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Pathophysiology and Pharmacology > Upper Respiratory Problems > Flashcards

Upper Respiratory Problems Flashcards

1
Q

Deviated Septum

A

CROOKED NASAL SEPTUM, APPEARS BENT

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2
Q

Causes of a DEVIATED SEPTUM

A

CAUSED BY TRAUMA; ALSO CONGENITAL DISPROPORTION IN THE SIZE OF
THE SEPTUM VS. THE NOSE

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3
Q

SYMPTOMS OF A DEVIATED SEPTUM

A

OBSTRUCTION, NASAL EDEMA, DRYNESS OF THE
NASAL MUCOSA WITH CRUSTING/EPISTAXIS; IF SEVERE CAN CAUSE BLOCK DRAINAGE OF SINUS CAVITIES RESULTING IN INFECTIONS (SINUSITIS)

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4
Q

MANAGEMENT OF A DEVIATED SEPTUM

A

CONTROL OF NASAL ALLERGIES (ALLERGIC RHINITIS);

SEVERE SYMPTOMS REQUIRE NASAL SEPTOPLASTY (REALIGNMENT)

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5
Q

CAUSES OF A NASAL FRACTURE

A

TYPICALLY CAUSED BY TRAUMA

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6
Q

NASAL FRACTURE COMPLICATIONS

A

EPISTAXIS, AIRWAY OBSTRUCTION, MENINGEAL TEARS, COSMETIC DEFORMITY

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7
Q

CLASSIFICATIONS OF NASAL FRACTURES

A

UNILATERAL, BILATERAL OR COMPLEX

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8
Q

ASSESSMENTS OF NASAL FRACTURES

A

ASSESS ABILITY TO BREATH THROUGH EACH NOSTRIL, NOT EDEMA, BLEEDING,
HEMATOMA; MAY BE ECCHYMOSIS UNDER ONE/BOTH EYES ‘RACCOON EYES;
INSPECT FOR SEPTAL DEVIATION, HEMORRHAGE, OR CLEAR DRAINAGE (CHECK CLEAR DRAINAGE FOR CSF)

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9
Q

NASAL FRACTURES NURSING MANAGEMENT

A

REDUCE EDEMA, PREVENT COMPLICATIONS,

EMOTIONAL SUPPORT; APPLY ICE; MAY REQUIRE SURGERY FOR REALIGNMENT (SEPTOPLASTY, RHINOPLASTY)

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10
Q

NURSING MANAGEMENT: NASAL SURGERY (RHINOPLASTY, SEPTOPLASTY)

A

• OUTPATIENT PROCEDURE, REGIONAL ANESTHESIA
• INSTRUCT PATIENT TO NOT TAKE ASPIRIN-CONTAINING DRUGS OR NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) FOR 2 WEEKS BEFORE SURGERY.
• TISSUE ADDED OR REMOVED; USE OF PLASTIC IMPLANTS, NOSE LENGTHEN OR SHORTENED
• POST OP: MAY HAVE NASAL SPLINTS AND OR PACKING
• IMMEDIATE POSTOPERATIVE PERIOD INCLUDES ASSESSMENT OF RESPIRATORY STATUS, PAIN MANAGEMENT, AND OBSERVATION OF THE
SURGICAL SITE FOR HEMORRHAGE AND EDEMA.
• TEACHING IS IMPORTANT BECAUSE THE PATIENT MUST BE ABLE TO DETECT COMPLICATIONS AT HOME.

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11
Q

EPISTAXIS

A

Nosebleed

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12
Q

CAUSES OF EPISTAXIS

A

TRAUMA, FOREIGN BODIES, NASAL SPRAY ABUSE, STREET DRUG USE, ANATOMICAL MALFORMATION, ALLERGIC RHINITIS, TUMOURS

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13
Q

How does HTN affect epistaxis

A

HTN IS NOT A CAUSE BUT DOES MAKE CONDITION MORE DIFFICULT TO CONTROL

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14
Q

DRUG CONTRAINDICATIONS

A

ASPIRIN, NSAIDS, WARFARIN AND CONDITIONS PROLONGING BLEEDING TIME OR ALTERING PLATELET COUNTS PREDISPOSE PATIENTS TO EPISTAXIS

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15
Q

NURSING AND COLLABORATIVE MANAGEMENT: EPISTAXIS

A
  • KEEP THE PATIENT QUIET.
  • PLACE THE PATIENT IN A SITTING POSITION, LEANING FORWARD, OR IF NOT POSSIBLE, IN A RECLINING POSITION WITH HEAD AND SHOULDERS ELEVATED.
  • APPLY DIRECT PRESSURE BY PINCHING THE ENTIRE SOFT LOWER PORTION OF THE NOSE FOR 10 TO 15 MINUTES.
  • APPLY ICE COMPRESSES TO THE FOREHEAD AND HAVE THE PATIENT SUCK ON ICE.
  • APPLY DIGITAL PRESSURE IF BLEEDING CONTINUES.
  • OBTAIN MEDICAL ASSISTANCE IF BLEEDING DOES NOT STOP.
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16
Q

