Fund 51 - Ch 18 Flashcards
URI - most common cause viral or bacterial?
URI is often defined as an infection of the mucous membranes of the nose, sinuses, pharynx, upper trachea, or larynx. Virus is the most common cause. can be acute or chronic.
Allergic rhinitis is further classified as
seasonal or perennial rhinitis a
Drug-induced rhinitis (Ace ventra and beta have rhinitis)
may occur with antihypertensive agents, such as angiotensin-converting enzyme (ACE) inhibitors and beta-blockers; “statins,” such as atorvastatin and simvastatin; antidepressants and antipsychotics such as risperidone; aspirin; and some antianxiety medications
vasometer - cause of rhinosinutisis
idoiopathic, abuse of nasal decongestants
mechanical - - cause of rhinosinutisis (mechanical tumor)
tumor, deviated septum, crusting
chronic inflammatory - - cause of rhinosinutisis (just 2, think of Tu)
polyps, sarcoidosis (rare condition that causes small patches of swollen tissue, called granulomas)
infectious - - cause of rhinosinutisis
viral
hormonal - - cause of rhinosinutisis
pregnancy, use of oral contraceptives, hypothyroidism
Cromolyn (chrome mast)
inhibits release of histamine. a mast cell stabilizer for rhinitis
nasal spray use
keep head upright, spray quickly wait 1 min before second spray
common cold (the cold is self-limited)
URI that is self-limited and caused by a virus.
colds are highly contagious because
virus is shed for about 2 days before the symptoms appear and during the first part of the symptomatic phase
viral rhinitis lasts (think about your viruses)
1 to 2 weeks
overuse of topical nasal decongestants can cuase
rhinitis medicamentosa = rebound rhinitis
rhinosinitus (pair of sinuses)
inflammation of paranasal sinuses and nasal cavity
Rhinosinusitis is classified by duration of symptoms (Jimmy is a rhino)
as acute (less than 4 weeks), subacute (4 to 12 weeks), and chronic (more than 12 weeks).
Recurrent acute rhinosinusitis (4 is a cute rhino number)
is characterized by four or more acute episodes of ABRS per year
Although antibiotics kill bacteria in the biofilm margin,
cells deep in the biofilm are not affected, allowing for regrowth
Symptoms of ABRS (acute bacterial rhinosinitus) include (think bacteria..and it’s full)
purulent nasal drainage (anterior, posterior, or both) accompanied by nasal obstruction or a combination of facial pain, pressure, or a sense of fullness
The symptoms of AVRS are similar to those of ABRS, except (a virus fever)
the patient does not present with a high fever, nor with the same intensity of symptoms (e.g., there tends to be an absence of facial pain–pressure–fullness), nor with symptoms that persist for as long a period of time
ARBS duration (10 arbors)
10 or more days
untreated rhinosinitis can lead to
osteomyelitis and mucocele (cyst of the paranasal sinuses).
ARBS treatment
antibotics
AVRS treatment - virus gets the lavage
saline lavage and decongestant. Dont use topical decongestants longer than 3 to 4 days.
intranasal steroids - only use with which patients?
help both bacterial adn viral rhinosinisuitis, but should only be used with pts who have a history of allergic rhinosinitius
nurse management rhinosininutis - and when can’t you use meds?
start decongestants like ephedrine at first sign of symptoms. check if pt has hypertension - can’t use.
nuchal rigiditiy
stiff neck, sign of meninegitis
reoccuring rhinosinusitis (reoccuring is like cute, 4)
when 4 or more episodes of ABRS occur within a year and no signs of it between episodes.
CRS (chronic recurring rhinosinositis) cause (a chronic problem is just mechanical)
mechanical obstruction of frontal and maxillary ethmoid - obstruction prevents drainage
Clinical manifestations of CRS include
impaired mucociliary clearance and ventilation, cough (because the thick discharge constantly drips backward into the nasopharynx), chronic hoarseness, chronic headaches
CRS assessment
nasal mucous membranes are assessed for erythema, pallor, atrophy, edema, crusting, discharge, polyps, erosions, and septal perforations or deviations. teeth pain, eyes, pharnyx
Ethmoid rhinosinusitis
orbital cellulitis, which usually begins with edema of the eyelids and rapidly progresses to ptosis (droopy eyelid), proptosis (bulging eye), chemosis (edema of the bulbar conjunctiva), and diminished extraocular movements.
CRS management
hydration, saline sprays, NSAIDs, decongestants. elevated HOB during sleep. avoid caffeine and alcohol.
CRS surgery - FESS
excising and cauterizing nasal polyps, correcting a deviated septum, incising and draining the sinuses, aerating the sinuses, and removing tumors
Acute pharyngitis
Acute pharyngitis is a sudden painful inflammation of the pharynx = sore throat
Acute pharyngitis - viral or bacterial? (pharrell is a virus)
mostly viral. includes tongue and tonsils. can be from dry heat.
strep (GAS) - how long after exposure do get symptoms? (strep fast, I’m dying)
can turn into scarlet fever, sore throat starts 1 to 5 days after exposure. fever without chills, malaise. usually give penicillin. group A strep. IV penicillin can be every 4 hrs. warm saline or heat or ice.
pharnygitis nursing practices (pharrell needs liquid and watch out for ruby)
stay in bed, 2 - 3L of liquid, check for rash, may proceed rubella,