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Nursing of Adults I > Chapter 29: Upper Respiratory Problems > Flashcards

Chapter 29: Upper Respiratory Problems Flashcards

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1
Q

To treat chronic bacterial sinusitis, ______________________ may be used for ____________ (time period) due to presence of ___________________.

A

broad-spectrum antibiotics, 4-6 weeks, mixed bacterial flora

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2
Q

clear or pink-tinged persistent drainage after bleeding is controlled after a nasal fracture suggests ______________

A

CSF leakage

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3
Q

Treatment for posterior nosebleeds after packing includes monitoring ___________ status, _______ management, and prophylactic ______________.

A

respiratory, pain, antibiotics

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4
Q

After a laryngectomy, monitor patency of drainage tubes every ________ in the first few hours after surgery, then every ___________ to ensure proper functioning.

A

hour, 4 hours

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5
Q

______________________ can be used to realign a simple nasal fracture, while complex nasal fractures will require __________ after edema subsides, which may take _________ days

A

Manual manipulation, surgery, 5-10

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6
Q

type of allergic rhinitis in which symptoms are present more than 4 days a week and for more than 4 weeks per year

A

persistent allergic rhinitis

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7
Q

four risk factors for head and neck cancer
(health promotion for each)

A

tobacco use (tobacco cessation)
excess alcohol use (alcohol cessation)
poor oral hygiene (encourage good oral hygiene)
HPV infection (safe sex practices, condoms)

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8
Q

Anterior nosebleeds are typically treated by placing a _________ impregnated with ____________ and/or ____________ into the nasal cavity

A

pledget (nasal tampon)
anesthetic solution (lidocaine)
vasoconstrictive agents (epinephrine)

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9
Q

Laryngectomy: The purpose of an NG tube is to remove _______________ via intermittent suction for the first _______________ (time period) until peristalsis returns. Do not manipulate or move the tube because _____________________________________.

A

gastric contents, 24-48 hours, the NG tube lies close to internal incision lines

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10
Q

Acute pharyngitis is an acute inflammation of the pharyngeal walls, which may include the _________, ____________, and ___________.

A

tonsils, palate, uvula

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11
Q

two main manifestations of nasal fracture: _____________ is common, but only manifestation may be ___________

A

facial deformity, nosebleed

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12
Q

preoperative nursing care for rhinoplasty includes considering (psychosocial) changes in ____________, obtaining a _______________ history, and encouraging __________________

A

body image, medication (may need to stop ASA/NSAIDs for 5-14 days beforehand to reduce risk of bleeding), smoking cessation

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13
Q

A self-expanding implant called __________ may be placed directly in the sinus during surgery to help maintain _________ and provide local _____________ delivery directly to the sinus lining before dissolving after 30 days.

A

Propel, patency, corticosteroid

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14
Q

Saline irrigation of nasal cavity can ________ nasal passages, promote __________, and decrease _____________.

A

rinse, drainage, inflammation

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15
Q

After a laryngectomy, drainage from Hemovac, Jackson-Pratt, or Penrose drains may be ___________ at first, then _______________. Drainage should gradually decrease in volume over _____________ (time period).

A

bloody, serosanguineous, 24-48 hours

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16
Q

hand-held, battery-powered device that creates speech with the use of sound waves

A

electrolarynx

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17
Q

a concentrated and localized method of delivering radiation that involves placing a radioactive source near or into the tumor (head and neck cancer)

A

brachytherapy

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18
Q

type of sinusitis that lasts longer than 12 weeks and is a persistent infection usually related to allergies or nasal polyps

A

chronic sinusitis

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19
Q

four classic manifestations/criteria of acute pharyngitis

A
  1. fever greater than 100.4 degrees F
  2. anterior cervical lymph node enlargement
  3. tonsillar or pharyngeal exudate
  4. absence of cough
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20
Q

stoma care and head and neck cancer: cover the stoma when ______________ and during any activity that may lead to inhalation of _______________; wear a _______________ when taking a shower

A

coughing, foreign materials, plastic collar

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21
Q

Patient with a laryngectomy needs frequent _______________ to help decrease secretions

A

suctioning (via tracheostomy tube)

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22
Q

drug of choice for pharyngitis caused by group A beta-hemolytic streptococci; is taken for ________ (time period) to prevent complications such as ____________

A

penicillin, full 10 days, rheumatic fever

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23
Q

After a laryngectomy, check skin flaps ____________ for _________ and any change in ________ or ____________.

