Pediatrics
Pediatric Respiratory Nursing
Overview
Respiratory conditions are the most frequent cause of hospitalization in the pediatric population due to the small diameter of their airways. Common issues range from acute infections like bronchiolitis and croup to chronic conditions such as asthma and cystic fibrosis. Nursing care focuses on maintaining airway patency, humidification, and monitoring for signs of respiratory failure.
Key nursing concepts
- Children have smaller, narrower airways that are easily obstructed.
- Epiglottitis is a medical emergency caused by H. influenzae type b.
- Croup is typically viral and managed with cool mist and steroids.
- Asthma is a chronic inflammatory disease with reversible airway obstruction.
- Cystic fibrosis involves thick mucus secretions affecting multiple systems.
- Foreign body aspiration is a leading cause of accidental death in toddlers.
Important nursing considerations
- Assess for the 'barking' cough and inspiratory stridor characteristic of croup.
- Maintain a calm environment to prevent crying, which worsens airway obstruction.
- Keep emergency intubation equipment at the bedside for suspected epiglottitis.
- Avoid using a tongue blade to examine the throat if epiglottitis is suspected.
- Monitor oxygen saturation and work of breathing, including retractions.
- Administer humidified oxygen and nebulized racemic epinephrine as ordered.
Patient teaching
- Teach the use of a spacer with metered-dose inhalers for better drug delivery.
- Instruct parents on how to perform chest physiotherapy for cystic fibrosis.
- Advise parents to seek immediate care for 'tripod positioning' or drooling.
- Encourage increased fluid intake to help thin respiratory secretions.
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