management of pts with upper airway problems

Question 1

upper airway infections

Answer 1

rhinitis, rhino sinusitis, pharyngitis, tonsilitis, adenoiditis, peri-tonsillar abscess, laryngitis

Question 2

rhinitis

Answer 2

reaction that happens in eyes, nose, throat when allergens in air trigger histamine to be released in the body (swelling)

Question 3

rhinosinusitis (acute/ chronic)

Answer 3

acute is symptomatic inflammation of the nasal cavity and paranasal sinuses lasting less than 4 weeks/ chronic lasts at least 12 weeks despite attempts to treat (nasal congestion, mucus discharge back of throat, facial pain)

Question 4

epistaxis

Answer 4

nosebleed

Question 5

pharyngitis

Answer 5

inflammation of pharyngeal (sore throat/ strep)

Question 6

peri-tonsillar abscess

Answer 6

get so large the tonsils touch

Question 7

laryngitis

Answer 7

vocal cords inflamed

Question 8

noninvasive respiratory therapies

Answer 8

oxygen (considered a medication) normal standing order, IS, chest physiotherapy

Question 9

hypoxemia level

Answer 9

< 80 or 75

Question 10

signs of oxygen toxicity

Answer 10

lethargic, agitated, stop drive to breath, high PaO2(over 100)

Question 11

different chest physiotherapies

Answer 11

postural drainage (head down, pound on back to cough up), chest percussion (loosen secretions), pulmonary rehabilitation (pulse ox, oxygen on, walking)

Question 12

airway management

Answer 12

endotracheal intubation, tracheostomy, mechanical ventilation

Question 13

endotracheal intubation

Answer 13

once past vocal cords inflate balloon, mark on lip line how far tube is in, will be able to tell if coughed up some/ inner cannula can come out/ operator for if pt pulls out trach and guides it back in place

Question 14

mechanical ventilation

Answer 14

breaths for the pt when the pt stops breathing

Question 15

tracheotomy

Answer 15

surgical procedure in which an opening is made into the trachea

Question 16

tracheostomy

Answer 16

is the actual opening

Question 17

uses of a tracheostomy

Answer 17

bypass an upper airway obstruction, removal of tracheobronchial secretions, long term use of mechanical ventilation, prevent aspiration of oral or gastric secretions, surgical procedures done for cancer

Question 18

nursing care of tracheostomy

Answer 18

patency of airway (may have to suction), infection prevention, prevent accidental decannulation, keep trach secure with strap or twill tape, STERILE CARE in hospital, clean care at home, monitor pulse ox and between suctions, push pull to catch mucus around surface (pt may turn purple)

Question 19

with trach care DO NOT

Answer 19

attempt to change or remove until stoma is established > 96 hrs/ instill NS into trach to stimulate cough (increase risk of infection & cause more irritation)

Question 20

obstructive sleep apnea

Answer 20

recurrent episodes of upper airway obstruction and a reduction in ventilation during sleep/ air flow blocked by anatomical structures or soft tissue

Question 21

obstructive sleep apnea increases risk for

Answer 21

HTN, MI, stroke, arrhythmias, CHF, increased insulin resistance, impaired social interactions, more sudden deaths between midnight and 6am, accidents

Question 22

central apnea

Answer 22

dysfunction in respiratory control center/ brain doesn’t send proper signals to the muscles that control your breathing

Question 23

risks factors that increase chance of OSA

Answer 23

obesity, male gender, postmenopausal, old age

Question 24

OSA treatment

Answer 24

weightless, CPAP (continuous air flow)/ BiPAP(bilevel pressure, starts low then blasts at high), dental appliance, medications (modafinil), surgery, sleep positioning