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NRSG 110: Med Surg 2 > [Exam 2] Chapter 22: Management of Patients with Upper Respiratory Tract Disorders (Page 552-560, 567-570) > Flashcards

[Exam 2] Chapter 22: Management of Patients with Upper Respiratory Tract Disorders (Page 552-560, 567-570) Flashcards

1
Q

Upper Airway Infections: URIs are the most common cause of

A

illness and affect most people on occasions

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2
Q

Upper Airway Infections: Most frequently occurign example of a URI??

A

Common cold

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3
Q

Upper Airway Infections: URI occurs when microorganisms are

A

inhaled, such as viruses

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4
Q

Upper Airway Infections: Viruses and URIs.. they affect the upper respiratory passage and lead to

A

subsequent mucous membrane inflammation

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5
Q

Upper Airway Infections: Adult typically averages how many URIs a year?

A

2-4

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6
Q

Upper Airway Infections: URIs may be how threatening?

A

Anywhere from minor to life threatening

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7
Q

Upper Airway Infections: URIs treated where?

A

Doctor offices, urgent care clinics, long-term care facilities or self-care at home

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8
Q

Upper Airway Infections: Early detection of signs and symptoms and approrpriaite interventions can avoid

A

unnecessary complications

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9
Q

Upper Airway Infections:

A

prevention and health promotion

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10
Q

Upper Airway Infections: URIs are spread by

A

droplet and direct contact through mucuous membranes

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11
Q

Rhinitis: WHat is this?

A

Group of disorders characterized by inflammation and irritation of the mucous membranes of the nose

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12
Q

Rhinitis: These issues contribute to what problms in individuals?

A

Sinus, ear, and sleep problems and learning disorders

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13
Q

Rhinitis: Often coexists with other respiratory problems, such as

A

asthma

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14
Q

Rhinitis, Patho: Most common cause of nonallergic rhinitis is

A

the common cold

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15
Q

Rhinitis, Patho: Drug induced rhinitis may occur with

A

antihypertensive agents, such as ACE inhibitors or beta blockers

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16
Q

Rhinitis, Clinical Manifestations: Signs and symptoms include

A

rhinorrhea , nasal congestion, nasal discharge, and sneezing

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17
Q

Rhinitis, Clinical Manifestations: What is Rhinorrhea ?

A

Excessive nasal drainage, runny nose

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18
Q

Rhinitis, Medical Management: How to fix viral rhinitis?

A

Medications may be prescribed to relieve the symptoms

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19
Q

Rhinitis, Medical Management: How to fix allergic rhinitis?

A

Allergy tests may be performed to identify possible allergens

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20
Q

Rhinitis, Medical Management: How to fix a bacterial infection?

A

An antimicrobial agent i sused

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21
Q

Rhinitis, Medical Management: How to fix patients with nasal septal deformities or nasal polyps?

A

May be referred to an ear, nose, and thorat specialist

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22
Q

Rhinitis, Pharmacologic Therapy: Most common treatment for this?

A

Antihistamines and given for sneezing pruritis, and rhinorrhea.

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23
Q

Rhinitis, Pharmacologic Therapy: Why would Cromolyn be used?

A

Mast cell stablizier that inhibits releease of histamine and other chemicals

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24
Q

Rhinitis, Pharmacologic Therapy: Oral Decongestant may be used for

A

nasal obstruction

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25
Q

Rhinitis, Pharmacologic Therapy: Use of saline spray can act as

A

mild decongestant and can liquefy mcuus to prevent crusting

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26
Q

Rhinitis: Information on duration?

A

Low grade fever onset, short duration

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27
Q

Rhinitis: Virus is shed when?

A

2 days prior to onset of S&S

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28
Q

Rhinitis: What does the presence of this virus produce?

A

Local inflammatory response

Swelling of mucous membranes of nasal passage

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29
Q

Rhinitis: This leads to hyperactivity of

A

mucus - secreting glands

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30
Q

Rhinitis: What is Hay Fever-Allergic Rhinitis

A

Longer duration with triggers, seasonal

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31
Q

Rhinitis: How is Hay Fever-Allergic Rhinitis treated?

