Week 1 ENT 4 of 4 Flashcards
B-hemolytic streptococcus, Aspergillus, Klebsiella, and Candida may be causative agents of what condition
epiglottitis
describe the 4 SUBJECTIVE findings of epiglottitis
Severe odynophagia, dysphagia
fever
shortness of breath
describe the OBJECTIVE findings of epiglottitis
Erythema
edematous epiglottis with narrow opening
what is the Health Promotion /disease prevention of epiglottitis
HIB immunizations may be preventive
in the most general terms what is epiglottitis
acute inflammation of the epiglottis and surrounding structures
name the three different general causes of epiglottitis
bacterial
viral
thermal injury
what is candidiasis caused by
candida albicans
What is the treatment of Candidiasis
nystatin oral suspension
SWISH AND SWALLOW
what is herpes labialis caused by
HSV -1
or
HSV -2
what is the treatment for herpes labialis (cold sores)
acyclovir
and
valacyclovir
aphthous stomatitis (canker sores) treatment
topical steroids such as kenalog
dexamethasone elixir
avoidance of spicy foods
what is parotitis
inflammatory process of the parotid gland
what can cause the inflammatory process of the parotid gland
bacteria
virus
fungal
mycobacterial
where does parotitis infection begin
begins with retrograde migration of oral cavity from ductal obstructive decreased stimulation of saliva from anorexia, decreased mastication, and poor oral hygiene.
parotitis subjective findings
Rapid onset of pain to the affected gland worse with mastication, fever, malaise, edema, headache
parotitis objective findings
In infectious cases, a suppurative discharge will be present from Stensen’s duct with palpation. Viral cases will exhibit a clear discharge with milking of Stensen’s duct.
parotitis Management:
Palpation of affected gland, Augmentin and cephalosporins for infectious cases. Proper hydration, sugar-free sour candies, heat to area may be helpful.
parotitis Health promotion/disease management
Good oral hygiene is needed for prevention.
how does peritonsillar abscess occur
when theres an accumulation of microorganisms located within the peritonsillar tissue
what pathogens can result from the ineffective treatment of pharyngitis
B-lactamase production by anerobes and some staphylococci strains
peritonsillar abscess subjective findings
High fever, fatigue, foul breath, severe odynophagia, pain to affected side
peritonsillar abscess objective findings
Unilateral, marked edema and erythema of the peritonsillar tissue, positive exudate to area, displaced uvula from tonsilar edema, drooling, anxiety, appearance of being acutely ill
peritonsillar abscess management
Needle aspiration, I & D to area, antibiotics, and pain control
peritonsillar abscess health promotion/disease management
Smoking is a risk factor for peritonsillar abscess.
is this when hammon said peritonsillar abscess can drool?
drooling
Pharyngitis and Tonsillitis: subjective findings
Non-infectious – sore, dry throat, rhinorrhea, watery eyes, postnasal drip. Infectious – fever, malaise, cough, headache, fatigue and malaise
Pharyngitis and Tonsillitis: objective findings
Non-infectious – mild erythema, little to no exudate, swollen, pale pharynx. Infectious – pharyngeal, tonsilar exudate, lymphadenopathy, petechnia of the soft/hard palate.
Pharyngitis and Tonsillitis:
Management:
Non-infectious – rest, fluids, humidification, voice rest, warm saline rinses. Infectious – antibiotics of penicillin IM or po, Biaxin, Zithromax are all indicated.
Pharyngitis and Tonsillitis:
Health Promotion:
Pharyngitis in an adult smoker that last greater than 2 weeks should be considered cancerous until proven otherwise.
name the 3 viruses that can cause pharyngitis and tonsillitis
Epstein-barr
influenza
CMV
name the bacteria causes of pharyngitis and tonsillitis
what bacteria is the MOST common
steptococcus pyogenes A, C, and G
B-hemolytic streptococcus
ENT- what do we think about with small children and foreign bodies
the ENT is a great hiding place for lots of small things like beads seeds rocks
clear, watery discharge from the nose, turbinates are red and swollen, discharge may become purulent, may become chronic- this is referred to as what
acute rhinitis
facial pain usually over the orbits, maxillary or frontal sinus cavities, fever, red nasal mucosa and turbinates, headache- referred to as
sinusitis
describe nasal polyps
small gray nodules seen among the turbinates, client may be able to feel these as he breaths, may occlude breathing
cold sores on the lips, clear vesicles with an indurated erythematous base, painful
Herpes simplex- 1
painful fissures at the corners of the mouth from excessive saliva, candidiasis
Cheilitis
tell me…
between leukoplakia and candidiasis…which one will have white lesions that can be scrapped off
candidiasis
if an infant has candidiasis will it eat?
no
white lesions in the buccal areas, tongue, hard/soft palate that will scrape off, may be painful and cause the mouth to be sore.
candidiasis
whitened hyperkeratotic plague on the tongue or in the buccal areas, may be cancerous, will not scrape off with tongue depressor
leukoplakia
what is the clinical term for tongue tied
shortened frenulum
a short frenulum will prevent the client from placing the tip of the tongue on the roof of the mouth - it can impair
articulation
this is painless and occurs with antibiotic usage (tongue)
hairy tongue (furry tongue)
hairy tongue
overgrowth of mycelial threads of candida albicans or aspergillus - looks like it is growing small dark hairs
Edema of the uvula
hot gases through the mouth may cause a thermal burn to the uvula, swelling and difficulty swallowing may occur
in class discussion- patient has soot around mouth what is our primary concern
Early airway intervention (tube them NOW, you may miss your opportunity once swelling occludes the airway)
Torticollis (wryneck)
stiff neck caused from trauma to the neck
Thyroiditis
thyroid is tender, enlarged, pain and fever may accompany
Graves Disease
(thyroid bruit may be present) When the thyroid becomes hyperplasic, increased blood flow through the enlarged arteries may cause a bruit.
Mononucleosis
acute infection of the lymphocytes with the Epstein-Barr virus (EBV), lymphadenopathy, acute pharyngitis, low grade temp, malaise, cough, headache,
Acute laryngitis –
Most common cause of hoarseness, unproductive cough, dryness to throat
Croup
acute obstruction of the upper airway, occurs with infection, allergy, foreign bodies. Harsh cough with dyspnea, can lead to stridor
Thyroid nodule –
always carefully palate the thyroid for nodules, may be benign or malignant- esp in young adults
in class discussion- patient has tonsillitis what do we need to be so careful about when we intubate them?
have FINESSE!
if you scratch those tonsils it can cause a host of other issues. DO NOT SCRATCH THE TONSILS!
