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Upper Respiratory Tract Disorders Flashcards

1
Q

What are the most common causes of illness?

A

Upper Respiratory Tract Infections

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2
Q

Most Upper Respiratory Infections are what kind of infections?

A

Viral Infections

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3
Q

Upper Respiratory Tract Infections

A

Group of disorders characterized by inflammation and irritation of the mucous membranes of the nose and maybe eyes
-Acute or chronic

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4
Q

Rhinitis

A

the most frequent viral infection - common cold

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5
Q

S/S Rhinitis

A
  • Rhinorrhea
  • Nasal Congestion
  • Nasal discharge
  • Headache
  • General malaise, low grade fever, chills, and muscle aches
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6
Q

Risk Factors for Rhinitis

A
  • highly contagious
  • Adults avg 2-4 colds/year
  • Adult women are more susceptible
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7
Q

What is the most common treatment for Rhinitis?

A

Antihistamines

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8
Q

Side effects of Antihistamines

A

Sedation, dry mouth, GI upset, cardiac arrhythmias

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9
Q

What patients must be cautious w/ taking antihistamines?

A

Patients w/ asthma, urinary retention, hypertension, open-ended glaucoma, BPH

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10
Q

What other medications can be used to help w/ Rhinitis?

A
  • Nasal spray
  • Expectorants
  • Herbal medications
  • Bacterial infections may need antibiotics
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11
Q

How much fluids should the patient be encouraged to drink?

A

2-3 L

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12
Q

Who should not be encouraged to increase fluid intake?

A

Patients w/ kidney problems, CHF, or pulmonary edema

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13
Q

Rhinosinusitis = Sinusitis

A

Classified as Acute Bacterial or Viral rhinosinusitis

  • Acute < 4 weeks
  • Chronic >12 weeks
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14
Q

When is Rhinosinusitis considered recurrent?

A

3 or more episodes in 1 year

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15
Q

S/S of Rhinosinusitis

A
  • Purulent Nasal Drainage
  • Drainage
  • Cough
  • Chronic hoarseness
  • Chronic headaches
  • Hyposmia
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16
Q

Goals for Rhinosinusitis

A

Treat infection, shrink the nasal mucosa and relieve pain

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17
Q

Nursing Management for Rhinosinusitis

A
  • Adequate hydration
  • Steam inhalation 20-30 mins tid
  • Saline irrigation
  • Avoid smoking
  • Medications (Amoxicillin-Doxycycline)
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18
Q

Pharyngitis

A

Inflammation of the pharynx involving the back portion of the tongue, soft palate, and tonsils
-Acute or chronic

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19
Q

Who is more likely to develop pharyngitis?

A

< 25 years old
ages 5-15
teachers, singers, alcoholics

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20
Q

S/S of Pharyngitis

A
  • fiery-red pharyngeal membrane and tonsils
  • tonsils are swollen and flecked w/ white-purple exudate
  • NO cough
  • Tender cervical lymph nodes
  • Fever > 100.4, malaise, sore throat, vomiting, anorexia
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21
Q

What 2 diagnostic tests may be used for pharyngitis?

A

RADT- rapid antigen detecting testing

STCX- strep culture

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22
Q

RADT

A

Ask the patient to open their mouth, tilt head back, stick out tongue, then take qtip around the back of the throat and around the tonsils
-may gag/vomit

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23
Q

Bacterial Pharyngitis Medications

A
  • Penicillin (Choice treatment)
  • Nasal congestion = meds w/ ephedrine sulfate
  • Aspirin/acetaminophen for anti-inflammatory/analgesic
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24
Q

Laryngitis Causes

A

voice abuse or exposure to dust, chemicals, smoke, pollutants, or viruses that cause the common cold

