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NUR 240 > NUR 240 E3 ch 18 upper resp > Flashcards

NUR 240 E3 ch 18 upper resp Flashcards

1
Q

most common cause for illness, reason for seeking care, missing work

A

Upper respiratory infections (URIs)

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2
Q

Treatment of URI and duration

A

usually treated at home
usually last 3-5 days, if it last longer it could be something like sinusitis

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3
Q

common cold

A

Viral rhinitis

acute inflammation of the nasal cavity that is typically self-limiting with nasal congestion, rhinorrhea, sneezing, sore throat, and general malaise.

rhinitis, pharyngitis and laryngitis- distinguish sites of the symptoms

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4
Q

Epistaxis

A

hemorrhage from the nose (most common site- anterior septum- very thin and vascular)

can be caused by aspirin or changes in atmospheric pressure

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5
Q

medical management of epistaxis

A

pinch soft portion of nose for five mins, sit upright
phenylephrine spray, vasoconstriction

avoid nasal trauma, picking, forceful blowing, spicy foods (vasodilation), tobacco, and exercise (vasodilation)

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6
Q

Rhinitis and Rhinosinuitis presents as

A

congestion, runny nose, itchy nose, mouth/throat itching

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7
Q

Rhinitis

A

inflammation and irritation of the mucous membranes of the nose

can be acute or chronic

most common cause is the common cold

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8
Q

rhinorrhea

A

excessive nasal drainage, runny rose

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9
Q

signs and symptoms of rhinitis

A

rhinorrhea, nasal congestion , nasal discharge, sneezing, and pruritus of the nose, roof of mouth, throat, eyes, and ears

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10
Q

most common treatment for sneezing, pruritus, and rhinorhhea

A

Antihistamines

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11
Q

Medical treatments for allergic and nonallergic rhinitis

A

antihistamines, nasal sprays, decongestant, intranasal corticosteroids

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12
Q

how to use nasal medications

A

blow the nose before applying any medication into the nasal cavity.
keep the head upright; spray quickly and firmly into each nostril away from the nasal septum wait at least 1 minute before administering the second spray.

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13
Q

most contagious time of VIRAL rhinitis (common cold)

A

highly contagious 2 days before the symptoms appear and during the first part of the symptomatic phase

fall and spring

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14
Q

common symptoms of VIRAL rhinitis

A

low-grade fever,
nasal congestion,
rhinorhhea,
nasal discharge
halitosis
sneezing
tearing/watery eyes
“scratchy” or sore throat
general malaise
chills
headache
muscle aches

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15
Q

viral rhinitis may exacerbate

A

herpes simplex

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16
Q

viral rhinitis duration

A

often last 1-2 weeks

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17
Q

Rhinitis medicamentosa (rebound rhinitis)

A

caused by an overuse of topical nasal decongestants

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18
Q

most effect way to prevent viral rhinitis

A

WASH HANDS
and use tissues to prevent spread of virus
cough into upper arm

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19
Q

Rhinosinusitis (sinusitis)

what is it
duration
caused by

A

inflammation of the paranasal sinuses and nasal cavity

acute (less than 4 weeks), subacute (4 to 12 weeks), and chronic (more than 12 weeks)

caused by bacterial or viral infections

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20
Q

Acute rhinosinusitis is classified as acute bacterial rhinosinusitis (ABRS)(MOST ARE BACTERIAL) or acute viral rhinosinusitis (AVRS)
chronic rhinosinusitis- four or more acute episodes of ABRS per year

A
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21
Q

difference between the symptoms of ABRS and AVRS

A

ABRS: nasal drainage, nasal obstruction, facial pain, pressure or a sense of fullness, high fever
- occurrence of symptoms for 10 days or MORE after the initial onset of upper respiratory symptoms indicates ABRS

AVRS: similar to those of ABRS but no fever, and not the same intensity (tends to be an absence of facial pain),
- shorter duration
- symptoms of AVRS occur FEWER than 10 days after the onset of the URI and do not worsen

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22
Q

treatment of acute rhinosinusitis

A

for bacterial: 14 day course antibiotic (most common= Amoxicillin),

for patients allergic to penicillins: doxycycline or respiratory quinolones (levofloxacin or moxifloxacin) can be prescribed

