Lecture 10 Upper Respiratory Tract Flashcards by Isabel Ostroski

what is the most common cause of illness?

upper respiratory tract infection

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what is rhinitis

inflammation and irritation of mucous membrane in nose

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causes of rhinitis

environmental triggers
allergen foods
medications - BB, ACE, statins, viagra, NSAIDs
infection
cocaine

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manifestations of rhinitis

rhinorrhea = runny nose
nasal congestion
sneezing
headache
itching

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treating rhinitis

tylenol and ibuprofen
antihistamines
decongestants
saline spray
expectorants
antitussives

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rhinosinusitis

inflammation of nasal cavity AND sinuses
lasts >4 weeks

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why does rhinosinusitis occur?

usually secondary to viral URI
congestion obstructs sinuses and allows for bacterial growth

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bacterial vs viral rhinosinusitis

bacterial - high fever and symptoms >10 days
viral - no fever and symptoms <10 days

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3 main symptoms of rhinosinusitis

purulent nasal drainage
nasal obstruction
facial pain, pressure, fullness

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when should decongestants be used for rhinosinusitis?

only when it is acute and viral

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three main goals for treating rhinosinusitis

shrink swelling in nose
pain relief
treat infection

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complications of rhinosinusitis

orbital cellulitis
orbital abscess
osteomyelitis
meningitis
sepsis
subdural abscess

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what should be avoided with rhinosinusitis

swimming and diving
air travel
smoking

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how to tell if nasal spray is not properly applied

burning or irritation
bad taste in mouth
bloody nose

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pharyngitis

inflammation of pharynx

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what kind of pathogen mostly causes pharyngitis

usually viral

5-15% group A strep

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risk factors for phaaryngitis

age
smoking
alcohol
dusty environment

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signs and symptoms of pharyngitis

red pharynx
swollen lymph nodes
no cough
fever
malaise
sore throat
irritation and fullness inn throat

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treating pharyngitis

supportive measures for viral etiology
10 day penicillin for bacterial etiology
benzocaine
tonsillectomy if chronic

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complications of untreated strep

rhinosinusitis
otitis media
peritonsillar abscess
mastoiditis
cervical adenitis
PNA
sepsis
meningitis
rheumatic fever
nephritis

signs and symptoms of tonsillitis and adenoiditis

sore throat
fever
snoring
difficulty swallowing
mouth breathing

what can cause tonsillitis

GAS
epstein-bar
cytomegalovirus

when is tonsillectomy indicated

repeat infection
hypertrophy
repeat otitis media
airway obstruction

tonsillectomy education

avoid irritating foods
no smoking or heavy lifting for 10 days
voice rest
humidifier

signs and symptoms of peritonsillar abscess

severe sore throat fever inability to open mouth drooling dyspnea dysphagia

signs and symptoms of hemorrhage post tonsillectomy

vomiting blood tachycardia restlessness

causes of laryngitis

voice abuse irritants, dust, chemicals, smoke, pollutants infection severe GERD intubation

signs and symptoms of laryngitis

voice loss severe cough throat tickle improves in warmer climate

managing laryngitis

voice rest humidifier fluids eliminate irritants PPI for GERD pain control monitor airway

when to call doctor for laryngitis

coughing up blood difficulty swallowing saliva noisy breathing hoarse for more than 5 days

what causes obstructive sleep apnea?

airway collapse while sleeping

3 S of sleep apnea

snoring sleepiness during the day sleep apnea episodes - breathing pauses then gasping for air

other signs of sleep apnea

frequent wakening during night insomnia short attention span or irritability

risk factors for sleep apnea

obesity alcohol use near bedtime

what conditions can sleep apnea cause if untreated?

hypertension CVA or MI

treating sleep apnea

weight reduction no alcohol before bed CPAP and BiPAP mandible advancement devices do not lie on back to sleep

surgery for sleep apnea

tonsillectomy/adenoidectomy remove some soft tissue in pharynx septoplasty nasal polypectomy tongue reduction epiglottoplasty

treating epistaxis

pressure for 5-10 mins tilt head forward

what is the most common cause of nose fracture

aassault

signs and symptoms of nose fracture

pain bleeding swelling orbital bruising

signs and symptoms of nasal obstruction

chronic nasal congestion sleep deprivation rhinosinusitis

what can cause laryngeal obstruction

foreign body anaphylaxis acute laryngitis

signs and symptoms of laryngeal obstruction

hoarseness stridor cough accessory muscles low O2 sat

what is the most common head/neck cancer?

laryngeal cancer

signs and symptoms of laryngeal cancer

hoarseness >2 weeks raspy voice persistent cough painful throat lump dysphagia and dyspnea weight loss

how is laryngeal cancer treated?

radiation chemo laser surgery laryngectomy

nursing care for laryngectomy

communication strategies monitor airway, hemorrhage, infection respiratory toileting hydration only via IV for first 7 days enteral feeding

when is tracheostomy needed

laryngeal trauma airway obstruction total laryngectomy long term ventilation >21 days

trach care

monitor bleeding suction - pre-oxygenate for deep suction clean, change dressing, change neck ties prevent moisture from entering trach