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Adult Health > Exam 2 respiratory 26 27 28 29 > Flashcards

Exam 2 respiratory 26 27 28 29 Flashcards

1
Q

Problems associated of Nose and Paranasal Sinuses (3)

A

Deviated septum
Nasal fracture
Rhinoplasty

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2
Q

What are common CAUSES of deviated septum and SYMPTOMS?

A 
Most common causes:
-Trauma
-Congenital 
Symptoms variable
-Breathing obstruction
-Nasal mucosa dryness
-Epistaxis
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3
Q

What is the Deflection of the normally straight nasal septum?

A

Deviated Septum

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4
Q

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?

A

Nasal Fracture

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5
Q

What are COMPLICATIONS of a Nasal Fracture?

A
  • airway obstruction
  • epistaxis
  • meningeal tears
  • septal hematoma
  • cosmetic deformity.
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6
Q

What are the 3 types of nasal fractures?

A
  • 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.
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7
Q

______ 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.

A
  • Unilateral
  • Complex
  • Bilateral
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8
Q 
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

A

Nasal Fracture

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9
Q

What is Rhinoplasty and what is it used for?

A

Surgical nose reconstruction

  • Cosmetic
  • Improve airway
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10
Q

What COLLABORATIVE CARE can you provide for a patient who had RHINOPLASTY?

A
  • 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
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11
Q

What are examples of Nasal Surgery?

A

Examples: : rhinoplasty, septoplasty, and nasal fracture reductions

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12
Q

In Nursing Management for Nasal Surgery why would the nurse in Pre-op prep give: No aspirin-containing drugs or nonsteroidal antiinflammatory drugs (NSAIDs)

A

for 2 weeks to reduce the risk of bleeding.

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13
Q

What are some Nursing Interventions for POST-OP of Nasal Surgery?

A 
maintenance of the airway
assessment of respiratory status
pain management 
observation of the surgical site for bleeding
infection
edema
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14
Q

What are some Teaching for a patient who had Nasal Surgery?

A
  • 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.
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15
Q

What is the Bimodal age distribution of Epistaxis and the Causes

A
  • Bimodal age distribution (50)
  • Causes: trauma, foreign bodies, topical corticosteroid use, nasal spray abuse, street drugs, anatomic malformation, allergic rhinitis, tumors
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16
Q

What is Allergic Rhinitis and what are the 2 types?

A

-Rxn of nasal mucosa to specific allergen
2 types:
Seasonal (intermittent) <4d/wk, 4wks/yr

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17
Q

Allergic Rhinitis Environmental triggers and manifestations?

A

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.

18
Q

What are 2 essential management steps in proving NURSING and COLLABORATIVE management for ALLERGIC RHINITIS?

A 
-Identify and avoid triggers
Medication: 
-to reduce associated inflammation
-Reduce nasal symptoms
-Improve sleep
19
Q

What is RHINITIS?

A

is irritation and inflammation of the mucous membrane inside the nose

20
Q

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?
A
  • 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
21
Q

Symptoms of Acute Rhinitis are?

A

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.

22
Q

What are NURSING and COLLABORATIVE management for ACUTE VIRAL RHINITIS?

A
  • 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
23
Q

Why do Antibiotics have no effect on what?

A

Viruses

Example, Acute Viral Rhinitis

24
Q

INFLUENZA Etiology and Pathophysiology
Where is comes from?
How is it transmitted?
Clinical manifestations?

A

-Wild birds
-Droplet & inhalation
Clinical Manifestations
-Abrupt chills and fever
-Cough fever, HA, sore throat

25
Q

In providing Nursing and Collaborative Management: Influenza
What are 2 types of vaccines?
Contraindications?
Nursing Goals (2 main goals)

A 
2 types of vaccines
-Live virus
-Attenuated virus (live virus that is weak)
Contraindications
-Guillain-Barre- neurologic disorder
-Egg Allergy ( most important)
Nursing Goals
-Symptom relief
-Prevention of secondary infection
26
Q

Sinusitis
-Inflammation of what?
-Secretions accumulate where?
Other than growth occurring there
Viral Sinusitis follows?
Other than Fungal what patient would this be common in?
What is the difference between ACUTE and CHRONIC? (time frame)

A

-Inflammation of mucosa narrows or blacks the ostia
-Secretions accumulate behind the obstruction
-Growth occurs there
-Viral sinusitis Follows URI
-Fungal – uncommon happens in Immunocompromised pts
ACUTE vs CHRONIC 3 weeks

27
Q

Most common causes are?

