM, CVA
-O2-> KNEE-CHEST POSITION, SQUATTING
2. TRANSPOSITION OF -Transposed Aorta -Cyanosis, murmurs A. Surgery -1wk-3mos
GREAT VESSELS (TOG) -Transposed pulmo artery -Baloon catheter to create artificial ASD
-MALE or Large babies (9- -(Arterial Switch Procedure- JATENE Procedure)
10lbs)
3. TOTAL ANOMALOUS -Pulmonary v. drain -Cyanosis, Fatigue A. Surgery
PULMONARY VENOUS to SVC or R atrium  PGE, surgery (re-implant pulmoveins to L
RETURN (TPV) -PDA or foramen atrium)
ovale essential
4. COARCTATION OF Constriction of -asymptomatic HPN, irritability, headache, A. Surgery- 2y.o
AORTA (COA) descending epistaxis, dyspnea, leg claudication, higher BP in -Angiography and surgery
 aorta upper extremities, dec femoral and distal pulses -Post-op- Monitor ABD PAIN, INC BP
-MALE B. Nsg Care
-Complications: Left untreated-> leads to chronic
HPN, CVA
OTHER Disorder Cause S/Sx Management
1. KAWASAKI DSE/ -Rare childhood disease -Spiking fever x 5 days, A. Diagnostic- clinical only as it can’t be seen in
MUCOCUTANEOS that affects the -bilateral conjunctivitis, reddened pharynx, blood and urine
LYMPH NODE blood vessels -dry lips, strawberry tongue, B. Complications- May lead to ANEURYSM and
SYNDROME (inflammation) -cervical lymphadenopathy, peripheral edema, MI
-before puberty, peaks erythema and desquamation, truncal rash B. Meds: Salicylates(Aspirin) and IV
4y.o. Immunoglobulins
C. Nsg Care:
-Monitor for HF-> dec urine output, tachy, dob
-LIVE VACCINES (Varicella, MMR)- >should be
delayed up to 11mos after IV Immunoglobulins
administration
2. RHEUMATIC FEVER -Autoimmune-> GABHS DIAGNOSTIC S/SX: A. Meds:
(1-3wks after untreated -Salicylate
infxn) 5 MAJOR CRITERIA (JONES CRITERIA) -Corticosteroid
-6-15 y.o. peaks 8 y.o 1. J-oints- POLYARTHRITIS -Antibiotics (Benzathine, penicillin)
2. H-eart()-CARDITIS -Ibuprofen
3. N-odules- subcutaneous nodule -Digoxin
4. E- rytHema marginatum -Phenobarbital
5. S- Sydenham’s chorea (St. Vitu’s Dance) -Diazepam
B. Nsg Care
6 MINOR CRITERIA -Prevent further Infection
1. Fever
2. Polyarthralgia
3. History of RF
4. INC ESR
5. Antecedent STREP infection
6. Prolonged PR interval (1st degree Heartblock)

POSITIVE RF: 2 major/1major + 2 minor present