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Health Alteration > Mod 1 & 2 > Flashcards

Mod 1 & 2 Flashcards

1
Q

Rhinitis is a disorder characterized by inflammation and irritation of mucous membranes of what anatomical structure?

A

Nasal cavity

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2
Q

Upper airway infections (URI’s) are the most common cause of illness.

This type of infection affects the mucous membranes of what five anatomical regions?

A

Nose, sinuses, pharynx, upper trachea, or larynx

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3
Q

What causes rhinitis?

A

Changes in temperature or humidity

Presence of foreign body

Age or systemic disease

Allergic rhinitis: Exposure to allergens: environmental or food

Medications

non-allergic rhinitis caused by common cold

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4
Q

Why do antihistamines and decongestants used to treat upper respiratory disorders need to be used with caution in older adults?

A

Potential interactions with other medications

Serious consequences if the patient has concurrent medical problems that compromise their respiratory or immune status

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5
Q

Laryngitis in older adults is common and maybe secondary to what other medical condition?

A

Gastroesophageal reflux disease (GERD)

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6
Q

Signs and symptoms of rhinitis include:

A

Rhinorrhea = excessive nasal drainage/runny nose

Nasal congestion

Nasal discharge (purulent bacterial)

Sneezing and itching of nose, roof of the mouth, throat, eyes, and ears.

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7
Q

What is the most common pharmacologic therapy for rhinitis?

A

Antihistamines

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8
Q

Viral rhinitis is the most frequent viral infection in the general population.
(MOST OFTEN IN FALL & SPRING)

What are the signs and symptoms?

A

Low-grade fever, nasal congestion, rhinorrhea, tiredness, sore throat, chills, headache/muscle aches and nasal discharge

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9
Q

Management of viral rhinitis consist of symptomatic therapy which includes

A

Adequate fluid intake, Rest, Prevention of chilling, Use of expectorants

Warm salt water gargle sooth sore throats

Aspirin or ibuprofen relieves aches

Antihistamines are used to relieve sneezing, rhinorrhea, and nasal congestion

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10
Q

Cold and cold sores (Herpes simplex virus or HSV-1) is a contagious infection through contaminated, razors, towels, and dishes.

Approximately 80% of Americans are infected by age 30. Most are asymptomatic.

What are the signs and symptoms?

A

Eruption of small painful blisters on the skin of the lips, mouth, gums, tongue, or around the mouth

Early symptoms: burning, itching, and increased sensitivity or tingling.

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11
Q

Herpes simplex virus is managed through what medication’s?

A

Antiviral medication (Acyclovir)

Acetaminophen (pain)

Topical anesthetics (lidocaine)

Occlusive ointments with antiviral properties (docosanol)

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12
Q

Rhinosinusitis (sinusitis) is an inflammation of what anatomical region

A

Paranasal sinuses and nasal cavity

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13
Q

Acute rhinosinusitis is classified as acute bacterial rhinosinusitis (ARBS)

Signs and symptoms include :

A

Purulent nasal drainage, Nasal obstruction or a combination of facial pain, pressure, or a sense of fullness.

May present with high fever (102 F)

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14
Q

ARBS treatment consist of what for bacterial cases?

A

14 day course of antibiotics

Usually amoxicillin, but any type of antibiotic may be used

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15
Q

Acute pharyngitis is a sudden painful Inflammation of the pharynx, this includes the back portion of the throat. * commonly referred to as a sore throat.***

Signs and symptoms of acute pharyngitis include ???

A

Fiery red pharyngeal membrane and tonsils

Lymphoid follicles that are swollen and flecked with white – purple exudate

Swollen lymph nodes

No cough

Fever and tiredness may be present

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16
Q

Viral pharyngitis is treated with supportive measures

Bacterial pharyngitis is treated with what types of medication ??

A

Bacterial pharyngitis is commonly treated with penicillin for 10 days

Severe sore throat can be relieved by analgesic medication’s like aspirin or acetaminophen

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17
Q

What symptoms would cause concern for a patient with pharyngitis.

For what symptoms should the patient call their HCP?