A

S. pneumoniae
H. influenzae
M. catarrhalis

28
Q

CLINICAL MANIFESTATIONS of Sinusitis are OFTEN DIFFICULT-non specific symptoms?

A
  • Pain
  • Purulent nasal drainage
  • Nasal obstruction
  • Congestion
  • Fever
  • Malaise
29
Q

What are some Nursing and Collaborative Management: Sinusitis?

A
  • Avoid environmental triggers
  • Treat symptoms & possibly antibx
  • Increase fluid intake (6-8 glasses)
  • Nasal cleansing: saline spray – better to use sterile spray
30
Q

What are two obstructions of Nose and Sinuses?

A 
Nasal Polyps
-benign mucous membrane masses that form slowly in response to repeated inflammation of the sinus or nasal mucosa
Foreign Bodies
-Organic - smelly
-Inorganic
31
Q

What problem of the Pharynx is this?

  • 70% of cases are viral
  • 5-15% of cases are β-hemolytic streptococcal
  • Fungal – candidiasis
  • Prolonged steroid use
  • HIV/AIDS
A

Acute Pharyngitis

32
Q

What is this?
Complication of acute pharyngitis or acute tonsillitis
high fever, leukocytosis, “hot potato voice,” and chills
TX: emergency tonsillectomy

A

Peritonsillar Abcess

33
Q

What are Clinical Manifestations of Acute Pharyngitis

A

-Scratchy throat
-Pain
-Red, edematous pharynx
Differential dx
-Streptococcal pharyngitis
-Candida albicans
-Diphtheria

34
Q

In Nursing and Collaborative Management: Acute Pharyngitis (3)

A

Goals:
Infection control
Symptom relief
Prevention of secondary infection

35
Q

What is the difference/ examples in COMPLETE or PARTIAL problems of Trachea and Larynx: Airway obstruciton?

A 
Complete: A MEDICAL EMERGENCY
Partial
-Food aspiration
-Foreign body
-Post-extubation: laryngeal edema, stenosis
-CNS depression
-Allergy rxn
36
Q

Symptoms of Problems of Trachea and Larynx: Airway Obstruction ?

A

Symptoms

  • Stridor
  • Use of accessory muscles
  • wheezing
  • Restlessness
  • Tachycardia
  • Cyanosis
37
Q

What interventions can a nurse do for Symptoms
problems of trachea and larynx: Airway Obstruction? Also what additional tests can be given if symptoms are UNEXPLAINED or RECURRENT?

A 
Interventions
-Obstructed airway (Heimlich) maneuver
-Cricothyroidotomy
-Endotracheal intubation
-Tracheostomy
Unexplained/recurrent Sxs:
-Chest Xray
-PFTs
-Bronchoscopy
38
Q

A __________ is a surgical incision into the trachea for the purpose of establishing an airway.

A

tracheotomy

39
Q

A __________ is the stoma (opening) that results from the tracheotomy. Indications for a tracheostomy are to (1) bypass an upper airway obstruction, (2) facilitate removal of secretions, (3) permit long-term mechanical ventilation, and (4) permit oral intake and speech in the patient who requires long-term mechanical ventilation. Most patients who require mechanical ventilation are initially managed with an endotracheal tube, which can be quickly inserted in an emergency.

A

tracheostomy

40
Q

What are some NURSING MANAGEMENT needed for Tracheostomy and what complications are you protecting the patient from?

A 
Tracheostomy care
Tracheostomy tube suctioning
Protection against complications
-Accidental decannulation(tube out)
-Aspiration
-Pneumonia 
-Infection
-Others??
-Patient teaching: Self-management

Adult Health (9 decks)

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