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Med-Surg Spring 2024 > Chapter 29 - Problems of the Nose (p.577-588) - Exam 2 > Flashcards

Chapter 29 - Problems of the Nose (p.577-588) - Exam 2 Flashcards

1
Q

a deviated septum can interfere with what

A

airflow and sinus drainage

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2
Q

s/s of deviated septum vary but they might include

A

asymptomatic, nasal congestion, frequent sinus infections, facial pain, nose bleeds, obstruction to nasal breathing

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3
Q

the medical management of minor septal deviation focuses on symptom control. For nasal inflammation and congestion use

A

saline rinses, decongestants to clear nasal passage

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4
Q

for severe septal deviation a ________may be needed

A

nasal septoplasty, which reconstructs and properly aligns the deviated septum

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5
Q

nasal fractures occur mostly from

A

blunt trauma, fights, accidents, falls, sports

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6
Q

when assessing for a nasal fracture you may find these symptoms/signs

A

difficulting breathing, bleeding, edema, hematoma

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7
Q

what are the goals of nursing care r/t nasal fracture

A

maintain patent airway, reduce edema and pain, prevent complications, provide emotional support

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8
Q

the best way to maintain airway is to keep the patient in what position

A

sitting upright.

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9
Q

apply ice to the face in 10 to _____ minute intervals to help reduce _______ and bleeding

A

20, edema

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10
Q

tell the patient not to _____ their nose once bleeding has stopped

why?

A

blow

so they do not disrupt the clot or cause further trauma

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11
Q

___________is preferred over NSAIDS or aspirin for the first 48 hours to avoid prolonging clotting time and increasing risk for bleeding

A

acetaminophen

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12
Q

nasal stuffiness may be relieved with

A

nasal decongestants, saline nasal sprays, humidifier

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13
Q

the patient should avoid ________ showers and ______ for the first 48 hours to prevent an increase in swelling

A

hot, alchohol

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14
Q

when fracture is confirmed, the goals are to _________ the fracured bones using either manual manupulation or surgery

A

realign

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15
Q

with complex fractures, considerable swelling occurs it may be necessary to wait to repair the fracture until what subsides

A

edema

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16
Q

an anterior bleed may be treated medically by placing a

A

pledget, aka nasal tampon

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17
Q

_______nitrate may be used to chemically cauterize a specific bleeding point

A

silver

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18
Q

what is an epistaxis

A

nose bleed

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19
Q

why do nose bleeds occur

A

trauma, low humidity, UPI, allergies, sinusitis, foreign bodies, chemical irritants, overuse of decongestant sprays, facial or nasal surgery, tumors, anatomic malfomation

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20
Q

posterior bleed often need packing with

A

compressed nasal sponges or epistaxis balloons

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21
Q

nasal sponges, packing, balloons can impair _______status

A

respiratory

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22
Q

therefore we should closely monitor

A

LOC, HR, RR, and O2 sat
observe for signs of difficulty breathing or swallowing

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23
Q

because of risk for complications due to posterior location of injury all patients with posterior packing should be ___________ for close observation

A

monitored closely

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24
Q

Nasal packing predisposes patient to ___________ from bacteria

A

infection

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25
Q

before discharge, teach the patient about followup care, review how to use

A

saline nasal spray or humidifier

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26
Q

have the patient sneeze with mouth

A

open

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27
Q

teach patient to avoid taking _____for pain

A

aspirin or NSAIDS

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28
Q

characteristics of allergic rhinitis are

A

sneezing, watery eyes, itchy eyes and nose, decreased sense of smell, thin watery nasal discharge, nasal turbinates appear pale, boggy, swollen

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29
Q

___________, soft painless growths in the sinus cavity may form due to chronic exposure to allergens

A

nasal polyps

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30
Q

____________ occurs when mucous runs down the back of the throat

A

postnasal drip

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31
Q

both __________and __________ are the most common causes of cough for people with allergies

A

nasal polyps and postnasal drop

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32
Q

the key to managing allerfic rhinitis is

A

identifying and avoiding triggers of allergic reactions

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33
Q

the goal of drug therapy r/t allergic rhinitis is

A

reduce inflammation, minimize complications, and maximize quality of life

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34
Q

______________ antihistamines are used before first generation antihistamines because of their ___________effects

A

2nd gen, non-sedating

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35
Q

appropriate oral meds r/t allergic rhinitis include

A

h1 antihistamines, decongestants

36
Q

appropriate intranasal meds r/t allergic rhinitis include

A

antihistamines, decongestants, anticholinerics, corticosteroids

37
Q

first gen antihistamines may cause

A

drowsiness and sedation

38
Q

allergens r/t allergic rhinitis include

A

dust, mites, mold, pets, pollens, smoke

39
Q

an upper respiratory infection URI is an infection of

A

the nose, sinuses, and/or throat

40
Q

__________cause most URIs

A

viruses

41
Q

the most common bacterium r/t URI is

A

streptococcus pyogenes

42
Q

factors that may cause URI

A

highly contagious, fatigue, emotional/physical distress, compromised immune system

43
Q

true or false: r/t URI, patients are contagious 1 to 2 days before onset and remain contagious until symptoms have subsided

A

true

44
Q

RN interventions are directed at _______symptoms

A

relieving

45
Q

care r/t URI includes

A

rest, fluids, antipyretics, analgesics

46
Q

complications from an URI include

A

acute broncitis, sinusitis, otitis media, tonsillitis, and pneumonia

47
Q

true or false: r/t URI, antibiotics have no effect on viruses. they are an option only if complications are present

A

true

48
Q

r/t URI, teach patients to recognize the manifestations of a ____________bacterial infection

A

secondary

49
Q

Symps of a secondary bacterial infection include

A

temp higher than 103, tender swollen glands, severe sinus or ear pain, significantly worsening symptoms.

50
Q

what is sinusitis

A

develops when inflammation or swelling of the mucosa blocks the openings (ostia) in the sinuses, through which mucus drain into the nose

51
Q

what is rhinosinusitis,

A

may accompany sinusitis, concurrent inflammation or infection of the nasal mucosa

52
Q

nasal ____, foreign bodies, deviated septa, or tumors can cause obstruction of mucus drainage

A

polyps

53
Q

true or false: secretions that accumulate behind blocked ostia provide a rich medium for growth of bacteria, viruses, fungi, which may call infection

A

true

54
Q

acute sinusitis causes these symptoms

A

significant pain, purulent drainage, nasal obstruction, congestion, fever, malaise

55
Q

rn: inspect the nasal mucosa and ______ the paranasal sinuses for pain

A

palpate

56
Q

findings that indicate acute sinusitis include

A

edematous mucosa, discolored purulent drainage, enlarged turbinates, tenderness over the sinuses, and halitosis, recurrent headaches.

57
Q

xrays or ________ may help confirm diagnosis of sinusitis

A

ct scan

58
Q

the symptoms of chronic sinusitis are often_______ although severe ______ and purulent drainage are often present

A

nonspecific, pain

59
Q

as many as 50% of patients with moderate to severe ________ also have chronic sinusitis

A

asthma

60
Q

chronic sinusitis is a persistent infection r/t

A

allergies or nasal polyps

61
Q

initial treatment of acute sinusitis focuses on

A

symptom relief, including decongestants, intranasal corticosteroids, analgesics, saline nasal spray

62
Q

teach patients to use topical decongestants no longer than 5 days to prevent

A

rebound congestion

63
Q

nasal polyp form slowly in response to repeated

A

inflammation of the sinus or nasal mucosa

64
Q

true or false: nasal polyps can exceed the size of a grape

A

true

65
Q

true or false small polyps are typically asymptomatic.

A

true

66
Q

manifestations of larger polyps include

A

nasal obstruction, nasal discharge, speech distortion

67
Q

topical and systemic corticosteroids are primary therapies to used to shrink

A

nasal polyps

68
Q

acute pharyngitis is __________ which includes

A

acute inflammation of the pharyngeal wall

tonsils, palate, uvula

69
Q

what causes acute pharyngitis

A

viral, bacterial, fungal infection

70
Q

symptoms r/t acute pharyngitits range from

A

scratchy throat to difficulty swallowing

71
Q

four classic manifestations present in bacterial pharyngitis

A

fever greater than 100.4
anterior cervical lymph node enlargement
tonsillar or pharyngeal exxudate
absence of cough

72
Q

the goals r/t acute pharyngitis

A

infection control, symptom relief, prevention of secondary complications

73
Q

for viral pharyngitis antibiotics are not recommended. for bacterial pharyngitis caused by group A strep __________ is the drug of choice

A

penicillin

74
Q

candida infections are treated with

A

nystatin, an antifungal antibiotic

75
Q

what can we teach the patient w/ acute pharyngitis

A

ibuprofen or acetaminophen for pain relief
increase fluids
gargle warm salt water
drink warm or cold liquids
popsicles, hard candies, lozenges
encourage use of humidifier

76
Q

what is a peritonsillar absecess. what are the symptoms

A

complication of tonsillitis, abscess causes pain, swelling, blockage of throat when severe, causing airway blockage
patient may have high fever, chills, leukocytosis, difficulty swallowing, muffled voice

77
Q
A
78
Q

some character from little women cant play today because he has the quincy aka

A

peritonsillar abscess

79
Q

treatment of peritonsillar abscess

A

needle aspiration, iv antibiotics, tonsillectomy

80
Q

acute laryngitis is swelling and inflammation of the larynx, classic signs include

A

tingling, burning sensation in the back of throat, persistent need to clear throat, hoarseness, loss of voice

81
Q

patient eduction r/t laryngitis

A

dont talk, dont whisper, increase fluids, cough suppresents, acetaminophen

82
Q

diagnoses r/t airway infections

A

ineffective airway clearance r/t

acute pain r/t irritation 2’ infection

fluid volume deficit rt dec intake

knowledge deficit regarding prevention or treatment

83
Q

Goals r/t airway infection

A

avoiding major complication: brain abscess, meningitis, sepsis

maintaining airway, promoting comfort, proper fluid intake

84
Q

okay, we have packed the posterior of a patients nose with sponges/gauze/or balloon after a severe epistaxis

what are the nurses responsiblity post procedure

A

monitor LOC, HR, O2, and RR
these patients should be very closely monitored

it is also painful patient should receive appropriate analgesia

85
Q
A

Med-Surg Spring 2024 (12 decks)

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