- Best time - morning upon arising, 1 hr before meals or 2-3 hrs after meals - Stop if pain occurs - Provide mouth care

URTI & LRTI Flashcards by Nathalie Jorge Marasigan

Humidifies, warms & filters inspired air

NOSE

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Air-filled cavities within the hollow bones that surround the nasal
passages, provide resonance during speech

SINUSES

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Located behind the oral & nasal cavities

Divided into the nasopharynx, oropharynx & laryngopharynx
Passageway for both the respiratory & digestive tracts

PHARYNX

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Located above the trachea & just below the pharynx at
the root of the tongue
* Commonly called the “VOICE BOX”
* Contains 2 pairs of vocal cords, the false & true cords

LARYNX

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Valsalva Maneuver

GLOTTIS

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Leaf-shaped elastic structure that is attached along
one end to the top of the larynx
* Prevents the food from entering the tracheo-bronchial
tree by closing over the glottis during swallowing

EPIGLOTTIS

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Where gas exchange takes place
(diffusion of oxygen and carbon dioxide)

ALVEOLI

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Respiratory disease risk factors

Smoking
Use of chewing tobacco
Allergies
Frequent respiratory illnesses
Chest injury
Surgery
Exposure to chemicals & environmental pollutants
Family history of infectious disease
Geographic residence & travel to foreign countries

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Diagnostic study:
Information on the anatomic location &
appearance

CHEST X-RAY (CXR) FILM (RADIOGRAPH)

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Obtained by expectoration or tracheal suctioning
identify organisms or abnormal cells

SPUTUM SPECIMEN

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visual examination of the larynx, trachea & bronchi with a fiber-optic
bronchoscope

BRONCHOSCOPY

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What are the respiratory treatments?

Chest Physiotherapy
Deep Breathing Exercises
Cough Exercises
Nebulizer
Oral Suctioning
ET Suctioning

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Contraindications for Chest Physiotherapy (CPT)

Increased respiratory distress
Dx of fractures
Chest incisions

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Nursing Care for CPT

Best time - morning upon arising, 1 hr
before meals or 2-3 hrs after meals
Stop if pain occurs
Provide mouth care

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a hemorrhage from the nose, is caused by the rupture of tiny, distended vessels in the mucous membrane of any area of the nose.

Epistaxis (Nosebleed)

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The location of the number of arterial anastomoses between vessels arising from branches of the internal and external carotid arteries.

anterior nasal septum

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series of anastomoses are formed into a triangular shape and known as

Kiesselbach’s plexus.

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The area of the nasal septum involved is commonly referred to as

Little’s area.

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Bleeding not arising from Kiesselbach’s plexus, referred to as _________ may originate from any part of the remainder of the nasal cavity or nasopharynx.

posterior epistaxis

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Nursing Management for Epistaxis

Monitor vital signs
Provide tissues and an emesis basin to allow the patient to expectorate any excess blood
Assure the patient in a calm, efficient manner that bleeding can be controlled can help reduce anxiety
IV infusions of crystalloid solutions (normal saline)
Cardiac and pulse oximetry monitoring

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The most common facial fracture and the
most common fracture in the body

Nasal fracture

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Nursing Management for Nasal Fracture

Ice application and keep the head elevated - to decrease swelling
Mouth gargle - to moisten the mucous membranes and to reduce the odor and taste of dried blood in the oropharynx and nasopharynx.
Use of analgesic agents such as acetaminophen or NSAIDs (i.e., ibuprofen or naproxen)
Cotton pledgets removal - inspects the mucosa for lacerations or a septal hematoma
Instruct the patient to avoid sports activities for 6 weeks.

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Obstruction of the larynx because of edema is a serious condition that may be fatal without swift, decisive intervention.

Laryngeal Obstruction

Swelling of the laryngeal mucous membranes may close off the opening tightly, leading to ________

Hypoxia

A cessation of breathing (apnea) during sleep usually caused by repetitive upper airway obstruction.

Obstructive Sleep Apnea (OSA)

Nursing Management for Laryngeal Obstruction

- Emergent maneuvers to clear an airway obstruction - Tracheotomy is necessary - Administration of subcutaneous epinephrine and a corticosteroid - Ice may be applied to the neck - Pulse oximetry monitoring

Clinical manifestations of Laryngeal Obstruction

- Decreased o2 sat - Use of accessory muscles as manifested by retractions in the neck or abdomen during inspirations

Clinical manifestations of Obstructive Sleep Apnea (OSA)

- Excessive daytime sleepiness - Frequent nocturnal awakening - Insomnia - Loud snoring/morning headaches - Intellectual deterioration - Personality changes/irritability - Impotence - Systemic hypertension - Dysrhythmias - Cor pulmonale - Polycythemia - Enuresis

A complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.

