Exam 2 - Respiratory Alterations Flashcards
most common reason for seeking healthcare
URI
where are URI treated?
community settings, doctors offices, long-term care facilities, self-care at home
goal when working within the community for URI
education - hygiene, meds, adverse effects
URI pt teaching
prevention
health promotion
inflammation of the paranasal sinus and nasal cavities
URI / Rhinosinusitis
cause of Rinosinusitis
alleriges
viral
bacterial
streptococcus pNA
haemophilus influenza
acute rhinosinusitis last how long
< 4 weeks
subacute rhinosinusitis last how long
4-12 weeks
chronic rhinosinusitis last how long
> 12 weeks
s/sx of viral and bacterial rhinosinusitis
HA cough hoarseness fever stuffiness generalized discomfort/fatigue
viral and bacterial rhinosinusitis diagnostics
physical exam
XR, CT, MRI
viral sinusitis usually follows ___
URI
how long does it for viral sinusitis to resolve on its own
14 days
what additional s/sx is present with bacterial rhinosinusitis
blood tinged - purulent sputum
worse after 3-5 days
fever 39C/102F
s/sx > 10 days
must tx with abx
rhinosinusitis interventions
elevate head ice collar to reduce inflammation hot packs to reduce congestion warm shower analgesics gargles for sore throat 2-3L liquid daily soft, bland diet rest
how long should you use decongestants?
no more than 3-5 days
rhinosinusitis med group symptom relief
analgesics antipyretics nasal corticosteriods saline nasal spray antihistamines
bacterial: abx therapy 2-4 weeks, up to 12 weeks; PCN, cephalosporins, fluroquinolines
how to prevent rhinosinusitis
hand hygiene
flu vaccine
what occurs with obstructive sleep apnea (OSA)?
uvula blocks the airway
mild apnea
5-10 per hour
severe apnea
15-30 per hour
apnea periods
10-90 seconds
3 S’s of OSA
sleepiness (daytime)
snoring
significant other - reports
OSA risk factors
obesity neck size > 17" male > 65 y/o post menopausal high PPD hx
OSA hypoxia and hypercapnia s/sx
sleep disturbances early morning HA irritability HTN dysrhythmias
how to dx OSA
sleep studies
PSG
Stop Bang quiestionnaire
OSA treatment/management
lose weight
side lying, HOB elevated
CPAP
BiPAP
caution which meds with OSA
benzo
opiates
what is CPAP
continuous positive airway pressure
what is BiPAP
bilevel positive airway pressure
surgical management of OSA
ablation
CPAP, BiPAP education
how to use
keeping the device clean
Four serotypes to the flu
A - can also effect animals
B - Avian (H5N1) Bird
C - Swine (H1N1) Pig, GI complication
D
Flu precautions
droplet, contact
flu incubation period
1-4 days
when are you most contagious with the flu
1 day before symptoms occur
contraindications to the INACTIVE (?) flu shot
previous vaccine rxn allergy to eggs, chicken pregnancy hx Guillian Barre < 2, > 50 y/o immunocompromised chronic illness HCP, caregivers of those with severe health problems
s/sx of flu
abrupt fever 102-104 chills, aches HA sore throat cough fever fatigue, exhaustion
gold standard test for the flu
throat culture
can take 7-10 days for results
most convenient flu test
rapid
takes 30 minutes; occasional false positive or miss
how is the live attenuated flu vaccine administered
nasal spray
age range for nasal spray
healthy ages 2-49
no as effective in older adults
how to administer inactivated vaccine
IM - deltoid in all individuals 6 months and older
individuals who must have the flu shot
> 65 y/o caregivers of infants < 6 months old; immunocompromised cancer pts heart disease, stroke DM HIV/Aids children with neuro deficits HCP
complications from the flu
secondary infection PNA bronchitis/ear infection hospitalization death
PNA vaccine prevents ___ PNA
bacterial
viral PNA is best prevented by the ___ vaccine
flu
care of the flu
rest; stay home 34 hours until fever is gone
wash hands
antipyretics
anyone less than __ y/o should not receive salicylates including pepto d/t possibility of ___ ___
18; Ryes syndrome
What can help reduce severity and duration of the flu if administered within 24 hours?
zinc
zinc nursing considerations
intranasal = loss of smell lozenges = bad taste, nausea oral = caffeine, dairy reduce absorption
how long to be on droplet precaution for the flu?
7 days or 24 hours after fever has resolved