ALLERGIC RHINITIS

A

REACTION OF THE NASAL MUCOSA TO ALLERGENS

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17
Q

TYPES ALLERGENS THAT CAUSE ALLERGIC RHINITIS

A
  • SEASONAL: POLLEN – TREES, GRASSES, FLOWERS

* PERENNIAL: PET DANDER, DUST MITES, MOLDS, COCKROACHES

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18
Q

CLINICAL MANIFESTATIONS OF ALLERGIC RHINITIS

A
  • NASAL CONGESTION; SNEEZING; WATERY, ITCHY EYES AND NOSE; ALTERED SENSE OF SMELL; THIN, WATERY NASAL DISCHARGE
  • NASAL TURBINATES APPEAR PALE, BOGGY, AND SWOLLEN
  • CHRONIC EXPOSURE TO ALLERGENS: HEADACHE, CONGESTION, PRESSURE, POSTNASAL DRIP, NASAL POLYPS
  • PATIENT MAY COMPLAIN OF COUGH, HOARSENESS, SNORING, OR RECURRENT NEED TO CLEAR THE THROAT
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19
Q

NURSING AND COLLABORATIVE MANAGEMENT: ALLERGIC RHINITIS

A

• IDENTIFY AND AVOID TRIGGERS OF ALLERGIC REACTIONS

DRUG THERAPY (TABLE 29-2)
• NASAL SPRAYS, LEUKOTRIENE RECEPTOR ANTAGONISTS (LTRAS), ANTIHISTAMINES, AND DECONGESTANTS TO MANAGE SYMPTOMS
• INTRANASAL CORTICOSTEROID AND CROMOLYN SPRAYS (DECREASE INFLAMMATION LOCALLY)
• PROVIDE INSTRUCTIONS ON PROPER USE OF NASAL INHALERS (THEY CAN CAUSE REBOUND EFFECT FROM PROLONGED USE).

  • IMMUNOTHERAPY (“ALLERGY INJECTIONS”) MAY BE USED IF DRUGS ARE NOT TOLERATED OR ARE INEFFECTIVE.
  • INVOLVES CONTROLLED EXPOSURE TO SMALL AMOUNTS OF A KNOWN ALLERGEN THROUGH FREQUENT (AT LEAST WEEKLY) INJECTIONS WITH THE GOAL TO DECREASE SENSITIVITY
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20
Q

ACUTE VIRAL RHINITIS

A

COMMON COLD

21
Q

ACUTE VIRAL RHINITIS IS CAUSED BY

A

VIRUSES THAT INVADE THE UPPER RESPIRATORY TRACT; SPREAD BY AIRBORNE DROPLET SPRAYS EMITTED WHILE BREATHING, TALKING, SNEEZING, OR COUGHING OR BY DIRECT HAND CONTACT

22
Q

RISK FACTORS ACUTE VIRAL RHINITIS

A 
WINTER MONTHS (MORE TIME INDOORS), CHILLING,
FATIGUE, EMOTIONAL STRESS, IMMUNOCOMPROMISE
23
Q

CLINICAL MANIFESTATION OF ACUTE VIRAL RHINITIS

A

TICKING IRRITATION, SNEEZING OR DRYNESS OF NOSE FOLLOWED BY RHINORRHEA, NASAL CONGESTION, WATERY EYES, ELEVATED TEMPERATURE, HEADACHE, MALAISE

24
Q

THREE VIRUSES OF INFLUENZA

A

A, B, C

25
Q

CLINICAL MANIFESTATIONS OF INFLUENZA

A
  • ONSET ABRUPT; SYSTEMIC SYMPTOMS OF COUGH, FEVER, MYALGIA, HEADACHE, SORE THROAT
  • IN UNCOMPLICATED CASES, SYMPTOMS SUBSIDE WITHIN 7 DAYS; OLDER ADULTS MAY EXPERIENCE PERSISTENT WEAKNESS OR LASSITUDE.
26
Q

MOST COMMON COMPLICATION OF INFLUENZA

A

PNEMONIA

27
Q

TREATMENT OF INFLUENZA

A
  • SUPPORTIVE CARE, SYMPTOMS RELIEF – REST, FLUIDS, NUTRITION, ANTIPYRETICS, ANALGESICS
  • ANTIVIRALS I.E. TAMIFLU (TO PREVENT OR DECREASE SYMPTOMS)
28
Q

NURSING AND COLLABORATIVE MANAGEMENT OF INFLUENZA

A
  • HANDWASHING

* INFLUENZA VACCINATION

29
Q

SINUSITIS IS DUE TO WHAT?