ATELECTASIS

Nursing Management for Atelectasis

- Deep breathing exercises (incentive spirometry). - Removing obstructions in your lung (usually using bronchoscopy). - Physical therapy to help promote expansion of your lungs. - Inhaled medications to open up your airways (bronchodilators).

An infection that affects one or both lungs. It causes the air sacs, or alveoli, of the lungs to fill up with fluid or pus. Bacteria, viruses, or fungi may cause this disease

PNEUMONIA

(also called pneumococcus bacteria) is the most common cause.

Streptococcus pneumoniae

TYPES OF PNEUMONIA

1. VIRAL PNEUMONIA 2. PRIMARY ATYPICAL PNEUMONIA (MYCOPLASMA PNEMONIAE) 3. BACTERIAL PNEUMONIA 4. ASPIRATION PNEUMONIA

SIGNS AND SYMPTOMS of PNEUMONIA

high grade fever Chills Chest pain Grating sound Rusty Sputum Rales or crackles on auscultation Dullness or hyperesonance

Dx test for pneumonia

x-ray gram-staining sputum culture & sensitivity

Nursing Management for Pneumonia

- Increase Fluids - Chest Physiotherapy - Chest splinting - Incentive Spirometer - Increase calorie & CHON diet - Small frequent meals - Rest & activity as tolerated - Administer antibiotics as Rx – Penicillin DOC - Administer antipyretics, bronchodilators, cough suppressants, mucolytic agents & expectorants as Rx - Handwashing & proper disposal of secretions

It is caused by a lung injury leading to extravascular lung fluid - interstitial edema - respiratory acidosis & hypoxemia - the CXR film shows interstitial edema

ADULT RESPIRATORY DISTRESS SYNDROME (ARDS)

Signs and Symptoms of ARDS

Tachypnea Dyspnea decreased breath sounds Deteriorating blood gas decreased oxygen

Nursing Management for ARDS

- Oxygen therapy - High Fowlers Position - Restrict Fluid - Administer diuretics and corticosteroids as prescribed - Prepare client for intubation and mechanical ventilation

This refers to the obstruction of the pulmonary artery or one of its branches by a blood clot (thrombus) that originates somewhere in the venous system or in the right side of the heart.

Pulmonary Embolism

Most commonly, pulmonary embolism is due to a clot or thrombus from the deep veins of the _______

lower legs

Nursing Management for Pulmonary Embolism

Oxygen therapy STAT Early ambulation post-operative Monitor obese patient Do not massage legs Relieve pain- analgesics Head of bed elevated Heparin (2 weeks) then Coumadin (3-6 months)

Patient Teaching for prevention of Pulmonary Embolism

- Active leg exercises to avoid venous stasis - Early ambulation - Use of elastic compression stockings - Avoidance of leg-crossing and sitting for prolonged periods

defined as abnormal accumulation of fluid in the lung tissue, the alveolar space, or both. It is a severe, life-threatening condition.

Pulmonary Edema

Nursing Management for Pulmonary Edema

- The patient is positioned upright, preferably with the legs dangling over the side of the bed. - Providing Psychological Support - Monitoring Medications - assesses the degree of dyspnea - auscultates the lung fields and heart sounds - assesses the degree of peripheral edema.

Early indicators of developing pulmonary edema.

hacking cough fatigue weight gain increased edema decreased activity tolerance

Pulmonary edema may be alleviated by increasing doses of _________

diuretics

Characterized by elevated pulmonary arterial pressure and secondary right heart ventricular failure

Pulmonary Hypertension

Nursing Management for Pulmonary Hypertension

Administer oxygen therapy Health teaching Emotional and psychosocial aspects of this disease must be addressed.

A condition that causes the right side of the heart to fail. Long-term high blood pressure in the arteries of the lung and right ventricle of the heart can lead to _____________

Cor Pulmonale

Signs and Symptoms of Cor Pulmonale

Chest discomfort (front of the chest) chest pain edema of the feet or ankles wheezing, coughing, phlegm production cyanosis

Nursing Management for Cor Pulmonale

Bedrest Oxygen therapy diuretics vasodilators digitalis theophylline anticoagulation

the collection of pus in a cavity in the body, especially in the pleural cavity.

EMPYEMA

The most common cause of empyema is __________ caused by a bacterial infection of the lungs.

pneumonia

Signs and symptoms of Empyema

- Chest pain (which worsens when you breathe in deeply, pleurisy) - dry cough - excessive sweating, especially night sweats - fever and chills - general discomfort, uneasiness or ill feeling (malaise) - shortness of breathe - unintentional weight loss - dullness to percussion on affected area

Nursing Management for Empeyema

Increased fluid and protein Adequate pain relief Use of incentive spirometry Surgical Intervention: VATS (Video-Assisted Thorascopic Surgery)