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Nursing > Upper Respiratory Tract Disorders > Flashcards

Upper Respiratory Tract Disorders Flashcards

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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
Q

Laryngitis may be associated w/?

A

exposure to sudden temperature changes
dietary deficiencies
malnutrition
immunosuppressed state

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26
Q

What is a patient likely to have w/ laryngitis?

A

Pharyngitis

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27
Q

S/S Laryngitis

A
  • Aphonia- complete loss of voice
  • Hoarseness
  • Dry cough
  • Tickle in throat
  • Pain in throat worse in the morning
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28
Q

Nursing Management of Laryngitis

A
  • Resting the voice
  • Avoid irritants
  • Hydration
  • Avoid decongestants
  • Bacterial = antibiotics
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29
Q

Obstructive Sleep Apnea (OSA)

A

Cessation of breathing during sleep, usually caused by repetitive upper airway obstruction

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30
Q

What characterizes OSA?

A

Recurrent episodes of upper airway obstruction and reduction in ventilation

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31
Q

What has to happen to be diagnosed w/ OSA?

A

the presence of at least 5 obstructive events per hour during sleep

32
Q

Repetitive Apneic Events result in what?

A

hypoxia and hypercapnia which triggers a SNS response

33
Q

Risk Factors for OSA

A
  • Older/overweight women
  • Postmenopausal and overweight women
  • Obesity around the neck that narrows and compresses the upper airway
34
Q

Manifestations of OSA

A
  • 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
Q

Classic S/S of OSA

A
  • excessive daytime sleepiness
  • frequent nocturnal wakening
  • insomnia
  • loud snoring
  • morning headaches
  • personality changes
  • arrhythmias
  • enuresis
36
Q

What is used to diagnose OSA?

A
  • Clinical symptoms

- Polysomnographic findings

37
Q

Treatment for OSA

A
  • weight loss
  • avoidance of alcohol
  • avoidance of hypnotics/sedatives
  • oral appliances to reposition the mandible/tongue
  • non-invasive positive pressure ventilation
38
Q

Non-invasive positive pressure ventilation machines

A

CP AP

BiP AP

39
Q

CPAP

A

provides positive pressure to the airways throughout the respiratory cycle, preventing collapse
-leak-proof mask keeps the alveoli open, preventing respiratory failure

40
Q

Epistaxis (Nosebleeds)

A

Hemorrhage from the nose, caused by a rupture of tiny, distended vessels in the mucous membranes if any are of the nose

41
Q

What is the most common site for nose bleeds?

A

Anterior septum

42
Q

Risk Factors for Epistaxis

A
  • local infections
  • dry nose
  • deformities
  • inhalation of illicit drugs
  • hypertension
  • tumor
  • coagulopathy
  • drugs
43
Q

What to do when epistaxis occurs?

A
  • 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
Q

What the nurse monitors w/ epistaxis?

A
  • 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
Q

Fractures of the Nose

A

Usually result from direct assault

46
Q

S/S of Fractured Nose

A

pain, bleeding, swelling, periorbital ecchymosis, nasal obstruction, deformity

47
Q

What may clear fluid indicate w/ a fractured nose?

A

CSF leakage

48
Q

CSF fluid tests positive for what?

A

glucose

49
Q

How to diagnose a fracture?

A

Careful inspection of the deviations of the bone

-X-rays

50
Q

What to do for an Uncomplicated fracture

A
  • Analgesics
  • Ice
  • ENT follow up
51
Q

What to do for a Complicated fracture

A
  • Reduction ASAP
  • Drainage of hematoma
  • Antibiotics
52
Q

Pneumonia

A

Infection of the lower respiratory tract caused by a variety of microorganisms

53
Q

What is the leading cause of death for the elderly and the 8th leading cause of death in the world?

A

Pneumonia

54
Q

Four Classifications of Pneumonia

A
  • Community acquired pneumonia (CAP)
  • Hospital-acquired and ventilator associated pneumonia (HAP)
  • Health Care-associated pneumonia (HCAP)
  • Pneumonia in immunocompromised hosts
55
Q

Community-Acquired Pneumonia

A

Occurs in either community dwelling person or within first 48 hours after hospitalization/institutionalization

56
Q

Why would a person w/ CAP need hospitalization?

A
  • altered mental status
  • respiratory rate > 30
  • low blood pressure
  • tachycardia > 125
  • fever > 104
  • PaO2 < 70
57
Q

Hospital-Acquired and Ventilator Associated Pneumonia (HAP/VAP)

A

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
Q

VAP

A

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
Q

Health-Care Associated Pneumonia (HCAP)

A

Occurs in non-hospitalized patients who have extensive health care contact

60
Q

Pneumonia in the Immunocompromised Host

A

Occurs in patients who use corticosteroids, take chemo, are nutritionally compromised, AIDS, long term life support on mechanical ventilators

61
Q

Risk Factors for CAP

A
  • Smoking/alcohol
  • Altered mental status
  • Malnutrition
  • Age > 65
  • Previous episodes of pneumonia
62
Q

HAP/VAP Risk Factors

A
  • Malnutrition
  • Altered mental status
  • Hospital stays > 5 days
  • Immunosuppressive therapies/diseases
  • Prolonged > 48 hours of intubation/ventilation
63
Q

S/S of Pneumonia

A
  • Fever
  • Cough (productive/nonproductive
  • Dyspnea
  • Leukocytosis
  • Rigors
  • Tachypnea
  • Use of accessory muscles
  • Tachycardia
  • Chest pain
  • Fatigue
  • Anorexia
64
Q

What is used to diagnose Pneumonia?

A
  • history/physical
  • chest x-ray
  • blood cultures
  • sputum analysis
65
Q

Pharmacological Treatment for Pneumonia

A
  • 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
Q

Oxygen Inhalation Therapy

A

Administration of oxygen at a concentration > that found in the environment atmosphere

67
Q

What is the goal of oxygen inhalation therapy?

A

To prevent or correct hypoxia, which is decreased oxygen supply to the tissues

68
Q

Signs of Hypoxia

A
  • change in respiratory pattern
  • change in mental status
  • change in BP and HR
  • development of arrhythmias
  • diaphoresis
  • fatigue, drowsiness
  • dyspnea on exertion
  • cyanosis
69
Q

What should be done when administering oxygen?

A

Oxygen should be moistened by passing through a humidification system to prevent drying of the mucous membranes of the respiratory tract

70
Q

Low Flow Oxygen

A

patient breaths some room air along w/ oxygen through NC, simple mask, partial rebreather, and nonrebreather mask

71
Q

High Flow Oxygen

A

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
Q

Venturi Mask

A

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
Q

Liters to Percentages

A

1 L/min = 24%
2 L/min = 28%
3 L/min = 32%
4 L/min = 36%

74
Q

What can be done to support the recovery from pneumonia?

A
  • hydration
  • antipyretics
  • nutritional assessment
  • DVT prophylaxis
75
Q

What can be done to prevent Pneumonia?

A

Pneumococcal vaccination has been demonstrated to prevent pneumonia in otherwise healthy populations by 90%

76
Q

Who should receive a pneumonia vaccine?

A
  • Anyone 2-64 w/ chronic disease
  • immunocompromised
  • > 65 years old
  • Smokers w/ asthma 19-64
77
Q

How often should the vaccine be repeated if it was given prior to age 65?

A

every 5 years

Nursing (21 decks)

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