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2.0 - ABSN NUR 334 Respiratory > Upper Respiratory > Flashcards

Upper Respiratory Flashcards

1
Q

Epistaxis (nosebleed) Causes

A

-Irritation, trauma, infection, foreign bodies, tumors
-Systemic disease
Hypertension/blood dyscrasias
-Anticoagulant therapy
-Systemic treatment
Chemotherapy/anticoagulants

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2
Q

Epistaxis Care Anterior - How to treat?

A

-Position upright/lean forward
-Reassure/calm
-Lateral pressure
-Ice
-Nasal tampons
-Teaching:
Avoid blowing nose

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3
Q

Epistaxis Care Posterior - How to Treat?

A

-Emergency/hospitalization
-Posterior packing (balloon catheters)
-Assess respiratory status
-Humidification, oxygen, bedrest, pain control, oral care
-Teaching:
Saline spray/humidification
Avoid aspirin/NSAIDS
Avoid strenuous activities

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4
Q

How to stop an anterior nose bleed

A

Lean forward-
Pinch to press both sides of your nose firmly against the septum.
-Hold continuously for 10 minutes.

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5
Q

What is Obstructive Sleep Apnea?

A

-obstructive apneas
-hypopneas
-respiratory effort-related arousals r/t repetitive
collapse of upper airway during sleep

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6
Q

OSA: Risk Factors

A
  • Increased age
  • Male
  • Obesity
  • Nasopharyngeal structural abnormalities
  • Smoking (less est. risk factor)
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7
Q

OSA: Signs/Symptoms

A
  • Daytime sleepiness
  • Snoring, choking, gasping during sleep
  • Morning headaches r/t lack of sleep
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8
Q

OSA: Physical Exam

A
  • Obesity

- Large neck &/or waist circumference

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9
Q

OSA: Signs associated with complications

A
  • Motor vehicle crashes
  • Neuropsychiatric dysfunction
  • Hypertension
  • Heart failure
  • Metabolic syndrome
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10
Q

OSA: Diagnostic Test

A

Polysomnography (Gold Standard)

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11
Q

OSA Treatment: Positive Airway Pressure Therapy

A

CPAP (most common)
Continuous Positive Airway Pressure

-Simplest to use, works well & is cheapest
-Only maintains upper airway patency
-Adherence estimated 20-40% non use
(patient teaching opportunity)

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12
Q

What is CPAP?

A

-For spontaneously breathing patients to improve
oxygenation
-For nocturnal ventilation to prevent upper airway
obstruction in patients with OSA

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13
Q

What is BiPAP (noninvasive)?

A 
-2 pressures
    one during inhalation – one during exhalation
-Nocturnal ventilation in patients with:
   - neuromuscular disease
   - chest wall deformity
   - OSA & COPD
-To prevent intubation
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14
Q

OSA Treatment

A
  • Weight reduction & exercise
  • Avoid alcohol and smoking
  • Sleep on side
  • Improved sleep hygiene
  • Oral appliances (mild to moderate)
  • Surgery
    • Tissue removal or shrinkage
    • Jaw repositioning
    • Implant
    • Tracheostomy
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15
Q

What are the two types of trachs?

A 
-Shiley trach
   Disposable inner cannula
   Cuff
   Obturator
-Jackson trach
   Reusable inner cannula
   No cuff
   Obturator
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16
Q

Tube Dislodgement & Accidental Decannulation: What to do

A

-Obturator taped at bedside AAT
-Insert obturator into outer cannula
-Extend neck & open tissue; insert outer
cannula/obturator
-Remove obturator immediately
-Check bilateral breath sounds
-Secure trach

17
Q

Acute Pharyngitis: Defined

A

Inflammation of pharynx or tonsils

18
Q

Viral Pharyngitis - s/s

A 
-Viral difficult to distinguish viral from 
   Bacterial
- DO NOT GIVE ANTIBIOTICS
-Viral symptoms
   - rhinorrhea
   - cough
   - oral ulcers
   - ulcers
   - diarrhea
   - conjunctivitis
19
Q

Viral Pharyngitis Treatment

A
  • Local soothing treatments of warm/cool fluids &
    analgesics/antipyretics
  • DO NOT GIVE ANTIBIOTICS
20
Q

Bacterial Pharyngitis - how to test for it

A

-10% of adult & 30% of childhood pharyngitis is caused
by group A strep
-Rapid streptococcal antigen testing is indicated in all
patients w/o overt viral features

21
Q

Bacterial Pharyngitis Treatment

A
  • Treat with:
    • antibiotics
    • Local soothing treatments (warm/cool fluids) &
      analgesics/antipyretics
22
Q

Fungal pharyngitis (Thrush)

A
  • Caused by Candida albicans
23
Q

Fungal Pharyngitis Treatment

A
  • Treatment nystatin “swish & swallow” or “swish & spit”
  • Local soothing treatments (warm/cool fluids) &
    analgesics/antipyretics
24
Q

Streptococcal pharyngitis - S/S

A

-Sudden onset of sore throat with tonsillar hypertrophy
& erythema
-Tender lymphadenopathy & fever

25
Q

Streptococcal Pharyngitis Treatment

A
  • Treat with antibiotics
  • Local soothing treatments (warm/cool fluids) &
    analgesics/antipyretics
26
Q

Head and Neck Cancer Causes

A

-Tobacco use causes 85% of head & neck cancers
-Men > women; most often > 50 years old
-< 50 years old, often associated with HPV infection
-Most have locally advanced disease at time of
diagnosis

27
Q

Head and Neck Cancer Treatment

A
  • Surgery
  • Radiation therapy
  • Chemotherapy – or combination of all
28
Q

Head & Neck Cancers: Types of Surgical Therapy

A
  • Vocal cord stripping
  • Laryngectomy
  • Tracheostomy
  • Lymph node removal
  • Neck disection
29
Q

Artificial larynx (electrolarynx) - how it works

A
  • most common way to restore oral communication
  • electronic, battery-powered device produces
    vibrations transmitted through the neck/cheek/plastic
    tube into the oral cavity. Sound is shaped by
    movements of the tongue, jaw, lips, and pharynx.
30
Q

Tracheoesophageal (TE) voice restoration

A
  • most comparable to normal laryngeal speech in
    quality, fluency, and ease of production
  • TE speakers more satisfied with their speech
  • improved ability to communicate over the phone
  • fewer limitations in their interactions with others
  • include earlier use of the voice prosthesis for voice
    rehabilitation
  • the procedure may be done with a total laryngectomy
    procedure
31
Q

Esophageal speech - what is it & advantages/disadvantages

A
  • vibratory source is the pharyngoesophageal (PE)
    segment
  • oral air that is introduced into the esophagus and
    expelled past the PE
  • Advantages:
    • Hands-free & no extra devices
  • Disadvantages:
    • Length of time that it takes to learn the technique
    • Quality of speech not as good as other options
32
Q

What is a Radical Neck Dissection?

A
  • Removal of all tissue on side of neck - from mandible
    to clavicle.
  • Includes muscle, nerve, salivary gland & major blood
    vessels.
33
Q

Radical Neck Dissection - Post OP Care

A
  • Airway maintenance
  • Trach collar w/ O2 & humidification
  • Pulmonary toilet
  • Secretions – oral (tonsil tip/Yankauer) & tracheal
  • Normal: Blood-tinged sputum first 1-2 days
  • Stoma care
  • Pain management
  • Nutrition – feeding tube placement, may start before
    surgery
  • Physical therapy
  • Speech therapy

2.0 - ABSN NUR 334 Respiratory (8 decks)

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