Upper Respiratory - Quiz #1 Flashcards by Christi Bolin

Upper Respiratory Tract Infections

Common Cold, Sinusitis, Epiglottitis, Influenza, Scarlet Fever

How well did you know this?

Not at all

Perfectly

over 200 causative organisms

Rhinovirus

How well did you know this?

Not at all

Perfectly

transmitted through respiratory droplets-inhaled or touching contaminated objects
-prevent spread with hand and respiratory hygiene

Common Cold

How well did you know this?

Not at all

Perfectly

s/s- congestion, rhinorrhea, possibly sore throat or cough from nasal drainage, mild fever, HA

Common Cold

How well did you know this?

Not at all

Perfectly

Treatment for Common Cold

Self limiting illness

How well did you know this?

Not at all

Perfectly

Symptomatic/supportive care for common cold

humidifier, Tylenol, decongestants

How well did you know this?

Not at all

Perfectly

No antibiotic….. Why?
What illness?

Antibiotics do not cure viral infections and are usually for secondary bacterial infections such as sinusitis, otitis media, or tracheitis.
Prophylactic use in high risk patients

**Common Cold

How well did you know this?

Not at all

Perfectly

-Viral or bacterial
-Acute or chronic
-Secondary to upper respiratory infection or allergies (block sinus drainage)
s/s: headache, sinus pressure, facial pain, congestion, fever, sore throat

Sinusitis

How well did you know this?

Not at all

Perfectly

Treatment for Sinusitis

Decongestants, analgesics
** Antibiotics ONLY if bacterial

How well did you know this?

Not at all

Perfectly

-viral
-young children age 3 months to 3 years
PATHO:
-Begins as upper respiratory condition with nasal congestion and cough
-Inflammation of larynx and subglottic area-swelling and exudate cause obstruction
-Seal like bark
-Stridor while breathing on inspiration

Laryngotracheobronchitis

AKA: CROUP

How well did you know this?

Not at all

Perfectly

s/s: worse at night
-barking cough
-Hoarse voice
-Inspiratory stridor

Laryngotracheobronchitis

AKA: CROUP

How well did you know this?

Not at all

Perfectly

Treatment:
-Cool, moisturized air from a humidifier or steam from a hot shower
-Usually self-limited-full recovery occurs in several days

Laryngotracheobronchitis

AKA: CROUP

How well did you know this?

Not at all

Perfectly

-Acute infection with rapid onset
-MEDICAL EMERGENCY (airway occlusion)
* Haemophilus influenzae B (HIB)
-children age 3-7 years
-

Epiglottitis

How well did you know this?

Not at all

Perfectly

Patho:
-Swelling of the larynx, supraglottic area, and epiglottis
-Epiglottis becomes round, red ball that blocks the airway

Epiglottitis

How well did you know this?

Not at all

Perfectly

s/s:
-Toxic child: Fever, sore throat
-no cough
-child refuses to swallow, drooling
-inspiratory stridor b/c of swelling in airway
-anxious and pale, muffled voice
-tripod position with the mouth open-struggling to breathe

Epglottitis

How well did you know this?

Not at all

Perfectly

What should you (RN) never do to a patient with Epiglottitis?

CAUTION: NEVER try to visualize throat- May cause reflex spasm and total airway obstruction

How well did you know this?

Not at all

Perfectly

Treatment includes:
-Oxygen
-Antibiotics (if bacterial)
-Intubation or tracheotomy if necessary

*HINT- Tripod position

Epiglottitis

How well did you know this?

Not at all

Perfectly

There are three groups (Type A, B, and C)
-vaccinations are highly recommended

Influenza

How well did you know this?

Not at all

Perfectly

s/s:
-sudden, acute onset
-cold symptoms+fever, fatigue, muscle/body aches

Influenza (FLU Symptoms)

How well did you know this?

Not at all

Perfectly

Complications:
-secondary viral or bacterial pneumonia

Influenza

How well did you know this?

Not at all

Perfectly

Treatment includes:
-supportive care
-antivirals
-must be started within 48 hours of onset
-may reduce symptom severity and length of illness
-also helps prevent spread to others

Influenza

How well did you know this?

Not at all

Perfectly

What are the symptoms differences between the cold vs Flu?

Flu symptoms include symptoms present in colds in addition to:
-aching muscles/joints
-fever
-chills
-high fever

How well did you know this?

Not at all

Perfectly

Caused by group A B-hemolytic Streptoccocus (S. pyogens)

Typical strawberry tounge

Scarlet Fever

How well did you know this?

Not at all

Perfectly

s/s:
- Strawberry tongue
- fine, non-itchy rash on the chest, neck, groin, and thighs
- fever, sore throat

Scarlet Fever

How well did you know this?

Not at all

Perfectly

What is the treatment for Scarlet Fever?

Antibiotics - b/c it is a bacterial infection

What are three lower respiratory illnesses?

1. Bronchiolitis 2. Pneumonia 3. Tuberculosis

-caused by RSV (respiratory syncytial virus) -primarily affects infants and may be severe; now seeing more RSV in adult patients -transmitted by oral droplets, worse in winter -predisposing factors: familial history of asthma, exposure to cigarette smoke

Bronchiolitis

Patho: Inflammation (edema, increased secretions, & bronchospasm) necrosis of mucosa of small bronchi and bronchioles resulting in airway obstruction

Bronchiolitis

s/s: -increasing dyspnea and wheezing (bronchi constriction) -Rapid, shallow breathing -chest retractions, nasal flaring -copious secretions -cough, rales -fever, malaise

Bronchiolitis

Treatment: -supportive care (O2 intubation) -some require hospital admission for respiratory support -monitor ABGs (show O2 in blood, show CO2 level in blood) -frequent suctioning -RSV-immunoglobulin serum or palivizumab for some infants -O2 level low on venous

Bronchiolitis

Primary acute infection or secondary to another process (aspiration)

Pneumonia

Classification of pneumonias is based on:

-causative agent: viral, bacterial, fungal -anatomical location of infection: throughout both lungs, or consolidated in one lobe.

