[Exam 2] Chapter 22: Management of Patients with Upper Respiratory Tract Disorders (Page 552-560, 567-570) Flashcards
(128 cards)
1
Q
Upper Airway Infections: URIs are the most common cause of
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illness and affect most people on occasions
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Q
Upper Airway Infections: Most frequently occurign example of a URI??
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Common cold
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Upper Airway Infections: URI occurs when microorganisms are
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inhaled, such as viruses
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Upper Airway Infections: Viruses and URIs.. they affect the upper respiratory passage and lead to
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subsequent mucous membrane inflammation
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Q
Upper Airway Infections: Adult typically averages how many URIs a year?
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2-4
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Q
Upper Airway Infections: URIs may be how threatening?
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Anywhere from minor to life threatening
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Q
Upper Airway Infections: URIs treated where?
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Doctor offices, urgent care clinics, long-term care facilities or self-care at home
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Upper Airway Infections: Early detection of signs and symptoms and approrpriaite interventions can avoid
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unnecessary complications
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Upper Airway Infections:
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prevention and health promotion
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Q
Upper Airway Infections: URIs are spread by
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droplet and direct contact through mucuous membranes
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Q
Rhinitis: WHat is this?
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Group of disorders characterized by inflammation and irritation of the mucous membranes of the nose
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Q
Rhinitis: These issues contribute to what problms in individuals?
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Sinus, ear, and sleep problems and learning disorders
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Rhinitis: Often coexists with other respiratory problems, such as
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asthma
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Rhinitis, Patho: Most common cause of nonallergic rhinitis is
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the common cold
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Rhinitis, Patho: Drug induced rhinitis may occur with
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antihypertensive agents, such as ACE inhibitors or beta blockers
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Rhinitis, Clinical Manifestations: Signs and symptoms include
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rhinorrhea , nasal congestion, nasal discharge, and sneezing
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Q
Rhinitis, Clinical Manifestations: What is Rhinorrhea ?
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Excessive nasal drainage, runny nose
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Q
Rhinitis, Medical Management: How to fix viral rhinitis?
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Medications may be prescribed to relieve the symptoms
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Q
Rhinitis, Medical Management: How to fix allergic rhinitis?
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Allergy tests may be performed to identify possible allergens
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Q
Rhinitis, Medical Management: How to fix a bacterial infection?
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An antimicrobial agent i sused
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Rhinitis, Medical Management: How to fix patients with nasal septal deformities or nasal polyps?
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May be referred to an ear, nose, and thorat specialist
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Q
Rhinitis, Pharmacologic Therapy: Most common treatment for this?
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Antihistamines and given for sneezing pruritis, and rhinorrhea.
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Q
Rhinitis, Pharmacologic Therapy: Why would Cromolyn be used?
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Mast cell stablizier that inhibits releease of histamine and other chemicals
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Q
Rhinitis, Pharmacologic Therapy: Oral Decongestant may be used for
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nasal obstruction
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Rhinitis, Pharmacologic Therapy: Use of saline spray can act as
mild decongestant and can liquefy mcuus to prevent crusting
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Rhinitis: Information on duration?
Low grade fever onset, short duration
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Rhinitis: Virus is shed when?
2 days prior to onset of S&S
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Rhinitis: What does the presence of this virus produce?
Local inflammatory response
Swelling of mucous membranes of nasal passage
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Rhinitis: This leads to hyperactivity of
mucus - secreting glands
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Rhinitis: What is Hay Fever-Allergic Rhinitis
Longer duration with triggers, seasonal
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Rhinitis: How is Hay Fever-Allergic Rhinitis treated?
