Pediatric Notes III

RESPIRATORY DISORDERS  

BRONCHIOLITIS

Mani:

Rhinorrhea & ß fever

Lethargy

Poor feeding

Irritablity

Tachypnea

Dyspnea

Nasal flaring

Wheezing

Diminished breath sounds

Mgt: Ribavirin (Virazole)

PNEUMONIA

Types:

Viral : Whitish sputum

Bacterial: non productive hacking cough

Primary Atypical: Non productive – productive- blood streak sputum

NURSING CARE

• Administer O2, Mist tent
•  Suction PRN
•  Chest physiotherapy
•  Bed rest
•  Lie on the affected side     
•  Isolation precaution
•  Anti-tussives, antimicrobial therapy, antipyretics
•  Thoracenthesis

ASTHMA

ü   Wheezing

ü   Dyspnea

ü   Chest tightness

ü   Exacerbations

    - air is trapped behind occluded or narrow airways    

      and hypoxemia can occur

STATUS ASTHMATICUS

  - child displays respiratory distress despite vigorous 

    treatment

  - may result in respiratory failure & death if untreated

HOME CARE MEASURES

            - Allergens control

            - Avoid extremes of temperature

            - Avoid exposure to viral respiratory infection

            - Recognize early symptoms

            - Instruct the child in the administration of  medications as Rx

            - Adequate rest, sleep, and a well-balanced diet

            - Adequate fluid intake

            - Exercise as tolerated

SUDDEN INFANT ‘s DEATH SYNDROME

MATERNAL RISK FACTORS

Maternal smoking

Substance abuse

Younger mothers

APPEARANCE WHEN FOUND

Apneic &  blue

Frothy blood-tinged fluid in the nose & mouth

Typically found in a disheveled bed, with blankets over the head,

Diaper is wet & full of stool

GUT

Cryptorchidism

•       Whether or not to treat is still controversial.

     - If the testes remains in the abdomen, damage to the testes (sterility) is possible because of  increased body temperature.

•       If not descended by age 8-9 mos, chorionic gonadotropin can be given.

 Orchipexy

    - surgical procedure to retrieve and secure testes placement

    - preformed between ages 1-3 years

NURSING CARE

•       Advise parents of absence of testes and provide nformation about treatment options.

•       Support parents if surgery is to performed.

Post-op

•       Avoid disturbing the tension mechanism.

    - will be in place for about 1 week.

•       Avoid contamination of incision.

GIT DISORDERS

Celiac’s dse aka Gluten Enteropathy

- Increase in amino acid glutamine

Monitor gluten free diet

Provide supplement fat-soluble vitamins

Provide client teaching and discharge planning concerning:

             a. Gluten-free diet

             b. avoidance of infection.

             c. importance of adhering to diet      

             d. importance of long term ff-up management.

IMPERFORATED ANUS

•         Surgery to reconstruct the anus and perform a colon pull-through or sigmoid colostomy with anastomosis and pull-through 1 year later