A

hourly, color, size, edema

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24
Q

diffuse crackles and dyspnea in an influenza patient can indicate this complication

A

pneumonia

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25
Q

5-10% of cases of acute pharyngitis (viral or bacterial)

A

bacterial

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26
Q

most effective treatment strategy for influenza

A

prevention with vaccines

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27
Q

after rhinoplasty, this may be inserted to apply pressure and prevent bleeding or septal hematoma formation and is left in place for 1-2 days

A

nasal packing

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28
Q

After laryngectomy, patient should be kept in this position to decrease edema and limit tension on suture lines

A

Semi-Fowler’s

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29
Q

Topical decongestants should be used for no longer than _____ days to prevent rebound congestion caused by vasodilation.

A

5

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30
Q

nasal fracture type: unilateral or bilateral with little or no displacement

A

simple nasal fractures

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31
Q

type of allergic rhinitis that occurs year-round from exposure to environmental allergens

A

perennial allergic rhinitis

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32
Q

four activity restrictions aimed at preventing bleeding and injury after rhinoplasty and epistaxis

A

no nose blowing
no swimming
no heavy lifting/straining
no strenuous exercise

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33
Q

stoma care and head and neck cancer: wash area around stoma _______ with a(n) ___________

A

daily, moist cloth

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34
Q

stoma care and head and neck cancer: use a _____________ spray every ________ (time period) to keep the stoma moist and prevent crusting

A

nasal wash, 1-2 hours

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35
Q

acute pharyngitis caused by Candida albicans is treated with this drug

A

nystatin

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36
Q

periorbital bruising involving both eyes is called ______________, which suggests a(n) ______________________

A

raccoon eyes, basilar skull fracture

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37
Q

Other manifestations of head and neck cancer may include ear _____ or _________, ____________ or ________ in the neck and/or jaw, constant ____________ (sometimes with blood).

A

pain, ringing, swelling, lumps, coughing

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38
Q

Early manifestations of head and neck cancer vary with the location of the tumor but may include a feeling of a _______ in the throat, ______ throat that does not get better, ________ or ______ patches in the mouth, a change in ________ quality, and/or ___________ that lasts more than 2 weeks.

A

lump, sore, white, red, voice, hoarseness

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39
Q

Patients with acute pharyngitis should use ______________ or ___________ for pain relief and increase _________ intake.

A

ibuprofen, acetaminophen, fluid

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40
Q

nasal fracture patients should be evaluated for injury to these three places

A

cervical spine
orbital sockets
mandible

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41
Q

lotions and skin products that can be used while undergoing radiation therapy; avoid using within __________ before radiation treatment

A

prescribed; 2 hours

42
Q

immediate postoperative nursing care for rhinoplasty: ensuring _________________, continuous assessment of ____________________, monitoring for __________________, ________ management, and observing surgical site for ______, _________, and ___________

A

airway patency, respiratory status, airway obstruction, pain, edema, bleeding, infection

43
Q

Patients taking _______________________ are at risk for developing infection with Candida organisms. To prevent this, do this

A

inhaled corticosteroids
thoroughly rinse mouth with water after use

44
Q

radiation therapy and head and neck cancer: to help with fatigue, ______ 15-30 minutes a day; perform ____________ activities, and _____ during periods of low energy

A

walk, most important, rest

45
Q

Total laryngectomy changes _______________, and normal __________ production will not be possible.

A

airflow, voice

46
Q

most common and most virulent influenza virus

A

influenza A

47
Q

to treat head and neck cancer, radiation therapy can be delivered in these two ways

A

external-beam therapy
internal implants (brachytherapy)

48
Q

After a nasal fracture, keep patient in this position

A

sitting upright

49
Q

_____ present criteria for acute pharyngitis indicates a _________________ test or ____________ to assist with diagnosis

A

2-3, rapid antigen detection, throat culture

50
Q

Physical therapy for post op patients with head and neck cancer focuses on exercising the ________________ to help support and move the head and maintaining strength and movement in the _____________ and _______.

