Chapter 15: Caring for the Child With a Respiratory Condition

Understanding these developmental differences is essential for recognizing why children experience respiratory compromise more readily than adults. The chapter then presents diagnostic methodologies including pulmonary function testing through spirometry, noninvasive oxygen saturation monitoring via pulse oximetry, arterial blood gas analysis for acid-base assessment, sweat chloride testing for cystic fibrosis confirmation, and imaging studies to identify structural and infectious pathology. Congenital conditions such as esophageal atresia with tracheoesophageal fistula and acquired critical illnesses like acute respiratory distress syndrome are discussed with emphasis on surgical intervention and intensive supportive care. The chapter extensively covers chronic multisystemic disorders, particularly cystic fibrosis as an autosomal recessive condition affecting mucus-secreting glands throughout multiple organ systems, requiring comprehensive management including chest physiotherapy, nutritional support, and enzyme replacement. Upper airway infections including croup syndromes and epiglottitis receive careful attention given their potential for rapid deterioration and the critical importance of avoiding airway manipulation in epiglottitis. Lower airway and infectious conditions such as bronchiolitis, respiratory syncytial virus infection, pertussis, tuberculosis, and pneumonia are presented with appropriate infection control measures and diagnostic approaches. The chapter addresses common obstructive and allergic conditions, particularly childhood asthma as the most prevalent chronic pediatric disease, emphasizing action planning, peak flow monitoring, and the distinction between acute rescue medications and controller therapies. Foreign body aspiration risk in toddlers is highlighted as a potentially fatal emergency requiring bronchoscopic removal. Throughout the chapter, nursing care integrates disease management with developmental promotion, parental education regarding environmental hazards like secondhand smoke exposure, medication safety including avoidance of salicylates to prevent Reye syndrome, and immunization compliance to prevent vaccine-preventable respiratory infections.