Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nur 258 > Ch. 18: Upper Respiratory Tract Problems > Flashcards

Ch. 18: Upper Respiratory Tract Problems Flashcards

1
Q

What is the purpose of the upper respiratory tract?

A

to warm, humidify, and filter air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does nursing care include for upper respiratory tract infections?

A

-accurate assessments: is the Pt improving or worsening? look at trends!
- Patient education: chain of infection, good hand washing!!!, use tissues when sneezing/coughing, and treatment of s/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is rhinitis?

A

allergies

inflammation and irritation of nasal mucus layer that can impact QOL, contributes to sinus/ear/sleep problems due to increased mucus production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T or F: rhinitis does not coexist with asthma

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T or F: rhinitis is associated with airborne particles

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the treatment options for rhinitis?

A

treat cause: allergy shots, corticosteroids, antihistamines, steroid nasal spray

2nd generation antihistamines are preferred for non sedating effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is nursing management of rhinitis?

A
  • avoid or reduce exposure to allergens and irritants
  • hand hygiene
  • yearly flu vaccine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the pharmacological treatments for rhinitis?

A
  • antihistamine and corticosteroid nasal sprays
  • cromolyn: mast cell stabilizer that inhibits release of histamine
  • oral decongestants
  • saline nasal spray for mild decongestion
  • Singulair: leukotriene modifiers
  • Xolair: immunoglobulin E modifiers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is viral rhinitis

A

common cold

Coxsackie and adenoviruses are more severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is viral rhinitis spread?

A

airborne droplets

virus can survive up to 3 days on inanimate objects so it can also transmit by direct hand contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the s+s of viral rhinitis?

A

sore throat, nasal//sinus congestion, runny nose, sneezing, cough and hoarseness

duration: 1-2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the treatment of viral rhinitis?

A

rest, fluids, and treat symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are interventions of viral rhinitis?

A

rest, fluids, analgesics, warm saltwater gargles, ice chips, NSAIDs, antihistamines, nasal decongestant, and expectorants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are s+s of influenza?

A

high fever, muscle aches, joint aches, N+V, coughing, HA, sore throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are diagnostic studies of influenza?

A
  • Gold standard: viral cultures (able to identify which virus is actual cause)
  • Rapid flu test (first 48 hours of symptoms)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is nursing management of influenza?

A

VACCINES!!!

-assess for allergies before administration
-mindful of previous reactions
-egg hypersensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are antiviral medications for influenza and why are they given?

A
  • mainly for Pt’s with compromised immune system/ hx of respiratory disease
  • Ex: zanamivir (inhaler), oseltamivir (oral), and peramivir (IV)
  • Max benefit: given 2 days of onset of S+S
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is sinusitis?

A

inflammation/swelling of mucosa (sinuses) that blocks sinus openings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is rhinosinusitis?

A

inflammation/infection of nasal mucosa and sinus mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the differences of sinusitis v. rhino sinusitis?

A

rhino sinusitis is more spread through the nasal cavity and is more symptomatic for a longer period of time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are causes of sinusitis?

A

viral, bacterial, allergies, pollutants, fungal infections, structural problems with nose, weak immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are s+s of sinusitis?

A

HA that is not relieved with Tylenol only sinus medications, nasal congestion/discharge, postnasal drip, ST, fever, cough, bad breath, pain/tenderness of sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are complications of sinusitis?

A
  • Local: osteomyelitis and mucocele (paranasal sinus cyst)
  • Intracranial (rare): cavernous sinus thrombosis, meningitis, brain abscess, ischemic brain infarct, and severe orbital cellulitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treatment of sinusitis that is caused by bacteria?

A
  • Amoxicillin x 10-14 days
  • Broader spectrum ABX if no improvement after 14 days: cephalosporins (ceph- or cef- meds)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what s+s shows bacterial sinusitis?

A

-green/brown mucus accompanied by nasal obstruction
-facial pain, pressure, or a sense of fullness
-Localized or diffused HA
-High fever (102 degrees F)

the occurrence of s+s for 10 days+ after initial onset of s+s indicates bacterial sinusitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment of viral sinusitis?

A

-nasal saline lavage
- decongestants: oral decongestants and topical decongestants (should not be used for more than 3 days)
- OTC/prescribed antihistamine if allergic components suspected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are s+s of meningitis that Pt’s need to be educated on?

A

fever, severe HA, and nuchal rigidity (severe stiffness of neck)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is acute pharyngitis and how is it spread?

A

it is a sore throat/strep throat that is spread by droplets of coughs and sneezes or unclean hands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are the causes of acute pharyngitis?

A
  • viral: adenovirus, influenza, Epstein-Barr, and herpes simplex
  • bacterial: group A beta-hemolytic streptococcus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how is acute pharyngitis diagnosed?

