DISORDERS OF THE UPPER RESPIIRATORY TRACT Flashcards
Hemorrhage from the nose
Epistaxis (Nosebleed)
Risk Factors of Epistaxis
-Local Infections
-Systemic infections
-Drying of nasal mucous membranes
-Nasal inhalation of corticosteroids or illicit drugs
- Trauma (digital trauma, blunt, trauma, fracture, forceful nose blowing)
- Arteriosclerosis
-Hypertension
-Tumor (sinus or nasopharynx)
-Thrombocytopenia
-Use of aspirin
-Liver disease
- Rendu-Osler- Weber
Medical management of Epistaxis
Position: sitting upright with head tilted forward
-Instruct patient to pinch the soft outer portion of the nose against the midline septum for 5 to 10 minutes continuously
-Phenylephrine nasal decongestant spray, as necessary
If origin of bleeding cannot be identified
Do nasal packing
Nursing management of Epistaxis
-Monitor VS
-Assist in control of bleeding
-Provide tissues and emesis basin
-Assure the patient in a calm, efficient manner that bleeding can be controlled can help reduce anxiety
-Continuously assess airways, breathing, and vitals
Upon discharge (Epistaxis)
-Avoid vigorous exercise for several days
-Avoid hot or spicy foods and tobacco
-Avoid forceful nose blowing, straining, high altitudes, nasal trauma
-Provide adequate humidification
-Apply direct pressure to nose x 15 minutes in case of recurrence.
Refers to a URI that is self-limited and caused by a virus
Common cold
Refers to an infectious, acute inflammation of the mucous membranes of the nasal cavity characterized by nasal congestion, rhinorrhea, sneezing, sore throat, and general malaise
Cold
Causative Agents of Viral Rhinitis
-Rhinovirus- most common
-Coronavirus
-Adenovirus
-Respiratory syncytial virus
-Influenza virus
-Parainfluenza virus
Clinical Manifestation of Viral Rhinitis
-Low-grade fever
-Nasal Congestion
-Rhinorrhea and nasal discharge
-Halitosis
-Sneezing
-Tearing watery eyes
-Sore throat
-General malaise
-Chills
-Headache and muscle aches
Medical Management (Symptomatic)
-Adequate fluid intake
-Rest
-Prevention of chilling
-Warm salt-water gargle for sore throat
- Ibuprofen for aches and pains
-Antihistamines for sneezing, rhinorrhea, and congestion
-Guaifenesin (Mucinex) - an expectorant which removes secretions
Nursing Management of Viral Rhinitis or Common Cold
-Institute hand hygiene practices
-Emphasize cough etiquette
-Educate on symptomatic treatment strategies
Is an inflammation of the paranasal sinuses and the nasal cavity
Rhinosinusitis
Classifications of Rhinosinusitis
Acute
Subacute
Chronic
symptoms lasts less than 4 weeks
acute
symptoms lasts from 4 to 12 weeks
subacute
symptoms > 12 weeks
chronic
The cause of acute rhinosinusitis can be bacterial or viral
True
ABRS
Acute Bacterial Rhinosinusitis
AVRS
Acute viral rhinosinusitis
Risk factors of Acute Rhinosinusitis
-Unresolved viral or bacterial infection
-Allergic rhinitis
-Diving and swimming
-Tooth infection
-Tumors
-Environmental hazards: cigarette smoke, paint, sawdust, chemicals
Causative agent of Acute Rhinosinusitis
Bacterial organisms account for >60% of cases
-S.pneumoniae
-H.influenzae
-S.aureus
-M.catarrhalis
Clinical Manifestations of Acute Rhinosinusitis (Bacterial)
-Purulent nasal discharge
-Nasal Obstruction
-Pain
-Nasal stuffiness
-Headache
-High-grade fever (39C and above)
-Persistent for 10 days or more
Acute Rhinosinusitis viral clinical manifestations
The same with ABRS except:
-no high fever
-less severe intensity
-symptoms persist fewer than 10 days
Complications of Acute Rhinosinusitis
-Osteomyelitis
-Mucocele
-Meningitis
-Brain abscess
Nursing Management of Acute Rhinosinusitis
-Instruct to humidify air at home
-Warm compress to relieve pressure
-Instruct to avoid swimming, diving, and air traveling during acute infection
-Instruct to stop cigarette smoking
Characterized by four or more episodes of ABRS per year
Recurrent Acute Rhinosinusitis
12 weeks or more of the following: mucopurulent drainage, nasal obstruction, facial pain, hyposmia
Chronic Rhinosinusitis
Etiology or cause of Chronic and Recurrent Acute Rhinosinusitis
Obstruction of the osteomeatal complex
Causative Agents of Chronic and Recurrent Acute Rhinosinusitis (Aerobic)
S.Aureus
Streptococci
Causative Agents of Chronic and Recurrent Acute Rhinosinusitis (Anaerobic)
-Klebsiella
-Bordetella
-Haemophilus
Clinical Manifestations of Chronic and Recurrent Acute Rhinosinusitis
-Cough
-Chronic hoarseness
-Chronic headaches
-Periorbital edema
-Facial pain
-Halitosis (mouth breathing)
-Symptoms are more pronounced in AM
Medical Management of Chronic and Recurrent Acute Rhinosinusitis
-Nasal saline sprays
-Acetaminophen/NSAIDS for pain
-Antibiotic therapy
Surgical Management of Chronic and Recurrent Acute Rhinosinusitis
-FESS (Functional Endoscopic Sinus Surgery)
-Caldwell-Luc Surgery
Used as surgical treatment of severely diseased maxillary sinus and the incision is between upper gum and upper lip
Caldwell-Luc Surgery
Nursing Management of Chronic and Recurrent Acute Rhinosinusitis
-Instruct to sleep with HOB elevated
-Avoid exposure to cigarette smoke and fumes
-Avoid caffeine and alcohol- may cause dehydrations
-Encourage fluid intake
-Apply hot wet packs
-Instruct to strictly adhere to medication regimen
Is a sudden painful inflammation of the pharynx, the back portion of the throat that includes the posterior third of the tongue, soft palate, and tonsils
Acute Pharyngitis
Cause of Acute Pharyngitis
-Viral infection- most common
-Bacterial infection (Group A beta- hemolytic streptococci) (GABHS)7745
Acute Pharyngitis
Clinical Manifestations (Viral)
-Fiery- red pharyngeal membrane and tonsils
-Enlarged and tender cervical lymph nodes
-High grade fever (> 38.3 C
-Malaise
-Sore throat
-NO COUGH!
Clinical Manifestations (GABHS)
-Nausea and vomiting
-Headache
-Swollen and erythematous tonsils, with or without exudate
-Soft palate is erythematous with petechiae
-Halitosis
Nursing Management for Acute Pharyngitis
-TBS (Tipid Sponge Bath) for fever
-Encourage bed rest
-Monitor for development of rashes
-Encourage warm saline gargles (40.3C to 43.3 C)
-Provide frequent oral care
-Instruct to daily return to work or school until after 24 hours of antibiotic therapy
-Emphasize importance of taking full course of antibiotics as prescribed
