Pediatric Respiratory Disorders

Pediatric Respiratory Assessment
General History
General History Questions to Ask
-Ask about gestational age
-Any past medical history, including onset of current s/s.
****recurrent sore throats, eczema, resp problems at birth
-Detailed family hx****chronic resp conditions-asthma
-Exposures to enviormental irritants
****pets, smoke
-Feeding and sleeping patterns
-Growth
-Milestones for age
-International travel
Things to Remember Before Assessment of Child
-Childs airway is shorter than adults
-Newborns=nose breathers
-Child's airway can easily spasm
-Pronounced abd wall mvmt is normal until age 6
-Higher O2 demand
-Anterior-Posterior diameter of the chest is equal at birth and decreases with age
Auscultation:
~ Anterior and posterior chest, and bilateral mid-axillary for aretion {Respiratory rate -- varies based on child's age}
~Heart rate depends on age; increased with fever, dehydration.
~Adventitious breath sounds {Crackles (rales) are fine crackling noises heard on inspiration} -Results as air moves through fluid-filled alveoli, as in pneumonia -May not change after coughing -Sound can be stimulated by rolling hair b/w fingers {Rhonchi are low-pitched sounds heard throught out respiration} -Air passes through thick secretions throughout respiration -May clear after coughing {Stridor is a high-pitched sound on inspiration} -Heard when child has croup {Wheezing is a high-pitched musical sound; heard throughout respiration} -Results from air passing through constricted bronchioles/ narrowed airways [Asthma]
AUSCULTATION:
Respiratory rate varies based on the child's age. Auscultate anterior & posterior chest, and bilateral mid-axillary for aeration.
Heart rate depends on age; increased with fever and dehydration.
Adventitious Breath Sounds:
Crackles: (rales) are fine crackling noises heard on