Upper Respiratory Problems Key Points

Question 1

Deviated Septum

Answer 1

Deflection of the normally straight nasal septum that is most commonly caused by trauma to the nose

Question 2

Nasal Fracture

Answer 2

Nursing responsibilities include assessing the patient’s ability to breathe and ascertaining that hemorrhage and leakage to CSF are not present

Question 3

Rhinoplasty

Answer 3

The surgical reconstruction of the nose

Performed for cosmetic reasons or to improve airway function when trauma or developmental deformities result in nasal obstruction

Question 4

Epistaxis

Answer 4

Nosebleed

Question 5

Epistaxis Treatment

Answer 5

Wide variety of causes

Treat with simple measures including direct pressure while sitting upright

Question 6

Epistaxis Does Not Stop

Answer 6

Application of a vasoconstrictive agent, packing, or cauterization may be needed

Question 7

Nasal Packing

Answer 7

Medical procedure inserts material into the nasal cavity to stop nose bleeds

Monitoring respiratory status is a critical nursing responsibility

Question 8

Allergic Rhinitis

Answer 8

Reaction of the nasal mucosa to a specific allergen. Can be classified as seasonal, perennial, episodic, intermittent, or persistent

Question 9

Seasonal Rhinitis

Answer 9

Caused by allergies to pollen from trees, flowers, grass, or weeds.

Question 10

Perennial Rhinitis

Answer 10

From exposure to environmental allergens such as animal dander, dust mites, molds, and cockroaches

Question 11

Allergic Rhinitis Initial Manifestations

Answer 11

Sneezing, watery/itchy eyes/nose, and thin nasal discharge that leads to congestion.

Question 12

Allergic Rhinitis Drug Therapy

Answer 12

Uses oral H1-antihistamines, corticosteroids, decongestants, and leukotriene receptor antagonists (LTRAs). Intranasal drugs include antihistamines, anticholinergics, corticosteroids, cromolyn, and decongestants

Question 13

Acute Viral Rhinopharyngitis

Answer 13

Common Cold

Infection of the upper respiratory tract caused by more than 200 different viruses

Question 14

Common Cold Treatment

Answer 14

Rest, oral fluids, proper diet, antipyretics, and analgesics are recommended

Question 15

Cold Season

Answer 15

Tell patients with chronic illness or a compromised immune system about measures to decrease the risk of getting a cold

Question 16

Influenza

Answer 16

Typically has a n abrupt onset with systemic symptoms of chills, fever, anorexia, malaise, and generalized myalgia which can be accompanied by a headache, cough, rhinorrhea, and sore throat.

Question 17

Malaise

Answer 17

General feeling of being sick that is hard to identify

Question 18

Myalgia

Answer 18

Muscle pain

Question 19

Rhinorrhea

Answer 19

Runny nose

Question 20

Influenza Antivirals

Answer 20

Zanamivir (Relenza), oseltamivir (Tamiflu), and peramivir (Rapivab) are used to prevent and treat influenza A and B

Question 21

Influenza Vaccination

Answer 21

2 types of flu vaccines are available: inactivated and live/attenuated

Advocate for use in all patients older than 6 months but especially those at high risk

Health care workers should be vaccinated to prevent transmission of influenza to high risk patients

Question 22

Sinusitis

Answer 22

Develops when the exit from the sinuses is narrowed or blocked by inflammation or swelling of the mucosa. Accumulating secretions provide a rich medium for growth of bacteria, viruses, and fungi, all of which may cause infection

Question 23

Acute Sinusitis

Answer 23

Typically begins within 1 week of an upper respiratory infection and lasts less than 4 weeks. Symptoms include significant pain over the affected sinus, purulent nasal drainage, nasal obstruction, congestion, fever, and malaise

Question 24

Chronic Sinusitis

Answer 24

Lasts longer than 12 weeks and is a persistent infection usually associated with allergies and nasal polyps. Although there may be facial or dental pain, nasal congestion, and increased drainage, severe pain and purulent drainage are often absent

Question 25

Sinusitis Treatment

Answer 25

Includes supportive care, antibiotics, and the use of ancillary medications to relieve symptoms, including oral or topical decongestants, nasal corticosteroids, analgesics, and saline nasal spray

Question 26

Nasal Polyps

Answer 26

Causes obstruction and speech distortion, necessitating surgical removal

Question 27

Acute Pharyngitis

Answer 27

Acute inflammation of the pharyngeal walls that may include the tonsils, palate, and uvula

Question 28

Acute Pharyngitis Symptoms

Answer 28

Range in severity from a “scratchy throat” to pain so severe that swallowing is difficult. Both viral and streptococcal infections appear as a red and edematous pharynx, with or without patchy exudates, so appearance is not always diagnostic

Question 29

Peritonsillar Abscess

Answer 29

A complication of acute pharyngitis, may threaten the airway if severe

Question 30

Peritonsillar Abscess Treatment

Answer 30

Includes IV antibiotics, needle aspiration, drainage, or surgery

Question 31

Laryngeal Polyps

Answer 31

Develop on the vocal cords because of vocal abuse or irritation Most common sign is hoarseness

Question 32

Laryngeal Polyps Treatment

Answer 32

Voice rest and hydration Surgical removal may be indicated for large polyps, which can cause dyspnea

Question 33

Acute Laryngitis

Answer 33

Inflammation of the voice box, most commonly caused by a viral Main sign is hoarseness, which may be accompanied by total loss of voice

Question 34

Acute laryngitis Treatment

Answer 34

Supportive Focuses on resting the voice, acetaminophen for throat discomfort, cough suppressants, and increasing fluid intake

Question 35

Airway Obstruction

Answer 35

Medical emergency! Interventions to reestablish a patent airway include the obstructed airway (Heimlich) maneuver, cricothyroidotomy, ET intubation, and tracheostomy

Question 36

Head and Neck Tumors

Answer 36

This category of tumors arises from the mucosal surfaces of the paranasal sinuses, oral cavity, or nasopharynx, oropharynx, or larynx

Question 37

Head and Neck Cancer Symptoms

Answer 37

Early signs and symptoms of head and neck cancer vary with the tumor location. Difficulties in chewing, swallowing, moving the tongue or jaw, and breathing are typically late symptoms Unintentional weight loss and pain are late symptoms

Question 38

Head and Neck Cancer Treatment

Answer 38

Choice of treatment for head and neck cancer is based on exact location of tumor, disease stage, patient age and general health, cosmetic and functional (e.g., ability to talk, swallow, and chew) considerations, urgency of treatment, and patient choice

Question 39

Head and Neck Cancer Stages I and II

Answer 39

Potentially curable with single-modality radiation therapy or larynx sparing surgery

Question 40

Head and Neck Cancer Stages III and IV

Answer 40

Treated with various combinations of surgery, radiation, chemotherapy, and targeted therapy Surgery typically involves a total laryngectomy with a permanent tracheostomy

Question 41

After Radical Neck Surgery

Answer 41

The patient may be unable to take in nutrients through the normal route because of swelling, the location of sutures, or difficulty with swallowing. Enteral feeding is used to maintain adequate nutrition