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Journal of Community Health Nursing Vol. 3, No. 1 (1986) , pp. 11-23 (13 pages) Published By: Taylor & Francis, Ltd. https://www.jstor.org/stable/3427321 Journal Information This innovative publication focuses on health care issues relevant to all aspects of community practice schools, homes, visiting nursing services, clinics, hospices, education, and public health administration. Well-researched articles provide practical and up-to-date information to aid the nurse who must frequently make decisions and solve problems without the back-up support systems available in the hospital. The journal is a forum for community health professionals to share their experience and expertise with others in the field. Publisher Information Building on two centuries' experience, Taylor & Francis has grown rapidlyover the last two decades to become a leading international academic publisher.The Group publishes over 800 journals and over 1,800 new books each year, coveringa wide variety of subject areas and incorporating the journal imprints of Routledge,Carfax, Spon Press, Psychology Press, Martin Dunitz, and Taylor & Francis.Taylor & Francis is fully committed to the publication and dissemination of scholarly information of the highest quality, and today this remains the primary goal. Rights & Usage This item is part of a JSTOR Collection. Home > All Topics > Difficulty Breathing In Infants And Young Children: An Update
AbstractPediatric respiratory distress is a common and troubling presenting complaint to the emergency department (ED). Although many respiratory illnesses are due to upper respiratory tract infections, which are self-limited and need only parental reassurance, the emergency clinician must constantly be alert and prepared for the few children with an underlying condition that can progress to respiratory compromise or failure. Emergency clinicians must utilize clues from both the history and physical examination to uncover the cause of the distress and then employ the most up-to-date modalities to prevent the child’s deterioration. Although uncommon, respiratory failure can rapidly ensue in some instances and cause cardiopulmonary arrest. Respiratory failure is the most common cause of cardiac arrest in children.1 The unexpected and rapid respiratory collapse of the pediatric patient can most often be avoided by early recognition of the severity of illness and should prompt initiation of appropriate therapies. Case PresentationsYou’ve just come in for the early morning shift. You finish taking sign-outs. As you walk toward the coffee machine, the triage nurse runs by you carrying a toddler in her arms who is coughing, crying, and gasping for air. You follow her to the room, squeeze past 2 frightened parents, a crying grandparent, 2 other nurses, and an EMT student trying to get to the child. They are all trying to keep him on the gurney, place monitor leads, place a nasal cannula for oxygen, and start looking for IV sites. In the meantime, the child’s distress continues to worsen, and everyone in the room starts looking at you. Critical Appraisal Of The LiteratureDue to the number of conditions that result in respiratory distress, the literature on this topic is quite extensive and diverse. While certain illnesses are well-studied, the literature on other disease states is sparse. For instance, the scope of the literature on foreign body aspiration is limited to case reports and case series. This is due to the fact that there are only a handful of cases each year that present to a single ED, making it difficult to conduct large studies. On the other hand, there are many large randomized trials and systematic reviews on asthma, bronchiolitis, and croup. Risk Management Pitfalls In The Treatment Of Difficulty Breathing
Tables and FiguresReferencesEvidence-based medicine requires a critical appraisal of the literature based on study methodology and number of subjects. Not all references are equally robust. The findings of a large, prospective, randomized, and blinded trial should carry more weight than a case report. To help the reader judge the strength of each reference, pertinent information about the study, such as the type of study and the number of patients in the study, will be included in bold type following the reference, where available.
Which precursor would the nurse recognize as common in children who develop Reye's syndrome?Reye syndrome is preceded by a viral infection, most commonly chickenpox or influenza.
Which clinical finding of an 8 year old child with a history of asthma requires immediate intervention?Asthma emergencies
Significant trouble breathing. Persistent coughing or wheezing. No improvement even after using a quick-relief inhaler, such as albuterol (ProAir HFA, Ventolin HFA, others) Being unable to speak without gasping.
Which step would the nurse undertake during the administration of ear drops in children ages 1 to 3 years?Straighten the ear canal as follows: For children younger than 3 years, gently pull the outer ear down and toward the back of the head. For children older than 3 years, gently pull the outer ear up and toward the back of the head.
What is the maximum acceptable heart rate of a 16 year old record your answer using a whole number beats per minute?What is a Typical Pulse?. |