Steptococcal Pharyngitis CA: GABHS S/sx: DX: MX:

-inflammation of pharynx Odynophegi Antibiotic

a Antipyretic
Dysphegia Sore throat
Throat Swab and culture Meds Analgesic
4-7 y/o Fever Pus/
exudate
Special: At risk for rheumatoid heart Swollen -IFI
disease and rheumatoid arthritis lymph node -gargle warm water
-NO spicy foods and acid
Tonsillitis CA: bacteria or virus S/Sx: DX: MX:
-inflammation of palatine tonsils Dysphonia Antibiotic
Sore throat Antipyretic
Dysphegia Swollen
Meds Analgesic
Special: At risk toddler and school Fever lymph node
age
 Sleep apnea and mouth
Aditional lang: breathing -IFI
 Difficulty hearing -Gargle warm water/salt
5 cardinal sign of inflammation (Eustachian Tube) mouthwash
 Halitosis
redness (rubor) Invasive: TONSILECTOMY
swelling (tumour)
heat (calor; only applicable to the
IF: breathing compromised
body' extremities)
pain (dolor)
loss of function (functio laesa) NOTE: If pt has frequent
swallowing--- suspect bleeding :No.
1 action of nurse post op

At risk for aspiration during

tonsillectomy---presence of loose
teeth

If pt vomits bright red blood initial

action is to ----Turn pt to side to
prevent aspiration

Other interventions:
 Give ONLY clear, cool liquids
when pt is awake and alert
 NO milk, carbonated
drinks,citrus juice (because
this may irritate the throat)
  NO COLORED foods (this
may appeared as red or the
color of blood
 MOST IMPORTANT lab value
to check: Prothrombin time
(To check gaano katagal
mastop ang bleeding)
 Discourage coughing and
crying – (may increase
bleeding and open the
suture)
 Avoid person w/ infection

NOTE: Suctioning done only if ---

problem w/ breathing (because this
may cause trauma to the surgical
site)

Keywords: TONSILS
T- urn to side (prevent aspiration)
O- bserve for bleeding ( frequent
swallowing)
N-o milk/colored foods
S- uctioning is not allowed (only if
breathing is compromised)
I-rritants not allowed
L-ab test to check: Prothrombin
Time
S- ide lying position (post op
position)

Epiglottitis CA: HIB (Hemophilus Influenzae S/Sx: DX: MX:

-inflammation of epiglottis Bacteria)
Cherry red tongue CBC (leukocytosis (20-20k) N- 4.5-10 Emergency tx: intubation or
Epiglottis shut downs to the glottis (cocci bacteria) Fever k) tracheostomy
to prevent food from entering to Dysphagia and dysphonia Elevated c reactive CHON (0-10
the lungs mg/dl
Corticosteroid ( anti -
Epiglottis culture Meds inflam)(dexamethasone
 2-7 y/o Restlessness Neck X-ray )
Cyanosis
Respiratory Antibiotic
Sternal Antipyretic
distress retractions
Nasal flaring
-NPO (to prevent aspiration
-IVF (to prevent dehydration)
-O2 (humidified)
Tripod position – sitting upright, -semi fowler’s position
learning forward, hand on knees
and protruding tongue) NOTE: NO visual inspection,invasive
procedure or any anxiety provoking
activity done until aiwayr is secure --
- at risk for laryngospasm and
respiratory arrest

Pag sinabing no visual inspection—

di mo titingan loob ng bungaga w/
tongue depressor – dahil lalong mas
sasarado ang epiglottis at lalong
sasara airway
Foreign Body Aspiration CA: foreign objects (peanuts,small S/Sx: DX: MX:
Coughing
-inhalation of foreign objects usually toys)
Hoarseness
R bronhus Choking dyspnea X-ray, bronchoscopy, fluoroscopy More than 1 y/o : Heimlick
Restlessness Maneuver
Special: infant and toddler cyanosis
Inspiratory stridor Less than 1 y/o: 5 back flows, 5
infection chest thrust

