WEEK 4- NOSE, THROAT, MOUTH

Question 1

Identify & landmark major structures & features of the nose, mouth, & throat.

Answer 1

nose
- nasal cavity
- septum
- superior, middle, inferior turbinates’
- meatus
- paranasal sinuses (4)

mouth
- tongue
- uvula
- teeth
- salivary glands- parotid gland
-frenulumn
- papialle
- vallate papilale
- oral cavity
- lips
- hard palate and soft palate
- cheeks

throat
- pharynx
- oropharynx
- nasopharynx
- tonsils

Question 2

Identify health promotion strategies.

Answer 2

• no more vaping, smoking, tobacco chewing= oral cancer

Question 3

Identify equipment needed for physical examination & safe infection prevention & control practices.

Answer 3

Otoscope Penlight
Two tongue blades
Cotton gauze pad (10 × 10 cm)
Gloves
∗

Question 4

Abnormal Findings: Abnormalities of nose: epistaxis, foreign body, sinusitis.

Answer 4

epistaxis- nose bleeds
foreign body- lodged in nose, prevent proper breathing/in airway

sinusitis- inflammation or infection of sinuses

Question 5

Lip/Mouth: cleft lip, herpes simplex 1, dental caries, gingivitis, candidiasis infection, aphthous ulcers, fissured or scrotal tongue, bifid uvula.

Answer 5

cleft lip- split or opening in the upper lip, could extent to nose, tissues in lip don’t fully fuse during fetal development

herpes simplex 1; infectious, affects mucous membranes and skin, infected persons salvia- you can get it from kissing, sharing any type of salvia with an infected person.

dental caries- tooth decay or cavities, too much sugar, poor oral hygiene, no brushing/flossing.

gingivitis- common mild form of peridontal, gum disease, gums are inflamed and bleeding.

candidiasis- fungal infection, white creamy on tongue- oral thrush

aphthous ulcers- canker sores, inner round sores, inside of mouth, inner lips, throat,

fissured tongue- pysoriss- usually benign, sometimes not

bifid uvula- split or cleft lip in uvula- congenital

Question 6

Throat: acute tonsilitis

Answer 6

inflammation and infection of tonsils
- viral or bacterial infection

Question 7

Epistaxis is common in which population?

Answer 7

pregnant women

Question 8

A client has purulent nasal discharge and a temperature of 38.6. What should the nurse’s priority action be?

Answer 8

tell clients family they need to thoroughly and frequently wash and clean hands

Question 9

The nurse that assessing the back of the throat of a client requires

Answer 9

tongue depressor and penlight

Question 10

When assessing the gums of pregnant woman the nurse noted swelling of the gums. What is the nurse’s response to this finding

Answer 10

document swelling of gums as a result of pregnancy

Question 11

The nurse knows that assessment of the tongue may reveal which findings that are within normal range: (Select all that Apply)

Answer 11

• fissures on surface
• raised taste buds
• small brown macules

Question 12

The nurse assess the teeth of a client. Findings within normal range include: (Select all that Apply)

Answer 12

• teeth are not movable
• gums are in close contact with teeth
• teeth has varying shades of white

Question 13

the nose

Answer 13

Sensory organ
First segment of respiratory system
Warms, humidifies & filters
Nasal cavity
Nares & nasal mucosa
Septum -Kiesselbach’s plexus
Three bony turbinates
Lateral walls
Increase surface area
Sinuses and nasolacrimal ducts drain into turbinates

Question 14

paranasal sinuses

Answer 14

Frontal
Maxillary
Ethmoid
Sphenoid

(4)

Question 15

mouth and pharynx

Answer 15

Gums, buccal mucosa and 32 teeth
Hard and soft palates
Uvula
Tongue (papillae)
Tonsils
Anterior & posterior pillars
Salivary glands

