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T/F Respiratory infections are the most common cause for hospitalizations in the pediatric population in the US.
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True
What season(s) is/are allergies most prevalent?
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Spring and Fall
What season(s) is/are RSV more prevalent?
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Winter
Why do infants younger than three months have better resistance to respiratory infections than those that are older?
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They still have maternal antibodies assisting them in fighting infections
Why do respiratory infection rates increase between the ages of 3-6 months?
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Maternal antibodies start to disappear and no longer provide protection
Newborns are obligatory nose breathers until at least ________ of age, meaning they cannot open their mouth to breathe if their nose is obstructed.
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4 weeks
Newborns only breathe through their mouths while _________.
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Crying
Why are newborns and young children less likely to develop sinus infections?
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Newborns and young children are less likely to develop sinus infections due to the fact that the frontal and sphenoid sinuses aren’t fully developed until ages 6-8.
What factor would prevent a newborn from breathing while eating?
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Nares that aren't patent.
Newborns produce very little mucus, what impact does this have?
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Mucus is a substance that serves as a cleaning agent, if there isn't much present, the newborn is more prone to respiratory infections.
Posterior placement of an infant's tongue can lead to severe airway obstruction. Why is this?
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Newborns have a larger tongue in proportion to their oropharynx than adults.
Why are infants and children under the age of 8 at higher risk for hypoxemia and carbon dioxide retention?
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Newborns/infants have about 50 million alveoli at birth (adults have 200 million). During the first three months of life, alveoli growth is slowed, placing the child at higher risk of hypoxemia and carbon dioxide retention. By age 7-8, alveoli reach adult numbers.
What factors contribute to a smaller airway diameter in children when compared to adults?
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Through school-age, young children tend to have enlarged tonsillar and adenoidal tissue, even in the absence of illness. The trachea is smaller, starting at 4 mm in infancy and growing to 20 mm wide in adulthood. The cricoids cartilage is underdeveloped, also narrowing the laryngeal opening and making it a funnel shape (instead of tubular).
What are some structural differences of the airway in children when compared to adults?
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The larynx and glottis are located higher in the neck, increasing the risk of aspiration into the lower airways. Bifurcation of the trachea occurs at the 3rd thoracic vertebra in children, as opposed to the 6th in adults.
What factors increase the risk/frequency of respiratory infections in children? (3)
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Smaller airway diameter, shorter distances between structures in the airway, and the presence of short, open eustachian tubes.
Why is airway resistance a concern in children and what are some possible causes?
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Small reductions in the diameter of a child’s airway can increase resistance to airflow, resulting in increased work of breathing. Mucus and edema, coupled with a seemingly minor narrowing results in an exponential increase in resistance to airflow and work of breathing
Described the pediatric larynx in comparison to an adult's...
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Funnel shaped, underdeveloped cricoid cartilage, located higher in the neck than in adults, highly compliant, making it susceptible to collapse from an airway obstruction, muscles supporting airway are less functional than those in an adult
Describe the pediatric trachea in comparison to an adult's...
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Smaller airway lumen (approximately 4 mm at birth to 20 mm at adulthood), large amount of soft tissue surrounding the trachea, mucus membranes lining the airway are less securely attached increasing the risk of edema & obstruction
What are the three major nursing considerations when providing oxygenation to a child?
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• Do not allow oxygen to blow directly on an infant’s face. • Change linens and clothes frequently • Monitor temperature for hypothermia
An oxygen hood is a small plastic hood that fits over the baby’s head. It uses a minimum flow rate of ____ L/min to prevent CO2 buildup.
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An oxygen hood is a small plastic hood that fits over the baby’s head. It uses a minimum flow rate of 4-5 L/min to prevent CO2 buildup.
What should you check for after placing an oxygen hood on an infant?
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Make sure the child’s neck, chin, or shoulders don’t rub against the hood.
An oxygen tent is a large plastic tent that fits over a crib/bed. It is used for children older than ______. Oxygen is set on a high flow rate to flood the tent with oxygen and then adjusted down prior to placing the child into it. 30-50% FiO2 is the highest level to maintain without difficulty.
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2-3 months
What are some nursing considerations related to use of an oxygen tent?
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Use plastic or vinyl toys in the bed, avoid soft toys or mechanical/electrical ones. Keep the child warm. Oxygen is not lost from the top of the tent because oxygen is heavier than air, however, the bottom perimeter of the tent should be tucked snuggly to prevent loss of oxygen from there.
Nasal cannula are used to provide oxygenation and a measure of mobility. It delivers 24-40% FiO2 at a flow rate of ______L/min. Humidification needs to be provided for flow rates greater than ____ L/min.
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1-6 L/ min, Humidification needs to be provided for flow rates greater than 4 L/min.
What factors can impact the efficiency of oxygen therapy? (3)
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The efficiency of oxygen therapy can be affected by the child’s respiratory effort, the liter flow of oxygen delivered, and whether the equipment is used appropriately
What is the purpose of humidification of oxygen therapy?
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It Moistens oxygen being breathed to moisten the airways and promote loosening & mobilization of pulmonary secretions. It prevents drying and injury to the airways, and is warmed to prevent hypothermia in children
_________ delivers medications via droplets in a mist via a nebulizer. The medication droplets are more fine than those delivered via inhaler
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Aerosols
What is the ultimate goal of oxygenation therapy?
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The goal of oxygen therapy is to achieve an O2 saturation of 91% with the lowest flow rate possible to prevent complications
What are the early signs of hypoxemia? (9)
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Early signs of hypoxemia: tachypnea, tachycardia, restlessness, pallor, elevated BP, use of accessory muscles, nasal flaring, tracheal tugging, adventitious lung sounds
What are the late signs of hypoxemia? (7)
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Late signs of hypoxemia: confusion, stupor, cyanosis, bradypnea, bradycardia, hypotension, cardiac dysrhythmias


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