A

rapid streptococcal antigen test
If (-), confirm with culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the s+s of acute pharyngitis?

A

fever, swollen and red throat, lymphoid follicles that are swollen and flecked with white spots, HA, bad breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what are complications of untreated acute pharyngitis?

A

sinusitis, otitis media, peritonsillar abscess, mastoiditis, and cervical adenitis

rare: bacteremia, pneumonia, meningitis, rheumatic fever, and nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are treatments of bacterial acute pharyngitis?

A

penicillin or azythromycin if allergic to penicillin

34
Q

what population is chronic pharyngitis common in?

A

adults that work in dusty environments, use voice to excess, chronic cough, habitual tobacco/alcohol

35
Q

what are the 3 types of chronic pharyngitis?

A
  • Hypertrophic: general thickening and congestion of pharyngeal MM
  • Atrophic: most likely late stage of 1st type; MM is thin, whitish, glistening, and may be wrinkled
  • Chronic granular: numerous swollen lymph follicles on pharyngeal wall
36
Q

what are the clinical manifestations of chronic pharyngitis?

A

constant fullness in throat/irritation, mucus that collects in throat, difficulty swallowing, and intermittent postnasal drip

37
Q

what are the treatment options for chronic pharyngitis?

A

relieve s+s, avoid exposure/irritants, avoid alcohol/tobacco/exposure to cold, increase fluid intake, gargle warm saltwater, nasal sprays, antihistamines, decongestants, ASA, Tylenol

38
Q

what is tonsillitis and adenoiditis?

A

Tonsillitis is inflammation of tonsils located on each side of oropharynx

Adenoiditis is inflammation of adenoids (pharyngeal tonsils) that is usually accompanied by tonsillitis

39
Q

what is the common viral pathogen of tonsillitis?

A

Epstein Barr

40
Q

what is the common bacterial pathogen of tonsillitis?

A

GABHS

41
Q

what is the difference between viral tonsillitis and bacterial tonsillitis?

A
  • Bacterial: a lot of swelling, pus pockets are present, and gray furry tongue is present
    -viral: less swelling, no pus pockets, and no gray furry tongue
42
Q

what is the treatment of tonsillitis?

A

increase fluids, analgesics, salt water gargles, rest

If bacterial: PCN or cephalosporins

43
Q

what are the requirements for a tonsillectomy?

A

repeat tonsillitis, hypertrophy of tonsils causing obstruction and OSA

44
Q

what is education for a tonsillectomy?

A
  • Increased risk for hemorrhage
  • complete ABX therapy post-op
  • Use humidifier
  • Avoid spicy, hot, acidic, rough foods and milk/milk products
  • Avoid smoking
  • Bleeding can occur up to 8 hours post-op
  • Good hydration
45
Q

what is post-op nurse management for a tonsillectomy?

A
  • Place pt in prone with head turned to side for drainage
  • NPO until gag/swallowing reflex is present
  • Post-op complications s+s: fever, throat pain, ear pain, bleeding
46
Q

what is a peritonsillar abscess?

A

a complication of tonsillitis that causes pain, swelling, and airway blockage

47
Q

what are s+s of peritonsillar abscesses?

A

fever, chills, elevated WBC, difficulty swallowing, ear pain, raspy voice, bad breath

48
Q

what is the treatment of peritonsillar abscesses?

A
  • ABX therapy and corticosteroids
  • May need an incision and drainage if pt does not improve
49
Q

T or F: peritonsillar abscesses can be life threatening.

A

T- due to edema that can spread to neck and chest that compromises the airway

50
Q

what is laryngitis?

A

inflammation of larynx due to voice abuse, exposure to chemicals, dust, smoke, pollutants, URI, and GERD

51
Q

what are s+s of laryngitis?

A

hoarseness of voice, aphonia, severe cough

52
Q

what is the treatment of laryngitis?

A

vocal rest, avoidance of irritants, ABX if bacterial, increase fluids, stop smoking, medications like corticosteroids and PPI’s, and use of CPAP if prescribed for OSA

53
Q

what is a complication of laryngitis?

A

report hoarseness of voice if it persists after 5 days of vocal resting b/c it can be a sign of malignancy

54
Q

what are laryngeal polyps?

A

polyps that can occur on vocal cords due to vocal abuse, intubation, or smoking

55
Q

what is the treatment of laryngeal polyps?

A

voice rest and adequate hydration

surgical removal if polyps are large and cause airway compromise

56
Q

what is the treatment if the laryngeal polyps are malignant?

A

radical laryngectomy and mechanical voices due to removal of vocal cords

57
Q

why does OSA occur?

