Upper Respiratory

Question 1

what are some symptoms of nasal fx ?

what to check for if you have a nasal fracture?

Answer 1

Presence of edema, bleeding/hematoma, ecchymosis, black eye, assess ability to breathe through nares

inspect for csf and perform glucose check

Question 2

nasal fracture management what should you do?

Answer 2

Administer acetaminophen over ASA salicylic due to bleeding.

Advise no hot showers or ETOH for 48 hr to prevent swelling

Question 3

epistaxis can be caused by which over the counter medications?

Answer 3

NSAIDs such as ibuprofen and Salicylic Acids.

Question 4

for epistaxis you will apply pressure by pinching lower portion of the nose for how long?
if bleeding continues what are a few things you should do?

when using nasal packing to decrease bleeding you should monitor for?

Answer 4

10-15

apply digital pressure, seek medical attention, application of a vasoconstriction agent (lidocaine, cocaine via nasal pledget) or cauterization via silver nitrate stick

respiratory status and level of consciousness

Question 5

allergic rhinitis symptoms are

what are some ways to manage allergic rhinitis?

Answer 5

Sneezing, itching, watery eyes, rhinorrhea and moderate congestion

Avoid triggers and use antihistamine, intranasal corticosteroids, and leukotriene receptor antagonists. Avoid triggers mold, smoke, mites,dust, pets, etc

Question 6

Viral rhinitis is what?

How is this transmitted?

how long can virus survive on inanimate object

how long should nasal decongestant for rhinitis

Answer 6

adenovirus of upper respiratory tract. rhinitis- stuffy nose

airborne droplets emitted with talking sneezing, coughing, and hand to hand contact

up to 3 days

no more than 3 days to prevent rebound effect

Question 7

What are the 2 classifications of influenza ?

How long does the flu last?

Those with the flu should be monitored for what most common complication?

How can you tell you have the flu

Answer 7

A and B

7

Pneumonia

Blood tests or nasopharyngeal throat swab

Question 8

What antivirals can you administer to treat and prevent the flu?

Answer 8

Relenza and tamiflu for maximum benefit initiate administer within 2 days of onset of symptoms to shorten the course.

Question 9

acute sinusitis develops from
what?

how can you treat acute sinusitis?

if acute sinusitis last longer than 7 days what should you use?

Answer 9

upper respiratory infection, allergic rhinitis, swimming, dental manipulation

control of allergens, drug therapy, same stuff you treat allergic rhinitis with.

antibiotics (amoxicillian which is first line)
bactrim or erythromycin

Question 10

A few things one should do if they have sinusitis are?

Answer 10

Take hot shower, use a steam inhaler, vaporizer, saline nasal sprays, bedside humidifiers, avoid exposure to smoke, report temp of 100.4 or greater.

Question 11

what are a few advantages of tracheostomy vs endotracheal tube

Answer 11

easier breathing, increased comfort, patient can eat and speak, more secure airway

Question 12

What are the steps of Tracheostomy Care?

Answer 12

1. Explain procedure to patient.
2. Use tracheostomy care kit or collect necessary sterile equipment NOTE:
   Clean rather than sterile technique is used at home.
3. Position patient in semi-Fowler’s position.
4. Assemble needed materials on bedside table next to patient.
5. Wash hands. Put on goggles and clean gloves.
6. Auscultate chest sounds. If rhonchi or coarse crackles are present, suction the patient if unable to cough up secretions. Remove soiled dressing and clean gloves.
7. Open sterile equipment, pour sterile H2O or normal saline into two compartments of sterile container or two basins, and put on sterile gloves. NOTE: Hydrogen peroxide (3%) is no longer
   recommended unless an infection is present. If it is used, rinse the inner cannula and skin with sterile H2O or normal saline afterward to prevent trauma to tissue.
8. Unlock and remove inner cannula, if present. Many tracheostomy tubes do not have inner cannulas. Care for these tubes includes
   all steps except for inner cannula care.
9. If disposable inner cannula is used, replace with new cannula. If a nondisposable cannula is used:
   • Immerse inner cannula in sterile solution and clean inside and
   outside of cannula using tube brush or pipe cleaners.
   • Rinse cannula in sterile solution. Remove from solution and
   shake to dry.
   • Insert inner cannula into outer cannula with the curved part downward, and lock in place.
10. Remove dried secretions from stoma using 4 × 4 gauze pad soaked in sterile water or saline. Gently pat area around the stoma dry. Be sure to clean under the tracheostomy faceplate,
    using cotton swabs to reach this area.