A

Dyspnea, drooling, inability to swallow, and inability to fully open the mouth

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18
Q

Patient education for chronic pharyngitis includes

A

Avoidance of alcohol, tobacco, secondhand smoke, and exposure to cold, environmental or occupational pollutants 

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19
Q

Adenoids or pharyngeal tonsils consist of lymphatic tissue on the posterior wall of the nasal pharynx.

 symptoms of tonsillitis include:

A

Sore throat, fever, snoring, and difficulty breathing

Enlarged adenoids may cause: mouth breathing, earache, draining ears, frequent head colds, bronchitis, foul smelling breath, and noisy respirations 

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20
Q

For diagnosis of acute tonsillitis, what test is quick inconvenient?

A

RADT

however this test is less sensitive than a throat swab culture

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21
Q

Tonsillitis is treated with supportive measures and bacterial infections are treated with what antibiotic?

A

Commonly penicillin or cephalosporins

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22
Q

Nursing considerations for postoperative care of a tonsillectomy?

A

Most comfortable position is prone, with patient’s head, turned to the side to allow for drainage

Maintain oral airway until gag and swallowing reflexes return.

Monitor for signs of hemorrhage

Apply ice collar to neck

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23
Q

Patient education regarding tonsillectomy care

A

Bleeding may occur up to eight days after surgery

Pain should subside in 3 to 5 days

Take full course of antibiotics, prescribe due to surgery

Diet: soft foods and liquid acetaminophen for pain

Milk products may be restricted because they make mucus removal more difficult

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24
Q

Peritonsillar abscess is a collection of purulent exudate between the tonsillar capsule and surrounding tissues.

 This often occurs after an acute tonsillar infection, what are the signs and symptoms?

A

Severe sore throat, fever, inability to open the mouth, and drooling.

Less common symptoms: raspy voice, severe burning of throat, dysphasia, and pain in the ear.

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25
Q

What medications are used to treat peritonsillar abscess?

A

Antibiotics, usually penicillin are effective in controlling the infection

Corticosteroid for swelling

IF antibiotics do not resolve: abscess aspiration with a needle or incision is required

26
Q

Laryngitis is the inflammation of the larynx.

What are common causes of laryngitis?

A

Result of voice abuse, exposure to dust, chemicals, smoke, and other pollutants.

27
Q

Signs of acute laryngitis
VS
chronic laryngitis

A

Acute laryngitis: aphonia (loss of voice), and severe cough

Chronic laryngitis: marked by persistent harness

28
Q

Treatment for both acute and chronic laryngitis include resting voice and avoiding irritants.

What additional treatment is given for chronic laryngitis ?

A

Corticosteroids reduce local inflammatory reactions.

When secondary to GERD: treatment includes use of proton pump inhibitors (omeprazole)

29
Q

Chronic hoarseness of voice or laryngitis that persist for longer than five days should be reported because???

A

Hoarseness that persists for weeks could be a sign of malignancy (cancer)

30
Q

Obstructive sleep apnea is a disorder characterized by reoccurring episodes of upper airway obstruction and reduction ventilation.

What are some risk factors for OSA?

A

Obesity, male gender, postmenopausal status in women, and advanced age

31
Q

OSA is often found in patients with what other medical conditions?

A

Hypertension, patient should be screened for both

32
Q

OSA signs and symptoms include:

A

Loud snoring with breathing cessation for 10 seconds or longer and at least five episodes per hour.

Three “S”
snoring, sleepiness, significant other report of sleep apnea episodes

33
Q

OSA treatment options include:

A

Weight loss, avoidance of alcohol, oral appliances, CPAP (continuous, positive airway pressure)

34
Q

Information needed when a patient comes out of the OR?

A

Patient ID, date of birth and allergies

Code status and any complications

Last vitals and pain meds

Estimated blood loss

where the incision is and type of surgery

Type of anesthesia and airway 

35
Q

Postoperative nursing priorities include:

A

Maintaining patent airway

Avoiding hypopharyngeal obstruction: caused by relaxation of tongue and blocks airway

36
Q

Common postoperative complications

A

Hypoventilation:
Related to effects of anesthesia or pain meds

Hypotension:
Related to blood loss (hypovolemia)

Hypertension and dysrhythmias:
Related to pain, holding blood pressure meds prior to surgery, electrolyte imbalance (potassium & magnesium)

37
Q

When patient arrives to floor postoperatively, what assessment should you anticipate?

A

Full head to toe, but concentration on respiratory and circulation.

check wound site

Respiratory: SPO2, symmetry of respiration, SOB, secretions, breath sounds, LOC

38
Q

What did you teach, observe, and reinforced to the patient postop regarding respiratory system?

