Disorder of URT Flashcards
Deviated Septum
S/S
Etiology
Broken nose: protrudes more to one side of nasal passage
S/S: post nasal discharge, sinusitis, facial pain, deformity, nose bleeds
Et: trauma, congenital
Septoplasty
deviation reconstruction & alignment with minimal cartilage and bone removal
Submucosal Resection
Removal of deviated section of cartilage and bone
Pre-op interventions
Avoid aspirin or NSAIDS two weeks prior; inform of swelling & discomfort post-op
Post-op assessment
AIRWAY, HOB 45°, mouth breathing; bleeding-ice pack 24 hrs, no blowing nose, avoid swimming, smoking, nasal sprays, no lifting(straining)
Epistaxis
nosebleed
Anterior epistaxis occurs in
children, young adults
Posterior epistaxis occurs in and it is an _____!!!
older adults EMERGENCY
Epistaxis caused by:
trauma, foreign bodies, chronic infections, nasal spray abuse, street drugs, anatomic malformation, allergic rhinitis, tumors
Therapeutic Management of epistaxis
Keep pt quiet, pressure, sit and lean forward, breath through mouth, and pinch nostrils. apply ice, cauterization
management of nasal packing:
check position of packing, bed rest, assess respiratory distress, liquid diet, ↑ mouth care, monitor for infection.
Complications of nasal packing:
1)septal hematoma- from trauma, 2)septal pressure necrosis- from being too tight and 3)sinusitis 4)toxic shock syndrome
If packing fails to stop bleeding?
surgery
Discharge instructions for packing:
avoid vigorous nose blowing, sneeze with mouth open, lifting, straining (4-6 weeks), NSAIDS
Acute viral rhinitis
acute coryza or common cold: inflammation of nasal mucosa
Most common symptom of cold:
cough
Colds are caused by _______:
Viruses
Colds are spread by:
droplet-breathing(talking sneezing coughing)
hand to mouth, nose or eyes
winter months spent inside
Patho of acute viral rhinitis
virus causes mucous membranes to swell and become congested
S/S of acute viral rhinitis
COUGH, tickling, irritation, sneezing, dry nasopharynx, nasal secretions, nasal obstruction, watery eyes, ↑ temp, genreal malaise, and headache
Treatment for acute viral rhinitis
no cure, salt water gargle, antihistamine, 2-4 L fluids/day, rest, proper nutrition
Allergic Rhinitis
reaction of nasal mucosa to allergen
Seasonal allergic rhinitis
same time each year
Chronic Allergic Rhinitis
Tx:
-intermittent, no seasonal pattern
-exposure to dust, dander etc
Tx:antihistamines
Influenza caused by:
Etiology:
S/S
VIRUS
Et: direct or indirect droplet contact
S/S: abrupt onset of respiratory symptoms, nasal discharge, SOB
Flu medications
-Rimantadine(Flumadine) or Amantadine(Symmetrel)-prevents or reduces symptoms in high risk its exposed to flu but not vaccinated
Zanamivir(Relenza) or Oseltamivir(Tamiflu)-prevents virus budding & spreading to other cells
Given 2 days after symptoms develop
Shown to reduce symptoms & severity of flu
Sinusitis Etiology: S/S: Diagnostics Tx:
-Infection of mucous membranes of one of the paranasal sinuses
-Et:Blockage of sinus drainage occurs, rich medium for bacteria
MAXILLARY SINUS MOST FREQUENTLY AFFECTED-largest ad easiest to treat
can cause brain and ear infections when frontal sinus affected
S/S: nasal blockage, stuffiness, purulent discharge, slight temperature increase, pressure and pain over involved area. Malaise, lack of appetite, nausea, cough sore throat, orbital edema, headache
Diagnostics: sinus x-ray, CT scan
Tx:Pain relief, HOB up, control infection
Antitussive
good for a dry hacking cough
non-narcotic(Benylin DM, Novahistine)
Adverse Rx: dixxiness, drowsiness, GI upset
Narcotics
(Codene)
Supress cough reflex, direct depressant effect on cough center in medulla, symptom relief of non-productive cough
Common sx: sedation, dizziness, nausea, dry mouth, constipation
Expectorants
Meds:
- Facilitate removal of secretions of bronchopulmonary mucous membranes
- Guaifenesin(Mucinex), Robotussin, Organidin
- Terpin Hydrate:decreases phlegm adhesiveness
Nasal Decongestants
Relieves nasal congestion & cold symptoms, direct vasoconstrictive action on arterioles in nasal mucosa
CAN BE ADDICTIVE
Antihistamines
Meds:
Relieve allergic response symptoms of sneezing, congestions, secretions.
-Tavist, Benedryl, Chlor-Trimeton
Polyps
S/S
Benign mucous membrane masses. From slowly in response to repeated inflammation of sinus or nasal mucosa
-Bluish glossy projections in nares
S/S: nasal obstruction, clear discharge, speech distortion
