2.1 Respiratory
📚 Main topics
- Pediatric respiratory differencesChildren have smaller airways, higher oxygen needs, and other developmental differences that increase their risk of obstruction and respiratory distress. Infants are nose breathers, and their horizontal Eustachian tubes raise their risk of ear infections. 0:32
- Otitis mediaAcute otitis media often follows a respiratory infection and can cause ear pain, fever, and fluid buildup; persistent or recurrent infections may affect hearing. Care may include watchful waiting, pain relief, antibiotics when indicated, or ear tubes for recurrent cases. 2:04
- Tonsillitis and adenoiditisInflammation of the tonsils or adenoids can cause pain, difficulty swallowing or breathing, and sometimes airway obstruction. Treatment focuses on symptom relief; tonsillectomy or adenoidectomy may be considered for select problems such as obstructive sleep apnea or recurrent ear infections. 7:46
- Croup and epiglottitisCroup causes airway inflammation, a barking cough, and inspiratory stridor; treatment ranges from supportive care to corticosteroids or nebulized epinephrine. Epiglottitis is a life-threatening emergency requiring airway management before other procedures. 10:56
- Bronchitis and bronchiolitisBronchitis is usually viral and managed with supportive care, while bronchiolitis—often caused by RSV—can obstruct infants’ small airways and impair gas exchange. Care emphasizes airway support, oxygen as needed, fluids, and infection precautions. 17:14
- PneumoniaViral and bacterial pneumonia inflame the lung tissue involved in gas exchange. Treatment includes supportive care, with antibiotics for bacterial infection and additional interventions if complications such as pleural effusion occur. 23:00
- AsthmaAsthma causes reversible airway narrowing from bronchospasm, inflammation, and thick secretions. Rescue medicines treat acute attacks, while an asthma action plan, trigger management, and maintenance medicines support long-term control. 26:05
- Cystic fibrosisThis genetic disease produces thick, sticky mucus that affects the lungs and other systems. Care includes airway clearance, infection management, exercise, high-calorie nutrition, and pancreatic enzymes with meals and snacks. 31:48
- Foreign body aspirationYoung children are at risk of inhaling small objects or choking on certain foods; airway obstruction can lead to serious complications. Prevention education, prompt removal when needed, and monitoring afterward are important. 36:26
- Sudden infant death syndrome (SIDS)SIDS has no known cause, but risk factors include prone sleep, bed sharing, soft sleep surfaces, and smoke or alcohol exposure. Prevention centers on safe-sleep education, and care after a death includes compassionate support for the family. 39:02
✨ Key takeaways
- Recognize respiratory distressAirway obstruction, increased work of breathing, and poor fluid intake can lead to gas-exchange problems and dehydration. Assessment and care should be guided by the likely underlying process. 21:55
- Know emergency warning signsStridor at rest, cyanosis, retractions, inability to drink, or a sudden absence of wheezing in a child with asthma may signal severe or worsening obstruction. 13:03
- Prioritize airway in epiglottitisDo not examine the throat when epiglottitis is suspected, because this may worsen obstruction; establish a patent airway before other interventions. 16:13
- Use antibiotics appropriatelyMany ear infections resolve on their own, and tonsillitis should be treated with antibiotics only when bacterial infection is confirmed. 5:08
- Prevent RSV spreadHandwashing and contact isolation help limit RSV transmission, particularly to infants and other high-risk patients. 19:18
🧠 Lessons learned
- Provide family educationTeach caregivers about appropriate feeding positions, medication instructions, choking hazards, signs that warrant medical attention, and safe-sleep practices. 6:43
- Match care to the conditionRespiratory illnesses often need supportive measures such as fluids, rest, oxygen when needed, and airway clearance; some conditions require targeted treatments or urgent intervention. 20:20
- Support families after SIDSOffer parents the option to see their child, respect their decision, and help connect them with grief resources and support. 41:07
🏁 Conclusion/next steps
- Apply pathophysiology to prioritiesUnderstanding how each illness affects the airway, breathing, gas exchange, and hydration helps identify the most urgent nursing concerns. 22:27
- Continue learning and seek helpUse condition-specific guidance and ask questions when further clarification is needed. 42:10
Transcript excerpt
0:01 hi it's Amy we are going to be talking about the respiratory system focusing on the child and sorry I'm just gonna get my computer plugged in real quick sorry about that um focusing on the child so the first thing just reviewing our respiratory structures so you're familiar with those we've got our upper respiratory tract that involves our nose our pharynx there are larynx and then our lower respiratory tract with our trachea
0:32 bronchi our lungs our bronchioles and our alveoli so it's important when we're talking about our kids that we understand the Pediatric differences with the respiratory system so our Peds patients obviously are going to have smaller Airways and underdeveloped cartilage and this increases the risk of obstruction by mucus swelling on foreign body aspiration you guys probably learned last semester that infants are nose breathers so if they have
1:03 um you know a stuffed up nose or anything like that that's blocking their nose and they are forced to breathe through their mouths breathing is more difficult through for them through their mouths um children have an increased metabolic rate which increases their oxygen needs um and our younger kids are eustachian tubes are horizontal instead of vertical like they are in an adult and this increases the risk of bacteria entering that middle ear and causing ear infection um the tonsil tissue is enlarged during
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Questions & Answers
Common questions about this video
What safe-sleep practices can help reduce the risk of SIDS?
Place infants on their backs to sleep in a crib with no blankets, pillows, or stuffed animals. Avoid sleep positioners and putting infants to sleep in car seats, carriers, or swings. Room-sharing is encouraged, but the infant should sleep in their own space, not in the parents’ bed. Pacifiers during sleep are also encouraged. 40:04
What are some risk factors associated with SIDS?
Non-modifiable risk factors include genetic predisposition, being male, and prematurity. Modifiable risk factors include prone sleeping, bed-sharing, sleeping on soft surfaces, and exposure to cigarette smoke or alcohol before or after birth. 39:34
What should caregivers do when an infant with suspected epiglottitis arrives for care?
Prioritize establishing a patent airway, usually through intubation. Avoid examining the epiglottis because doing so can worsen obstruction. Other procedures, such as cultures, IV placement, and antibiotics, come after the airway is secured. 16:13
How is acute otitis media commonly managed when symptoms are mild?
A watch-and-wait approach may be used for 48 to 72 hours, with the child reassessed afterward. Pain can be treated with acetaminophen or ibuprofen. Antibiotics are prescribed sooner when the child is significantly symptomatic, such as having a red, bulging eardrum along with pain and fever. 5:08
Why can RSV bronchiolitis cause breathing and gas-exchange problems in infants?
Edema, mucus, and cellular debris can obstruct infants’ very small bronchioles. This increases airway resistance, can cause air trapping and lung hyperinflation, and may lead to atelectasis and hypoxia. 19:18
What does a rising carbon dioxide level indicate in a child with asthma?
A rise in carbon dioxide can indicate severe airway obstruction and impending respiratory failure. If wheezing suddenly disappears, that can also be a warning sign of severe obstruction rather than improvement. 28:12
What care is important for children with cystic fibrosis?
Care focuses on clearing airway secretions, preventing and treating pulmonary infections, and supporting nutrition. Children may use airway-clearance techniques and prescribed inhaled therapies, need a high-calorie, high-protein diet, and take pancreatic enzymes with meals and snacks. 33:50
What signs may suggest a child is bleeding after a tonsillectomy?
Watch for excessive swallowing, fresh blood in the throat, or vomiting bright red blood. An increased pulse, decreased blood pressure, and restlessness not explained by pain may also indicate hemorrhage. 10:20
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