Pathophysiologic changes: changes in interstitial tissue, alveolar septae, alveoli Epidemiologic data: Nosocomial (hospital acquired) or community-acquired Spread by: Respiratory droplets

Pneumonia

Community-based pneumonia, often in healthy young adults Caused by Streptococcus pneumoniae

Lobar Pneumonia

Path: Infection localized in one or more lobes -inflammation and vascular congestion -exudate forms in alveoli -Exudate contains fibrin and forms consolidation that can be seen on x-ray -Exudate may produce RUSTY SPUTUM -Infection may spread to pleural cavity---empyema (area of pus in pleural cavity) **empyema inhibits expansion

Lobar Pneumonia

s/s: -sudden onset System signs- high FEVER with chills, fatigue, leukocytosis (elevated in WBC) -Dyspnea, tachypnea , tachycardia -Pleural pain, pleural friction rub -Rales/rhonchi (coarse bubbling sound (due to fluid, pus, exudate) -Productive cough (yellow or rust colored) -Restlessness, confusion, and agitation (decreased level of O2, starting to go septic)

Lobar Pneumonia

-A form of atypical pneumonia -Opportunistic infection -Patients with AIDS or cancer or severely immunocompromised are at greater risk -FUNGUS that attaches to cells in alveoli -necrosis and diffuse interstitial inflammation -Avleoli fill with exudate and fungi

Pneumocystis Carinii Pneumonia

Caused by Leionella pneumophila bacterium -thrives in warm, moist environments-air conditioning, hot tubs - Often nonsocomial (get in hospital) infection

Legionnaires Disease

Patho: -cause sever congestion and consolidation -Necrosis in the lung -Possibly fatal

Legionnaires Disease

s/s: SEVER pneumonia symptoms

Legionnaires Disease

Caused by: Myobacterium tuberculosis

Tuberculosis (TB)

How is TB transmitted?

-oral droplets from persons with ACTIVE infection

Primarily affects the lungs; other organs may also be invaded (brain, kidneys, spine) *Hard to kill/eradicate

Tuberculosis

TB risk factors:

-people living in crowded conditions -immunodeficiency -malnutrition -alcoholism -conditions of war -chronic disease -HIV infection

When does TB not spread? When does TB spread?

Not spread when dormant Spreads when active

TB- secondary infections

Occurs when client's cell-mediated immunity is impaired because of: -stress -malnutrition -HIV infection -Age

TB-secondary infection

-Mycobacteria that have been dormant for years become active, begin to reproduce and infect lung -Cavitation occurs- Large areas of necrosis form and erode into blood vessels and bronchi -This is the active TB stage, which can spread to others

s/s: (when Active) -anorexia -malaise and fatigue -weight loss -afternoon low grade fever -night sweats -progressively worsening cough -hemopytosis (coughing up blood)

Primary tuberculosis is?

Asymptomatic

PPD tuberculin

skin test for TB -results (looking for firm swelling at site of administration)

Who cannot use a PPD test for TB accuracy

Patients who have had the BCG vaccine or have had previous positive tests

Active TB infection tests

Acid fast sputum test: 3 separate early morning sputum samples, preferably 3 consecutive days Chest x-ray or CT

Long-term treatment with a combination of 3 drugs for 6-12 months -isoniazid -Rifampin -Ethambutol

Tuberculosis treatment

What illness will have a sputum culture that is usually negative after 1 to 2 months of treatment

What is essential to eradicate infection and prevent antibiotic resistance

COMPLIANCE of TB treatments

Where is BCG vaccine widely used

North America

TB treatment recommendations

-contacts of the patient be given prophylactic isoniazid for 1 year and receive tuberculin testing

Obey gooey babies with copious secretions

Bronchiolitis

Stop breathing

Apnea

Rare abnormal breathing pattern

Cheyne- Stokes Respirations

Abnormal pattern of breathing characterized by complete irregularity of breathing, with irregular pauses and increasing periods of Apnea

Ataxic Breathing

Abnormally slow breathing rate

Bradypnea

Normal, good, healthy and unlabored breathing

Eupnea

Adventitious breath sound heard on auscultation of the lungs

Friction Rub

Taking in deeper breaths than usual, which increases the volume of air in the lungs

Hyperpnea

Fast, deep breaths that occur in response to metabolic acidosis

Kussmaul’s Respirations

Discomfort when breathing while lying down flat; Common in people with some types of heart and lung conditions

Orthopnea

Abnormal lung sounds characterized by discontinuous clicking or rattling sounds

Rales

“Large airway sounds” continuous gurgling or bubbling sounds typically heard during both inhalation and exhalation

Rhonchi

Harsh vibrating noise when breathing, caused by and obstruction of the windpipe or larynx

Stridor

Rapid breathing

Tachypnea

Breathe with a whistling or rattling sound in the chest, as a result of an obstruction in the air passages

Wheezes

Sensation of shortness of breath that awakens the patient, often after 1-2 hours of sleep, and is usually relieved in the upright position

Paroxysmal nocturnal dyspnea

Bluish discoloration of the skin resulting from poor circulation or inadequate oxygen

Cyanosis

Excessive carbon dioxide in the bloodstream, typically caused by inadequate respiration

Hypercapnea

Low levels of oxygen in the blood

Hypoxemia