URTI & LRTI Flashcards
Humidifies, warms & filters inspired air
NOSE
Air-filled cavities within the hollow bones that surround the nasal
passages, provide resonance during speech
SINUSES
Located behind the oral & nasal cavities
Divided into the nasopharynx, oropharynx & laryngopharynx
Passageway for both the respiratory & digestive tracts
PHARYNX
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
Valsalva Maneuver
GLOTTIS
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
Where gas exchange takes place
(diffusion of oxygen and carbon dioxide)
ALVEOLI
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
Diagnostic study:
Information on the anatomic location &
appearance
CHEST X-RAY (CXR) FILM (RADIOGRAPH)
Obtained by expectoration or tracheal suctioning
identify organisms or abnormal cells
SPUTUM SPECIMEN
visual examination of the larynx, trachea & bronchi with a fiber-optic
bronchoscope
BRONCHOSCOPY
What are the respiratory treatments?
Chest Physiotherapy
Deep Breathing Exercises
Cough Exercises
Nebulizer
Oral Suctioning
ET Suctioning
Contraindications for Chest Physiotherapy (CPT)
- Increased respiratory distress
- Dx of fractures
- Chest incisions
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
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)
The location of the number of arterial anastomoses between vessels arising from branches of the internal and external carotid arteries.
anterior nasal septum
series of anastomoses are formed into a triangular shape and known as
Kiesselbach’s plexus.
The area of the nasal septum involved is commonly referred to as
Little’s area.
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
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
The most common facial fracture and the
most common fracture in the body
Nasal fracture
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.
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
- VIRAL PNEUMONIA
- PRIMARY ATYPICAL PNEUMONIA (MYCOPLASMA PNEMONIAE)
- BACTERIAL PNEUMONIA
- 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)