Nasalcrom to inhibit histamine release and other chemicals
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Viral Rhinitis (Common Cold): Common cold often is used when referring to
A URI that is self-limited and caused by a virus
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Viral Rhinitis (Common Cold): The term cold refers to
an infectious, acute inflammation of the mucous memrbanes of the nasal cavity
Also used when causative virus is influenza
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Viral Rhinitis (Common Cold): Colds are highly contagious because they are shed
2 days before the symptoms appear and during first part of symptomatic phase
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Viral Rhinitis (Common Cold), Clinical Manifestations: Signs and Symptoms include a
low-grade fever, nasal congestion, rhinorrhea and nasal discharge
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Viral Rhinitis (Common Cold), Clinical Manifestations: When this progresses , it may appear and exacerbate what?
Herpes simplex, commonly called a cold sore
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Viral Rhinitis (Common Cold), Clinical Manifestations: Symptoms ma last from
1-2 week s
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Viral Rhinitis (Common Cold), Medical Management: This consists of symptomatic therapy that includes
adequate fluid intake, rest, prevention of chilling and use of expectorants
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Viral Rhinitis (Common Cold), Medical Management: Antihistamines are used to
relieve sneezing, rhinorrhea and nasal congestion
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Viral Rhinitis (Common Cold), Medical Management: Guaifensin is used to promote
removal of secretions
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Viral Rhinitis (Common Cold), Medical Management: Antibiotics should not be used because
they do not affect the virus or reduce the incidence of bacterial complications
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URIs and RSv: Mimics what?
Common cold in adult population
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URIs and RSv: In older adults can present as
lower respiratory infection, fever, or pneumonia
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URIs and RSv: In infants, it can manifest as a
URI, but more likely to progress to pneumonia, bronchiolitis and tracheobronchiolitis
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URIs and Influenza: Onset of the fever is?
Abrupt and is a high grade fever
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URIs and Influenza: Inflammation of epithelium lining of respiratory tract causes
necrosis and sheeding of serous and cilated cells within the respiratory tract
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URIs and Influenza: During recovery, the serous cells are placed more quickly than ciliated cells. Without cilated cells what cant happen?
REspiratory tract cannot remove microorgansisms as easily or move mucous. Increases riskk of bacterial infection.
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URIs and Influenza: This usually occufrs when?
In epidemics or pandemics
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Rhinosinusitis: What is this?
Inflamamtion of the paranasal sinuses and nasal cavity.
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Rhinosinusitis: Uncomplicated Rhinosinusitis occurs without
extension of inflammation outside of the paranasal sinuses
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Rhinosinusitis: Classified by duration of symptoms, which are
acute (less than 4 weeks)
Subacute (4-12 weeks)
Chronic (more than 12 weeks)
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Rhinosinusitis: How can this be classified infection wise?
Bacterial or viral
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Acute Rhinosinusitis: Chacterized by how many episodes per year?
4 or more
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Acute Rhinosinusitis, Patho: They usually follows what?
Viral URI or Cold.
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Acute Rhinosinusitis, Patho: Nasal congestion caused by inflammation, edema leads to
obstruction of the sinus cavities, providing excellent medium for bacteria growth
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Acute Rhinosinusitis, Clinical Manifestations: Symptoms of ABRS include
nasal drainage accompanied by nasal obstruction
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Acute Rhinosinusitis, Clinical Manifestations: Acute Rhinosinusitis classified as
Acute Bacterial Rhinosinusitis (ABRS)
Acute Viral Rhinosinusitis (AVRS)
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Acute Rhinosinusitis, Clinical Manifestations: Symptoms of AVRS similar to that of
ABRS except patient does not resent with high fever
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Acute Rhinosinusitis, Assessment and Diagnostic Findings: Some things that cna be examined are
Head, neck, and chest
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Acute Rhinosinusitis, Complciations: If untreated, may lead to complications such as
osteomyelitis and mucocele (cyst of the paranasal sinuses)
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Acute Rhinosinusitis, Complciations: How do you fix mucoceles (cyst of the paranasal sinuses)?
Surgical treatment to estalish intranasal drainage or complete excision
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Acute Rhinosinusitis, Medical Management: What is prescribed for bacterial cases?
