Upper Resp Flashcards by Nick Wrobel

Problems in the upper resp system are primarily a

ventilation prob

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When it comes to itis’s do we treat them aggresively

yes

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What does IND mean

incision and drainage

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What if the itis is caused by a virus

treat the symptoms and let it resolve itself

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What are structural causes of upper resp probs

deviated septum 
nasal fracture 
edema 
epitaxis 
rhinoplasty

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What are interventions for someone with a traumatic prob causing edema and swelling

elevate HOB for 48 hrs

use ice to limit swelling

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What are the steps for treating epitaxis

keep the patient
get them sitting 
apply direct pressure for 10-15mins
use ice compresses
apply small gauze pads into nostrils

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What do you do if the initial steps for treating epitaxis are not effective

use vasoconstrictor agents, cauterization, or anterior or posterior packing packing for minimum 3 days

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What type of trauma is still considered to affect the person in the same way (edema bleeding and swelling) as blunt force trauma

surgeries for example rhino and septoplasty

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What are some interventions to treat a surgery of the nose

elevate HOB

reduce agents that increase bleeding

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What do we need to teach to nose surgery patients

dont change their dressing, let the surgeon do it

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What are manifestations of rhinisitis and sinusitis

Nasal congestion, sneezing, watery/itchy eyes, altered smell, watery discharge, headache, congestion, pressure

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What are some interventions for rhinisitis and sinusitis

if their symptomatic give tylenol
push fluids to liquify secretions
reduce exposure to causal agents

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What is the first line med specifically for treating nasal probs

inhaled corticosteroid spray

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What should we teach our patients with rhinisitis or sinusitis

avoid allergens
get refill/use intranasal corticosteroids before allergy season
Wash hands often bec common cold could be a trig
monitor suptum for color moving towards yellow/clear and thin from greenish and thick

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Who are high risk pop for influenza

elderly 
longterm steroid use 
chemotherapy
Chronic cardiac or pulmonary (COPD cancer) 
Hospitalized in previous year
LongtermcareTC residents
Immunocompromised
Pregnancy – in 2nd or 3rd trimester during flu season

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What are some symptoms of the flu

cough, fever, myalgia, HA, sore throat

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What could the flu lead to and what does it look like

pneumonia that has exacerbated cough and purulent sputum

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If the flu is uncomplicated how fast should it subside

within a week

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What is a potential occurance with elderly that get the flu

the symptoms last for weeks

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What should you teach about the flu

get vaccinated unless contraindicated like egg allergies

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What are some causes of nasal and paranasal sinus obstruction

nasal polyps

foreign objects

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What do nasal polyps look like

bluish glossy protrusions

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What are the manifestations of nasal polyps

clear discharge

speech distortion

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What are some treatments for nasal polyps

endoscopy into laser surgery

What is the prognosis of nasal ppolyps if untreated

probs recurrent

What can slow the growth of nasal polyps

corticosteroids

What are the manifestations of foreign objects

clear dis | local inflammation

How do you treat foreign object obstruction

remove via point of entry/ sneese with the opposite nostril closed

What is acute pharyngitis usu caused by

virus

What is acute follicular pharyngitis caused by

strep

What is fungal acute pharyngitis usu caused by

candida

Who are at the most risk for fungal acute pharyngitis

long term corticosteroid or antibiotic use | immunocomp

What are the common manifestations for all types of acute pharyngitis

redness edema progresses from scratchy to dysphagia

What are some manifestation of acute pharyngitis that might apppear

patchy yellows eudate | white patches

if untreated or not fully treated what can acute pharyngitis lead to

rheumatic heart dis

How do we treat acute pharyngitis

Infection control- wash hands, throw away tissues Symptomatic relief Prevent secondary infections Fluid . . . . . Citrus could irritate Treat with antibiotics or nystatin (fungal)

What shoudl you teach the patient when they are treating acute pharyngitis with oral solutions

swish and swallow

What is a complication of acute pharyngitis or acute tonsilitis

tonsilar abscess

What are the mani's of tonsilar abscess

hi fever (>101.5), leukocytosis, and chills

What are some treatments of tonsilar absscess

Antibiotics Needle aspiration IND Tonsillectomy

What is OSA

partial or complete obstruction of aurways from tongue or soft palate falling back

What happens during a OSA attack

airway is obst'd for 15-90 seconds causing severe hypoemia and hypercapnia, jolting the patient awake

What are mani's of OSA

Frequent awakenings with HA Loud snoring (partner complains) Complains (in part) – Morning headaches (hypercapnia), irritability, male impotence

How is OSA usu diagnosed

with polysomnography with multiple episodes

What are some ways to treat OSA

``` lose weight oral apps that move the tongue and mandible forward CPAP BiPAP Surgery to remove tissue ```

What is a recommendation to give patients with OSA

avoid alc and sedatives

What are some advantages of a tracheostomy over a endotracheal tube

less risk for long term damage hygeine improved increased mobility can still eat

What shoudl you teahc your pat before getting a trach

you wont be able to speak while the inflated cuff is in

What are some guidelines for inflating a cuff on a trach

use the min volume to create a seal dont inflate more than 20mmHG or 25cm H2O Use the min leak technique

What is the min leak technique

after inflating min enough to create the seal, withdraw 0.1 ml of air

Why should you monitor the pressure of the cuff daily after inflating it

the underlying tissue can swelling up from the irritation causing an increase in pressure

What type of cleanliness does suctioning need

sterile

What are the steps for suctioning

pre O2 insert 5-6 in or until resistance suction up the way up

What are some guidelines for trach suctioning

use sterile technique dont suction for longer than 15 secs total try to aim for as little passes as possible

What is a potential problem with trachs

dislodgement

When is dislodgement most likely

first 5-7 days

What are some precautioins we can take to prevent/help dislodgement

keep replacement tube at bedside do not change ties for 24 hours let the physician perform the first tube cchange

When does the first tube change typically happen

after 7 days

Is the tube can be replaced what should you do for dislodgement of the trach

spread the opening by the rentention sutures call for help use a hemostat to keep airways open insert replacemnt tube with an obturator insert suction catheter for passage of air and to guide the insertion of replacement tube

What should you do if the trach tube cannot be replaced after dislodgement

call for help assess level of resp distress position in semi-fowles Cover the stoma with a sterile dressing and ventilate them with a BMV (bag-mask-ventilation)

Upper Resp Flashcards

(61 cards)