a MCPHS- Provider I- Ch 22 Management of Pts w/UR Tract Disorders

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Most common reason for seeking health care  Upper Respiratory Infections(URI's)  
90% of URI's are d/t  Viral infection  
Drugs causing Drug-induced Rhinitis  Antihypertensive agents, Oral contraceptives, Chronic use of nasal decongestants  
Rhinitis(Common cold) d/t inflamed  Mucous membranes  
Sinusitis d/t  Mucous secretions filling and occluding sinus cavities  
Time b/w Nasal spray administrations  At least 1 minute, Clean spray after each use  
Women vs. Men r/t Rhinitis susceptibility  Women are more susceptible  
Three major time periods r/t Rhinitis  September(school begins), Late January, End of April  
Cold temperatures and exposure to rainy weather r/t Incidence/severity of Common colds  No relationship  
Antibiotic usage r/t Rhinitis  Contraindicated b/c they do not effect viruses  
Most effective measure to prevent transmission of organisms  Handwashing  
Acute vs. Subacute vs. Chronic sinusitis  A:rapid-onset infection cured w/treatment, S:persistent nasal discharge not cured w/treatment lasting < 3 months, C:symptoms > 3 months  
Determining acute bacterial sinusitis  Four or more symptoms must be present  
Rebound congestion r/t Decongestant spray dependence  When decongestant is stopped, nasal passages close and congestion occurs  
Pt's susceptible to fungal sinusitis  Immunocompromised Pt's  
Time period in which periorbital edema is most pronounced  Awakening in morning  
Head position r/t Rhinitis/Sinusitis drainage promotion  Head elevated & Fowler's positions  
Most cases of acute pharyngitis d/t  Viral infections  
Strep throat is acute pharyngitis is caused by  Bacterial infections  
S/Sx r/t Acute pharyngitis  Fiery-red pharyngeal membrane and tonsils, Lymph structures swollen w/white-purple exudate, No cough  
Areas swabbed r/t Rapid Strep Test(RST)- Both tonsils & posterior pharyngeal wall  (blank)  
Hypertrophic vs. Atrophic vs. Chronic granular r/t Chronic pharyngitis  H:thickening and congestion of pharyngeal mucous membranes, A:pharyngeal mucous membranes are thin, glistening and sometimes wrinkled, CG:numerous swollen lymph follicles on pharyngeal wall  
Signs r/t Acute laryngitis  Hoarseness/aphonia & sever cough  
Aphonia  Complete loss of voice  
Improving throat pain r/t Acute laryngitis  Warmer climates and later time of day  
Factors of increased fluid loss d/t URI's  Increased respiratory rate leads to increased insensible loss, Fever increases metabolic rate and diaphoresis  
Obstructive vs. Central vs. Mixed sleep apneas  O:pharyngeal occlusion, C:simultaneous cessation of air flow and respiratory movements, M:both obstructive and central apnea w/in one apneic episode  
Obstructive sleep apnea(OSA) characteristics  Snoring w/breathing cessation at least 5x per hour  
Epistaxis  Hemorrhage from nose(nosebleed)  
Initial treatment r/t Epistaxis  Apply direct pressure to soft portion of nose w/Pt sitting upright w/head tilted forward for at least 5 minutes  
Most common fracture r/t Face & body  Nasal fracture  
Clear fluid draining from nasal fracture indicates  Leakage of CSF  
Test determing CSF leakage  dipstick(Dextrostix)  
Initial hand placement r/t Abd Thrust Maneuver  Thumb side of fist above navel & below xiphoid process  
Fowler's positions r/t Laryngectomy  Promotes patent airway and lung expansion, Decreases surgical edema  
Early ambulation prevents  Atelectasis, Pneumonia, DVT  
Time schedule r/t Changing/cleaning inner cannula  Every 8 hours  
Time schedule r/t Stoma cleaning  Daily  
Large amounts of musous are coughed up through stoma until  Tracheobronchial mucosa adapts to altered physiology  
Hands r/t IV infusions and Writing  Writing hand is documented so opposite arm is used for IV infusion so Pt can still communicate afer laryngectomy  
Sweet foods r/t Adequate hydration & nutrition  Avoid b/c they increase salivation and suppress appetite  
S/Sx r/t Respiratory distress/hypoxia  Restlessness, Irritation, Agitation, Confustion, Tachypnea, Accessory muscle usage, Decreased oxygen saturation  
ADL special precautions r/t Laryngectomy  Shower, Swimming not recommended, Haircuts, No strenous exercise  
Exercise r/t Laryngectomy  All exercise may be enjoyed except strenous exercise  


   

 
 

 
 

 

 
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