A

Nasalcrom to inhibit histamine release and other chemicals

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32
Q

Viral Rhinitis (Common Cold): Common cold often is used when referring to

A

A URI that is self-limited and caused by a virus

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33
Q

Viral Rhinitis (Common Cold): The term cold refers to

A

an infectious, acute inflammation of the mucous memrbanes of the nasal cavity

Also used when causative virus is influenza

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34
Q

Viral Rhinitis (Common Cold): Colds are highly contagious because they are shed

A

2 days before the symptoms appear and during first part of symptomatic phase

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35
Q

Viral Rhinitis (Common Cold), Clinical Manifestations: Signs and Symptoms include a

A

low-grade fever, nasal congestion, rhinorrhea and nasal discharge

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36
Q

Viral Rhinitis (Common Cold), Clinical Manifestations: When this progresses , it may appear and exacerbate what?

A

Herpes simplex, commonly called a cold sore

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37
Q

Viral Rhinitis (Common Cold), Clinical Manifestations: Symptoms ma last from

A

1-2 week s

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38
Q

Viral Rhinitis (Common Cold), Medical Management: This consists of symptomatic therapy that includes

A

adequate fluid intake, rest, prevention of chilling and use of expectorants

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39
Q

Viral Rhinitis (Common Cold), Medical Management: Antihistamines are used to

A

relieve sneezing, rhinorrhea and nasal congestion

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40
Q

Viral Rhinitis (Common Cold), Medical Management: Guaifensin is used to promote

A

removal of secretions

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41
Q

Viral Rhinitis (Common Cold), Medical Management: Antibiotics should not be used because

A

they do not affect the virus or reduce the incidence of bacterial complications

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42
Q

URIs and RSv: Mimics what?

A

Common cold in adult population

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43
Q

URIs and RSv: In older adults can present as

A

lower respiratory infection, fever, or pneumonia

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44
Q

URIs and RSv: In infants, it can manifest as a

A

URI, but more likely to progress to pneumonia, bronchiolitis and tracheobronchiolitis

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45
Q

URIs and Influenza: Onset of the fever is?

A

Abrupt and is a high grade fever

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46
Q

URIs and Influenza: Inflammation of epithelium lining of respiratory tract causes

A

necrosis and sheeding of serous and cilated cells within the respiratory tract

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47
Q

URIs and Influenza: During recovery, the serous cells are placed more quickly than ciliated cells. Without cilated cells what cant happen?

A

REspiratory tract cannot remove microorgansisms as easily or move mucous. Increases riskk of bacterial infection.

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48
Q

URIs and Influenza: This usually occufrs when?

A

In epidemics or pandemics

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49
Q

Rhinosinusitis: What is this?

A

Inflamamtion of the paranasal sinuses and nasal cavity.

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50
Q

Rhinosinusitis: Uncomplicated Rhinosinusitis occurs without

A

extension of inflammation outside of the paranasal sinuses

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51
Q

Rhinosinusitis: Classified by duration of symptoms, which are

A

acute (less than 4 weeks)

Subacute (4-12 weeks)

Chronic (more than 12 weeks)

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52
Q

Rhinosinusitis: How can this be classified infection wise?

A

Bacterial or viral

53
Q

Acute Rhinosinusitis: Chacterized by how many episodes per year?

54
Q

Acute Rhinosinusitis, Patho: They usually follows what?

A

Viral URI or Cold.

55
Q

Acute Rhinosinusitis, Patho: Nasal congestion caused by inflammation, edema leads to

A

obstruction of the sinus cavities, providing excellent medium for bacteria growth

56
Q

Acute Rhinosinusitis, Clinical Manifestations: Symptoms of ABRS include

A

nasal drainage accompanied by nasal obstruction

57
Q

Acute Rhinosinusitis, Clinical Manifestations: Acute Rhinosinusitis classified as

A

Acute Bacterial Rhinosinusitis (ABRS)

Acute Viral Rhinosinusitis (AVRS)

58
Q

Acute Rhinosinusitis, Clinical Manifestations: Symptoms of AVRS similar to that of

A

ABRS except patient does not resent with high fever

59
Q

Acute Rhinosinusitis, Assessment and Diagnostic Findings: Some things that cna be examined are

A

Head, neck, and chest

60
Q

Acute Rhinosinusitis, Complciations: If untreated, may lead to complications such as

A

osteomyelitis and mucocele (cyst of the paranasal sinuses)

61
Q

Acute Rhinosinusitis, Complciations: How do you fix mucoceles (cyst of the paranasal sinuses)?

