Med Surg: Upper Respiratory Problems Flashcards
What are the causes of Epitaxsis?
Trauma
Foreign Bodies
topical corticosteriod use
nasal spray abuse
street drug use
anatomic malformation
allergic rhinitis
Tumor
What is the treatment for Epitaxsis?
Sit upright
Direct pressure to nose for 10-15 minutes
Seek medical treatment if doesnt stop
Monitor respiratory status, LOC, signs of aspiration
Do not blow nose for several hours
Avoid strenous activity, sneeze with mouth open and avoid use of NSAIDs
What is allergic rhinitis?
Reaction of nasal mucosa to an allergen
Symptoms must be more then 4 days during a week or 4 weeks out of a year
What are the S&S of allergic rhinitis?
Sneezing
Watery itchy eyes and nose
altered sense of smell
thin weatery nasal discharge
nasal turbinates become swollen and can push on nasal septum
Rebound rhintis from nasal spray or cocaine use
What is the treatment of rhinitis?
Identify triggers and avoid them
Medication to reduce inflammation
Medicaiton to decrease nasal symptoms
What is Acute viral rhintis and what is it caused by?
common cold
caused by adenovirus
often accompanies acute URI
Increased frequency in winter
INcreased susceptibility related to: fatigue, physical and emotional stress and compromised immune status
What are the signs and symptoms of acute viral rhintis?
tickling
irritation
sneezing
dryness of nose or nasopharynx
copious nasal secretions
nasal obstruction
watery eyes
elevated temperature
What is the treatment of viral rhinitis?
Rest
Fluids
Proper diet
Antipyretics and analgesics
What are complications of viral rhintis?
Pharyngitis
Sinusitis
Otitis media
Tonsilitis
Lung infections
What is sinusitis?
Inflammation or hypertrophy of the mucous membranes of one or more sinuses
Occurs when the ostia is blocked or narrowed
Secretions accumulate: growth of bacteria, viruses or fungi
What is the treatment for sinusitis?
Acute: antibiotics if lasts over 7 days without treatment
Chronic: broad spectrum antibiotics for 4-6 weeks, decongestants, nasal corticosteriods and antihistamines
What is Pharyngitis?
Sore Throat
Inflammation of the mucous membranes of the throat
May have scratchy throat to severe swallowing difficulty
Red and edematous parynx: may have patchy exudates
What is the treatment for pharyngitits?
infection control
symptom relief
prevention of secondary complications
What is laryngitis?
inflammation of mucous membranes lining the larynx
What is tonsilitis?
Inflammation and infection of the tonsils and lymphatic tissues on each side of the throat
capture bacteria
airborne, caused by bacteria
What is a peritonsillar abscess?
infection of tissues around tonsils and forms an abscess complication of acute tonsillitis
Surgery when acute pahse, drain absess, deviation uvula away from abcess, pain radiate to ear, voice change, severe difficulty swallowin
What in isnfluenza and the signs and symptoms?
Highly contagious, acute, viral respiratory infections
headache
cough
sore throat
muscle aches
fever
chills
fatigue
weakness and anorexia
What is the treatment of influenza?
relief of symptoms and prevention of secondary infection
What are nasal polyps?
May cause airways obstruction
benign clusters of tissue from repeated episodes of inflammation
What are S&S of Nasal Polyps?
continues breathing through nose
voice quality
change drainage from allergies
chronic sinusitis
What is the treatment of nasal polyps?
inhaled nasal sprays
Nasal steriods
Polypectomy
What is obstructive sleep apnea?
muscles relax and tongue and neck structures are displaced
no problem with chest wall movement
sleep study which includes EEG, ECH, pulse ox and EMG
What are S&S of Obstructive sleep apnea?
obesity
large uvula
short neck
smoking
large tonsils
oropharngeal edema
increase CO2
increase pH
What is the treatment for obstructive sleep apnea?
nonsugical management: change of sleep position, weight loss, positive-pressure ventilation
Surgical management: adenoidectomy, uvulectomy or uvulopalatopharyngoplasty
What are causes of upper airway obstruction?
Foreign body aspiration
tongue edema
smoke inhalation edema
thick secretion
anaphylaxis
head and neck cancer
peritonsillar and pharyngeal abscess
What is a tracheostomy
surgical incision into the trachea for purpose of establishing an airway
stoma (opening) that results from the tracheotomy
What are indications for a tracheotomy?
bypass an upper airway obstruction
facilitate removal of secretions
permit long-term mechanical ventilation
permit oral intake and speech in patient who requires long-term mechanical ventilation
What is facial trauma with the nasal fractures?
may involve damage to adjacent structures
may have obvious deformity
may only have epistaxis
assess ability to breathe through each side of nose
“Raccoon eyes” ecchymosis below eyes
assess for clear drainage
May need to wait 5-10 days for edema to subside to perform surgery
What is the nursing management of nasal fractures?
Maintain airways: upright position, relieve pressure, prevent aspiration of drainage
Reduce edema: ice to face
Prevent complications: make sure patent airway
Provide emotional support: may need open or does reduction fracture surgery
What are facial/head & neck trauma?
LeFort fractures
First action: airway assessment
Assess injury for facial symmetry
Check for leakage of spinal fluid from the nose or ear
chick vision and EOM’s
“Battle signs”: brusing behind ears, fractues
What are the different types of LeFort fractures?
I: nasoethmoid complex fracture
II: maxillary and nasoethmoid complex fracture
III: combination of I&II plus orbital-zygoma frature
What is the S&S and treatment of the cancer of the Larynx?
Painless hoarseness
CT of head and neck
Direct laryngoscopy: look and see whats there
Treat via radiaiton, chemotherapy or surgery
