NSG 101 Maternal Child Nursing Final Study Guide - 2021
Respiratory Disorders
CHOANAL ATRESIA
Something that obstructs the
nasalpassages
Blockage
... [Show More] could be due to abnormal
bonygrowth or soft tissue or
membrane
Watch out for cyanosis
- Cyanosis increases during feeding
- Cyanosis decreases when
infant iscrying
CAUSES
Idiopathic, even the contributing
factors
SIGNS & SYMPTOMS
Initially (especially bilateral),
difficulty ofbreathing, later on
manifestation: cyanosis
- This cyanosis manifests
moreduring feeding.
*New-borns are obligatory nose
breathers
Continuous mucous draining from
nostrils
- Mucous has no other way but
togo out due to the blockage
DIAGNOSIS
Catheter
- Nasal catheter NGT
- If it fails to pass through,
there isan obstruction
- To confirm, but ordered by
doctor
- Done by nurse
X-ray or CT Scan
- To confirm
- ordered by doctor
One way to check if nostrils is
patent(check if 2 holes are
obstructed)
- Occlusion of one nostril to palpate
for any obstruction then same for
the other (Initial way for a nurse
to diagnose for choanal atresia)
MANAGEMENT
Temporary:
Insertion of oral airway
- To allow baby to breathe prior to
surgery
- Alleviates onlySurgery
- Only treatment
▪ Tissue or
membrane:
perforate (pierce
throughmembrane
or tissue)
- Bony growth: More
complicatedsurgery,
removal of bony growth
NURSING CARE
Participate in early screening
Maintain patency of oral airway
Continuous monitoring of respiration
Provide pre/post-op care
Vital signs
Administer medications if any
Any surgery that requires the
child to bein supine position or
involving the face, check the
presence of loose tooth to prevent
aspiration during surgery
Consent signed only by parents
Ensure proper positioning
- Since client is in supine (high
risk foraspiration), reposition
the client in prone to allow the
passage or drainage of
secretions
SUDDEN INFANT DEATH
SYNDROME
Bangungot – SIDS
SUNDS - Sudden Unexplained
Nocturnal Death Syndrome/young
Asian’s syndrome
- Common in young male Asians
Commonly mistaken for acute
pancreatitis
- AP – possible to die when you
aresleeping but can’t be said as
bangungot
Related to cardiac problems
- Heart can restart (able to wake
upfrom a nightmare)
- Heart can stop (won’t be able to
wake up)
Quiet death of a healthy infant that
cannot be explained (even by
autopsy)
Idiopathic cause
There are theories and precipitating factor
SIDS increases due to prematurity
- Preterm babies are highly vulnerablePeak age: 2 months (first 28 days – high Stridor
risk for neonatal morbidity and mortality)
SIDS increases if there is a history of
- Baby in supine position makes
noisethat sounds like a snore
previous baby who died secondary to SIDS Cough
Common for babies sleeping in prone - Tries to expel out any irritant
position - Brassy, croupy, barking (dry)
cough
Only said that it’s SIDS if there is death - Morning: client appears fine
- Afternoon: manifestations come
out
MANIFESTATIONS
Apnea
Pallor & limpness
Cool to touch
Referring to a dead body
already
MANAGEMENT
Resuscitation
- If baby can still be saved
- Noisy breathing when sleeping
Retractions
- 2 kinds: sternal & intercoastal
- Intercoastal: lower airway is
alreadyaffected
- Indention/depression is
anindication of
retraction
Late sign
- Cyanosis
NURSING CARE
Monitor
- Apnea
- Vitals
- Resuscitation
Resuscitation
- 20 rescue breaths (once
every 5cardiac compression)
If baby dies
- Provide comfort
- Anticipatory grieving
CROUP
Inflammation of the larynx, trachea,
andbronchia that results to spasm
Caused by a viral infection
Incidence rate is higher among
youngerchildren (<3 years old)
Seasonal (peak season during winter
andlate fall)
When its colder, the immune
systemweakens
SIGNS & SYMPTOMS
Fever
- Low grade/febrile (usual in viral)
*In bacterial infection more severe
fever (high grade)MANAGEMENT
Mild case: home remedy
- warm
▪ Steam, if without the
diffuser do it in the
shower, with hot water
with a window open(do
not suffocate)
- Cool-mist vapor
▪ Breathing in a cool place
(fridge)
Bronchodilator
- Nebulizer or
oral
Feve
r -
Antipyretic
- Acetaminophen
Corticosteroids
IV Fluid
EPIGLOTITIS
Considered as an emergency
Need for intubation
Inflammation of the epiglottis
Cause: bacterial infection
HIB vaccine (check record), if
with HIBvaccine, then it may be
streptococcal infection and not
bacterial (HIB)
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