A

Incentives spirometry every hour the patient is awake.

Cough and deep breathing

Splint wound for coughing or deep breathing

39
Q

Cardiovascular complications postop may include

A

Hypotension, hypertension, shock, or hemorrhage

Assess wound for bleeding and check drains that were replaced.

* saturation of dressing = shadowing**

40
Q

Factors that affect wound healing

A

Diet, Smoking, high BMI, high blood sugar, age, overactivity, hygiene, and area of wound

(moist areas like skin in the groin, armpits, under skin folds delay healing)

41
Q

THREE stages of wound healing include:

A

Inflammatory: begins when the wound develops. Marked by edema erythema, inflammation and pain.

Proliferative: granulation tissue fills the wound. Wound edges began to contract.

Remodeling: final phase of healing process in which granulation tissue matures into scar tissue. This increases the strength of the tissue.

42
Q

Primary intention:

A

Wound edges are surgically closed or well approximated

43
Q

Secondary intention:

A

Wound is left open, so that tissue can fill the cavity.

44
Q

Tertiary intention:

A

Wound is left open and closed at a later date when enough granulation tissue has formed.

45
Q

What are the four types of wound drainage?

A

SEROUS: clear with lots of protein

SANGUINEOUS: bloody secretion 🩸

SEROSANGUINEOUS: watery blood (most common) PINK

PURULENT: pus like = infection

46
Q

What are the three common types of wound drains?

A

Penrose= tube placed in surgery usually has a safety pin at the end

Hemovac = suction over wound, monitor output

Jackson Pratt (JP) = bulb suction, monitor output (hopefully trending down) watch for occlusion

47
Q

Wound complication may include hemorrhage. What are the signs and symptoms of a hemorrhage?

A

Decreased blood pressure

Decreased O2 stat

Increased heart rate 💓

48
Q

wound dehiscence

           VS.

wound evisceration

A

Wound dehiscence= complete or partial separation of wound related to infection or stress (coughing)

Wound evisceration= protruding of organs out of wound opening

  • cover wound with sterile dressings and sterile saline*
49
Q

Other postop complications to assess for include deep vein thrombosis (DVT).

What are the signs and symptoms of DVT?

What nursing interventions can prevent DVT ?

A

Signs and symptoms:
include pain, edema, and redness often in calf area.

Prevention includes: ambulation, hydration, anticoagulants, smoking cessation, compression stockings, or compression device (SCD)

50
Q

Postoperative nausea and vomiting treatment includes

A

Advancing diet slowly, and promoting activity (ambulation helps with gastrointestinal peristalsis)

51
Q

Paralytic ileus occurs when part of the bowel is not functioning properly.

What are some signs and symptoms?

A

Nausea and vomiting

Pain

Stomach is large, tender, and swollen

52
Q

Postoperative delirium is usually seen an elderly patients. How can you help prevent this?

A

Sensory deprivation: place patient and well lighted room, close to staff

Sensory overload: be conscious of machine noise

53
Q

Intraoperative RN role is to:

A

Advocate for the patient, provide and overlook physical care, and emotional support

54
Q

Circulating RN role in surgery:

A

Circulating RN is NOT sterile unlike most of the team

Assures patient safety, monitors aseptic practices, calls timeouts

55
Q

Scrub RN role during operation:

A

Preparing sterile field and maintaining field

Assisting surgeon

Preforming sponge and sharps count

56
Q

Stages for GENERAL inhaled or administered IV anesthesia:

😴4 STAGES😴

A

Beginning anesthesia
Excitement
Surgical anesthesia
Medullary depression

57
Q

Types of regional anesthesia:

A

epidural, spinal, blocks

consciousness is maintained

Epidural : more medication, required, absence of spinal headache

Spinal : subarachnoid space(direct contact with spinal cord) plus medication, but at risk for spinal headache

58
Q

anesthesia awareness is a potential complication that includes??

A

Patient is cognizant of surgical intervention while under general anesthesia

Cannot feel pain, but is aware of what’s happening

59
Q

Malignant hyperthermia is a muscle disorder induced by anesthetic agents.

What happens to the body?

A

Increase temperature and heart rate

Decrease blood pressure

May lead to central nervous system damage and death ☠️

60
Q

Geriatric considerations for anesthesia include

A

Depressed bodily functions and lower cardiac reserves increase chance of complications in elderly adults

Health Alteration (1 decks)

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