part 3 Flashcards
is a condition in which, during sleep, the person is making breathing effort but there is no or extremely limited airflow.
Obstructive sleep apnea OSA
what is common with OSA
snoring
Daytime symptoms of obstructive sleep apnea
fatigue, morning headaches, and difficulty concentrating.
Physical examination of patients with OSA typically reveals?
obesity, enlarged neck circumference, and hypertension
mild apnea may be treated with conservative measures
and a sleep study should be performed to determine what
weight loss, avoiding alcohol for 4 to 6 hours before bed, and sleep position modification
The severity of the condition of
What is the first line of therapy for sleep apnea?
nasal continuous positive airway pressure (CPAP) applied with nasal prongs.
if the cpap doesnt work what is the next line of therapy?
bilevel positive airway pressure (BiPAP) may be tried with a face mask or nasal mask
Another way to maintain an airway is by
Oral appliance
Untreated sleep apnea can treat can contribute to what
Myocardial infraction or strokes
often results from sports injuries, motor vehicle accidents, or physical assault and is the most common type of facial fracture.
nasal fracture
Displacement of cartilage or bonE can interfere w/
AIRFLOW AND DERFOMITY
and can become a potential spot of infection
Diagnosis of nasal fracture
by
and what should also be order if additional fracture are suspected
visual inspection for deformity,
a change in nasal breathing,
and presence of crepitation (grating sound or a feeling of rough surfaces rubbing together) on palpation
imaging studies
If the patient is seen within the first 24 hours after nasal fracture what need to be done
a closed reduction is most often performed using local or general anesthetic.
treatment for a nasal fracture is
pain relief and ice and cold compression to reduce swelling
if the facture is serve what may be done to improve airflow and cosmetic appearance
rhinoplasty
If you have rhinoplasty, it may take..
it may take 6 to 12 months before the final result of the surgery is evident.
cancer of the larynx risk factors ***
cigarette or cigar smoking, excessive use of alcohol, asbestos exposure, wood dust, helicobacter pylori, lack of fruits
pollutant= asbestos, paint fumes, wood or coal dust
What is the most common malignant tumor of the larynx
squamous cell carcinoma It grows from the mucous membrane lining the respiratory tract. Metastasis may occur to the lung
Signs of possible throat cancer
Hoarseness lasting more than 3 weeks
• Sore throat that lasts more than 2 weeks
• Consistent pain in or around the ear when swallowing
• Difficulty swallowing
• Dry, persistent cough for no known reason
• Blood in phlegm or saliva lasting more than a few days
• Lumps or knots on the neck indicating enlarged cervical lymph nodes
After symptoms spread beyond vocal cords what are the symptoms?
difficulty in swallowing or breathing, halitosis, blood-tinged sputum, fatigue and weakness, a sensation of having a lump in the throat, cough, enlarged lymph nodes in the neck, pain in the region of the Adam’s apple, or an airway obstruction
Diagnosis of throat cancer
visualizing the larynx with a laryngoscope, by a computed tomography scan of the larynx and throat, by magnetic resonance imaging, and by microscopic examination of a sample of tissues taken from the site.
if caught early, can cure 85% of cancers what type of treatment is given
Radiation in throat cancer and endoscopic laser
along w/ external beam radiation is used for certain types of lesion
bracchytherapy
When is a total laryngectomy performed?
why is it performed ?
if the tumor has progressed to surrounding tissues, and radiation therapy has failed, or better survival can be obtained by the more aggressive surgery.
CANNOT SPEAK OR SWALLOW.
for organ preservation
may be performed to facilitate breathing
temporarily but the stoma is eventually closed and the pt may resume talking after the affected area is completely healed
tracheostomy
may be the initial treatment in some cases of laryngeal cancer
what do this treatment do and goal
chemotherapy
shrink the malignancy so that it can be removed surgically
the goal is to preserve as much function as possible
in a laryngectomy what structure is removed
epiglottis thyroid cartilage hyoid cricoid two or more ring of the trachea
What is removed from a radical neck surgery ?
all the muscle, lymph nodes, and soft tissue from the lower edge of the mandible to the clavicle and from the top of the trapezius muscle to the midline are remove
if the tumor has extended to lymph node neck dissection is performed on the
side of the lession
extensive surgeries will often include placement
what should done b4 giving a pt giving them food
of a feeding tube for nutrition
a swallow evaluation
is inserted into the trachea through the nose or the mouth w/ the use of a what
intubation and laryngoscope
when is endotracheal done
an endotracheal is done for airway protection against aspiration when there is upper airway obstruction and mechanical ventilation
tracheostomy is done
to assist or control ventilation by mechanical means
to facilitate suctioning of secretion in the air passages when the pt w/ chronic disease cannot cough
to prevent aspiration of oral; and gastric secretion
to bypass a constricted or obstructed upper airway body
what is the nursing management for tracheostomy
Monitor continuously for signs of respiratory distress.
Immediate postoperative care
Psychological support
Communication
Rehabilitation
for pt who cannot master esophageal speech what is implanted
a tracheosphageal
one of the primary aspect of community care for nurses is to
is to promote immunization for influenzas and pneumonia
