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Medsurg Review > Sinusitis-Laryngitis > Flashcards

Sinusitis-Laryngitis Flashcards

1
Q

A condition characterized by the inflammation of the mucus membrane lining the sinuses

A

Sinusitis

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2
Q

May either be a bacterial infection or secondary to a viral exposure

A

Sinusitis

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3
Q

What are the two types of Sinusitis?

A

Acute sinusitis
Chronic Sinusitis

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4
Q

What are the most common causes of Acute Sinusitis?

A

Allergy and bacterial infection

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5
Q

Damage to the mucusa of the sinuses are reversible

A

Acute sinusitis

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6
Q

Chronic sinusitis may result from?

A

untreated acute sinusitis

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7
Q

Damage to the mucosa of the sinuses are irreversible

A

Chronic Sinusitis

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8
Q

What are the manifestations of Sinusitis?

A

o Facial pain and headache
o Swollen upon inspection and tender upon palpation
o Toothaches if the maxillary sinuses are affected
o Headache for frontal and ethmoid sinuses
o Mucoid nasal discharge
o Nasal congestion
o Orbital edema or edema over the affected sinus
o Pain over the infected sinus
o Cough and sore throat
o Inability to smell
o Lack of appetite
o Fever
o Body malaise
o WBC increased

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9
Q

What are the two most common presenting symptoms of sinusitis?

A

Facial pain and headache

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10
Q

What are the diagnosis for sinusitis?

A

history and physical exam
Sinus X-rays
Computed tomography scanning

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11
Q

Upon physical examination of patient having sinusitis, what will you do?

A

Percussion = tenderness to palpation over the infected sinus area

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12
Q

The sinuses are percussed using the?

A

Transillumination

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13
Q

This decrease in the transmission of light

A

Transillumination

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14
Q

What is detected during sinus x-rays?

A

detect sinus opacity, mucosal thickening, bone destruction, and air-fluid levels.

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15
Q

It is the most effective diagnostic tool for sinusitis

A

computed tomography scanning

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16
Q

what is the other use of computed tomography scanning?

A

used to rule out other local or systemic disorders, such as tumor, fistula, and allergy.

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17
Q

Treatment fir sinusitis

A

o Administration of antibiotics (oral for simple sinusitis and IV for diffused)
o Humidification with a vaporizer to help drain the sinuses

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18
Q

If the sinusitis does not respond to antibiotics, what surgical intervention may be required?

A

Functional Endoscopic Sinus Surgery (FESS)

Anthral Irrigation

Caldwell-Luc Surgery

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19
Q

What surgical intervention for sinusitis uses a fiberoptic endoscope is used to disect nasal tissue?

A

FESS

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20
Q

what are the complications of FESS?

A

Complications:
o Nasal bleeding
o Orbital hematoma
o Injury to the optic nerve which may lead to blindness

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21
Q

What do you call the sharp metal that is inserted through anthrum into the lateral wall of the nose into the sinus, in anthral irrigation?

A

trocar

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22
Q

other term for caldwell-luc surgery?

A

radical anthrum surgery

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23
Q

Caldwell-Luc Surgery is indicated for?

A

chronic maxillary sinusitis

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24
Q

This surgical intervention for sinusitis is done when antibiotic treatment is no longer effective

