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68wm6 p2 U.R.D.

Upper Respiratory Disorders

What are adrenergics? Drugs that stimulate the sympathetic nerve fibers of the autonomic nervous system that uses epinephrine or epinephrine-like substance
What is the therapeutic use of adrenergics? Bronchodilators
Are adrenergics a short term or long term control of bronchospasms? Short term
What are anticholinergic drugs? Drugs that block the action of acetylcholine and similar substances at acetylcholine receptors, resulting in inhibition of the transmission of parasympatheric nerve impulse
What does acetylcholine control? bodily functions not under voluntarily control, including sweating, balancing, pupil dilation, contraction of bladder muscles, digestion and salivation
How do decongestants open nasal passages, regardless of the cause? By shrinking blood vessels.
How much blood can adults lose from severe nasal hemorrhage (epistaxis)? One liter of blood per hour
What is the medical management of epistaxis? *Nasal packing with cotton saturated with Epinephrine 1:1000 *Cautery (electrical or chemical) *Posterior packing
How should you place a PT with epistaxis? Place in sitting position, leaning forward
What are nasal polyps? Tissue growths on the nasal tissues, caused by prolonged sinus inflammation
What are the clinical manifistations of a deviated septum and of nasal polyps? *Stertorous breathing *Dyspnea *Postnasal drip
A surgical correction for deviated septum involving reconstruction, alignment and straightening of the nasal septum Nasoseptoplasty
A surgical correction for nasal polyps involving the surgical removal of polyps. Polypectomy
What is allergic rhinitis? Atopic allergic condition as a result of antigen-antibody reactions occurring in the nasal membranes, nasopharynx, and conjunctiva from inhaled or contact allergens
True or False: Allergic rhinitis is a year round condition which requires regular medication. False. May be seasonal or perennial condition
What are the symptoms of allergic rhinitis? *Ciliary action slows *Mucosal gland secretion increases *Local tissue edema due to leukocyte infiltration
List 3 clinical manifistations of allergic rhinitis. *Edema *Photophobia *Excessive tearing *Blurring of vision *Pruritus *Excessive secretions *Inability to breathe through the nose
Untreated allergic rhinitis can lead to what? *Otitis media *Bronchitis *Sinusitis *Pneumonia
What are the diagnostic tests used to test for allergic rhinitis? *Physical exam (pale mucosa of the turbines) *Allergen skin testing *Serum radioallergosorbent test (RAST): A blood allergen test.
What is used to treat the motion sickness triggered by allergies? Dimenhydrinate and meclizine.
What is diphenhydramine used to treat in PTs with allergies? Insomnia and parkinsons-like symptoms.
True or False: Anti-histamines work by blocking histamine release. False. Antihistamines block the effects of histamine at the histamine receptor sites. They do NOT block histamine release, antibody production, or antigen-antibody reactions
Antihistamines May have anticholinergic (acetylcholine antagonist) properties and may cause; *Constipation *Dry eyes *Dry mouth *Blurred vision *Sedation
What are the contraindications of antihistamines? *Hypersensitivity *Narrow-angle glaucoma *Premature or newborn infants
Antihistamines have an increased risk of CNS depression when taken with what? Other antihistamines, alcohol, opioid analgesics, and sedative/hypnotics.
Anticholinergic effects of antihistamines are increased when taken with what? Tricyclic antidepressants, quinidine, or disopyramide.
What intensifies the anticholinergic effects of antihistamines when taken with them? MOA inhibitors
How much fluid intake per day should the PT have while taking antihistamines to decrease viscosity of bronchial secretions? 1500L - 2000L per day.
How long before departure should antihistamines be taken to precipitate motion sickness? At least 30 minutes before, preferably 1hr - 2hrs before
How long before bedtime should antihistamines be taken when used for insomnia? 20 minutes
How should PO antihistamines be administered? With meals or milk.
What is the action of decongestants? produces vasoconstriction (rapid, long-acting) of arterioles, thereby decreasing fluid exudation, mucosal engorgement by stimulation of alpha-adrenergic receptors in the vascular smooth muscle.
What are the contraindications of decongestants? *Hypersensitivity. *Acute attacks of asthma. *Lactation.
List 3 precautions of decongestants? *Narrow-angle glaucoma *Liver disease *Geriatrics *Hyperthyroidism *Hypertension *Pregnancy *Children < 12 yrs old (safety not established).
How long should decongestant nose drops be used? No more than 3 days
What should be done when nasal burning/stinging becomes severe with topical nasal decongestants? Discontinue use
What should the PT do after administration of a nasal decongestant spray? Sit upright and sniff hard for a few minutes.
What is a common side effect of decongestants? Hypertension
90% of larynx cancer occures in who, and why? Men, due to alcohol and tobacco use.
What is an early sign of cancer of the larynx? Progressive or persistent hoarseness, usually greater than 2 weeks.
What does metastasis of larynx cancer include? Pain in the larynx radiating to ear
List 3 clinical manifistations of larynx cancer *Progressive or persistent hoarseness *Metastasis *Dysphagia *Lump in throat *Enlarged cervical lymph nodes
How should a laryngeal cancer PT be fed? Tube feedings
What should the nurse expect to find upon visual examination of the throat in a PT with rhinitis? Erythema and/or edema
What can cause tonsilitis? *Air or foodborne bacterial infection *Group A beta-hemolytic Streptococcus
Who is tonsilitis most common in? School-age children
List 3 clinical manifestations of tonsilitis *Sore throat *Fever *Chills *Malaise *Enlarged tonsils with purulent exudate
What pains, aside from throat, can accompany tonsillitis? Ear and joint pain, and headache
What is the most common form of throat inflammation? Pharyngitis
Though most cases of pharyngitis are viral in origen, what else can it be caused by? Hemolytic strep, staph or other bacteria
What is the severe form of pharyngitis known as? Strep throat
How long after the onset of s/s is strep throat contagious? 2-3 days
What can the nurse do for a PT with strep throat? *Provide warm saline gargles *Assess level of pain and offer medications *Offer frequent oral care
How long do the symptoms of strep throat last? 4-6 days
What are the clinical manifestations of sinusitis? *Constant severe headache *Pain and tenderness in affected area *Purulent exudate
What operation is performed to removed disease tissue from sinusitis? Caldwell-Luc operation
Untreated sinusitis can lead to what? Spread of infection to bone, brain, meninges, and develop meningitis, osteomyelitis or septicemia
What is laryngitis secondary to? Laryngitis is secondary to other respiratory disorders and often accompanies viral or bacterial infections.
Laryngitis can cause severe respiratory distress in who? Children.
What is adenoiditis? Inflammation of lymphatic tissue
Adenoiditis is secondary to what? Other airway infections
What does adenoiditis result in? Acute or chronic ear infections
How do the tonsils appear in a PT with adenoiditis? Enlarged and reddened with patchy exudate
When should post-op bleeding be reported to the physician immediately? first 12-24 hours post-op and then 7-10 days post-op
What is a peritonsillar abscess? an abscess that develops in connective tissue around the tonsil
What does a peritonsillar abscess result from? Sever staph/strep infections of the tonsils.
How should a PT with peritonsillar abscess be placed? Semi-fowlers
Created by: Shanejqb