A

upper extremities, shoulders, neck

51
Q

first-line treatment for head and neck cancer

A

surgery

52
Q

removal of part or all of larynx

A

laryngectomy

53
Q

Laryngectomy: If tubing becomes obstructed, fluid will ______________ under the skin flap, which predisposes the patient to ________________ or _________________, impaired _____________________, and increased risk for _______________.

A

accumulate, hematomas, seromas, wound healing, infection

54
Q

treatment used in combination with radiation therapy for patients with stage 3 or 4 head and neck cancers

A

chemotherapy

55
Q

key step to managing allergic rhinitis

A

identifying and avoiding triggers of allergic reactions

56
Q

To relieve symptoms of sore throat with acute pharyngitis, patients may use these three techniques

A
  1. gargle with warm salt water (1/2 tsp salt in 8 oz water)
  2. drink warm or cold liquids
  3. suck on popsicles, hard candies, throat lozenges
57
Q

five nursing care priorities after laryngectomy

A
  1. airway management
  2. wound care
  3. nutrition
  4. communication
  5. psychosocial issues related to body image changes
58
Q

a fistula is created in the tracheoesophageal wall which diverts pulmonary air across the pharyngoesophageal mucosa for phonation when the tracheostoma is occluded

A

tracheoesophageal puncture (TEP) voice restoration

59
Q

Medications/therapies for sinusitis include oral or topical _________________ to promote drainage, ___________________ to decrease inflammation, ___________ to relieve pain, and _______________ to relieve congestion.

A

decongestants, intranasal corticosteroids, analgesics, saline nasal spray

60
Q

three oral drug classes used to treat allergic rhinitis

A

H1-antihistamines
decongestants
leukotriene receptor antagonists (LTRAs)

61
Q

white, irregular patches on the oropharynx suggest this cause of acute pharyngitis

A

fungal infection with Candida albicans

62
Q

radiation therapy and head and neck cancer: four methods to help irritation, ulceration, and pain associated with oral mucositis

A
  1. oral care basics
  2. wearing mouth protection during radiation
  3. warm bland rinses 4-6 times daily
  4. ice chips
63
Q

In sinusitis patients where medical therapy does not relieve symptoms, _________________________ may relieve blockage.

A

nasal endoscopic surgery

64
Q

A (high, low) calorie diet is needed for tissue repair after surgery for head and neck cancer.

A

high

65
Q

type of analgesic preferred for first 48 hours after a nasal fracture

A

acetaminophen (avoids prolonged clotting time and increased risk of bleeding)

66
Q

type of allergic rhinitis that usually occurs in the spring and fall from a pollen allergy

A

seasonal allergic rhinitis

67
Q

bacterial pharyngitis usually results from infection with _______________

A

group A beta-hemolytic streptococci

68
Q

stoma care and head and neck cancer: dried secretions can be removed with __________

A

tweezers

69
Q

treatment preferred for early head and neck cancer and reason why

A

radiation therapy
offers good results with voice preservation

70
Q

corticosteroid nasal sprays (do, do not) typically cause systemic effects

A

do not

71
Q

stoma care and head and neck cancer: provide ______________ with mechanical ventilation or tracheostomy mask

A

humidification

72
Q

90% of cases of acute pharyngitis (viral or bacterial)

A

viral

73
Q

Late manifestations of head and neck cancer may include unintentional _______________; difficulty with ______________, _________________, moving the __________ or ______, and ___________; and a partially or fully __________________

A

weight loss, chewing, swallowing, tongue, jaw, breathing, obstructed airway

74
Q

manifestations include sneezing; watery, itchy eyes/nose; decreased sense of smell; thin, watery nasal discharge; nasal polyps; postnasal drip

A

allergic rhinitis

75
Q

head and neck cancer: speech therapy option that allows for speech immediately after surgery

A

electrolarynx

76
Q

Most people with streptococcal pharyngitis are contagious until they have been on antibiotics for ____________ (time period)

A

24-48 hours

77
Q

complications of nasal fracture include __________ obstruction, _________, __________ tears causing ________ leakage, septal __________, and cosmetic __________

A

airway, nosebleeds, meningeal, CSF, hematoma, deformity

78
Q

Head and neck cancers, especially post op: To help with difficulty swallowing, add mild ______ and ________ to food, provide (thick, thin) liquids, and avoid (thick, thin) liquids.

