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Stack #122922

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

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
Created by: rpclothier