Cold Vs Influenza and Epistaxis

Question 1

What is Rhinitis

Answer 1

Cold- Inflamation of the mucous membranes of the nose. Most common cause of the common cold.

Question 2

How is Rhinitis Spread and how contagious is it?

Answer 2

It is spread via Droplet Nuclei. It is very contagious with a virus that spreads two full days before a patient or host is symptomatic

Question 3

What are the two Tyoes of Rhinitis

Answer 3

Allergic - ie Seasonal Allergies

Chronic- Found more in the elderly due to older mucous membranes and dehydration

Question 4

What are some Risk factors attributed to Rhinitis

Answer 4

Age- More prone in elderly/Children

Immuno compromised patients are at higher risk

Time of the Year

Smoking or exposure to enviornmental toxins/pollutants

excessive excersise(drying of mucosal areas)

Stress

Question 5

4 types of influenza

Answer 5

Swine Flu - H1N1 spread from pigs

Avian(bird) Flu- Birds, open air markets SARS

MERS- Middle eastern respiratory Syndrome

Ebola- Early s/s of ebola similar to influenza

Question 6

Cold Vs Flu Ability to function

Answer 6

With a cold you can function with a flu you are very sick

Question 7

S/S of Cold

Answer 7

• Fever is rare
• slight body aches
• chills are uncommon
• fatigue is mild
• develops over a few days
• mucus, cough, sneezing, Sore throat, stuffy nose
• Mild to moderate chest discomfort

Question 8

S/S of Flu

Answer 8

• Fever Chills, headach
• severe aches, Severe fatigue
• S/S have rapid onset
• dry cough, Chest discomfort can be severe
• Sneezing stuffy nose and sore throat are not as common

Question 9

Complications of a cold

Answer 9

Asthma, sinus congestion, and middle ear infections

Question 10

Complications of the Flu

Answer 10

Bronchittis, Pnemonia

Question 11

What are some preventative Measures to avoid the cold and Flu

Answer 11

1 Hand washing, Hand Washing, Hand Washing

Avoid sick people

Stay home when sick

Clean hands

Avoid touching eyes, nose mouth

Eating Healthy

Question 12

What is herd immunity

Answer 12

The majority of those are vacinated protecting those not vacinated.. if the majority are not vacinated one person who is ill can affect the whole herd

Question 13

Possible Nursing Diagnosis for Pts with Upper Respiratory infections

Answer 13

Inefective airway clearance

Acute Pain

Fluid volume deficit( tachycardia, Decrease urine output)

Knowledge Deficit R/T Prevention, treatment, regimen

Question 14

Nursing interventions for Respiratory Illness r/t ineffective airway clearence

Answer 14

Elevate HOB

Humidity

Increase fluids( Non productive Cough)(cough Suppressent)

Encourage Rest (Dyspnea on exertion)

Expectorants PRN with productive coughs only

NSAIDS for Pain

Notify MD if no improvement withing 3-5 Days.

Question 15

Medications for Upper respiratory disorders

Answer 15

Antihistamines(H1 Receptor Blockers)-diphenhydrAMINE(benydryl)

Nasal Decongestants- Cause Vascular Constriction (Afryn)

Systmeic Decongestants- Pseudophedrine- Do not use with HTN, or MAOI due to increase HR/ BP

Intranasal Glucocorticoids- Do not use more than 30 Days (Flonase)

Normal Saline- Na2 decreases mucous membrane size by pulling fluid.

Question 16

Antitussives

Answer 16

Acts on cough supressing cough reflex (tussin)

Question 17

Expectorants

Answer 17

Loosen Secretions (guafenison)

Question 18

What should you do if pt presents with cough > a week or fever

Answer 18

Refer to MD

Question 19

What is the most important patient education with Cold and Flu

Answer 19

Handwashing

Question 20

What is the number one prevention used for flu

Answer 20

Vacinne

Question 21

Flu Is diagnosed with a

Answer 21

Rapid immunoassay on a nasal or throat swab, or quick vac that takes 15minutes

Question 22

Key Facts on seasonal influenza

Answer 22

• Is an acurte viral infection that spreads easily form person to person
• circulate worldwide and can affect anybody in any age group
• causes annual epidemics thant peak during winter months
• prevention of infection is done with vaccination
• antiviral medication is effective in treating influenza

Question 23

Influenza treatment is similar to cold, but can adminitser what?

Answer 23

Antiviral drugs

oseltamivir(Tamiflu)

Zanamivir (Relenza)

Andamantanes

• amantadine
• rimantadine

Must be given within 1st 48 hours to reduce symptoms

Question 24

The annual flu vacine is a Trivalent Vaccine. What does this mean

Answer 24

Trivalent vaccines protect against three strands of the flu determined by current epidemiology. There is a quadravalent vaccine that protects against 4 strains.

