Respiratory Distress and Failure Flashcard 1

A. Rationale: Respiratory distress is a clinical condition characterized by increased work of breathing or respiratory rate in an effort to meet the body’s metabolic demands. Signs and symptoms include tachypnea, tachycardia, retractions, and abnormal breath sounds such as grunting, wheezes, or crackles.

B. Rationale: Respiratory failure is the inability to maintain adequate oxygenation and ventilation to maintain the body’s metabolic demands. Signs and symptoms include slow breathing, lack of respiratory effort due to fatigue, abnormal breath sounds, bradycardia, lethargy and lack of responsiveness, and cyanosis.

A. Rationale: Croup is a medical condition that causes inflammation of the trachea and larynx. The presence of stridor in a patient with croup signifies that there is an obstruction in the upper airway due to inflammation. Additional assessment of the patient is necessary to determine the severity of the obstruction. In mild croup, stridor may only be present when the child is crying or upset. In more severe croup, stridor may be present at rest.

A. Rationale: Bronchial asthma is a disease that causes widespread narrowing of the conductive airways, causing increased airway resistance that ultimately reduces the amount of oxygen in the airways and leads to hypoxemia.

B. Rationale: The antidote for heroin overdose is naloxone. Naloxone competes with the opiates and binds with opioid receptors, reversing the effects of drug overdose with heroin, a synthetic opiate.

D. Rationale: Children with breathing difficulties show signs of having to work hard to breathe or not getting enough oxygen, indicating respiratory distress. These include nose flaring, retractions seen in the thorax, marked tachypnea, increased respiratory effort, poor distal air movement, tachycardia, abnormal breath sounds such as wheezes, grunting, and stridor, hypoxemia despite oxygen supplementation, and cyanosis. Respiratory failure ensues if the problem is not addressed promptly. Absent respiratory effort or distal air movement and decreased level of consciousness in addition to the signs mentioned above are indicative of respiratory failure.

A. Rationale: Corticosteroids, such as methylprednisolone, can be administered to this patient. It can be injected intramuscularly, but some preparations make it possible to be inhaled. Corticosteroids are an adjunctive therapy that take time to be effective. Epinephrine should always be administered first when airway swelling is present due to anaphylaxis. Providing positive pressure ventilation after giving this medication can help the respiratory effort.

A. Rationale: Respiratory acidosis is a disturbance in the acid-base balance that occurs when the lungs cannot remove the CO₂ produced by the body, causing an increase in the PaCO₂ and lowering the pH in the blood. In this case, there is insufficient gas exchange at the level of the alveoli and capillaries, increasing the amount of CO₂ in the body and decreasing the oxygen in the blood. Respiratory alkalosis occurs when the lungs expel or remove CO₂ at a faster rate, as in alveolar hyperventilation resulting in a reduced PaCO₂. Metabolic acidosis occurs when the body produces too much acid or when the kidneys cannot remove enough acid from the body. Metabolic alkalosis is an acid-base imbalance brought about by a decrease in the body’s hydrogen ion concentration leading to an increased bicarbonate concentration or as a direct increase of bicarbonate.

B. Rationale: Capnography measures the amount of carbon dioxide in a patient’s breath as end-tidal carbon dioxide (ETCO₂). It cannot measure the partial pressure of carbon dioxide (PaCO₂) in the blood nor the oxygen saturation. PaCO₂ is directly obtained through arterial blood gas analysis, while oxygen saturation is measured using a pulse oximeter.

C. Rationale: To save time and provide the appropriate interventions to a pediatric patient in respiratory distress, the healthcare provider must identify the type and severity of the respiratory problem rather than the etiology of the disease. Determining the etiology will require more time-consuming tests. Immediately intubating the patient is also not recommended because it is invasive, and the severity of the disease has not yet been established. A crash cart is always present, but it is unnecessary at this point since the patient is not in cardiac arrest.