Upper Respiratory Flashcards
Where is the divide between the upper and lower respiratory tract?
The Carina-this is where the trachea forks in two
Periorbital bruising (raccoon eyes) is suggestive of what?
Basilar skull fx
What should patients with recent epistaxis avoid for 48 hours?
Alcohol and hot shower
What is another word for the common cold?
Nasopharyngitis
What are peak months of flu season?
Dec–Feb
What is the most common type of flu?
Type A
What is incubation period for flu?
1—4 days
When is peak transmission time for flu?
1 day before onset of symptoms and continuing 5–7 days after onset of symptoms
What is biggest differences between flu and cold?
Flu=abrupt onset vs cold=gradual
Flu=fever, headache, myalgia, fatigue vs cold=mostly head, chest symptoms only
When is the best time to get a flu vax?
Sept, Oct
Takes 2 weeks to have full protection
At what age can inactived flu vaccine be given yearly?
Live attenuated vax?
6 months
Live vax can start at 2 yo
What are the two types of flu vaccines?
Inactivated (Trivalent and Quadrivalent)
This is given as shot to most people.
Safe for pregnant, immunocompromised, elderly, babies over 6 months.
Live attenuated
Given as nose spray
NOT safe for very young (<2) or very old (>50) or pregnant
What is suffix to most antiviral meds?
—MIVIR
When should antiviral meds be started for treatment of flu?
Within 2 days of onset
What are the 4 classifications of sinusitis and what is timing for each?
ACUTE: Starts within 1 week of URI and lasts up to 4 weeks.
SUBACUTE: 4–12 weeks
RECURRENT: 4x a year
CHRONIC: Lasting longer than 12 weeks.
What is s/sx of pharyngitis? What is usually the cause?
S/Sx: Fever, swollen lymph nodes in neck, exudate from throat, no cough.
Scratchy, painful throat with difficulty swallowing.
Cause is 90% viral, 10% bacterial (usually strep)
What is ABx of choice for strep throat?
PCN
If allergic, erythromycin or clindamycin.
Most contagious until ABx onboard for 24–48 hours.
What are s/sx of laryngitis?
Tingling, burning in throat
Clearing throat
Hoarseness
Voice loss
Low grade fever
What is most important in treatment of laryngitis?
Rest the voice
Not even whisper, this puts an increased strain on voice box.
Biggest risk factors for head and neck cancer?
Smoking, alcohol excess (for those over 50)
HPV (for those under 50)
What may head/neck cancer feel like?
Sore throat
Hoarseness
Lump in throat
–That won’t go away–
What is key to patient survival in head/neck cancer?
Early detection
Must do physical assessment of mouth, ears, nose, neck.
What are some chemo meds used for head/neck cancers?
Cisplatin
Carboplatin
5-fluorouracil
Docetaxel
Paclitaxel
Methotrexate
Bleomycin
What is a targeted therapy med used to treat late stage head/neck cancer?
Cetuximab
Remember: targeted therapy prevents cancer cells from growing by targeting specific proteins within them.
What is a really big part of treating patients with head/neck cancer?
Nutrition
These patients will already be malnourished before they start treatment.
What is a big problem for a patient with head/neck cancer?
Swallowing
They are at a high risk for aspiration.
Thickened liquids or pureed foods in High Fowlers.
What is the most common type of tracheostomy tube used in health care settings?
Cuffed
This allows the tube to stay anchored in place. Used on vent
In an emergency setting, when ET tube placement is impossible, what can be done?
Emergency cricothyroidotomy
What are the 2 types of suctioning for trach tubes?
Sterile glove and catheter
In-line suctioning (this isn’t a sterile procedure)
How often should the inner cannula of trach be cleaned?
Every shift
What position should patient be placed in if there is an accidental decannulation of the trach?
Semi-Fowlers
What are some options if there is an accidental decannulation of trach?
- Call a rapid (always 1st)
- Assess patient
- Use hemostat and obturator to replace with new trach (always have extra at bedside)
- OR-Insert suction catheter to guide and thread the trach over the catheter
- If unable to replace trach: Cover stoma with sterile dressing and BVM over nose and mouth. If there has been a laryngectomy, don’t BVM over mouth/nose but over stoma.
