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Perioperative Nursing - PRELIMS > Upper Respiratory Infections > Flashcards

Upper Respiratory Infections Flashcards

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1
Q

group of disorders characterized by inflammation and irritation of the nasal mucous membranes. •acute or chronic •nonallergic or allergic (AR)

A

Rhinitis

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2
Q

Rhinitis during pollen seasons

A

Seasonal Rhinitis

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3
Q

Rhinitis throughout the year

A

Perennial Rhinitis

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4
Q
  • changes in temperature
  • odors
  • infection
  • age
  • systemic disease
  • use of OTC/prescribed nasal decongestants
  • presence of foreign body
A

Rhinitis Etiology

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5
Q
  • pruritus of the nose
  • rhinorrhea (large amount of fluid drain from the nose)
  • sneezing
  • teary eyes
A

Symptoms of Rhinitis

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6
Q
  • nuts
  • shellfish
  • eggs
  • milk
  • penicillin
  • aspirin
  • drugs with potential allergic reaction
A

Allergens for Rhinitis

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7
Q

Symptomatic treatment

A

Rhinitis Medical Management

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8
Q
  • antihistamines (most common)
  • corticosteroid nasal spray
  • saline nasal spray (mild decongestant)
  • oral decongestants (for nasal obstruction)
  • antimicrobial agents (bacteria)
A

Rhinitis Pharmacologic therapy

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9
Q
  • avoid/reduce exposure to allergens/irritants
  • medication health teachings
  • hand hygiene technique
  • emphasize the importance of flu vaccination
  • keep head upright and spray quickly (spray away from the nasal septum)
  • close one nostril while spraying and wait for at least a minute to spray the other
  • blow and keep the nose clean before putting on any medication
A

Education

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10
Q
  • Most frequent viral infection and most common cause of non-allergic rhinitis.
  • Self limiting
A

Viral rhinitis (common cold)

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11
Q
  • nasal congestion
  • rhinorrhea
  • sneezing
  • sore throat
  • general malaise
  • nasal discharge
  • rhinorrhea
  • watery eyes
  • chills
  • sore throat
  • halitosis
A

Viral Rhinitis Manifestation

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12
Q

adequate fluid intake and rest

A

Viral rhinitis self care

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13
Q
  • antihistamines

- expectorants

A

Symptomatic therapy

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14
Q

Rebound rhinitis

  • overuse of topical nasal decongestants (ND)
  • ND should not be used for more than 3-5 days in a row
A

Rhinitis Medicamentosa

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15
Q
  • feeling congested shortly after using a nasal spray
  • strong urge to use the spray/drops more number of times than recommended
  • feeling that the ND doesn’t work well enough despite using it several x in a day
A

Rhinitis Medicamentosa

Clinical Presentation

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16
Q
  • turbinate hyperplasia
  • chronic sinusitis
  • septal perforation
A

Rhinitis Medicamentosa Complications

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17
Q

Permanent swelling of the nasal tissues

A

Turbinate Hyperplasia

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18
Q

Hole in the nasal septum (divides the nose)

A

Septal Perforation

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19
Q
  • hand hygiene

- cough etiquette

A

Rhinitis Medicamentosa

Educate about Self-care

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20
Q
  • stop nasal spray
  • oral steroids
  • intranasal steroid spray
  • oral antihistamine
  • surgery (turbine reduction/ septal perforation repair)
A

Rhinitis Medicamentosa Management

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21
Q
  • formerly called sinusitis
  • inflammation of the paranasal sinuses and nasal cavities
  • bacterial or viral
A

Rhinosinusitis

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22
Q

Acute (<4 weels)

  • Subacute (4-12 weeks)
  • Chronic (>12 weeks)
A

Rhinosinusitis classification

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23
Q
  • Acute bacterial rhinosinusitis (ABRS)

- Acute viral rhinosinusitis (AVRS)

A

Acute Rhinosinusitis classification

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24
Q
  • Purulent nasal drainage
  • Facial pain-pressure fullness
  • Colored/cloudy nasal discharge congestion
  • Blockage or stuffiness
  • Localized/Diffused headache
  • High fever (39C)
  • Symptoms occur 10 DAYS OR MORE after initial UR symptoms
A

ABRS Manifestations

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25
Q
  • Purulent nasal drainage
  • Colored/cloudy nasal discharge congestion
  • Blockage or stuffiness
  • Localized/Diffused headache
  • Symptoms occur FEWER THAN 10 DAYS POST ONSET of UR symptoms
  • DOES NOT worsen
A

AVRS Manifestations

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26
Q
  • History and PA
  • CT scan for complications
  • Flexible endoscopic culture techniques
  • Swabbing of sinuses
  • Transillumination
A

Rhinosinusitis Assessment and Dx Findings

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27
Q

To shrink the nasal mucosa, relieve pain, and treat infections

A

Rhinosinusitis Medical Management Goal

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28
Q
  • Intranasal lavage (Viral)
  • Decongestants (common antiviral medication) and antihistamines (Viral)
  • Intranasal corticosteroids (Viral/Bacterial)
  • 5-7 days course of antibiotics (Bacterial)
A

