Pediatric Respiratory


Respiratory Alterations in Children
Kathleen Dennis, MSN, RN


Identify factors that lead to respiratory tract infections in infants & children

Compare the effects of different respiratory infections observed in infants & children

Describe post operative care of a child with a tonsillectomy

Formulate the care for a patient with croup

Identify priorities of caring for a infant with RSV

Describe various measures to relieve symptoms of asthma

Describe physiologic effects of CF on GI & pulmonary systems

Formulate a care plan for a child with CF

List major signs of respiratory distress in children

Pediatric Respiratory Assessment

How do you perform a respiratory assessment on an infant or child?

What are some physical differences between the airway & respiratory tract of a pediatric patient compared to an adult?

What are some behavioral signs of difficulty breathing in the pediatric population?

What are some signs the pediatric patient is having respiratory distress?

Respiratory Infections

What are some factors that influence respiratory tract infections?

What are the key infectious agents in respiratory infections?

How does age, size, resistance play a role in monitoring a child’s respiratory status?


Upper Respiratory Infection

What are the most common URIs?


What causes most URIs?

What are the clinical manifestations (CM) of URIs?

How would you encourage parents to manage URIs at home?

Early signs of respiratory complications


How is it transmitted?

What are the S&S?

How is it treated?

How is it prevented?

What are the complications?

Why do we worry about the Flu in pediatrics?



What is the function of the tonsils?

What are the indications for removing the tonsils &/or Adenoids?

List the key points you would include in the teaching plan for a patient that has had a tonsillectomy

Infectious Mononucleosis (Mono)

What causes Mono?

Who is most at risk?

What are the clinical manifestations?

What is the treatment?

Long term concerns?


What is croup?

What causes croup?

Who is at greatest risk?

How is it treated?


Acute Epiglottitis

What is the cause?

What are the S & S?

What are the nursing considerations?

Nursing Management of Epiglottis

Do not attempt to visualize the throat.

Do not leave the child unattended.

Do not place the child in a supine position.

Provide 100% oxygen in the least invasive manner.

If complete airway occlusion occurs, tracheostomy may be necessary.

Ensure emergency equipment is available

Youtube resp disorders

Respiratory Syncytial Virus & Bronchiolitis

When does it occur?

What are the S & S?

What is the pathophysiology?

How is it diagnosed?

How is it treated?

How is it prevented?

What are the nursing considerations?


Pneumonia (PNA)

What is pneumonia?

How is pneumonia classified?

How does age play a role?

What is the difference between viral & bacterial pna? Difference in tx?

What is the best way to prevent pna?

Nursing considerations

Pertussis (Whooping Cough)

What causes Pertussis?

What are the S & S?

What is the treatment?

What is the best form of prevention?

Otitis Media (OM)

What causes OM?

Why review OM in respiratory material?

Why does OM affect the pediatric population?

What are the clinical manifestations of OM?

How do we treat OM?

How do we prevent OM?

What are complications of OM?

What are some risk factors for OM?


What is asthma?

What causes the airway obstruction?

Asthma dx are based on symptoms & classified in one of four categories


Mild persistent

Moderate persistent

Severe persistent

Check your knowledge

What are the 3 cornerstones of drug therapy of asthma?

Is the problem with air trapping related to inhalation or exhalation?

In pediatrics, how would you describe the step wise approach to classifying the severity of asthma for your patient?

Asthma Assessment

Subjective data

Objective data

Risk Factors


Nursing care management

Asthma Medications

What are the medications used to treat asthma?

Why are there multiple drug categories to treat asthma?

Metered Dose Inhaler (MDI) with Spacer


Health Maintenance & Promotion

What are the goals of asthma treatment?

What are 5 key points you would share with parents regarding health maintenance & promotion teaching for asthmatics?

Complications of Asthma

Status Asthmaticus

Nursing Actions

Respiratory Failure

Nursing Actions

Cystic Fibrosis (CF)

What is CF?

How is CF diagnosed?

What are the clinical manifestations?

Pathophysiology of CF

Characterized by several clinical features

What are they?

Autosomal Recessive Inheritance

Respiratory presentation of CF

What are the respiratory symptoms of CF?

What are the infectious pathogens we are most concerned about?

How do we provide optimal respiratory management of the CF patient?

Gastrointestinal Tract & CF

How does CF affect the GI tract?

What complications occur from GI involvement?

How are the GI symptoms managed in CF?

Endocrine Management & CF

How is the endocrine system affected in the CF patient?

What are the key element to that management?

Reproductive Considerations

How does CF affect male reproduction?

How does CF affect female reproduction?

Nursing Considerations r/t CF

Respiratory considerations

ways to optimize function

GI considerations

ways to prevent malabsorption

Client education

Educate to prevent complications





Treatment Goals for CF

What are the treatment goals for CF?

What is the prognosis for the CF patient?

Sudden Infant Death Syndrome (SIDS) p 601

Sudden Infant Death Syndrome (SIDS): unexplained death, usually during sleep, of a seemingly healthy infant. AKA: crib death

SIDS is the third leading cause of infant mortality. Increased incidence in the winter months

Accounts for 40-50% of all deaths between 1 month and 1 year

Etiology: UNKNOWN

Lower incidence in breast fed babies & infants put to sleep with a pacifier

SIDS con’t

Risk Factors:

Maternal smoking


Prone sleeping (highest risk)

Heart arrhythmias

Soft bedding

Over-heating (thermal stress)

LBW or preterm babies

SIDS con’t

Nursing Care Management

Educating families about the risk of prone sleeping position (or side lying position) in infants from birth-6 mos (prone position has the highest risk of SIDS occurring)

Educating about using appropriate bedding surfaces

Avoid overheating the infant while sleeping (thermal stress)

Many people are concerned that if an infant is on it’s back it will aspirate emesis or mucous. Studies fail to show in increase in infant death from this position

Babies should be placed on their back when they go to sleep

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