Health teaching:
Check label of toys (choking hazard)
Laryngotracheobronchitis (Croup) CA: parainfluenza S/Sx: DX: MX:
-Infection of larynx, trachea, Steroids and
bronchus that causes edema, Barking cough @ night CBC epinephrine –
inflame and laryngeal obstruction Influenza Inspiratory Stridor Neck x-ray Meds for severe
RSV reaction(neb)
Prone are 1- 5 y/o children peak 1-2
y/o
Tachypnea
Substernal,
IFI
subcoastal Steam inhalation
Respi distress retractions O2 humidified
Hoarseness May assist ET insertion—if severe
Nasal flaring
Loose and
croupy cough Health teaching:
Restlessness
Cyanosis Wake up the child when bark-like
fever cough occurs @night and place child
in bathroom and run warm water

NOTE: don’t leave the child

Asthma CA: S/Sx: DX: MX:
-chronic, reversible hypersensitivity
to allergens that cause Food allergy Expiratory wheezing Allergy- skin test -Avoidance of irritants
bronchospasm(constriction of Animal dander Pulse ox -Position: high fowler’s (orthopneic)
Cough
bronchus), inflammation increase Viral infection Peak flow meter -nebulization
Dyspnea
mucus production Medication Respi distress Dec. expiratory -IVF
Change in climate flow -food should be non-allergenic
Environment: clean and free from
allergens
-provide oral hygiene after giving
bronchodilator to prevent mouth
sore
Bronchodilator
(albuterol)
Meds Antihistamine
Corticosteroid:
hydrocortisone IV

NOTE: NPO before, during, after

episodes of asthma (wheezing) to
prevent asthma

Only give food 30 mins before /after

meds (bronchodilator)
 NOTE: If using bronvhodilator via
MDI, pt should:
 First shake
 Slow deep breath and hold
for 10 secs before releasing
(exhale)

Status Asthmaticus S/Sx: DX: MX:

-progressive attack that is Beta b bloker
unresponsive to meds RR,HR increase Meds IV steroid
Upper respiratory tract infection
Dec. breath sounds “silent chest”
cyanosis
-O2 humidified
-Monitor I/O
-CBR
-Position I semi/high f

Sudden Infant Death Syndrome
(SIDS)
-sudden and silent unexpected
death of baby where post mortem
exam fails to identify the cause of
death
-occurs during sleep on prone
position
-most die w/o sounds—may
indicative laryngospasm
Emergency tx ( ET insertion)
CA: S/Sx: DX: MX:
Possible abnormalities in brain and -mild inflam Autopsy reveals: petechial in the -Assist mother psychologically
metabolic disorder - -RT congestion lungs
-blood-flecked sputum or vomits on Baby position during sleep: SUPINE
their clothes Own safe sleeping environment: no
quilts, blankets and pillows
NOTE: 99% of mother w/ baby died
of SIDS are now aware and careful

Special: prone are pre-tem babies,

SGA, SAD

Respiratory Distress Syndrome S/sx: DX: MX:

Special: premature (d/t under ABG Surfactant replacement via ET tube

developed lung surfactant, LGA d/t X-ray (intracheal)
diabetic mother, c/s, hx of asphyxia L: S ratio -O2 humidified connected to
Tachypnea
mechanical vent
Chest retractions
Nasal flaring
Respi distress Expiratory grunt
(d/t partial closure
of glottis)
Cyanosis
Hypothermia

PEDIA CARDIO DISEASES

Fetal Structure Adult Structure
Acyanotic Cyanotic
 L to R shunt ( ibig sabihin oxy to unoxy)  R to L shunt (unoxy to oxy) Foramen Ovale Fossa Ovalis (1 year) (ASD)
 High pressure to low pressure  Low pressure to high pressure Umbilical vein Ligamentum Teres (2-3MOS)
 They turn blue Ductus Venosus (carry oxy blood) Ligamentum Venosum (2 mos)
Ductus Arteriosum (carry unoxy blood) (1st Ligamentum Arteriosum (1 mos)
breath – 3 mos) (PDA)
Acyanotic Cyanotic
Umbilical arteries and abdominal Medial umbilicus ligaments, superior
 Coartation of Aorta  Transposition of the Great
ligaments vesicular artery (supplies bladder)
 PDA Vessels
 ASD  TOF
 VSD