Rhinosinusitis Medical Management

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29
Q

Educate about self care

  • air humidification
  • warm compress to relieve pain
  • avoid swimming (dirty water and chlorine), diving, air travel (pressure affects sinuses), and tobacco
  • health teaching on the use of medications
  • watch out for complications
A

Rhinosinusitis Nursing Management

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30
Q
  • Accompanied by nasal polyps
  • Lasts 12 weeks or longer with 2 or more of the following symptoms
    • mucopurulent drainage
    • nasal obstruction
    • facial pain-pressure fullness
    • hyposmia (decreased sense of smell)
A

Chronic Rhinosinusitis

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31
Q

diagnosed when 4 or more episodes of ABRS occur/year

A

Recurrent Acute Rhinosinusitis

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32
Q
  • History and Physical Assessment
  • Imaging Studies:
    • X-ray
    • Sinoscopy
    • Ultrasound
    • CT scanning
    • MRI
A

Chronic Rhinosinusitis Assessment and Diagnostics

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33
Q

golden standard in determining the presence of sinusitis

A

CT Scan

34
Q
  • OTC nasal sprays
  • analgesics
  • decongestants
  • antibiotics
  • corticosteroids nasal spray
A

Chronic Rhinosinusitis Medical Management

35
Q

Functional Endoscopic Sinus Surgery (FESS)

  • minimally invasive technique used to restore sinus ventilation and normal function
  • computer guided surgery
  • Chronic rhinosinusitis does NOT improve during surgery for more than 3 months.
A

Chronic Rhinosinusitis Surgical Management

36
Q
  • blow nose gently and use tissue to remove nasal drainage
  • increase fluid intake
  • apply local heat
  • elevate head of the bed
  • health teachings on medications
A

Chronic Rhinosinusitis Nursing Management

37
Q

sudden and painful inflammation of the pharynx, including the

  • posterior third of the tongue
  • soft palate
  • tonsils
A

Pharyngitis

38
Q
  • Acute

- Chronic

A

Pharyngitis Classifications

39
Q
  • spreads easily through droplets of coughs,s neezes, and unclean hands
A

Acute Pharyngitis

40
Q

Viral infection

A

Most common cause of Acute Pharyngitis

41
Q
  • adenovirus
  • influenza virus
  • herpes simplex virus
  • Epstein-Barr virus
A

Viruses that cause acute pharyngitis

42
Q

Group A Streptococcus (GAS) which then coins the term for the infection, Streptococcal Pharyngitis (Strep Throat)

A

Bacteria that causes Acute Pharyngitis

43
Q
  • Fiery-red pharyngeal membrane and tonsils enlarged
  • Tender cervical lymph nodes
  • No cough
  • Fever
  • Malaise
  • Sore throat (appears 1-5 days after exposure)

*Uncomplicated viral infection subsides 3-10 days onset

A

Acute Pharyngitis Symptoms

44
Q
  • determine the cause (bacterial/viral)
  • GAS: Initiate antibiotics
  • Rapid Streptococcal Antigen Test (RSAT)
  • Throat Culture (most dependable)
A

Acute Pharyngitis Diagnostic Findings

45
Q

Viral: supportive measures
Nutrition
- liquid/soft diet
- cool beverages, warm liquids, flavored frozen food

Bacterial: antimicrobial agents

  • Penicillin (drug of choice)
  • Analgesics
  • Cephalosporins or Macrolides if allergic to Penicillin
A

Acute Pharyngitis Medical Management

46
Q
  • Symptomatic management
  • Bed rest
  • Saline gargle (throat irrigation)
  • ice collar
  • Not sharing eating utensils
  • Replace old toothbrush
A

Acute Pharyngitis Nursing Management

47
Q

Persistent inflammation of the pharynx

A

Chronic Pharyngitis

48
Q

General thickening and congestion of the pharyngeal mucous membrane

A

Hypertrophic

49
Q

Late stage of type 1 (Membrane is thin, whitish, glistening, and at times wrinkled)

A

Atrophic

50
Q

Numerous swollen lymph follicles on the pharyngeal wall

A

Chronic Granular

51
Q
  • Constant sense of irritation/fullness in the throat
  • Intermittent post nasal drip
  • Sore throat
A

Chronic Pharyngitis Manifestations

52
Q
  • relieve the symptoms

- Avoid exposure to irritants

A

Chronic Pharyngitis Medical Management

53
Q

Tonsillectomy

A

Chronic Pharyngitis Surgical Management

54
Q
  • Nasal sprays

- Antihistamine decongestant

A

Chronic Pharyngitis Pharmacologic Therapy

55
Q

Avoid

  • tobacco
  • second hand smoke
  • exposure to cold, environmental/occupational pollutants
  • Minimize exposure to pollutants (use disposable masks)
  • High fluid intake
  • Gargling warm saline solution
  • Lozenges
A

Chronic Pharyngitis Nursing Management

56
Q

Inflammation of the tonsils (two oval-shaped pads of tissue at the back of the throat)

A

Tonsilitis

57
Q

Confused with pharyngitis

A

Acute Tonsilitis

58
Q

Less common and may be mistaken for disorders like allergy, asthma, and rhinosinusitis.