A

Surgical treatment to estalish intranasal drainage or complete excision

62
Q

Acute Rhinosinusitis, Medical Management: What is prescribed for bacterial cases?

A

5-7 days of antibiotics

63
Q

Acute Rhinosinusitis, Medical Management: Goals are to do what?

A

Drink nasal mucosa, relieve pain, and treat ifnection

64
Q

Acute Rhinosinusitis, Medical Management: When should antibiotics be given?

A

As soon as ABRS diagnosis is establishesd

65
Q

Acute Rhinosinusitis, Medical Management: Treamtnet of AVES typically involves

A

nasal saline lavage and decongestants.

66
Q

Acute Rhinosinusitis, Medical Management: Intranasal corticosteroids have been show to produce

A

complete or marked improvement in acute symptoms of either bacterial or viral rhinosinusitis

67
Q

Acute Rhinosinusitis, Nursing Management: Patient is advised to avoid what?

A

Swimming, diving, and air travel during acute infection

68
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis: Diagnosed in patients who has experienced

A

12 wweeks or longer of

mucopurulent drainage, nasal obstruction or facial pain

69
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis: Diagnosed when it occurs how many times in a year?

A

Four or more episodes per year

70
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Patho: Usual cause of CRS?

A

Mechanical obstruction in the ostia of the frontal, maxillary , and anterior ethmodi sinuses

71
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Patho: Obstruction prevents adequate drainge of

A

nasal passages.

72
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Patho: Persistent blockage may occur because of

A

infection, allergy, or structural abnomalities

73
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Clinical ManifestationsThis includes

A

impaired mucociliary clearance and ventilation, cough, and chronic hoarseness

74
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Clinical Manifestations: Patient normally breathes through the

A

mouth, because nasal is congested.

75
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Assessment and Diagnostic Findings: Assessment focuses on

A

onset and duration of symptoms

76
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Assessment and Diagnostic Findings: X Ray can assess

A

disorders of paranasal sinuses

77
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Assessment and Diagnostic Findings: CT scan of paranasal sinuses can idetnfiy

A

mucosal abnormalities

78
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Complications: Complciations include

A

severe orbital cellulitis, cavernous sinus thrombosis, and meningitis

79
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Complications: Can lead to itnracranial infectione ither by

A

direct spread through bone or via venous channels

80
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Complications: Frontal rhinosinusitis can lead to

A

osteomyelitis of the frontal bones

81
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Medical Management: General measures include

A

encouraging adequate hydration and recommending use of nasal saline rpays or NSAIDS

82
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Medical Management: Patients instructed to avoid

A

exposure to cigs and sleep with head of bed up..

Avoid caffeine and alcohol

83
Q

Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Surgical Management : FESS may be indicated to correct structural deformities. What is this?

A

Minimally invasive surgical procedure that is associated with reduced postoperative discomfort

84
Q

URI Potential Complications

A

Airway Obstruction

Sepsis

Acute Otitis Media

Dysphagis

Cellulitis

85
Q

URI Nursing PRocess - Assessment:

A

Health History

Allergies

Inspection of nose neck, and throat

86
Q

URI Nursing PRocess - Assessment: Signs and Symptoms are

A

headache, cough, hoarseness, fever

87
Q

URI Nursing PRocess - Planning:

A

Airway management, reduce risk of aspiration

Pain Management

Increase hydration

88
Q

URI Nursing PRocess - Interventions: You should elevate

89
Q

URI Nursing PRocess - Interventions: Ice collar to reduce

A

inflammation

90
Q

URI Nursing PRocess - Interventions: Hot packs to reduce

A

congestion

91
Q

URI Nursing PRocess - Interventions: Analgesics for

92
Q

URI Nursing PRocess - Interventions: Oxygen if

93
Q

URI Nursing PRocess - Interventions: What is administered via nebulizer?

94
Q

URI Nursing PRocess - Interventions: Gargles for

A

sore throat

95
Q

URI Nursing PRocess - Interventions: Encourage how much liquid?

A

2-3 L /Day

96
Q

URI Nursing PRocess - Evaluation: How do you evaluate this?

A

Maintenance of patent airway

Able to communicate needs

Evidence of postiive hydration

97
Q

URI Nursing PRocess - Evaluation: Absence of complications include

A

otitis media

Sinusitis

Pneumonia

98
Q

URI Nursing PRocess - Evaluation: Patient Education includes

A

Prevention of upper airway infections

Emphasize frequent handwashing

99
Q

Obstructive Sleep Apnea: What is this characterized as?

