Med Surg: Upper Respiratory Problems

Question 1

What are the causes of Epitaxsis?

Answer 1

Trauma

Foreign Bodies

topical corticosteriod use

nasal spray abuse

street drug use

anatomic malformation

allergic rhinitis

Tumor

Question 2

What is the treatment for Epitaxsis?

Answer 2

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

Question 3

What is allergic rhinitis?

Answer 3

Reaction of nasal mucosa to an allergen

Symptoms must be more then 4 days during a week or 4 weeks out of a year

Question 4

What are the S&S of allergic rhinitis?

Answer 4

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

Question 5

What is the treatment of rhinitis?

Answer 5

Identify triggers and avoid them

Medication to reduce inflammation

Medicaiton to decrease nasal symptoms

Question 6

What is Acute viral rhintis and what is it caused by?

Answer 6

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

Question 7

What are the signs and symptoms of acute viral rhintis?

Answer 7

tickling

irritation

sneezing

dryness of nose or nasopharynx

copious nasal secretions

nasal obstruction

watery eyes

elevated temperature

Question 8

What is the treatment of viral rhinitis?

Answer 8

Rest

Fluids

Proper diet

Antipyretics and analgesics

Question 9

What are complications of viral rhintis?

Answer 9

Pharyngitis

Sinusitis

Otitis media

Tonsilitis

Lung infections

Question 10

What is sinusitis?

Answer 10

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

Question 11

What is the treatment for sinusitis?

Answer 11

Acute: antibiotics if lasts over 7 days without treatment

Chronic: broad spectrum antibiotics for 4-6 weeks, decongestants, nasal corticosteriods and antihistamines

Question 12

What is Pharyngitis?

Answer 12

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

Question 13

What is the treatment for pharyngitits?

Answer 13

infection control

symptom relief

prevention of secondary complications

Question 14

What is laryngitis?

Answer 14

inflammation of mucous membranes lining the larynx

Question 15

What is tonsilitis?

Answer 15

Inflammation and infection of the tonsils and lymphatic tissues on each side of the throat

capture bacteria

airborne, caused by bacteria

Question 16

What is a peritonsillar abscess?

Answer 16

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

Question 17

What in isnfluenza and the signs and symptoms?

Answer 17

Highly contagious, acute, viral respiratory infections

headache

cough

sore throat

muscle aches

fever

chills

fatigue

weakness and anorexia

Question 18

What is the treatment of influenza?

Answer 18

relief of symptoms and prevention of secondary infection

Question 19

What are nasal polyps?

Answer 19

May cause airways obstruction

benign clusters of tissue from repeated episodes of inflammation

Question 20

What are S&S of Nasal Polyps?

Answer 20

continues breathing through nose

voice quality

change drainage from allergies

chronic sinusitis

Question 21

What is the treatment of nasal polyps?

Answer 21

inhaled nasal sprays

Nasal steriods

Polypectomy

Question 22

What is obstructive sleep apnea?

Answer 22

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

Question 23

What are S&S of Obstructive sleep apnea?

Answer 23

obesity

large uvula

short neck

smoking

large tonsils

oropharngeal edema

increase CO2

increase pH

Question 24

What is the treatment for obstructive sleep apnea?

Answer 24

nonsugical management: change of sleep position, weight loss, positive-pressure ventilation

Surgical management: adenoidectomy, uvulectomy or uvulopalatopharyngoplasty

Question 25

What are causes of upper airway obstruction?

Answer 25

Foreign body aspiration

tongue edema

smoke inhalation edema

thick secretion

anaphylaxis

head and neck cancer

peritonsillar and pharyngeal abscess

Question 26

What is a tracheostomy

Answer 26

surgical incision into the trachea for purpose of establishing an airway

stoma (opening) that results from the tracheotomy

Question 27

What are indications for a tracheotomy?

Answer 27

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

Question 28

What is facial trauma with the nasal fractures?

Answer 28

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

Question 29

What is the nursing management of nasal fractures?

Answer 29

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

Question 30

What are facial/head & neck trauma?

Answer 30

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

Question 31

What are the different types of LeFort fractures?

Answer 31

I: nasoethmoid complex fracture

II: maxillary and nasoethmoid complex fracture

III: combination of I&II plus orbital-zygoma frature

Question 32

What is the S&S and treatment of the cancer of the Larynx?

Answer 32

Painless hoarseness

CT of head and neck

Direct laryngoscopy: look and see whats there

Treat via radiaiton, chemotherapy or surgery