A

Caldwell-Luc Surgery

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25
During Caldwell-Luc Surgery, what is the point of entry and what does it produce?
An incision is made under the upper lip (point of entry), above the lateral incisor teeth and part of the bony anthrum is removed, producing a permanent window allowing drainage and removal of the deceased mucosa and periosteum
26
What are the Nursing Considerations for Sinusitis?
• Instruct patient not to chew on the affected side until the incision heals • Instruct client to observe caution when performing oral hygiene • Instruct client to avoid wearing dentures for about 10 days after the surgery • Avoid blowing nose for at least 2 weeks o Avoid sneezing or keep the mouth open when sneezing
27
Pharyngitis is commonly known as?
soar throat
28
it is an inflammation of the pharynx, resulting in a sore throat.
pharyngitis
29
This is a symptom rather than a condition
pharyngitis
30
What are the risk factors of pharyngitis?
Viral and/or bacterial infections allergies dry indior air and chronic mouth breathing muscle strain GERD
31
Manifestations of Pharyngitis
MANIFESTATIONS • Sore throat • Dry, scratchy throat • Pain when swallowing • Pain when speaking • Other symptoms may be present, depending on the cause. These include: o Fatigue o Malaise o muscle aches o headache and fever — especially with the flu or other viral infections
32
Diagnosis of Pharyngitis
• physical exam o ex: allow the client to swallow • laryngoscopy (scope exam in a clinic) to assess for all the possible causes of pharyngitis.
33
Treatment for Viral pharyngitis
❖ salt water gargles ❖ pain relievers ❖ extra fluids to help alleviate the symptoms.
34
Treatment for Bacterial pharyngitis
antibiotics
35
treatment for fungal pharyngitis
antifungal medications
36
it detects what bacteria is causing the infection so they’ll know what kind of antibiotic should be given to the patient.
culture sensitivity test
37
predisposing factor of rheumatic heart disease
GABHS
38
treatment for strep throat
prompt antibiotic therapy
39
strep throat can sometimes cause?
kidney problems and rheumatic fever, which can damage the heart valves.
40
Inflammation of the vocal cords can alter the way the vocal cords come together and vibrate, causing voice changes.
Laryngitis
41
Laryngitis can be?
Acute (short-term) = <3weeks Chronic (long-term) = >3 weeks
42
often a mild and self-limiting condition that typically lasts for a period of 3 to 7 days
Acute laryngitis
43
is a temporary condition caused by overusing the vocal cords. It can also be caused by an infection
acute laryngitis
44
What are the causes of acute laryngitis?
o viral infections o straining your vocal cords by talking or yelling o bacterial infections o drinking too much alcohol
45
What are the viral infections that causes acute laryngitis?
rhinovirus, parainfluenza virus, respiratory syncytial virus, coronavirus, adenovirus, and influenza are all potential etiologic agents
46
The condition lasts for over 3 weeks and is caused by prolonged exposure to one of the risk factors
Chronic laryngitis
47
results from long-term exposure to irritants. It’s usually more severe and has longer-lasting effects than acute laryngitis.
Chronic laryngitis
48
What are the causes of chronic laryngitis? and how?
o frequent exposure to harmful chemicals or allergens o acid reflux – can damage the larynx o frequent sinus infections — it travels and affects the adjacent organs o smoking or being around smokers o overusing your voice o low-grade yeast infections caused by frequent use of an asthma inhaler o Cancer, paralysis of the vocal cords, or changes in vocal cord shape as one age can also cause persistent hoarseness and sore throats.
49
TRUE OR FALSE: Initial symptoms of acute laryngitis are usually “abrupt” in “onset” and “worsen over two or three days”, though may persist up to a week without treatment
TRUE
50
Manifestations of Laryngitis
o Change in quality of voice, in later stages there may be a complete loss of voice (aphonia) o Discomfort and pain in the throat, particularly after talking o Dysphagia, odynophagia (if present, exercise caution - may hint at additional pathology) o Dry cough o General symptoms of dryness of throat, malaise, and fever o Frequent throat-clearing – one sign of throat filling o Early voice fatigue or loss of vocal range
51
What are the diagnosis for laryngitis
History and physical examination Formal voice analysis and fiberoptic laryngoscopy Stroboscopy Imaging or Laboratory Studies Culture
52
What diagnosis procedure for laryngitis can be used to confirm the diagnosis in cases that are refractory to treatment or otherwise convoluted?
Formal voice analysis and fiberoptic laryngoscopy
53
Stroboscopy reveals what?
asymmetry, aperiodicity, and reduced mucosal wave patterns.
54
This diagnosis procedure for laryngitis are not required unless….
Imaging or laboratory studies unless an atypical pathogen or neoplasm are suspected.
55
This may be indicated for diagnosis of laryngitis if patient has….
culture has exudate in the oropharynx or vocal cords
56
Treatment/Management of Laryngitis
Voice Rest Steam Inhalation Avoidance of Irritants Dietary Modification
57
In laryngitis, this is the single most important factor.
Voice Rest
58
Why do use of voice during laryngitis is prohibited?
it results in incomplete or delayed recovery
59
What should you instruct the patient if she/he needs to speak?
use a confidential voice - normal phonatory voice at low volume without whispering or projecting
60
Inhaling humidified air enhances…
moisture of the upper airway and helps in the removal of secretions and exudates.
61
Why should the patient avoid smoking and alcohol if he/she has laryngitis?
It delays prompt resolution of the disease process
62
In laryngitis, this treatment/management is recommended for patients with GERD?
dietary restriction
63
For patients with laryngitis, when he/she is advised for dietary restriction, what should be avoided?
caffeinated drinks spicy foods Fatty foods chocolate peppermint avoidance of late meals - have meal at least 3 hours before sleeping also advice patient to drink plenty of water
64
Medications for laryngitis
antibiotics oral antifungal agents Mucolytics lifestyle and dietary modification anti-reflux medications
65
TRUE OR FALSE: Antibiotics prescription for an otherwise healthy patient with acute laryngitis is currently unsupported; however for high-risk patients and patients with severe symptoms antibiotics may be given.
True
66
For patients with laryngitis, if there is a presence of identifiable gram stain and culture, what should be given as medication?
narrow-spectrum antibiotics
67
For patients with fungal laryngitis, what medication should be given?
oral antifungal agents (fluconazole)
68
For how many weeks oral antifungal agents is required?
for 3 weeks period, and may be repeated if needed
69
Oral antifungal agents as medication for fungal laryngitis should be reserved for patients with….
confirmed fungal infection via “laryngeal examination and/or culture”
70
For patients with laryngitis, what will you give to clear secretions?
Mucolytics (gauifenesin)
71
anti reflux medications is indicated for..
patients with LPR-related laryngitis
72
what medications suppress acid production and is effective against GERD?
H2 receptor and proton pump blocking agents
73
what is the most effective medication for LPR
proton pump inhibitors
74
How many doses is required for proton pump inhibitors to be effective?
require higher dose or twice-daily dosing
75
Give Nursing Diagnosis for Inflammatory disorders
• Ineffective airway clearance related to excessive mucus production secondary to retained secretions and inflammation • Acute pain related to upper airway irritation secondary to an infection • Impaired verbal communication related to physiologic changes and upper airway irritation secondary to infection or swelling • Deficient fluid volume related to increased fluid loss secondary to diaphoresis associated with a fever • Deficient knowledge regarding prevention of upper respiratory infections, treatment regimen, surgical procedure, or postoperative care

Medsurg Review (5 decks)

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