A

Recurrent episodes of upper airway obstruction adn reduction in ventilation.

100
Q

Obstructive Sleep Apnea: DEfined as

A

cessation of breathing during sleep causing by airway obstruction

101
Q

Obstructive Sleep Apnea: RF Includes

A

Obesity, male gender, postmenopausal status

102
Q

Obstructive Sleep Apnea, Patho: REpetitive apneic events results in

A

hypoxia (decreased oxygen saturation) and hypercapnia (increased CO2 concentration

103
Q

Obstructive Sleep Apnea, Patho: Patients thus have a high prevelance of

A

hypertension

104
Q

Obstructive Sleep Apnea, Clinical Manifestations: What are some signs of this?

A

Frequent and loud snoring with breathing cessation for 10 seconds or longer, for at least five episodes per hour

105
Q

Obstructive Sleep Apnea, Clinical Manifestations: Classic signs and symptoms include the 3S’s ,

A

Snoring, Sleepiness, and Significant

106
Q

Obstructive Sleep Apnea, Clinical Manifestations: Diagnosis of sleep apnea is based on

A

clinical features and polysomnographic finding (Sleep study)

107
Q

Obstructive Sleep Apnea, Patho: Loss of normal

A

pharyngeal muscle tone

108
Q

Obstructive Sleep Apnea, Patho: What collapses during inspiration?

109
Q

Obstructive Sleep Apnea, Patho: Obstructions causes what to fall and rise?

A

Fall: O2 Sat, PO2, pH

Rise: PCO2

110
Q

Obstructive Sleep Apnea, Patho: Asphyxia causes a

A

brief arousal from sleep

111
Q

Obstructive Sleep Apnea, Patho: Manifestations include

A

Loud snoring durign sleep

Excessive daytime drowseiness

Headable

Irritability

112
Q

Obstructive Sleep Apnea, Medical Management: First steps to correct this?

A

Weight loss, avoidance of alcohol, and positional therapy

and mandibular advancement devices (MADs)

113
Q

Obstructive Sleep Apnea, Medical Management: When correctly placed, MAD advances the

A

mandible so that slightly anterior to front teeth, prevent airway obstruction by tongue

114
Q

Obstructive Sleep Apnea, Surgical Management: Simple Tonsillectomy may be effective for those with

A

larger tonsils

115
Q

Obstructive Sleep Apnea, Surgical Management: Uvulopalatopharyngoplasty is

A

the resection of pharyngeal soft tissue and removal of 15 mm of free edge of soft palate

116
Q

Obstructive Sleep Apnea, Goal of Care

A

Restore airflow and prevent adverse effects of the disorder

117
Q

Obstructive Sleep Apnea, Treamtns of mild - to - moderate apnea

A

Weight reduction, alcohol abstinence, improve nasal patency

118
Q

Obstructive Sleep Apnea, Surgical Management: Tracheostomy , what is this?

A

Relieves upper airway obstruction but has numerous adverse effects, including speech difficulty

119
Q

Epistaxis: What is this?

A

Hemorrhage from the nose caused by rupture of tiny distended vessels in the mucous membrane

120
Q

Epistaxis: Most common site?

A

Anterior septum

121
Q

Epistaxis: Serious problem because it may result in

A

airway compromise or significant blood loss

122
Q

Epistaxis, Medical Management: Intiial treatment may include

A

apply direct pressure while head tilted forward to prevent swallowing and holds for 5-10 minutes

123
Q

Epistaxis, Interventions: Phenylephrine Spray causes

A

vasoconstriction

124
Q

Epistaxis, Interventions: Cauterize with

A

silver nitrate or electrocautery

125
Q

Epistaxis, Interventions: Monitor for

A

aspiration, VS, Pulse Oximetry, Airway, and breathing

126
Q

Epistaxis, Patient Teaching: Avoid what?

A

Nasal trauma, nose picking, forceful blowing

127
Q

Epistaxis, Patient Teaching: Adequate humidifcaion to prevent

128
Q

Epistaxis, Patient Teaching: Pinch nose to stop bleeding, if doesnt stop after 15 minutes, seek

A

medical attention

NRSG 110: Med Surg 2 (29 decks)

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