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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
Q

During Caldwell-Luc Surgery, what is the point of entry and what does it produce?

A

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

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26
Q

What are the Nursing Considerations for Sinusitis?

A

• 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

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27
Q

Pharyngitis is commonly known as?

A

soar throat

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28
Q

it is an inflammation of the pharynx, resulting in a sore throat.

A

pharyngitis

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29
Q

This is a symptom rather than a condition

A

pharyngitis

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30
Q

What are the risk factors of pharyngitis?

A

Viral and/or bacterial infections
allergies
dry indior air and chronic mouth breathing
muscle strain
GERD

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31
Q

Manifestations of Pharyngitis

A

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
Q

Diagnosis of Pharyngitis

A

• 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
Q

Treatment for Viral pharyngitis

A

❖ salt water gargles
❖ pain relievers
❖ extra fluids to help alleviate the symptoms.

34
Q

Treatment for Bacterial pharyngitis

A

antibiotics

35
Q

treatment for fungal pharyngitis

A

antifungal medications

36
Q

it detects what bacteria is causing the infection so they’ll know what kind of antibiotic should be given to the patient.

A

culture sensitivity test

37
Q

predisposing factor of rheumatic heart disease

A

GABHS

38
Q

treatment for strep throat

A

prompt antibiotic therapy

39
Q

strep throat can sometimes cause?

A

kidney problems and rheumatic fever, which can damage the heart
valves.

40
Q

Inflammation of the vocal cords can alter the way the vocal cords come together and vibrate, causing
voice changes.

A

Laryngitis

41
Q

Laryngitis can be?

A

Acute (short-term) = <3weeks
Chronic (long-term) = >3 weeks

42
Q

often a mild and self-limiting condition that typically lasts for a period of 3 to 7 days

A

Acute laryngitis

43
Q

is a temporary condition caused by overusing the vocal cords. It can also be caused by an infection

A

acute laryngitis

44
Q

What are the causes of acute laryngitis?

A

o viral infections
o straining your vocal cords by talking or yelling
o bacterial infections
o drinking too much alcohol

45
Q

What are the viral infections that causes acute laryngitis?

A

rhinovirus, parainfluenza virus, respiratory syncytial virus, coronavirus,
adenovirus, and influenza are all potential etiologic agents

46
Q

The condition lasts for over 3 weeks and is caused by prolonged exposure to one of the risk factors

A

Chronic laryngitis

47
Q

results from long-term exposure to irritants. It’s usually more severe and has longer-lasting effects than acute laryngitis.

A

Chronic laryngitis

48
Q

What are the causes of chronic laryngitis? and how?

A

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
Q

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

A

TRUE

50
Q

Manifestations of Laryngitis

A

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
Q

What are the diagnosis for laryngitis

A

History and physical examination
Formal voice analysis and fiberoptic laryngoscopy
Stroboscopy
Imaging or Laboratory Studies
Culture

52
Q

What diagnosis procedure for laryngitis can be used to confirm the diagnosis in cases that are refractory to treatment or otherwise convoluted?

A

Formal voice analysis and fiberoptic laryngoscopy

53
Q

Stroboscopy reveals what?

A

asymmetry, aperiodicity, and reduced mucosal wave
patterns.

54
Q

This diagnosis procedure for laryngitis are not required unless….

A

Imaging or laboratory studies
unless an atypical pathogen or neoplasm are
suspected.

55
Q

This may be indicated for diagnosis of laryngitis if patient has….

A

culture
has exudate in the oropharynx or vocal cords

56
Q

Treatment/Management of Laryngitis

A

Voice Rest
Steam Inhalation
Avoidance of Irritants
Dietary Modification

57
Q

In laryngitis, this is the single most important factor.

A

Voice Rest

58
Q

Why do use of voice during laryngitis is prohibited?

A

it results in incomplete or delayed recovery

59
Q

What should you instruct the patient if she/he needs to speak?

A

use a confidential voice - normal phonatory voice at low volume without whispering or projecting

60
Q

Inhaling humidified air enhances…

A

moisture of the upper airway and helps in the removal of secretions and exudates.

61
Q

Why should the patient avoid smoking and alcohol if he/she has laryngitis?

A

It delays prompt resolution of the disease process

62
Q

In laryngitis, this treatment/management is recommended for patients with GERD?

A

dietary restriction

63
Q

For patients with laryngitis, when he/she is advised for dietary restriction, what should be avoided?

A

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
Q

Medications for laryngitis

A

antibiotics
oral antifungal agents
Mucolytics
lifestyle and dietary modification
anti-reflux medications

65
Q

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.

A

True

66
Q

For patients with laryngitis, if there is a presence of identifiable gram stain and culture, what should be given as medication?

A

narrow-spectrum antibiotics

67
Q

For patients with fungal laryngitis, what medication should be given?

A

oral antifungal agents (fluconazole)

68
Q

For how many weeks oral antifungal agents is required?

A

for 3 weeks period, and may be repeated if needed

69
Q

Oral antifungal agents as medication for fungal laryngitis should be reserved for patients with….

A

confirmed fungal infection via “laryngeal examination and/or culture”

70
Q

For patients with laryngitis, what will you give to clear secretions?

A

Mucolytics (gauifenesin)

71
Q

anti reflux medications is indicated for..

A

patients with LPR-related laryngitis

72
Q

what medications suppress acid production and is effective against GERD?

A

H2 receptor and proton pump blocking agents

73
Q

what is the most effective medication for LPR

A

proton pump inhibitors

74
Q

How many doses is required for proton pump inhibitors to be effective?

A

require higher dose or twice-daily dosing

75
Q

Give Nursing Diagnosis for Inflammatory disorders

A

• 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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