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25
Laryngitis may be associated w/?
exposure to sudden temperature changes dietary deficiencies malnutrition immunosuppressed state
26
What is a patient likely to have w/ laryngitis?
Pharyngitis
27
S/S Laryngitis
- Aphonia- complete loss of voice - Hoarseness - Dry cough - Tickle in throat - Pain in throat worse in the morning
28
Nursing Management of Laryngitis
- Resting the voice - Avoid irritants - Hydration - Avoid decongestants - Bacterial = antibiotics
29
Obstructive Sleep Apnea (OSA)
Cessation of breathing during sleep, usually caused by repetitive upper airway obstruction
30
What characterizes OSA?
Recurrent episodes of upper airway obstruction and reduction in ventilation
31
What has to happen to be diagnosed w/ OSA?
the presence of at least 5 obstructive events per hour during sleep
32
Repetitive Apneic Events result in what?
hypoxia and hypercapnia which triggers a SNS response
33
Risk Factors for OSA
- Older/overweight women - Postmenopausal and overweight women - Obesity around the neck that narrows and compresses the upper airway
34
Manifestations of OSA
- Frequent and loud snoring w/ breathing cessation for 10 seconds or longer - Minimum of 5 episodes per hour - Followed by waking abruptly w/ a loud snort as the blood oxygen levels decrease
35
Classic S/S of OSA
- excessive daytime sleepiness - frequent nocturnal wakening - insomnia - loud snoring - morning headaches - personality changes - arrhythmias - enuresis
36
What is used to diagnose OSA?
- Clinical symptoms | - Polysomnographic findings
37
Treatment for OSA
- weight loss - avoidance of alcohol - avoidance of hypnotics/sedatives - oral appliances to reposition the mandible/tongue - non-invasive positive pressure ventilation
38
Non-invasive positive pressure ventilation machines
CP AP | BiP AP
39
CPAP
provides positive pressure to the airways throughout the respiratory cycle, preventing collapse -leak-proof mask keeps the alveoli open, preventing respiratory failure
40
Epistaxis (Nosebleeds)
Hemorrhage from the nose, caused by a rupture of tiny, distended vessels in the mucous membranes if any are of the nose
41
What is the most common site for nose bleeds?
Anterior septum
42
Risk Factors for Epistaxis
- local infections - dry nose - deformities - inhalation of illicit drugs - hypertension - tumor - coagulopathy - drugs
43
What to do when epistaxis occurs?
- Apply direct pressure - Sit upright w/ head tilted forward - Pinch soft outer portion of the nose for 5-10 mins continuously - May need cauterization - May need to be packed for 48 + hrs
44
What the nurse monitors w/ epistaxis?
- VS - Airway - Avoid vigorous exercise - Avoid forceful nose bleeds, straining, high altitudes, trauma, etc.. - For re-bleeds that can't be stopped call 911/ER
45
Fractures of the Nose
Usually result from direct assault
46
S/S of Fractured Nose
pain, bleeding, swelling, periorbital ecchymosis, nasal obstruction, deformity
47
What may clear fluid indicate w/ a fractured nose?
CSF leakage
48
CSF fluid tests positive for what?
glucose
49
How to diagnose a fracture?
Careful inspection of the deviations of the bone | -X-rays
50
What to do for an Uncomplicated fracture
- Analgesics - Ice - ENT follow up
51
What to do for a Complicated fracture
- Reduction ASAP - Drainage of hematoma - Antibiotics
52
Pneumonia
Infection of the lower respiratory tract caused by a variety of microorganisms
53
What is the leading cause of death for the elderly and the 8th leading cause of death in the world?
Pneumonia
54
Four Classifications of Pneumonia
- Community acquired pneumonia (CAP) - Hospital-acquired and ventilator associated pneumonia (HAP) - Health Care-associated pneumonia (HCAP) - Pneumonia in immunocompromised hosts
55
Community-Acquired Pneumonia
Occurs in either community dwelling person or within first 48 hours after hospitalization/institutionalization
56
Why would a person w/ CAP need hospitalization?
- altered mental status - respiratory rate > 30 - low blood pressure - tachycardia > 125 - fever > 104 - PaO2 < 70
57
Hospital-Acquired and Ventilator Associated Pneumonia (HAP/VAP)
The onset of pneumonia symptoms more than 48 hours after admission in patients who ahs no evidence of infection at the time of entry
58
VAP
type of HAP that is associated w/ endotracheal intubation and mechanical ventilation -occurs after the patient has been on the ventilator for at lest 48 hours
59
Health-Care Associated Pneumonia (HCAP)
Occurs in non-hospitalized patients who have extensive health care contact
60
Pneumonia in the Immunocompromised Host
Occurs in patients who use corticosteroids, take chemo, are nutritionally compromised, AIDS, long term life support on mechanical ventilators
61
Risk Factors for CAP
- Smoking/alcohol - Altered mental status - Malnutrition - Age > 65 - Previous episodes of pneumonia
62
HAP/VAP Risk Factors
- Malnutrition - Altered mental status - Hospital stays > 5 days - Immunosuppressive therapies/diseases - Prolonged > 48 hours of intubation/ventilation
63
S/S of Pneumonia
- Fever - Cough (productive/nonproductive - Dyspnea - Leukocytosis - Rigors - Tachypnea - Use of accessory muscles - Tachycardia - Chest pain - Fatigue - Anorexia
64
What is used to diagnose Pneumonia?
- history/physical - chest x-ray - blood cultures - sputum analysis
65
Pharmacological Treatment for Pneumonia
- Initial treatment is empiric antibiotics unless sputum culture and sensitivity results are available - Recommended treatment is minimum 5 days - Afebrile for 2 days before antibiotics are discontinued - HAP pneumonia is treated for 7-10 days - Antibiotics are ineffective in viral pneumonia
66
Oxygen Inhalation Therapy
Administration of oxygen at a concentration > that found in the environment atmosphere
67
What is the goal of oxygen inhalation therapy?
To prevent or correct hypoxia, which is decreased oxygen supply to the tissues
68
Signs of Hypoxia
- change in respiratory pattern - change in mental status - change in BP and HR - development of arrhythmias - diaphoresis - fatigue, drowsiness - dyspnea on exertion - cyanosis
69
What should be done when administering oxygen?
Oxygen should be moistened by passing through a humidification system to prevent drying of the mucous membranes of the respiratory tract
70
Low Flow Oxygen
patient breaths some room air along w/ oxygen through NC, simple mask, partial rebreather, and nonrebreather mask
71
High Flow Oxygen
a specific percentage of oxygen is delivered independent of the patients breathing -patients who require a constant, precise amount of oxygen through venturi masks, tracheostomy collars, face tents, trans tracheal catheters
72
Venturi Mask
Most reliable and accurate method for delivering precise concentrations of oxygen - should fit snugly - must understand how to convert % of oxygen w/ mask to liters
73
Liters to Percentages
1 L/min = 24% 2 L/min = 28% 3 L/min = 32% 4 L/min = 36%
74
What can be done to support the recovery from pneumonia?
- hydration - antipyretics - nutritional assessment - DVT prophylaxis
75
What can be done to prevent Pneumonia?
Pneumococcal vaccination has been demonstrated to prevent pneumonia in otherwise healthy populations by 90%
76
Who should receive a pneumonia vaccine?
- Anyone 2-64 w/ chronic disease - immunocompromised - > 65 years old - Smokers w/ asthma 19-64
77
How often should the vaccine be repeated if it was given prior to age 65?
every 5 years

Nursing (21 decks)

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