5-7 days of antibiotics
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Acute Rhinosinusitis, Medical Management: Goals are to do what?
Drink nasal mucosa, relieve pain, and treat ifnection
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Acute Rhinosinusitis, Medical Management: When should antibiotics be given?
As soon as ABRS diagnosis is establishesd
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Acute Rhinosinusitis, Medical Management: Treamtnet of AVES typically involves
nasal saline lavage and decongestants.
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Acute Rhinosinusitis, Medical Management: Intranasal corticosteroids have been show to produce
complete or marked improvement in acute symptoms of either bacterial or viral rhinosinusitis
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Acute Rhinosinusitis, Nursing Management: Patient is advised to avoid what?
Swimming, diving, and air travel during acute infection
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis: Diagnosed in patients who has experienced
12 wweeks or longer of
mucopurulent drainage, nasal obstruction or facial pain
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis: Diagnosed when it occurs how many times in a year?
Four or more episodes per year
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Patho: Usual cause of CRS?
Mechanical obstruction in the ostia of the frontal, maxillary , and anterior ethmodi sinuses
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Patho: Obstruction prevents adequate drainge of
nasal passages.
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Patho: Persistent blockage may occur because of
infection, allergy, or structural abnomalities
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Clinical ManifestationsThis includes
impaired mucociliary clearance and ventilation, cough, and chronic hoarseness
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Clinical Manifestations: Patient normally breathes through the
mouth, because nasal is congested.
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Assessment and Diagnostic Findings: Assessment focuses on
onset and duration of symptoms
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Assessment and Diagnostic Findings: X Ray can assess
disorders of paranasal sinuses
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Assessment and Diagnostic Findings: CT scan of paranasal sinuses can idetnfiy
mucosal abnormalities
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Complications: Complciations include
severe orbital cellulitis, cavernous sinus thrombosis, and meningitis
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Complications: Can lead to itnracranial infectione ither by
direct spread through bone or via venous channels
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Complications: Frontal rhinosinusitis can lead to
osteomyelitis of the frontal bones
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Medical Management: General measures include
encouraging adequate hydration and recommending use of nasal saline rpays or NSAIDS
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Medical Management: Patients instructed to avoid
exposure to cigs and sleep with head of bed up..
Avoid caffeine and alcohol
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Chronic Rhinosinusitis and Recurrent Acute Rhinosinusitis, Surgical Management : FESS may be indicated to correct structural deformities. What is this?
Minimally invasive surgical procedure that is associated with reduced postoperative discomfort
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URI Potential Complications
Airway Obstruction
Sepsis
Acute Otitis Media
Dysphagis
Cellulitis
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URI Nursing PRocess - Assessment:
Health History
Allergies
Inspection of nose neck, and throat
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URI Nursing PRocess - Assessment: Signs and Symptoms are
headache, cough, hoarseness, fever
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URI Nursing PRocess - Planning:
Airway management, reduce risk of aspiration
Pain Management
Increase hydration
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URI Nursing PRocess - Interventions: You should elevate
the head
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URI Nursing PRocess - Interventions: Ice collar to reduce
inflammation
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URI Nursing PRocess - Interventions: Hot packs to reduce
congestion
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URI Nursing PRocess - Interventions: Analgesics for
pain
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URI Nursing PRocess - Interventions: Oxygen if
needed
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URI Nursing PRocess - Interventions: What is administered via nebulizer?
Mucolytic
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URI Nursing PRocess - Interventions: Gargles for
sore throat
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URI Nursing PRocess - Interventions: Encourage how much liquid?
2-3 L /Day
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URI Nursing PRocess - Evaluation: How do you evaluate this?
Maintenance of patent airway
Able to communicate needs
Evidence of postiive hydration
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URI Nursing PRocess - Evaluation: Absence of complications include
otitis media
Sinusitis
Pneumonia
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URI Nursing PRocess - Evaluation: Patient Education includes
Prevention of upper airway infections
Emphasize frequent handwashing
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Obstructive Sleep Apnea: What is this characterized as?