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23
Q

ABRS adjunctive treatments with antibiotics

A

okay: nasal lavage- reduces inflammation
not okay: decongestants and antihistamines

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24
Q

treatment of AVRS

A

typically nasal lavage and decongestants (guaifenesin/pseudoephedrine)

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25
Q

decongestants or nasal saline sprays increases the…

A

increases the potency of the ostiomeatal unit and improve drainage

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26
Q

oral decongestants should be used cautiously in ____ patients

A

hypertensive

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27
Q

topical decongestants shouldn’t be used for more than

A

3-4 days

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28
Q

Patients with nasotracheal and nasogastric tubes in place are at the risk for development of sinus infections

A
29
Q

chronic rhinosinusitis (CRS) duration for diagnosis

A

CRS is accompanied by nasal polyps
last for at least 12 weeks

30
Q

nuchal rigidity

A

stiffness of the neck or inability to bend the neck

symptom of meningitis along with fever, and severe headache

31
Q

medical management of CRS

A

adequate hydration
OTC nasal saline spray
NSAIDs or acetaminophen
decongestants -pseudoephedrine

32
Q

surgical management of CRS

A

excising and cauterizing nasal polyps, correcting a deviated septum, incising and draining the sinuses, aerating the sinuses, and removing tumors.
Computer-assisted or computer-guided surgery is used to increase the precision of the surgical procedure and to minimize complications

33
Q

first line treatment for acute invasive fungal rhinosinsusitis

A

surgery - it requires debridement

34
Q

Acute Pharyngitis

A

sudden painful inflammation of the pharynx (includes the posterior third of the tongue, soft palate, and tonsils)
commonly referred to as sore throat
droplet precautions
winter and early spring
viral

35
Q

Group A streptococcus causes (bacterial)

A

acute pharyngitis (strep throat)
pain, fever, vasodilation, edema, and tissue damage. redness and swelling in tonsils, uvula, soft palate - a creamy white exudate may be present

36
Q

viral pharyngitis duration

A

3 to 10 days

37
Q

signs and symptoms of acute pharyngitis

A

fiery-red pharyngeal membrane and tonsils, lymphoid follicles that are swollen and flecked with white-purple exudate, enlarged and tender cervical lymph nodes, and no cough. Fever (higher than 38.3°C [101°F]) and malaise

38
Q

test for pharyngitis

A

rapid antigen detection test

39
Q

pharyngitis is treated with (med and no meds)

A

antibiotics
10 day course

in hospital: check hydration, offer ice chips, warm liquids or popsicles— reduction in swelling, lozenges, warm salt water gargle

40
Q

pharyngitis if left untreated can cause

A

sepsis (infection can enter your blood), meningitis, and pneumonia

41
Q

complications of URIS

A

Airway obstruction
● Hemorrhage
● Sepsis
● Meningitis or brain
abscess
● Nuchal rigidity
Medicamentosa
● Acute otitis media***
● Trismus- lockjaw
● Dysphagia
● Aphonia- unable to speak
● Cellulitis

42
Q

a patient with pharyngitis should avoid

A

vape, electronic nicotine device
second hand smoke

43
Q

(Assessment) Signs and symptoms of URI & info to obtain

A

headache, cough, hoarseness, fever, stuffiness, generalized discomfort and fatigue

health history- ALLERGIES
inspect- nose neck throat and palpate lymph nodes

44
Q

Nursing diagnosis for URI

A

activity intolerance
ineffective airway clearance
ineffective airway clearance
pain
anxiety always consider
impaired comfort
laryngitis - impaired verbal communication
impaired swallowing

45
Q

vital signs to watch for URI

A

temp and O2 stat

46
Q

prevention of URI

A

HAND WASHING
annual influenza vaccine (esp. for elderly and very young)

47
Q

tonsilitis symptoms

A

sore throat, fever, snoring, and difficulty swallowing

48
Q

treatment of tonsillitis

A

increased fluid intake, antispasmodic agents, salt-water gargles, and rest.
Bacterial infections are treated with penicillin (first-line therapy) or cephalosporins.
Viral tonsillitis is not effectively treated with antibiotic therapy.

