1. Define the vocabulary terms listed 2. List the differences found in the respiratory system of a child, and identify potential risks 3. Develop a teaching plan for the parents of a newborn regarding SIDS prevention 4. Illustrate the anatomic difference in the ear canals of adults and children, and describe the significance of this difference along with nursing care for a child with otitis media 5. Summarize the nursing care for an infant with bronchiolitis 6. Explain the dietary needs for a child with cystic fibrosis 7. Outline the nursing observation and care necessary for a 2-year-old child with croup 8. Describe the nursing care for a child undergoing surgery for removal of tonsils and adenoids 9. Describe the nursing care of the child with asthma, including monitoring of respiratory status, respiratory treatments and medications, and the psychosocial implications of the condition 10. Discuss the important nursing care of a child with tuberculosis Children with respiratory difficulties have common signs and symptoms that can progress to respiratory failure if not recognized. Assessment findings of the child’s respiratory system will vary depending on the age of the child. The nurse must recognize any change in the child’s breathing status. Signs and symptoms may include fever, anorexia, vomiting, diarrhea, abdominal pain, nasal blockage, nasal drainage, cough, sore throat, retractions, and abnormal respiratory sounds. Respiratory assessment should be comprehensive and frequent as the status can change rapidly. The assessment should include the guidelines shown in Box 11-2. Retractions can indicate respiratory distress. The severity of respiratory distress can be assessed using the depth and location of the retractions (Figure 11-1). Bronchopulmonary dysplasia (BPD) is a chronic lung disease that occurs in newborns that are premature or have pulmonary disorders that require mechanical ventilator support with high positive pressure and oxygen. The lung tissue is immature and unable to withstand tissue damage resulting from the required oxygen supplement. The resulting fibrosis and alteration in lung compliance may last from several months to years. Improvements in treatment of low–birth weight preterm infants have increased the incidence of this disorder, and continue to be the primary issue for infants younger than 27 weeks of age (Belcastro, 2004). Newer mechanical ventilators are being used for low birth weight neonates in hopes of decreasing BPD. Parents may be extremely anxious caring for a child with BPD. All equipment and procedures should be explained in simple terms. Children with tracheostomies can be cared for in the home setting, and home care teaching of the equipment is needed (Figure 11-2). Review care of the child with tracheostomy in Chapter 3. Extended hospitalization can interfere with the development of the normal parent-child relationship and with the normal development of the infant. Parental participation in the infant’s care should be encouraged. The family’s ability to cope and care for a child with a chronic illness needs to be evaluated as home discharge plans are developed. An adequate period of education may be necessary for the parents to become comfortable with the care required for their child. Families should be referred to social services to assist in providing additional support and to assist in helping the parent gain access to available community services. Parental support groups can be beneficial in providing additional assistance with coping skills necessary for caring for a child with complex care. When the causative organism is RSV, no medications can effectively treat the disease. Ribavirin, antimicrobials, antihistamines, and oral decongestants have been identified as being ineffective for treatment (Zorc, 2010). Medical attention has recently focused on active and passive immunizations. RSV-immune globulin (RespiGam) and palivizumab (Synagis) have been approved for use with children at high risk. Palivizumab may be preferred because of ease of administration (intramuscular); lack of interference with mumps, measles, and rubella (MMR) vaccine and varicella vaccine; and lack of complications associated with intravenous immune globulin (RespiGam). Monthly administration during RSV season (October to May) is recommended (AAP, 2009). Nursing diagnoses for the infant with bronchiolitis include the following: • Ineffective airway clearance, related to thick mucus • Impaired gas exchange, related to edema and mucus of the bronchioles • Deficient fluid volume, related to insensible fluid loss from tachypnea and decreased intake • Anxiety, related to unfamiliar environment, respiratory distress, and placement in croupette • Knowledge deficit, related to disease process and treatment
Respiratory Disorders
Respiratory System
evolve.elsevier.com/Price/pediatric/
Bronchopulmonary Dysplasia
Treatment and Nursing Care
Bronchiolitis
Treatment
Nursing Care
Respiratory Disorders
WordPress theme by UFO themes