Upper Respiratory Problems Key Points Flashcards
Deviated Septum
Deflection of the normally straight nasal septum that is most commonly caused by trauma to the nose
Nasal Fracture
Nursing responsibilities include assessing the patient’s ability to breathe and ascertaining that hemorrhage and leakage to CSF are not present
Rhinoplasty
The surgical reconstruction of the nose
Performed for cosmetic reasons or to improve airway function when trauma or developmental deformities result in nasal obstruction
Epistaxis
Nosebleed
Epistaxis Treatment
Wide variety of causes
Treat with simple measures including direct pressure while sitting upright
Epistaxis Does Not Stop
Application of a vasoconstrictive agent, packing, or cauterization may be needed
Nasal Packing
Medical procedure inserts material into the nasal cavity to stop nose bleeds
Monitoring respiratory status is a critical nursing responsibility
Allergic Rhinitis
Reaction of the nasal mucosa to a specific allergen. Can be classified as seasonal, perennial, episodic, intermittent, or persistent
Seasonal Rhinitis
Caused by allergies to pollen from trees, flowers, grass, or weeds.
Perennial Rhinitis
From exposure to environmental allergens such as animal dander, dust mites, molds, and cockroaches
Allergic Rhinitis Initial Manifestations
Sneezing, watery/itchy eyes/nose, and thin nasal discharge that leads to congestion.
Allergic Rhinitis Drug Therapy
Uses oral H1-antihistamines, corticosteroids, decongestants, and leukotriene receptor antagonists (LTRAs). Intranasal drugs include antihistamines, anticholinergics, corticosteroids, cromolyn, and decongestants
Acute Viral Rhinopharyngitis
Common Cold
Infection of the upper respiratory tract caused by more than 200 different viruses
Common Cold Treatment
Rest, oral fluids, proper diet, antipyretics, and analgesics are recommended
Cold Season
Tell patients with chronic illness or a compromised immune system about measures to decrease the risk of getting a cold
Influenza
Typically has a n abrupt onset with systemic symptoms of chills, fever, anorexia, malaise, and generalized myalgia which can be accompanied by a headache, cough, rhinorrhea, and sore throat.
Malaise
General feeling of being sick that is hard to identify
Myalgia
Muscle pain
Rhinorrhea
Runny nose
Influenza Antivirals
Zanamivir (Relenza), oseltamivir (Tamiflu), and peramivir (Rapivab) are used to prevent and treat influenza A and B
Influenza Vaccination
2 types of flu vaccines are available: inactivated and live/attenuated
Advocate for use in all patients older than 6 months but especially those at high risk
Health care workers should be vaccinated to prevent transmission of influenza to high risk patients
Sinusitis
Develops when the exit from the sinuses is narrowed or blocked by inflammation or swelling of the mucosa. Accumulating secretions provide a rich medium for growth of bacteria, viruses, and fungi, all of which may cause infection
Acute Sinusitis
Typically begins within 1 week of an upper respiratory infection and lasts less than 4 weeks. Symptoms include significant pain over the affected sinus, purulent nasal drainage, nasal obstruction, congestion, fever, and malaise
Chronic Sinusitis
Lasts longer than 12 weeks and is a persistent infection usually associated with allergies and nasal polyps. Although there may be facial or dental pain, nasal congestion, and increased drainage, severe pain and purulent drainage are often absent
Sinusitis Treatment
Includes supportive care, antibiotics, and the use of ancillary medications to relieve symptoms, including oral or topical decongestants, nasal corticosteroids, analgesics, and saline nasal spray
Nasal Polyps
Causes obstruction and speech distortion, necessitating surgical removal
Acute Pharyngitis
Acute inflammation of the pharyngeal walls that may include the tonsils, palate, and uvula
Acute Pharyngitis Symptoms
Range in severity from a “scratchy throat” to pain so severe that swallowing is difficult. Both viral and streptococcal infections appear as a red and edematous pharynx, with or without patchy exudates, so appearance is not always diagnostic
Peritonsillar Abscess
A complication of acute pharyngitis, may threaten the airway if severe
Peritonsillar Abscess Treatment
Includes IV antibiotics, needle aspiration, drainage, or surgery
Laryngeal Polyps
Develop on the vocal cords because of vocal abuse or irritation
Most common sign is hoarseness
Laryngeal Polyps Treatment
Voice rest and hydration
Surgical removal may be indicated for large polyps, which can cause dyspnea
Acute Laryngitis
Inflammation of the voice box, most commonly caused by a viral
Main sign is hoarseness, which may be accompanied by total loss of voice
Acute laryngitis Treatment
Supportive
Focuses on resting the voice, acetaminophen for throat discomfort, cough suppressants, and increasing fluid intake
Airway Obstruction
Medical emergency!
Interventions to reestablish a patent airway include the obstructed airway (Heimlich) maneuver, cricothyroidotomy, ET intubation, and tracheostomy
Head and Neck Tumors
This category of tumors arises from the mucosal surfaces of the paranasal sinuses, oral cavity, or nasopharynx, oropharynx, or larynx
Head and Neck Cancer Symptoms
Early signs and symptoms of head and neck cancer vary with the tumor location. Difficulties in chewing, swallowing, moving the tongue or jaw, and breathing are typically late symptoms
Unintentional weight loss and pain are late symptoms
Head and Neck Cancer Treatment
Choice of treatment for head and neck cancer is based on exact location of tumor, disease stage, patient age and general health, cosmetic and functional (e.g., ability to talk, swallow, and chew) considerations, urgency of treatment, and patient choice
Head and Neck Cancer Stages I and II
Potentially curable with single-modality radiation therapy or larynx sparing surgery
Head and Neck Cancer Stages III and IV
Treated with various combinations of surgery, radiation, chemotherapy, and targeted therapy
Surgery typically involves a total laryngectomy with a permanent tracheostomy
After Radical Neck Surgery
The patient may be unable to take in nutrients through the normal route because of swelling, the location of sutures, or difficulty with swallowing.
Enteral feeding is used to maintain adequate nutrition