49
Q

after tonsillectomy, patient is at risk for ___ which can compromise patient airway

A

hemorrhage

50
Q

peritonsillar abscess

A

most common major suppurative complication of sore throat accounting for roughly 30% of soft tissue head and neck abscesses

severe throat throat, fever, trismus (lockjaw) and drooling
inflammation of the pterygoid muscle leads to spasm

51
Q

medical management of peritonsillar abscess

A

antibiotics (usually amoxicillin) and corticosteroid therapy

52
Q

laryngitis

A

inflammation of the larynx as a result of voice abuse, exposure to dust, chemicals, smoke, or as a part of a URI
most commonly- viral (caused by the same pathogen as pharyngitis and the common cold

53
Q

acute laryngitis symptoms

A

hoarseness or aphonia (loss of voice) and severe cough

sudden onset worse in cold dry climate and improves in warmer climate

54
Q

management of laryngitis

A

resting the voice, avoiding irritants (smoking), resting, inhaling cool steam or an aerosol

nursing education: rest the voice and maintain a well humidified environment, increase fluid intake

55
Q

laryngectomy

A

results in permanent loss of voice, often have a trach after

56
Q

low levels of albumin are associated with

A

laryngeal cancer

57
Q

before laryngectomy…

A

make a communication plan before surgery
assess hearing as that affects communication

58
Q

laryngeal cancers account for ____ of head and neck cancers

A

half

59
Q

complications post laryngectomy

A

respiratory distress– hypoxia
hemorrhage- check for bleeding postop
infection- loss of protective structure
wound breakdown
aspiration
tracheostomal stenosis- narrowing of opening

60
Q

nursing interventions post laryngectomy

A

COUGH and DEEP breathing
Preoperative teaching
● Reduce anxiety
● Maintain patent airway, control secretions
● Support alternative communication
● Promote adequate nutrition and hydration- NPO for a week post op (may have TPN)
● Promote positive body image, self-esteem
● Monitor for potential complications
● Self-care management; homecare

61
Q

Which diagnostic test is used to confirm the diagnosis of maxillary and frontal sinusitis?

Sinus aspirates
CT scan
MRI
Sinus x-rays

A

Sinus aspirates

62
Q

A client finished a course of antibiotics for laryngitis but continues to experience persistent hoarseness. Which symptom would cause the nurse to suspect laryngeal cancer?

a feeling of swelling at the back of the throat
weight loss
discomfort when drinking cold liquids
headaches in the morning

A

a feeling of swelling at the back of the throat

63
Q

The nurse in the ICU is caring for a client with a nasotracheal tube. Because of the tube placement, the nurse understands that the client is at risk for developing

severe epistaxis.
subperiosteal abscess.
sinus infection.
orbital cellulitis.

A

sinus infection

64
Q

A surgeon completes a total laryngectomy. Postoperatively, the nurse explains to the patient’s family that:

-One vocal cord was removed along with a portion of the larynx.
-The voice was spared and a tracheostomy would be in place until the airway was established.
-A permanent tracheal stoma would be necessary.
-A portion of the vocal cord was removed.

A

A permanent tracheal stoma would be necessary

65
Q

A client has been diagnosed with acute rhinosinusitis caused by a bacterial organism. What antibiotic of choice for treatment of this disorder does the nurse anticipate educating the client about?

A

amoxicillin

66
Q

Which diagnostic test is used to confirm the diagnosis of maxillary and frontal sinusitis?

A

Sinus aspirates

67
Q

A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:

A

“I should become involved in a weight loss program.”

68
Q

After a tonsillectomy, a client is being prepared for discharge. The nurse should instruct the client to report which sign or symptom immediately?

A

bleeding

69
Q

The nurse is providing discharge instructions to a client who has nasal packing in place following nasal surgery. Which discharge instructions would be most appropriate for the client?

Avoid sports activities for 6 weeks.
Decrease the amount of daily fluids.
Take aspirin for nasal discomfort.
Administer normal saline nasal drops as ordered.

A

Avoid sports activities for 6 weeks

NUR 240 (18 decks)

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