A

sauces, gravies, thick, thin

79
Q

head and neck cancer: frequent adverse effect of radiation therapy (four symptom relief methods)

A

xerostomia (dry mouth)
(increasing fluids, sugarless gum/candy, nonalcoholic mouth rinses, artificial saliva)

80
Q

A muffled voice can indicate a __________________.

A

swollen airway (is a priority and emergency)

81
Q

surgical reconstruction of the nose

A

rhinoplasty

82
Q

these two methods can help minimize swelling and discomfort after rhinoplasty

A

cold compresses
elevating head

83
Q

type of sinusitis that is present when symptoms progress over 4-12 weeks

A

subacute sinusitis

84
Q

depends upon air entering the esophagus and then being expelled past the pharyngoesophageal segment

A

esophageal speech

85
Q

nasal fracture type: powerful frontal blows that may involve damage to adjacent facial structures (teeth, eyes)

A

complex nasal fractures

86
Q

head and neck cancer: speech therapy option that offers the best speech quality with the highest degree of patient satisfaction

A

tracheoesophageal puncture (TEP) voice restoration

87
Q

type of allergic rhinitis in which symptoms are present less than 4 days a week or less than 4 weeks per year

A

intermittent allergic rhinitis

88
Q

inflammation of the nasal mucosa, often in response to a specific allergen

A

allergic rhinitis

89
Q

(First-generation, Second-generation) antihistamines are used first to treat allergic rhinitis and why

A

Second-generation due to their non-sedating effects

90
Q

Diagnosis of head and neck cancer involves a focused assessment of these six things

A

ears, nose, throat, mouth, neck, lymph nodes

91
Q

type of allergic rhinitis that refers to symptoms related to sporadic exposure to allergens not typically encountered in the patient’s normal environment

A

episodic allergic rhinitis

92
Q

three ways nasal stuffiness may be relieved after a nasal fracture

A

nasal decongestants
saline nasal sprays
humidifier

93
Q

goals of nursing care for nasal fracture: maintain ________________, reduce ________ and _________, prevent ____________, and provide __________________

A

patent airway, edema, pain, complications, emotional support

94
Q

After a focused assessment, diagnosis of head and neck cancer involves an indirect _____________________ and _____________________ with multiple _________________ for suspected lesions, a _____ or ______ to detect local and regional spread, and _______ scanning.

A

pharyngoscopy, laryngoscopy, biopsy specimens, CT, MRI, PET

95
Q

patients with head and neck cancer are at risk for ______________ due to manifestations such as difficulty ____________ and treatment modalities

A

malnutrition, swallowing

96
Q

after rhinoplasty, this is inserted to protect and support the new shape of the nose during the healing process and is left in place for 1-2 weeks

A

external plastic splint

97
Q

type of sinusitis that typically begins within 1 week of a URI and lasts less than 4 weeks

A

acute sinusitis

98
Q

Antibiotics may be prescribed if symptoms of sinusitis worsen or last longer than __________.

A

1 week

99
Q

Posterior nosebleeds often need ____________ with compressed nasal ________ or epistaxis _________, which apply pressure along the _________ of the nasal cavity. If not stopped in this way, the patient may need _____________________.

A

packing, sponges, balloons, floor, arterial embolization

100
Q

surgery that corrects a deviated septum

A

septoplasty

101
Q

Simple first aid for a nosebleed:
1. Place patient in a(n) ____________ position, leaning slightly __________ with head tilted __________.
2. Apply _____________ by squeezing the entire soft lower part of the nostrils together for ________ minutes.
3. If bleeding does not stop within __________, seek medical assistance.

A

sitting, forward, forward
direct pressure, 5-15
15 minutes

Nursing of Adults I (21 decks)

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