A

BLOCKAGE OF THE NASAL PASSAGE (INFLAMMATION), SECRETIONS ACCUMULATE – IDEAL ENVIRONMENT FOR THE GROWTH OF VIRUSES, BACTERIA, FUNGI

30
Q

EXAMPLES OF ACUTE SINUSITIS

A

URTI, ALLERGIC RHINITIS, SWIMMING, DENTAL MANIPULATION

31
Q

EXAMPLES OF CHRONIC SINUSITIS

A

PERSISTENT INFECTION R/T ALLERGIES, NASAL POLYPS

32
Q

CLINICAL MANIFESTATIONS OF ACUTE SINUSITIS

A

SIGNIFICANT PAIN, PURULENT NASAL DRAINAGE, NASAL OBSTRUCTION, CONGESTION, FEVER, MALAISE, SINUSES TENDERNESS, HEADACHES, PAIN WITH CHANGE OF POSITION

33
Q

CLINICAL MANIFESTATIONS OF CHRONIC SINUSITIS

A

FACIAL PAIN, NASAL CONGESTION, INCREASED DRAINAGE; SEVERE PAIN AND PURULENT DRAINAGE ARE OFTEN ABSENT
• SYMPTOMS MAY MIMIC THOSE SEEN WITH ALLERGIES
• DIFFICULT TO DIAGNOSE BECAUSE SYMPTOMS MAY BE NONSPECIFIC; PATIENT IS RARELY FEBRILE

34
Q

NURSING AND COLLABORATIVE MANAGEMENT OF SINUSITIS

A
  • ENVIRONMENTAL CONTROL
  • APPROPRIATE DRUG THERAPY – ANTIBIOTICS, DECONGESTANTS, NASAL STEROIDS
  • PATIENT INTERVENTIONS
    • INCREASE FLUID INTAKE
    • NASAL CLEANING TECHNIQUES AND IRRIGATION
  • PERSISTENT COMPLAINTS MAY REQUIRE ENDOSCOPIC SURGERY
35
Q

TYPES OF SINUSES

A
  • FRONTAL
  • ETHMOIDAL
  • SPHENOIDAL
  • MAXILLARY
36
Q

TYPES OF OBSTRUCTION OF THE NOSE AND

PARANASAL SINUSES

A
  • POLYPS

- FOREIGN BODIES

37
Q

POLYPS

A

BENIGN MUCOUS MEMBRANE MASSES

38
Q

POLYPS CLINICAL MANIFESTATIONS

A

NASAL OBSTRUCTION, NASAL DISCHARGE

(USUALLY CLEAR MUCUS), SPEECH DISTORTION

39
Q

POLYPS TREATMENTS

A

TOPICAL STEROIDS REDUCE INFLAMMATION; SURGICAL REMOVAL

40
Q

FOREIGN BODIES OBSTRUCTING THE NOSE OR PARANASAL SINUSES CLINICAL MANIFESTATIONS

A
  • INORGANIC MAY GO UNDETECTED

* ORGANIC PRODUCE LOCAL INFLAMMATION, NASAL DISCHARGE

41
Q

FOREIGN BODIES OBSTRUCTING THE NOSE OR PARANASAL SINUSES TREATMENTS

A

SHOULD BE REMOVED THROUGH ROUTE OF ENTRY (SNEEZE WITH OPPOSITE NOSTRIL CLOSED, BLOWING NOSE)

42
Q

WHAT SHOULD NOT BE DONE WITH FOREIGN BODIES OBSTRUCTING THE NOSE OR PARANASAL SINUSES?

A

DO NOT IRRIGATE OR PUSH OBJECT UP NOSE (RISK FOR ASPIRATION OR AIRWAY OBSTRUCTION)

43
Q

ACUTE PHARYNGITIS

A
  • ACUTE INFLAMMATION OF THE PHARYNGEAL WALLS
  • MAY INCLUDE TONSILS, PALATE, AND UVULA
  • CAN BE CAUSED BY A VIRAL (MOST COMMON), BACTERIAL (“STREP THROAT”), OR FUNGAL INFECTION (CANDIDIASIS)
44
Q

CLINICAL MANIFESTATIONS OF ACUTE PHARYNGITIS

A
  • RANGE FROM “SCRATCHY THROAT” TO SEVERE PAIN
  • APPEARANCE NOT ALWAYS DIAGNOSTIC; CULTURES NEEDED
  • RED THROAT +/- EXUDATES
  • DIFFERENTIATE FROM CANDIDA (WHITE PATCHES)
45
Q

NURSING AND COLLABORATIVE MANAGEMENT OF ACUTE PHARYNGITIS

A
  • INFECTION CONTROL
  • SYMPTOMATIC RELIEF – INCREASED FLUIDS, ANALGESICS, COOL SOFT FOODS, AVOID ACIDIC JUICES
  • PREVENTION OF SECONDARY COMPLICATIONS (TREAT BACTERIAL STREP THROAT)
46
Q

PERITONSILLAR ABSCESS

A

A COMPLICATION OF ACUTE PHARYNGITIS OR ACUTE TONSILLITIS WHEN BACTERIAL INFECTION INVADES ONE OR BOTH TONSILS

47
Q

DANGERS OF PERITONSILLAR ABSCESS

A

TONSILS MAY ENLARGE SUFFICIENTLY TO THREATEN AIRWAY PATENCY

48
Q

PERITONSILLAR ABSCESS CLINICAL MANIFESTATIONS

A

PATIENT EXPERIENCES A HIGH FEVER, LEUKOCYTOSIS, AND CHILLS

Pathophysiology and Pharmacology (17 decks)

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