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Med Surg > Upper Resp > Flashcards

Upper Resp Flashcards

1
Q

Problems in the upper resp system are primarily a

A

ventilation prob

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2
Q

When it comes to itis’s do we treat them aggresively

A

yes

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3
Q

What does IND mean

A

incision and drainage

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4
Q

What if the itis is caused by a virus

A

treat the symptoms and let it resolve itself

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5
Q

What are structural causes of upper resp probs

A 
deviated septum 
nasal fracture 
edema 
epitaxis 
rhinoplasty
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6
Q

What are interventions for someone with a traumatic prob causing edema and swelling

A

elevate HOB for 48 hrs

use ice to limit swelling

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7
Q

What are the steps for treating epitaxis

A 
keep the patient
get them sitting 
apply direct pressure for 10-15mins
use ice compresses
apply small gauze pads into nostrils
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8
Q

What do you do if the initial steps for treating epitaxis are not effective

A

use vasoconstrictor agents, cauterization, or anterior or posterior packing packing for minimum 3 days

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9
Q

What type of trauma is still considered to affect the person in the same way (edema bleeding and swelling) as blunt force trauma

A

surgeries for example rhino and septoplasty

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10
Q

What are some interventions to treat a surgery of the nose

A

elevate HOB

reduce agents that increase bleeding

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11
Q

What do we need to teach to nose surgery patients

A

dont change their dressing, let the surgeon do it

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12
Q

What are manifestations of rhinisitis and sinusitis

A

Nasal congestion, sneezing, watery/itchy eyes, altered smell, watery discharge, headache, congestion, pressure

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13
Q

What are some interventions for rhinisitis and sinusitis

A

if their symptomatic give tylenol
push fluids to liquify secretions
reduce exposure to causal agents

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14
Q

What is the first line med specifically for treating nasal probs

A

inhaled corticosteroid spray

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15
Q

What should we teach our patients with rhinisitis or sinusitis

A

avoid allergens
get refill/use intranasal corticosteroids before allergy season
Wash hands often bec common cold could be a trig
monitor suptum for color moving towards yellow/clear and thin from greenish and thick

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16
Q

Who are high risk pop for influenza

A 
elderly 
longterm steroid use 
chemotherapy
Chronic cardiac or pulmonary (COPD cancer) 
Hospitalized in previous year
LongtermcareTC residents
Immunocompromised
Pregnancy – in 2nd or 3rd trimester during flu season
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17
Q

What are some symptoms of the flu

A

cough, fever, myalgia, HA, sore throat

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18
Q

What could the flu lead to and what does it look like

A

pneumonia that has exacerbated cough and purulent sputum

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19
Q

If the flu is uncomplicated how fast should it subside

A

within a week

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20
Q

What is a potential occurance with elderly that get the flu

A

the symptoms last for weeks

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21
Q

What should you teach about the flu

A

get vaccinated unless contraindicated like egg allergies

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22
Q

What are some causes of nasal and paranasal sinus obstruction

A

nasal polyps

foreign objects

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23
Q

What do nasal polyps look like

A

bluish glossy protrusions

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24
Q

What are the manifestations of nasal polyps

A

clear discharge

speech distortion

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25
Q

What are some treatments for nasal polyps

A

endoscopy into laser surgery

26
Q

What is the prognosis of nasal ppolyps if untreated

A

probs recurrent

27
Q

What can slow the growth of nasal polyps

A

corticosteroids

28
Q

What are the manifestations of foreign objects

A

clear dis

local inflammation

29
Q

How do you treat foreign object obstruction

A

remove via point of entry/ sneese with the opposite nostril closed

30
Q

What is acute pharyngitis usu caused by

A

virus

31
Q

What is acute follicular pharyngitis caused by

A

strep

32
Q

What is fungal acute pharyngitis usu caused by

A

candida

33
Q

Who are at the most risk for fungal acute pharyngitis

A

long term corticosteroid or antibiotic use

immunocomp

34
Q

What are the common manifestations for all types of acute pharyngitis

A

redness
edema
progresses from scratchy to dysphagia

35
Q

What are some manifestation of acute pharyngitis that might apppear

A

patchy yellows eudate

white patches

36
Q

if untreated or not fully treated what can acute pharyngitis lead to

A

rheumatic heart dis

37
Q

How do we treat acute pharyngitis

A

Infection control- wash hands, throw away tissues
Symptomatic relief
Prevent secondary infections
Fluid . . . . . Citrus could irritate
Treat with antibiotics or nystatin (fungal)

38
Q

What shoudl you teach the patient when they are treating acute pharyngitis with oral solutions

A

swish and swallow

39
Q

What is a complication of acute pharyngitis or acute tonsilitis

A

tonsilar abscess

40
Q

What are the mani’s of tonsilar abscess

A

hi fever (>101.5), leukocytosis, and chills

41
Q

What are some treatments of tonsilar absscess

A

Antibiotics
Needle aspiration
IND
Tonsillectomy

42
Q

What is OSA

A

partial or complete obstruction of aurways from tongue or soft palate falling back

43
Q

What happens during a OSA attack

A

airway is obst’d for 15-90 seconds causing severe hypoemia and hypercapnia, jolting the patient awake

44
Q

What are mani’s of OSA

A

Frequent awakenings with HA
Loud snoring (partner complains)
Complains (in part) – Morning headaches (hypercapnia), irritability, male impotence

45
Q

How is OSA usu diagnosed

A

with polysomnography with multiple episodes

46
Q

What are some ways to treat OSA

A 
lose weight 
oral apps that move the tongue and mandible forward
CPAP
BiPAP
Surgery to remove tissue
47
Q

What is a recommendation to give patients with OSA

A

avoid alc and sedatives

48
Q

What are some advantages of a tracheostomy over a endotracheal tube

A

less risk for long term damage
hygeine improved
increased mobility
can still eat

49
Q

What shoudl you teahc your pat before getting a trach

A

you wont be able to speak while the inflated cuff is in

50
Q

What are some guidelines for inflating a cuff on a trach

A

use the min volume to create a seal
dont inflate more than 20mmHG or 25cm H2O
Use the min leak technique

51
Q

What is the min leak technique

A

after inflating min enough to create the seal, withdraw 0.1 ml of air

52
Q

Why should you monitor the pressure of the cuff daily after inflating it

A

the underlying tissue can swelling up from the irritation causing an increase in pressure

53
Q

What type of cleanliness does suctioning need

A

sterile

54
Q

What are the steps for suctioning

A

pre O2
insert 5-6 in or until resistance
suction up the way up

55
Q

What are some guidelines for trach suctioning

A

use sterile technique
dont suction for longer than 15 secs total
try to aim for as little passes as possible

56
Q

What is a potential problem with trachs

A

dislodgement

57
Q

When is dislodgement most likely

A

first 5-7 days

58
Q

What are some precautioins we can take to prevent/help dislodgement

A

keep replacement tube at bedside
do not change ties for 24 hours
let the physician perform the first tube cchange

59
Q

When does the first tube change typically happen

A

after 7 days

60
Q

Is the tube can be replaced what should you do for dislodgement of the trach

A

spread the opening by the rentention sutures
call for help
use a hemostat to keep airways open
insert replacemnt tube with an obturator
insert suction catheter for passage of air and to guide the insertion of replacement tube

61
Q

What should you do if the trach tube cannot be replaced after dislodgement

A

call for help
assess level of resp distress
position in semi-fowles
Cover the stoma with a sterile dressing and ventilate them with a BMV (bag-mask-ventilation)

Med Surg (35 decks)

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