Chapter 2 (Part 6) Flashcards
Inflammation of the pharynx
Pharyngitis
Sudden painful
inflammation of the
pharynx, palate, and
tonsils
Acute Pharyngitis
Common in patient
younger than 25 years
of age particularly 5
and 15 years old
Acute Pharyngitis
Causes of Pharyngitis
- Adenovirus
- Influenza virus
- Epstein virus
Clinical manifestation of acute pharyngitis
- Sore throat (primary symptom)
- Fiery red pharyngeal membrane and tonsils
- Swollen lymph nodes with purple exudate
- Difficulty swallowing, fever, malaise
Persistent inflammation
of the pharynx.
Chronic pharyngitis
Common in adults who work in dusty surroundings, use their voice to excess, suffer from chronic cough, or habitually use alcohol and tobacco.
Chronic pharyngitis
Three types of chronic pharyngitis
- Hypertrophic
- Atrophic
- Chronic granular
General thickening and congestion of the
pharyngeal mucous
membrane
Hypertophic
late stage of the first type (the membrane is thin, whitish, glistening, and
at time wrinkled)
Atrophic
numerous swollen lymph follicles on the
pharyngeal wall
Chronic granular
Clinical manifestations of chronic pharyngitis
Consistent sense or irritation and cough
Diagnostic test for Pharyngitis
- Rapid strep culture (RST)
- Strep culture
Nursing management for pharyngitis
- Give antibiotic
- Gargle with warm salt water
- Use tissue to dispose phlegm properly
- Check skin
- Bed rest
- Avoid exposure to allergens
- Assess signs and symptoms
An inflammation of the larynx, often
occurs as a result of voice abuse or
exposure to dust, chemicals, smoke, and
other pollutants, or as part of upper
respiratory system.
Laryngitis
Causes of Laryngitis
Viral or bacterial
Manifestations of Laryngitis
- Hoarseness or Aphonia (Loss of voice)
- Severe cough and sore throat
Plan for Laryngitis
- Maintain patent airway
- Maintain effective ways of communication
- Maintain hydration
- Knowledge on how to prevent URI in absense of complication
Medical management of laryngitis
- Anti histamines
- Steroids
- Antibiotic
Nursing Management for Laryngitis
- Encourage to rest the voice box
- Maintain a well humidified environment
- Instructs patient about the importance of taking prescribed medications including proton pump inhibitors such as OMEPRAZOLE
a hemorrhage from the nose, is caused
by the rupture of tiny, distended vessels
in the mucous membrane of any area of the nose.
Epistaxis
Three major blood vessels
- the ANTERIOR ETHMOIDAL ARTERY on the forward part of the roof (Kiesselbach plexus)
- the SPHENOPALATINE ARTERY in the posterosuperior region, and
- the INTERNAL MAXILLARY BRANCHES (the plexus of veins located at the back of the lateral wall under the inferior turbinate).
Risk factors of Epistaxis
Local infections (vestibulitis, rhinitis,
rhinosinusitis)
Systemic infections (scarlet fever,
malaria)
Drying of nasal mucous membranes
Nasal inhalation of corticosteroids (e.g.,
beclomethasone) or illicit DRUGS
drugs (e.g., cocaine)
Trauma (digital trauma, blunt trauma,
fracture, forceful nose blowing)
Arteriosclerosis
Hypertension
Tumor (sinus or nasopharynx)
Thrombocytopenia (low platelet)
Use of aspirin
Liver disease
Rendu–Osler–Weber syndrome
(hereditary hemorrhagic telangiectasia)
Medical Management for Epistaxis
Apply direct pressure
sits upright with the head tilted forward
to prevent swallowing and aspiration of
blood
pinch the soft outer portion of the
nose against the midline septum for 5 or 10 minutes continuously.
Application of nasal decongestants
Silver nitrate application
Apply topical vasoconstriction
Apply cotton tampon
Suctioning to remove excess blood
Gauze packing
Balloon-inflated catheter
Antibiotic may be prescribed because of
the risk of iatrogenic sinusitis and toxic
shock syndrome
Nursing Management for Epistaxis
Monitor vital signs
Assist in the control of bleeding
Provide tissue and an emesis basin to
allow the patient to expectorate any
excess blood
Assess the patient’s breathing and airway
Avoid forceful nose blowing, straining,
high altitude, and nasal trauma.
Provide adequate humidification
is a disorder characterized by recurrent episodes of upper airway obstruction and a reduction in ventilation.
Obstructive Sleep Apnea
Risk factors for OSA
- Obesity
- Male
- Post menopausal women
- Alteration in upper airway, such as structural changes (tonsillar hypertrophy,
abnormal posterior positioning of one or
both jaws)
3 Types of SA
- Obstructive
- Central
- Mixed
lack of air flow due to
pharyngeal occlusion
Obstructive SA
simultaneous cessation of
both air flow and respiratory movement
Central OSA
combination of both
obstructive and central
Mixed OSA
Classis s/s of OSA
- Snoring
- Sleepiness
- Significant-other report of sleep apnea episodes
Manifestations of OSA
Excessive daytime sleepiness
Frequent nocturnal awakening
Insomnia
Loud snoring
Morning headaches
Intellectual deterioration
Personality changes, irritability
Impotence
Systemic hypertension
Arrhythmias
Pulmonary hypertension, or pulmonale
Polycythemia
Enuresis
Diagnosis of OSA
Polysomnographic findings (Sleep Study)
Management for OSA
- Continuous Positive Airway Pressure
(CPAP) - Medications
- Weight reduction/weight loss