A

Chronic Tonsilitis

59
Q
  • Inflammation of the adenoids (near the eustachian tube) caused by infection.
  • Frequently accompanied by acute tonsilitis
A

Adenoiditis

60
Q

Group A Betahemolytic Streptoccocus (GABHS)

A

Common bacteria that causes adenoiditis

61
Q

Epstein-Barr virus

A

Common virus that causes adenoiditis

62
Q
  • Sore throat
  • Fever
  • Snoring
  • Difficulty swallowing
  • Frequent swallowing (bleeding may be present)
  • Nasal obstruction
  • Hard to swallow and smell
A

Tonsilitis Clinical Manifestations

63
Q
  • Mouth breathing (foul smelling)
  • Earache
  • Draining ears
  • Frequent colds
  • Bronchitis
  • Voice impairment
  • Noisy respiration
A

Adenoiditis Clinical Manifestations

64
Q
  • Thorough Physical Examination and history
  • Specimen culture
  • Audiometric assessment 9for recurring otitis media)
A

Tonsilitis and Adenoiditis Assessment and Diagnostic Findings

65
Q
  • High fluid intake
  • Analgesics
  • Salt water garfles
  • Rest
A

Supportive Measures

66
Q
  • Penicillin (1st line)

- Cephalosporins

A

Antibiotics for bacterial infection

67
Q
  • Tonsillectomy

- Adenoidectomy

A

Surgical management

68
Q

Immediate Postoperative Care

  • Continuous monitoring
  • Prone position. head turned sideways
  • Maintain oral airaway until gag reflex returns
  • Apply ice collar
  • Antibiotics to relieve pain
A

Tonsilitis and Adenoiditis Nursing Management

69
Q
  • Understanding signs and symptoms of hemorrhage (it is noraml to have 8-10 days bleeding)
  • Health teaching about pain medications
  • Full course antibiotics as prescribed
  • Warm saline solution
  • Soft diet
  • Maintain good hydration
  • Avoid milk products (promotes thich mucus production (hard to remove))
  • Vomiting within 24 hours
  • Avoid heavy lifting for 10 days
A

Tonsilitis and Adenoiditis Self-care Education

69
Q
  • Understanding signs and symptoms of hemorrhage (it is noraml to have 8-10 days bleeding)
  • Health teaching about pain medications
  • Full course antibiotics as prescribed
  • Warm saline solution
  • Soft diet
  • Maintain good hydration
  • Avoid milk products (promotes thich mucus production (hard to remove))
  • Vomiting within 24 hours
  • Avoid heavy lifting for 10 days
A

Tonsilitis and Adenoiditis Self-care Education

70
Q
  • Also called quinsy
  • A bacterial infection which is a complication of untreated strep throat or tonsilitis
  • Most common suppurative (pus formation) complication of sore throat
  • Collection of purulent exudate between the tonsillar capsule and the surrounding tissues
A

Peritonsilar Abscess

71
Q
  • Severe sore throat
  • fever
  • Trismus (inability to open the mouth due to the inflammed muscles lying laterally at the tonsils)
  • Drooling
  • Odynophagia (painful swallowing)
  • Dysphagia (difficulty swallowing)
  • Otalgia (ear pain)
A

Peritonsilar Abscess Manifestations

72
Q
  • Abscess aspiration
  • Intraoral ultrasound
  • Transcutaneous cervical ultrasound
A

Peritonsilar Abscess Diagnostic Tests

73
Q
  • Antimicrobial agents
  • Corticosteroid therapy
  • Penicillin (prescribed early)
A

Peritonsilar Abscess Management

74
Q
  • Tonsillectomy (Poor candidates of needle aspiration)
  • Needle aspiration (Decompresses abscess and perform best sitting down)
  • Incision and drainage of abscess
A

Peritonsilar Abscess Surgical Management

75
Q
  • Preoperative nursing care
  • Maintain hydration status (cool and room temp)
  • Monitor the patient
  • Provide adequate nutrition
  • Sitting upright
  • gentle gargling post op 1-2 hours interval for 24-36 hours
A

Peritonsilar Abscess Nursing Management

76
Q
  • Inflammation of the larynx and often associated with pharyngitis and rhinitis
  • Result of: voice abuse. exposure to pollutants, and as part of URI
  • Caused by a virus same as cold and pharyngitis
A

Laryngitis

77
Q 
- Hoarseness
_ Aphonia (loss of voice)
- Severe cough
- Dysarthria (Difficulty speaking)
- Sore throat (worsens at night)
- URI
- Shortness of breath
- Painful swallowing
- Painful speaking
A

Laryngitis Manifestations

78
Q
  • Rest voice
  • Avoid irritants
  • Rest
  • Inhaling cool steam
  • Antibiotics
A

Laryngitis Medical Management

79
Q
  • Resting of voice
  • Maintain a well-humidified environment
  • Adequate fluid intake
  • Health teachings on prescribed medications
  • Follow up care
A

Laryngitis Nursing Management

Perioperative Nursing - PRELIMS (3 decks)

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