Question 25

Vaccines come in two forms Injection and nasal spray, which is the live vaccine

Answer 25

Nasal spray is a live virus that can only be given to healthy patients between the ages of 2-49 and women can not be pregnant. Patients over 65 it is recomended also recieve a Pnemo vax

Question 26

Who Should Get a Vaccine

Answer 26

Everyone who can tolerate it

Question 27

who should not get a vaccine

Answer 27

People with a fever or illness tha tis more than just a cold anyone who has had a moderate to severe reaction after a previous flu vaccine anyone who has developed Guillian Barre with in 6 weeks after recieving a flu vaccine

Question 28

True or False? If you are allergic to eggs you cannot get the flu vaccine.

Answer 28

False. However you must request a non egg medium

Question 29

Airway clearance in a client with an upper respiratory infection is facilitated by which of the following: 1. Decreased systemic hydration 2. humidifying inspired room air 3. positional drainage of affected side 1. administering vasoconstrive medications

Answer 29

2. Humidifying inspired room air. This helps to aid in moistening mucous membranes increasing ease of air exchange

Question 30

A school nurse is presenting a class to kindergarden students on preventing the common cold. Which information should be included by the nurse 1. Instruct the children to always keep a tissue or handkerchief with them 2. explain that children current with immunizations will not get a cold 3. tell the children they should go to the doctor if they get a cold 4. include a demonstration on how to wash hands

Answer 30

4. Include a demonstration on how to wash hands Hand washing is the number one way to prevent the spread of the common cold germs

Question 31

What is epistaxis

Answer 31

Epistaxis is bleeding from inside the nose either from the anterior nasal cavity or posterior nasal cavity

Question 32

if a patient is in the sitting positon where will blood flow if the pt has an anterior nose bleed

Answer 32

Blood will flow from the front of the nose out the nares if a pt is in the sitting positon and has an anterior nose bleed.

Question 33

A patient has a nose bleed in the posterior aspect of the nose. Where should the nurse expect to find bleeding

Answer 33

The blood with flow to the back of the throat. The patient may cough up this blood that will look like coffee grounds.

Question 34

Signs and symptoms of an Anterior Nose bleed

Answer 34

* prone for drying and micro trauma by picking nose * most common site for epistaxis in children * Trauma main cause * Bleeding is generally mild can be controlled by local pressure or anteriornasal packing

Question 35

Signs and Symptoms of Posterior Nose Bleed

Answer 35

* Less Common * Difficult to control * generally found in pts over 40 * it is Spontaneous, often caused by HTN or Arteriosclerosis * Severe bleeding , requires hospitialization and posterior packing or the post nasal area or balloon

Question 36

Select the True Statement 1. anterior epistaxis is usually caused by Hypertension 2. Posterior Epistaxis is more common 3. anterior expistaxis does not usually occure in children and young adults 4. Anterior epistaxis bleeding is usually mild

Answer 36

4. Anterior epistaxis bleeding is usually mild

Question 37

Local Causes of Epistaxis are

Answer 37

* Congenital: Telengectasia(osler-weber-rendau syndrome), Hemangioma * Infections: * Viral: Influenza, Measles * Bacterial: acute/chronic rhinitis/Sinusitis * Fungal * Trauma * Microtrauma * Forigen body * accidental * latrogenic

Question 38

What is a trauma to the nose

Answer 38

Injuries intra nasal surgery violent sneezing fracture of middle one third of face and base of skull

Question 39

What are some acute causes of Epistaxis

Answer 39

Viral Rinitis Nasal dipteria A/C Sinusitis

Question 40

What are some chronic Causes of nose bleed

Answer 40

Attrophic Rihinitis Rhinitis Sicca Tuberculosis Syphlis Rhinosporidosis

Question 41

Epistaxis Management

Answer 41

5-10 Minutes of Pressure Head errect and forward for anterior bleeds assess location of bleed may use a nasal decongestant to vaso constrict area of bleed

Question 42

If direct pressure does not stop a nose bleed, what treatment can be used.

Answer 42

Cauterization

Question 43

For posterior bleeds what is the primary treatment

Answer 43

Cotton spounge packing placed in through the mouth out the nose, may get rhinosiitis form packing, also toxic shock do to packing more that 6-7 days Also a catheter for posterior bleeds

Question 44

Pts prone to epistaxis should follow the following

Answer 44

* No vigurous activity * no spicy foods * no tobacco * no blowing of the nose * no straining or bearing down with BM * Avoid high altitudes * teach bleeding control