upper resp problems Flashcards
influenza vs cold
***
symptom onset
fever
myalgia
fatigue
HA
flu is more severe, higher fever, body aches
feel like you been hit by a truck
can cause pneumonia
influenza
tx and prevention ***
rest, po fluids, antipyretics
antiviral meds (oseltamivir/Tamiflu)
*start within 48 hours of symptoms
flu vaccine: all people 6 mon and older
*have a egg free vaccine now
*flu vaccine cant give you flu
pharngitis
what we get
s/s
diagnosis ***
can be viral, bacterial, fungal
*strep throat
viral pharngitis is 90% of cases
s/s:
sore throat
red/edematous pharynx
bacterial signs: temp >100.4, anterior cervical lymph node enlargement, absence of cough, tonsil/pharyngeal exudate
diagnosis: exam, or if bacterial with rapid strep/throat culture
pharyngitis tx ***
antibiotics for bacterial
ibuprofen/Acetaminophen for pain
warm salt water gargles
cool/bland liquids (popsickles)
recurrent strep may require tonsillectomy
tonsillectomy management
usually outpatient
monitor for bleeding
symptom may be freq swallowing (feeling blood)
tx: cool fluids (tx symptoms)
laryngitis
cause
s/s
diagnosis
tx
commonly viral (can be environmental, overuse of voice, chemical exposure)
s/s:
hourseness, aphonia, cough, tickle in throat, may have low grade fever
diagnosis : exam
tx: vocal rest, ↑fluid intake, steam inhalation (boil water on stove)
*dont whisper will strain voice
tracheostomy
what it is
safety***
surgical opening in trachea (new airway)
*in report as for type/size
monitor cuff inflation: max 20-25cm H20
*elevated cuff pressure could cause necrosis
always keep extra tube and obturator at bedside
tracheostomy
care and suction
speech with one***
suction if:
ordered
ask for it
sounds lik its needed (rhonchi)
must be uncuffed
hold finger over top and speak
if stable may get passy muir valve
larynx cancer
s/s
asymptomatic until its really bad
first s/s may be hoarseness
lasting >2weeks should be evalulated
unilateral throat/ear pain
persistent cough
LATE sign:
pain
dysphagia
↓mobility of tongue
airway obstruction
larynx cancer
diagnosis
management
diagnosis:
laryngoscopy
biopsy
CT or MRI
PET scan
tx:
radiation/chemo
surgical tx:
vocal stripping/cordectomy
partial or total laryngectomy
partial laryngectomy ***
portion of larynx and vocal cords removes
normal flow of airway tract
(temporary tracheostomy after surgery)
no swallowing issues postop
voice changes
total laryngectomy ***
throat is not attached to mouth or nose anymore
new opening and exit for trach
laryngectomy management : preop teaching ***
resp assessment and teaching
nutritional assessment
expectations for voice after surgery (change with partial)
financial and work concerns
geet baseline vitals bc they will be NPO for a week
laryngectomy nursing care ***
post op risk:
pain, communication, bleeding, infection, VTE, RR, atelectasis
care is similar to trach (humidified air is key
communication
often NPO for 7 days
self care total laryngectomy ***
stoma bib for warmth and protection
tub baths, or shower with water down low
no swimming
medical alert bracelet
psychosocial support