Atrial Septal defect CA: S/Sx: DX: MX:

Opening between atrium d/t failure
of the Foramen ovale to close Split S2 (2nd ICS LSB- pulmonic ECG- reveals enlarged RV and inc. Antibiotic for open heart surgery @
valve) pulmonary hypertension 3 y/o
Special: Prone is Female , late and Failure to thrive
early adulthood Dyspnea Surgery: Ablation @ 3 y/o
Fatigue Using Dacron Patch

CX: Post op intervention:

-monitor for arrhythmia (d/t edema
CHF in septum)
Right Hypertrophy
Pulmonary HPN
 endocarditis

Ventricular Septal Defect CA: S/Sx: DX: MX:

-opening between
Ventricles – (hole in the heart) Pansystolic murmur (L 2nd ICS) ECG- reveals enlarged RV and inc. Antibiotic for open heart surgery @
Failure to thrive pulmonary hypertension 2 y/o
Special: most common Resi infections
Dyspnea Surgery: Ablation @ 3 y/o
Fatigue Using Dacron Patch

CX: Post op intervention:

-monitor for arrhythmia (d/t edema
CHF in septum)
Right Hypertrophy
Pulmonary HPN
endocarditis

Patent Ductus Anteriosus CA: S/Sx: DX: MX:

-Descending aorta to pulmonary
artery Machinery murmur (2nd-3rd L ICS) ECG- reveals enlarged RV and inc. Indomethacin/Ibuprofen-
Clubbing pulmonary hypertension (prostaglandin inhibitor)- counteract
Special: common in Dyspnea PGE– infants
prematurity,maternal rubella,
females CX: Surgery /ligation @ 2-3 y/o
Plug/coil-- adult
CHF
Right Hypertrophy
Pulmonary HPN
endocarditis

Tetralogy of Fallot CA: S/Sx: DX: MX:

-4 heart anomalies
 VSD Polycythemia (hgb 20.5 g/dl) Chest X- ray: reveal boot shaped 1st action when dyspnea inc--- knee
 Pulmonary Stenosis Clubbing heart chest or squatting position
 Aorta overriding the hole Systolic murmur
 R V Hypertrophy tachycardia Severe Dyspnea
O2 humidified
relieved by squatting Propanolol- dec. vasospasm
Special: Cyanosis increases during or knee chest Morphine sulfate to relieve hypoxic
exertioncrying and feeding and seen Cyanosis episode
Failure
on nails and lips
 to thrive Invasive: Surgery

Tet spells/ Hypoxia spells Palliative: Blalock Tausig

 Squatting position  anastomose subclavian
 Pallor artery to pulmonary artery
 blackout  to inc .pulmonary blood
flow
CX:
Thromboembolism Post op intervention:
CVA  avoid BP and venipuncture
in the R arm

Complete: Brock
 done @ 2-4 y/o

Post op intervention:
-monitor for arrhythmia (d/t edema
in septum)
Transposition of the Great Vessel CA: S/Sx: DX: MX:
-Aorta to RV and P. artery to LV
creating complete mixture of o2 and ECG: reveals cardiomegaly Invasive Surgery:
unO2 blood Polycythemia (hgb 20.5 g/dl) Palliative: Rashkind
Clubbing  creation of VSD, ASD
Special: Male, large babies (9-10 lbs) Systolic murmur and PDA
tachycardia
Severe Dyspnea
NOTE: Very Fatal except if have /anoxi spells relieved Complete: Mustard
other defects such as septal defects by squatting or knee  done before 1 y/o
and PDA to sustain life Failure chest 
Deep Cyanosis Arterial switch procedure (-jaltene
to thrive
procedure)

Balloon catheter- to create artificial

ASD
CA: S/Sx: DX: MX:
CA: S/Sx: DX: MX:
CA: S/Sx: DX: MX: