DISORDERS OF THE UPPER RESPIIRATORY TRACT

Question 1

Hemorrhage from the nose

Answer 1

Epistaxis (Nosebleed)

Question 2

Risk Factors of Epistaxis

Answer 2

-Local Infections
-Systemic infections
-Drying of nasal mucous membranes
-Nasal inhalation of corticosteroids or illicit drugs
- Trauma (digital trauma, blunt, trauma, fracture, forceful nose blowing)
- Arteriosclerosis
-Hypertension
-Tumor (sinus or nasopharynx)
-Thrombocytopenia
-Use of aspirin
-Liver disease
- Rendu-Osler- Weber

Question 3

Medical management of Epistaxis

Answer 3

Position: sitting upright with head tilted forward

-Instruct patient to pinch the soft outer portion of the nose against the midline septum for 5 to 10 minutes continuously

-Phenylephrine nasal decongestant spray, as necessary

Question 4

If origin of bleeding cannot be identified

Answer 4

Do nasal packing

Question 5

Nursing management of Epistaxis

Answer 5

-Monitor VS
-Assist in control of bleeding
-Provide tissues and emesis basin
-Assure the patient in a calm, efficient manner that bleeding can be controlled can help reduce anxiety
-Continuously assess airways, breathing, and vitals

Question 6

Upon discharge (Epistaxis)

Answer 6

-Avoid vigorous exercise for several days
-Avoid hot or spicy foods and tobacco
-Avoid forceful nose blowing, straining, high altitudes, nasal trauma
-Provide adequate humidification
-Apply direct pressure to nose x 15 minutes in case of recurrence.

Question 7

Refers to a URI that is self-limited and caused by a virus

Answer 7

Common cold

Question 8

Refers to an infectious, acute inflammation of the mucous membranes of the nasal cavity characterized by nasal congestion, rhinorrhea, sneezing, sore throat, and general malaise

Answer 8

Cold

Question 9

Causative Agents of Viral Rhinitis

Answer 9

-Rhinovirus- most common
-Coronavirus
-Adenovirus
-Respiratory syncytial virus
-Influenza virus
-Parainfluenza virus

Question 10

Clinical Manifestation of Viral Rhinitis

Answer 10

-Low-grade fever
-Nasal Congestion
-Rhinorrhea and nasal discharge
-Halitosis
-Sneezing
-Tearing watery eyes
-Sore throat
-General malaise
-Chills
-Headache and muscle aches

Question 11

Medical Management (Symptomatic)

Answer 11

-Adequate fluid intake
-Rest
-Prevention of chilling
-Warm salt-water gargle for sore throat
- Ibuprofen for aches and pains
-Antihistamines for sneezing, rhinorrhea, and congestion
-Guaifenesin (Mucinex) - an expectorant which removes secretions

Question 12

Nursing Management of Viral Rhinitis or Common Cold

Answer 12

-Institute hand hygiene practices
-Emphasize cough etiquette
-Educate on symptomatic treatment strategies

Question 13

Is an inflammation of the paranasal sinuses and the nasal cavity

Answer 13

Rhinosinusitis

Question 14

Classifications of Rhinosinusitis

Answer 14

Acute
Subacute
Chronic

Question 15

symptoms lasts less than 4 weeks

Answer 15

acute

Question 16

symptoms lasts from 4 to 12 weeks

Answer 16

subacute

Question 17

symptoms > 12 weeks

Answer 17

chronic

Question 18

The cause of acute rhinosinusitis can be bacterial or viral

Answer 18

True

Question 19

ABRS

Answer 19

Acute Bacterial Rhinosinusitis

Question 20

AVRS

Answer 20

Acute viral rhinosinusitis

Question 21

Risk factors of Acute Rhinosinusitis

Answer 21

-Unresolved viral or bacterial infection
-Allergic rhinitis
-Diving and swimming
-Tooth infection
-Tumors
-Environmental hazards: cigarette smoke, paint, sawdust, chemicals

Question 22

Causative agent of Acute Rhinosinusitis

Answer 22

Bacterial organisms account for >60% of cases

-S.pneumoniae
-H.influenzae
-S.aureus
-M.catarrhalis

Question 23

Clinical Manifestations of Acute Rhinosinusitis (Bacterial)

Answer 23

-Purulent nasal discharge
-Nasal Obstruction
-Pain
-Nasal stuffiness
-Headache
-High-grade fever (39C and above)
-Persistent for 10 days or more

Question 24

Acute Rhinosinusitis viral clinical manifestations

Answer 24

The same with ABRS except:

-no high fever
-less severe intensity
-symptoms persist fewer than 10 days

Question 25

Complications of Acute Rhinosinusitis

Answer 25

-Osteomyelitis -Mucocele -Meningitis -Brain abscess

Question 26

Nursing Management of Acute Rhinosinusitis

Answer 26

-Instruct to humidify air at home -Warm compress to relieve pressure -Instruct to avoid swimming, diving, and air traveling during acute infection -Instruct to stop cigarette smoking

Question 27

Characterized by four or more episodes of ABRS per year

Answer 27

Recurrent Acute Rhinosinusitis

Question 28

12 weeks or more of the following: mucopurulent drainage, nasal obstruction, facial pain, hyposmia

Answer 28

Chronic Rhinosinusitis

Question 29

Etiology or cause of Chronic and Recurrent Acute Rhinosinusitis

Answer 29

Obstruction of the osteomeatal complex

Question 30

Causative Agents of Chronic and Recurrent Acute Rhinosinusitis (Aerobic)

Answer 30

S.Aureus Streptococci

Question 31

Causative Agents of Chronic and Recurrent Acute Rhinosinusitis (Anaerobic)

Answer 31

-Klebsiella -Bordetella -Haemophilus

Question 32

Clinical Manifestations of Chronic and Recurrent Acute Rhinosinusitis

Answer 32

-Cough -Chronic hoarseness -Chronic headaches -Periorbital edema -Facial pain -Halitosis (mouth breathing) -Symptoms are more pronounced in AM

Question 33

Medical Management of Chronic and Recurrent Acute Rhinosinusitis

Answer 33

-Nasal saline sprays -Acetaminophen/NSAIDS for pain -Antibiotic therapy

Question 34

Surgical Management of Chronic and Recurrent Acute Rhinosinusitis

Answer 34

-FESS (Functional Endoscopic Sinus Surgery) -Caldwell-Luc Surgery

Question 35

Used as surgical treatment of severely diseased maxillary sinus and the incision is between upper gum and upper lip

Answer 35

Caldwell-Luc Surgery

Question 36

Nursing Management of Chronic and Recurrent Acute Rhinosinusitis

Answer 36

-Instruct to sleep with HOB elevated -Avoid exposure to cigarette smoke and fumes -Avoid caffeine and alcohol- may cause dehydrations -Encourage fluid intake -Apply hot wet packs -Instruct to strictly adhere to medication regimen

Question 37

Is a sudden painful inflammation of the pharynx, the back portion of the throat that includes the posterior third of the tongue, soft palate, and tonsils

Answer 37

Acute Pharyngitis

Question 38

Cause of Acute Pharyngitis

Answer 38

-Viral infection- most common -Bacterial infection (Group A beta- hemolytic streptococci) (GABHS)7745

Question 39

Acute Pharyngitis Clinical Manifestations (Viral)

Answer 39

-Fiery- red pharyngeal membrane and tonsils -Enlarged and tender cervical lymph nodes -High grade fever (> 38.3 C -Malaise -Sore throat -NO COUGH!

Question 40

Clinical Manifestations (GABHS)

Answer 40

-Nausea and vomiting -Headache -Swollen and erythematous tonsils, with or without exudate -Soft palate is erythematous with petechiae -Halitosis

Question 41

Nursing Management for Acute Pharyngitis

Answer 41

-TBS (Tipid Sponge Bath) for fever -Encourage bed rest -Monitor for development of rashes -Encourage warm saline gargles (40.3C to 43.3 C) -Provide frequent oral care -Instruct to daily return to work or school until after 24 hours of antibiotic therapy -Emphasize importance of taking full course of antibiotics as prescribed