Question 16

health history questions- nose

Answer 16

Discharge
Colds
Sinus pain
Trauma
Epistaxis
Allergies
Altered smell

Question 17

health history questions- throat

Answer 17

Sores or lesions
Sore throat
Bleeding gums
Toothache
Hoarseness
Dysphagia
Altered taste
Smoking
Alcohol consumption
Self-care behavious

Question 18

objective data- inspect and palpate nose

Answer 18

External nose
Symmetry, midline, in proportion, deformity, lesions and inflammation
If injury suspected, palpate
Patency of nostrils

Question 19

inspection of nose
- objective data

Answer 19

Nasal cavity/mucosa
Lift tip of nose
Positioning of head
Erect, and then head tilted
Inspect
Colour, smooth moist surface, discharge, bleeding, swelling, foreign bodies
Nasal septum
Perforation, bleeding, and deviation
Deviation not significant unless air flow is obstructed
Turbinates
Colour, swelling, and polyps

Question 20

mouth
- objective data
inspect and palpate

Answer 20

*Tongue blade, penlight and gloves
Lips, teeth and gums
Tongue
Buccal mucosa
Hard and soft palate
Test CNIX (glossopharyngeal) and CNX (vagus nerve)
“ahhh”
- Soft palate and uvula rise
- Tonsillar pillars move medially
DO NOT TEST GAG REFLEX

Question 21

Tongue- what is normal vs abnormal

Answer 21

normal
- fissures
- painless bumps
- raised taste buds
- small brown macules
- sores- from biting something, etc, normal

abnormal
- white layers
- abnormal smoothness
- abnormal redness
- black and hairy
- thick yellow coating
- sores- consist

Question 22

objective data- throat

Answer 22

Throat—Inspect
Tonsils
Oval, rough surfaced with indentations
Colour and presence of exudate
Grade tonsils
Posterior pharyngeal wall
Colour, exudate, lesions
Note halitosis
Test cranial nerve XII (hypoglossal nerve)
“stick your tongue out”

Question 23

social/cultural considerations-

Answer 23

cleft lip and uvula and palate- most common in aboriginal and Asian descent

leukoedema- may be most common in African descent

periodontal disease and tooth decay- most common in aboriginal people in Canada

born with teeth- 1/2 in 100 Canadian inuit
1 in 3000, European descent

Question 24

developmental considerations

Answer 24

Some Developmental Considerations
Infants/children
Salivation starts at 3 months
Deciduous, temporary teeth replaced by permanent teet

Pregnancy
Epistaxis and gum bleeding

• as a result of increased vascularity in the upper
  respiratory tract.
• The gums may be hyperemic and softened and
  may bleed with normal tooth brushing.
• Contrary to folklore, no
  evidence shows that pregnancy causes tooth decay or loss.

Older adults
Nose becomes more prominent
Loss of taste buds and decreased salivary secretion and sense of smell

Question 25

teeth history

Answer 25

Both sets of teeth begin development in utero. Children have 20
temporary deciduous teeth. These erupt between 6 and 24
months of age. All 20 teeth should appear by 2½ years of age. The
deciduous teeth are lost between ages 6 to 12 years.

Question 26

nose development

Answer 26

the nose develops during adolescence, along with secondary sex
characteristics. This growth starts at age 12 or 13 years, reaching full
growth at age 16 years in girls and 18 years in boys

Question 27

subjective data

Answer 27

Nose
1. Discharge
2. Frequent colds (upper respiratory infections)
3. Sinus pain
4. Trauma
5. Epistaxis (nosebleeds)
6. Allergies
7. Altered smell
Mouth and Throat
1. Sores or lesions
2. Sore throat
3. Bleeding gums
4. Toothache
5. Sugar consumption
6. Bruxism (teeth grinding)
7. Hoarseness
8. Dysphagia
9. Altered taste
10. Tobacco consumption
11. Alcohol consumption
12. Sleep apnea
13. Self-care behaviours
Oral care pattern
Mouthwash

Question 28

health promotion

Answer 28

• no vaping
• no cigarettes
• no tobacco