Recurrent episodes of upper airway obstruction adn reduction in ventilation.
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Obstructive Sleep Apnea: DEfined as
cessation of breathing during sleep causing by airway obstruction
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Obstructive Sleep Apnea: RF Includes
Obesity, male gender, postmenopausal status
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Obstructive Sleep Apnea, Patho: REpetitive apneic events results in
hypoxia (decreased oxygen saturation) and hypercapnia (increased CO2 concentration
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Obstructive Sleep Apnea, Patho: Patients thus have a high prevelance of
hypertension
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Obstructive Sleep Apnea, Clinical Manifestations: What are some signs of this?
Frequent and loud snoring with breathing cessation for 10 seconds or longer, for at least five episodes per hour
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Obstructive Sleep Apnea, Clinical Manifestations: Classic signs and symptoms include the 3S's ,
Snoring, Sleepiness, and Significant
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Obstructive Sleep Apnea, Clinical Manifestations: Diagnosis of sleep apnea is based on
clinical features and polysomnographic finding (Sleep study)
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Obstructive Sleep Apnea, Patho: Loss of normal
pharyngeal muscle tone
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Obstructive Sleep Apnea, Patho: What collapses during inspiration?
Pharynx
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Obstructive Sleep Apnea, Patho: Obstructions causes what to fall and rise?
Fall: O2 Sat, PO2, pH
Rise: PCO2
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Obstructive Sleep Apnea, Patho: Asphyxia causes a
brief arousal from sleep
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Obstructive Sleep Apnea, Patho: Manifestations include
Loud snoring durign sleep
Excessive daytime drowseiness
Headable
Irritability
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Obstructive Sleep Apnea, Medical Management: First steps to correct this?
Weight loss, avoidance of alcohol, and positional therapy
and mandibular advancement devices (MADs)
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Obstructive Sleep Apnea, Medical Management: When correctly placed, MAD advances the
mandible so that slightly anterior to front teeth, prevent airway obstruction by tongue
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Obstructive Sleep Apnea, Surgical Management: Simple Tonsillectomy may be effective for those with
larger tonsils
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Obstructive Sleep Apnea, Surgical Management: Uvulopalatopharyngoplasty is
the resection of pharyngeal soft tissue and removal of 15 mm of free edge of soft palate
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Obstructive Sleep Apnea, Goal of Care
Restore airflow and prevent adverse effects of the disorder
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Obstructive Sleep Apnea, Treamtns of mild - to - moderate apnea
Weight reduction, alcohol abstinence, improve nasal patency
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Obstructive Sleep Apnea, Surgical Management: Tracheostomy , what is this?
Relieves upper airway obstruction but has numerous adverse effects, including speech difficulty
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Epistaxis: What is this?
Hemorrhage from the nose caused by rupture of tiny distended vessels in the mucous membrane
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Epistaxis: Most common site?
Anterior septum
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Epistaxis: Serious problem because it may result in
airway compromise or significant blood loss
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Epistaxis, Medical Management: Intiial treatment may include
apply direct pressure while head tilted forward to prevent swallowing and holds for 5-10 minutes
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Epistaxis, Interventions: Phenylephrine Spray causes
vasoconstriction
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Epistaxis, Interventions: Cauterize with
silver nitrate or electrocautery
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Epistaxis, Interventions: Monitor for
aspiration, VS, Pulse Oximetry, Airway, and breathing
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Epistaxis, Patient Teaching: Avoid what?
Nasal trauma, nose picking, forceful blowing
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Epistaxis, Patient Teaching: Adequate humidifcaion to prevent
dryness
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Epistaxis, Patient Teaching: Pinch nose to stop bleeding, if doesnt stop after 15 minutes, seek
medical attention
