T1-CH 26: Noninfectious UR problems

Question 1

To be classified as obstructive sleep apnea (OSA), disruption during sleep lasts at least _____ sec and occurs a minimum of ____ times in an hour; O2 typically drops below _____ %

Answer 1

-10 sec
-5x
-80%

Question 2

Causes of obstructive sleep apnea (3)

Answer 2

-CNS dysfunction
-poor circulation and oxygenation
-airway obstruction

Question 3

Specific causes of OSA (8)

Answer 3

-upper airway obstruction
-obesity
-large uvula
-short neck length
-smoking
-enlarged tonsils/adenoids
-oropharyngeal edema
-congenital abnormalities of oral cavity, pharynx, or neck

Question 4

OSA usually occurs with ________: low RR and depth insufficient for affective gas exchange

Answer 4

sleep time hypopnea

Question 5

what happens with OSA (4)

Answer 5

-head and neck muscles relax
-tongue, soft palate, and neck structures displace
-upper airway is obstructed
-Co2 levels increase; pH decreases

Question 6

Complications resulting from OSA (7)

Answer 6

-hypertension
-stroke
-cognitive deficits
-weight gain
-diabetes
-pulmonary disease
-CVD

Question 7

surgical treatment to stop OSA (4)

Answer 7

-Tracheostomy
-anterior mandibular osteotomy w/ genioglossua advancement
-uvulopalathopharygnoplasty
-nasal reconstruction, tonsillectomy, and/or adenoidectomy

Question 8

Tracheostomy and OSA (2)

Answer 8

-high success rate
-not first line of treatment

Question 9

stony created in the anterior mandible; not used in severe OSA cases

Answer 9

anterior mandibular osteotomy w/ genioglossus advancement

Question 10

used to treat snoring but is effective for OSA

Answer 10

uvulopalathopharygnoplasty

Question 11

CPap delivers ____cm H2O at ______ pressure setting(s)

Answer 11

20 cm H20
one setting

Question 12

BiPap delivers up to ___ cmH2O at ______ pressure setting(s)

Answer 12

25 cmH20
multiple settings

Question 13

medical term for nosebleeds

Answer 13

epistaxis

Question 14

epistaxis occurs from (9)

Answer 14

-loss of tissue integrity from trauma
-hypertension
-blood dyscrasia
-inflammation
-tumor
-decreased humidity
-nose blowing/picking
-chronic cocaine use
-procedures like NG suctioning

Question 15

when nose bleed occurs: (3)

Answer 15

-document amount and color of blood
-take vital signs
-assess number, duration, and cause of previous episodes

Question 16

Steps of emergency care for a patient with an nosebleed (6)

Answer 16

-maintain standard precautions
-position patient upright and leaning forward to prevent blood from entering larynx and causing aspiration
-Reassure and keep patient quite to reduce anxiety and blood pressure
-apply lateral pressure to nose for 10 min; apply icepack if possible
-if nasal packing is necessary, use loose gauze or nasal tampon
-Have patient not blow nose for 24 hours to prevent rebreeding

Question 17

laryngeal trauma can occur due to:

Answer 17

-crushing/direct blow injury
-fracture
-prolonged endotracheal intubation with loss of tissue integrity

Question 18

S/S of laryngeal trauma (4)

Answer 18

-difficulty breathing
-aphonia
-hoarseness
-subcutaneous emphysema

Question 19

Priority care in laryngeal trauma:

Answer 19

management of effective gas exchange

Question 20

To determine if gas exchange is effective, assess for signs of _________ and activate _______ if signs are present

Answer 20

-acute respiratory distress
-rapid response team