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MSU NUR 436 Exam 1 Questions with Latest Update
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MSU NUR 436 Exam 1 Questions with Latest Update
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MSU NUR 436 Exam 1 Questions withLatest Update
ALTE - Answer-First 2 months
Sudden cessation of breathing (irregular)- cyanosis, muscle tone decrease, bradycardia
Idiopathic-may be related to GI (GER) or seizures or respiratory cause.
May be while sleeping or awake
Caused by small or narrow airway, greater risk of obstruction or respiratory distress
Treat with monitoring, teaching, and CPR training
SIDS - Answer-sudden infant death syndrome
Risk factors-mother smoke/alcohol, co-sleeping, soft bedding, low birthweight, viral
illness, male, AA ethnicity
Prevent by sleeping on back, no blankets, pillow or objects in the crib
Strep pharyngitis - Answer-*Not infectious after 24 of starting antibiotics. *Group A Beta-
homotytic (GABHS) in upper airway, can be symptomatic if in nares. concern is in throat
or tonsils
Diagnosed by + strep test or anti-streptolysin O titer.
Not dangerous itself, dangerous to get other infection (acute rheumatic fever or acute
glomerulonephritis/nephritis
Onset-pharyngitis, HA, fever, abd pain, throat pain, tonsillitis/ covered w exudate
Progression-acute nephritis after 10d and rheumatic fever after 18d if untreated
tonsillits (snoring, dysphagia, odynophagia, mouth breathing/foul smelling breath
Treatment- oral abx for 10 d, teaching, pain/fever management, surgical management
(tonsillectomy) opioids are contraindicated
*watch for continuous swallowing after tonsillectomy
Epiglottitis - Answer-severe, life-threatening infection of the epiglottis and supraglottic
structures that occurs most commonly in children between 2 and 12 years of age
Edema pushes epiglottis backward-drooling, inspiratory stridor, tripod position
(upright/leaning forward), DROOLING, DYSPHAGIA, DISTRESS, frog like croaking,
restless and irritable, visible large red edematous epiglottis
Treatment- EMERGENCY, prevent obstruction, reduce inflammation, restore O2
meds- (bacterial) IV ABX followed by PO
procedure- Nasotrachial intubation or tracheostomy with severe distress
Humidified O2, do not put anything in mouth- can cause collapse
Timeline- decrease inflammation after 24 hours with abx and resolves after 3 days
Laryngotracheobronchitis (Croup) - Answer-infection (viral) caused inflammation of the
upper airways with swelling; creates a funnel-shaped elongation of tissue causing a
distinct "seal bark" cough with stridor. Obstruction causes increased effort to breathe.
Atelectasis occurs if extends to lung fields.
, s/sx- Gradual onset low fever, barky, brassy cough, inspiratory stridor, worse at night,
agitation and crying makes symptoms worsen, cough and hoarseness.
3 months old to 3 years old
Treatment- cool mist vaporizer (constricts edematous blood vessels), nebulized
epinephrine for unalleviated (B-adrenergic effects cause mucosal vasocontriction and
decrease in edema), IV/oral steroid single dose, CROPS (CORTICOSTEROID,
RACEMIC EPI, OXYGEN, PARAINFLUENZA VIRUS, SEAL BARKING
COUGH/STRIDOR/SUBGLOTTIC STENOSIS/ STEEPLE SIGN (trachial pointing
upward)
Respiratory Syncytial Virus Bronchiolitis - Answer-a virus that causes an infection of the
epithelial cells, lungs and breathing passages; can lead to other serious illnesses that
affect the lungs or heart, such as bronchiolitis and pneumonia. RSV is highly contagious
through droplets. Walls of bronchi infiltrated with inflammatory cells. Obstruction on
expiration leads to hyperinflation, areas of atalectasis resulting in crackles, wheezing,
and respiratory distress.
s/sx- rhinnorhea, dehydration, and anorexia. symptoms peak at day 5, resolve in 7-10.
Low grade fever, tachypnea/retractions/dyspnea/cough (increased nasal flaring)
grunting (worsening of condition), wheezing and crackles heard bilaterally. Irritability.
Treatment- oxygenation, hydration, airway patency (nasal suctioning).
IV fluids/NG feedings, 3% nebulized NS for increased clearance, observe for
bronchospasms.
Fluids by mouth contraindicated if tachypnic (RR >60) -aspiration
Droplet isolation- RSV can live on surfaces for a long time- possible contract isolation
too
Pertussis (whooping cough) - Answer-An airborne bacterial infection that affects mostly
children younger than 6 years. Patients will be feverish and exhibit a "whoop" sound on
inspiration after a coughing attack; highly contagious through droplet infection. Attach to
cilia on epithelial cells and paralyze cilia- cause inflammation on respiratory tract and
interfere with secretions. 1-2 weeks peak. Can last for 6-10 weeks.
Catarrhal stage- upper resp infection (sneeze, cough, low fever, dry hacking cough
means worsening)
paroxysmal stage- Caugh more common at night, whoop sound, cheeks flushed or
cyanotic, eyes bulging, tongue protrudes, thick mucus plug, stage lasts 4-6 weeks
followed by convalescence stage.
Prevention- IMMUNIZATION
Treatment- antimicrobial therapy
Asthma - Answer-A chronic allergic disorder characterized by episodes of severe
breathing difficulty, coughing, and wheezing.
Stimuli- airway edema and secretions- spasm of bronchi- decreases caliber of
bronchioles and airway remodeling- permanent changes
Asthma exacerbation- worsen at night, distress (tachypnea, hypoxia),
rhinnorhea/congestion, chest tightness, restless, decreased peak flow in child >8,
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