Exam 2 respiratory 26 27 28 29 Flashcards
Problems associated of Nose and Paranasal Sinuses (3)
Deviated septum
Nasal fracture
Rhinoplasty
What are common CAUSES of deviated septum and SYMPTOMS?
Most common causes: -Trauma -Congenital Symptoms variable -Breathing obstruction -Nasal mucosa dryness -Epistaxis
What is the Deflection of the normally straight nasal septum?
Deviated Septum
This makes up 40% of facial bone injuries and is usually caused by a blow to the middle of the nose. What type of problem is this?
Nasal Fracture
What are COMPLICATIONS of a Nasal Fracture?
- airway obstruction
- epistaxis
- meningeal tears
- septal hematoma
- cosmetic deformity.
What are the 3 types of nasal fractures?
- Unilateral fracture: produces little or no displacement.
- Bilateral fracture: the most common fractures, give the nose a flattened look.
- Complex fracture: caused by powerful frontal blows, which may also involve subsequent damage to adjacent facial structures such as the teeth, eyes, or other facial bones.
______ fracture: produces little or no displacement.
______ fracture: caused by powerful frontal blows, which may also involve subsequent damage to adjacent facial structures such as the teeth, eyes, or other facial bones.
______ fracture: the most common fractures, give the nose a flattened look.
- Unilateral
- Complex
- Bilateral
This EXPLAINS what type of PROBLEM? Diagnosis: -Based on Hx & physical -Ability to breath -Ecchymosis or raccoon eyes -Presence of CSF: glucose in drainage positive sign
Goals: maintain airway, reduce edema, prevent complications, emotional support
Nasal Fracture
What is Rhinoplasty and what is it used for?
Surgical nose reconstruction
- Cosmetic
- Improve airway
What COLLABORATIVE CARE can you provide for a patient who had RHINOPLASTY?
- Regional anesthesia
- (Health Care Team) Implants used to shape and prevent scarring
- Packing prevents bleeding/hematoma (Think tampons in the nose)
- Usually removed in 3-5 days post-op
What are examples of Nasal Surgery?
Examples: : rhinoplasty, septoplasty, and nasal fracture reductions
In Nursing Management for Nasal Surgery why would the nurse in Pre-op prep give: No aspirin-containing drugs or nonsteroidal antiinflammatory drugs (NSAIDs)
for 2 weeks to reduce the risk of bleeding.
What are some Nursing Interventions for POST-OP of Nasal Surgery?
maintenance of the airway assessment of respiratory status pain management observation of the surgical site for bleeding infection edema
What are some Teaching for a patient who had Nasal Surgery?
- patient must be able to detect early and late complications at home.
- Patient needs to know that they will typically experience edema and ecchymosis for a short period before achieving the final cosmetic effect.
What is the Bimodal age distribution of Epistaxis and the Causes
- Bimodal age distribution (50)
- Causes: trauma, foreign bodies, topical corticosteroid use, nasal spray abuse, street drugs, anatomic malformation, allergic rhinitis, tumors
What is Allergic Rhinitis and what are the 2 types?
-Rxn of nasal mucosa to specific allergen
2 types:
Seasonal (intermittent) <4d/wk, 4wks/yr
Allergic Rhinitis Environmental triggers and manifestations?
Manifestations of allergic rhinitis are initially sneezing; watery, itchy eyes and nose; altered sense of smell; and thin, watery nasal discharge that can lead to a more sustained nasal congestion.
Nasal turbinates appear pale, boggy, and swollen.
Turbinates may fill the air space and press against the nasal septum.
Posterior ends of the turbinates can become so enlarged that they obstruct sinus aeration or drainage and result in sinusitis.
With chronic exposure to allergens, the patient’s responses include headache, congestion, pressure, nasal polyps, and postnasal drip as the most common cause of cough.
The patient may complain of cough, hoarseness, and/or the recurrent need to clear the throat.
Congestion may cause snoring.
What are 2 essential management steps in proving NURSING and COLLABORATIVE management for ALLERGIC RHINITIS?
-Identify and avoid triggers Medication: -to reduce associated inflammation -Reduce nasal symptoms -Improve sleep
What is RHINITIS?
is irritation and inflammation of the mucous membrane inside the nose
What is another name for ACUTE VIRAL RHINITIS
- Cause?
- Most _____ infectious disease
- Spread by _____ & _____ hand-mouth contact
- Lives on ______ objects for up to 3 days
- What time of the year is it MOST frequent?
- Common cold (acute coryza)
- Caused by adenovirus that invades upper respiratory tract
- Often accompanies a URI
- Most prevalent infectious dz
- Spread by droplets & direct hand-mouth contact
- Lives on inanimate objects for up to 3 days
- More frequent in winter
Symptoms of Acute Rhinitis are?
The patient with acute viral rhinitis typically first experiences tickling, irritation, sneezing, or dryness of the nose or nasopharynx, followed by copious nasal secretions, some nasal obstruction, watery eyes, elevated temperature, general malaise, and headache. After the early profuse secretions, the nose becomes more obstructed, and the discharge is thicker. Within a few days the general symptoms improve, nasal passages reopen, and breathing returns to normal.
What are NURSING and COLLABORATIVE management for ACUTE VIRAL RHINITIS?
- Rest, fluids, food, antipyretics, analgesics
- Complications
- Antibiotics usually not indicated
- Overuse of antibx should actually be avoided due to the development of resistant strains
- Frequent hand washing
- Treat symptoms
- Use intranasal decongestant no more than 3 days
Why do Antibiotics have no effect on what?
Viruses
Example, Acute Viral Rhinitis
INFLUENZA Etiology and Pathophysiology
Where is comes from?
How is it transmitted?
Clinical manifestations?
-Wild birds
-Droplet & inhalation
Clinical Manifestations
-Abrupt chills and fever
-Cough fever, HA, sore throat