A

narrowing of air passages with relaxation of muscle tone during sleep and/or tongue and soft palate falling backward to partially or completely obstruct the pharynx

58
Q

how long do apnea periods last during OSA?

A

10 to 90 seconds long

59
Q

what are s+s of OSA?

A

snoring, extreme sleepiness, significant periods of apnea, night terrors, waking up at night gasping for air, morning HA, HTN due to increase pulmonary pressures

60
Q

what are risk factors for OSA?

A

male gender, postmenopausal, advanced age, structural changes to upper airway, obesity, stout neck

61
Q

what is medical management of OSA

A
  • CPAP
  • BiPAP
  • mandibular advancement device
62
Q

what is pharmacological therapy for OSA?

A
  • Modafinil: decreases daytime sleepiness
  • Protriptyline at bedtime: increases respiratory drive and improve airway tone
  • Provera and Diamox: opens alveoli
63
Q

what are risk factors for epistaxis?

A

local/systemic infections, drying of nasal mucosa, nasal inhalation of drugs, trauma, HTN, atherosclerosis, tumor, blood thinners, liver disease, and low humidity levels

64
Q

what is nursing care of epistaxis?

A
  • keep patient calm
  • sit patient up-right and lean forward
  • apply pressure to nasal septum for 10-15 mins
  • cauterize with silver nitrate
  • pack if nothing else helps
65
Q

what do nurses need to do for packing to treat epistaxis?

A
  • Assess respiratory status, LOC, and s+s of aspiration
  • provide pain relief with Tylenol
  • ABX therapy due to high risk of staph infection
66
Q

what is patient education for epistaxis?

A
  • Avoid vigorous exercise for 4-6 weeks
  • Avoid hot and spicy foods, tobacco, ASA and/or NSAIDS
  • Avoid forceful nose blowing and picking of nose
  • Adequate humidity and use nasal spray to moisten nose if needed
67
Q

T or F: epistaxis occurs more in summer months.

A

F- winter months

68
Q

what is the main cause of deviated septum?

A

trauma to nose

69
Q

what can a deviated septum cause for patients?

A

potential for interference with airflow and sinus drainage

can affect NG tube insertion: assess pt’s nose and ask if pt has hx of trauma to nose, ask which nostril they breath out of better

70
Q

what are s+s of a deviated septum?

A

Minor- asymptomatic

Can cause obstruction to nasal breathing, nasal congestion, frequent sinus infections, nosebleeds, and facial pain

71
Q

what is medical management of a deviated septum?

A

nasal septoplasty: reconstruction and properly align septum

72
Q

what are nasal polyps?

A

soft, painless, benign growths that form slowly due to repeated inflammation of sinus/nasal mucosa

73
Q

who gets nasal polyps most often?

A

men are 2x as likely to get it than women, Age > 40 years old

74
Q

what are s+s of nasal polyps?

A
  • size of grape
  • yellow gray or pink that are semitransparent
  • small: asymptomatic
  • large: nasal obstruction and drainage, speech distortion, pt becomes a mouth breather which dries oral mucosa
75
Q

what is primary medical therapy of nasal polyps?

A
  • topical and systemic steroids: shrinks polyps
  • antihistamine: allergy induced
  • endoscopic or laser surgery: to remove polyps
  • ABX therapy: underlying bacterial infection with s+s of increased nasal congestion, yellow/green discharge, facial pain/pressure, HA, fatigue, tooth pain
76
Q

T or F: nasal polyps are always benign.

A

F- they can become malignant

77
Q

how do you remove foreign bodies from nose?

A
  • sneezing and blowing the nose with opposite nostril closed to create pressure
  • avoid irrigating nose or pushing FB further in due to r/o aspiration and airway obstruction
78
Q

what causes laryngeal obstructions?

A

-angioedema: cause of death in severe anaphylaxis
- hereditary angioedema: episodes of life-threatening laryngeal edema
- Foreign bodies: aspirate into pharynx, larynx, or trachea –> difficulty breathing –> asphyxia
*can inhale further down into bronchi and bronchioles that cause increase irritation and inflammation

79
Q

what are clinical manifestations of laryngeal obstructions?

A
  • normal to low O2 sats
  • use of accessory muscles to breathe which causes high risk for respiratory collapse
80
Q

what should you assess for a pt with a laryngeal obstruction?

A

heavy alcohol or tobacco use, current meds, hx of airway problems, recent infections, pain or fever, dental pain or poor dentition, previous surgeries, radiation therapy, trauma

81
Q

what are medical management of laryngeal obstructions?

A
  • Patent airway!
  • Immediate tracheostomy
  • allergic reactions?: subq epinephrine and corticosteroid
  • edema: ice to neck
  • continuous pulse oximetry

Nur 258 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions