Cold Vs Influenza and Epistaxis Flashcards
What is Rhinitis
Cold- Inflamation of the mucous membranes of the nose. Most common cause of the common cold.
How is Rhinitis Spread and how contagious is it?
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
What are the two Tyoes of Rhinitis
Allergic - ie Seasonal Allergies
Chronic- Found more in the elderly due to older mucous membranes and dehydration
What are some Risk factors attributed to Rhinitis
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
4 types of influenza
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
Cold Vs Flu Ability to function
With a cold you can function with a flu you are very sick
S/S of Cold
- 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
S/S of Flu
- 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
Complications of a cold
Asthma, sinus congestion, and middle ear infections
Complications of the Flu
Bronchittis, Pnemonia
What are some preventative Measures to avoid the cold and Flu
1 Hand washing, Hand Washing, Hand Washing
Avoid sick people
Stay home when sick
Clean hands
Avoid touching eyes, nose mouth
Eating Healthy
What is herd immunity
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
Possible Nursing Diagnosis for Pts with Upper Respiratory infections
Inefective airway clearance
Acute Pain
Fluid volume deficit( tachycardia, Decrease urine output)
Knowledge Deficit R/T Prevention, treatment, regimen
Nursing interventions for Respiratory Illness r/t ineffective airway clearence
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.
Medications for Upper respiratory disorders
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.
Antitussives
Acts on cough supressing cough reflex (tussin)
Expectorants
Loosen Secretions (guafenison)
What should you do if pt presents with cough > a week or fever
Refer to MD
What is the most important patient education with Cold and Flu
Handwashing
What is the number one prevention used for flu
Vacinne
Flu Is diagnosed with a
Rapid immunoassay on a nasal or throat swab, or quick vac that takes 15minutes
Key Facts on seasonal influenza
- 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
Influenza treatment is similar to cold, but can adminitser what?
Antiviral drugs
oseltamivir(Tamiflu)
Zanamivir (Relenza)
Andamantanes
- amantadine
- rimantadine
Must be given within 1st 48 hours to reduce symptoms
The annual flu vacine is a Trivalent Vaccine. What does this mean
Trivalent vaccines protect against three strands of the flu determined by current epidemiology. There is a quadravalent vaccine that protects against 4 strains.
Vaccines come in two forms Injection and nasal spray, which is the live vaccine
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
Who Should Get a Vaccine
Everyone who can tolerate it
who should not get a vaccine
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
True or False?
If you are allergic to eggs you cannot get the flu vaccine.
False. However you must request a non egg medium
Airway clearance in a client with an upper respiratory infection is facilitated by which of the following:
- Decreased systemic hydration
- humidifying inspired room air
- positional drainage of affected side
- administering vasoconstrive medications
- Humidifying inspired room air.
This helps to aid in moistening mucous membranes increasing ease of air exchange
A school nurse is presenting a class to kindergarden students on preventing the common cold. Which information should be included by the nurse
- Instruct the children to always keep a tissue or handkerchief with them
- explain that children current with immunizations will not get a cold
- tell the children they should go to the doctor if they get a cold
- include a demonstration on how to wash hands
- Include a demonstration on how to wash hands
Hand washing is the number one way to prevent the spread of the common cold germs
What is epistaxis
Epistaxis is bleeding from inside the nose either from the anterior nasal cavity or posterior nasal cavity
if a patient is in the sitting positon where will blood flow if the pt has an anterior nose bleed
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.
A patient has a nose bleed in the posterior aspect of the nose. Where should the nurse expect to find bleeding
The blood with flow to the back of the throat. The patient may cough up this blood that will look like coffee grounds.
Signs and symptoms of an Anterior Nose bleed
- 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
Signs and Symptoms of Posterior Nose Bleed
- 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
Select the True Statement
- anterior epistaxis is usually caused by Hypertension
- Posterior Epistaxis is more common
- anterior expistaxis does not usually occure in children and young adults
- Anterior epistaxis bleeding is usually mild
- Anterior epistaxis bleeding is usually mild
Local Causes of Epistaxis are
- Congenital: Telengectasia(osler-weber-rendau syndrome), Hemangioma
- Infections:
- Viral: Influenza, Measles
- Bacterial: acute/chronic rhinitis/Sinusitis
- Fungal
- Trauma
- Microtrauma
- Forigen body
- accidental
- latrogenic
What is a trauma to the nose
Injuries
intra nasal surgery
violent sneezing
fracture of middle one third of face and base of skull
What are some acute causes of Epistaxis
Viral Rinitis
Nasal dipteria
A/C Sinusitis
What are some chronic Causes of nose bleed
Attrophic Rihinitis
Rhinitis Sicca
Tuberculosis
Syphlis
Rhinosporidosis
Epistaxis Management
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
If direct pressure does not stop a nose bleed, what treatment can be used.
Cauterization
For posterior bleeds what is the primary treatment
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
Pts prone to epistaxis should follow the following
- 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
