Lecture 10 Upper Respiratory Tract Flashcards
what is the most common cause of illness?
upper respiratory tract infection
what is rhinitis
inflammation and irritation of mucous membrane in nose
causes of rhinitis
environmental triggers
allergen foods
medications - BB, ACE, statins, viagra, NSAIDs
infection
cocaine
manifestations of rhinitis
rhinorrhea = runny nose
nasal congestion
sneezing
headache
itching
treating rhinitis
tylenol and ibuprofen
antihistamines
decongestants
saline spray
expectorants
antitussives
rhinosinusitis
inflammation of nasal cavity AND sinuses
lasts >4 weeks
why does rhinosinusitis occur?
usually secondary to viral URI
congestion obstructs sinuses and allows for bacterial growth
bacterial vs viral rhinosinusitis
bacterial - high fever and symptoms >10 days
viral - no fever and symptoms <10 days
3 main symptoms of rhinosinusitis
purulent nasal drainage
nasal obstruction
facial pain, pressure, fullness
when should decongestants be used for rhinosinusitis?
only when it is acute and viral
three main goals for treating rhinosinusitis
shrink swelling in nose
pain relief
treat infection
complications of rhinosinusitis
orbital cellulitis
orbital abscess
osteomyelitis
meningitis
sepsis
subdural abscess
what should be avoided with rhinosinusitis
swimming and diving
air travel
smoking
how to tell if nasal spray is not properly applied
burning or irritation
bad taste in mouth
bloody nose
pharyngitis
inflammation of pharynx
what kind of pathogen mostly causes pharyngitis
usually viral
5-15% group A strep
risk factors for phaaryngitis
age
smoking
alcohol
dusty environment
signs and symptoms of pharyngitis
red pharynx
swollen lymph nodes
no cough
fever
malaise
sore throat
irritation and fullness inn throat
treating pharyngitis
supportive measures for viral etiology
10 day penicillin for bacterial etiology
benzocaine
tonsillectomy if chronic
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
