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ch 22 UP RESP DISOR

ch 22 MGT PTS UPPER RESP DISORDER

QuestionAnswer
APHONIA impaired ability to use one's voice due to disease or injury to larynx
APNEA cessation of breathing
dysphaGia difficulties SWALLOWING
EPISTAXIS nose bleed / nasal blood vessel hemorrhage
MEDICAMENTOSA rebound nasal congestion commonly assoc. w. overuse of OTC nasal decongestants
NUCHAL RIGIDITY neck stiffness / inability to bend neck
RHINITIS inflammation of nasal mucus membranes may be: infectious, allergic, or inflammatory in origin Acute - Chronic
RHINORRHEA large amount of nasal drainage
RHINOSINUSITIS 'SINUSITIS' inflammation of nares and/or paranasal sinuses
XEROSTOMIA DRYNESS of the MOUTH from a variety of causes
URI upper airway infection / Upper Respiratory tract Infection common cold = most common average = adult, 2-4/yr
most common reasons for missing school/work and seeking health care... URI
Common INDOOR allergens: dust mite (feces) dog/cat dander cockroach droppings molds
Common OUTDOOR allergens: Tree pollen Weeds Grasses Molds
URI special condsiderations in ELDERLY: -more serious w. other conditions -influenza exacerbates COPD -use antihistamines cautiously (SE & Rx-Rx) -Laryngitis common in elderly, 2ndary to GERD
CRS CHRONIC RHINOSINUSITIS chronic sinusitis (benefit-endoscopic sinus surgery)
S/S RHINITIS: rhinorrhea, nasal congestion, sneezing, pruritis of nose, mouth, throat, eyes, ears, headache
Rx for Rhinitis (allergic/non-allergic)= symptom relief: Antihistamines Antihistamine/Decongestant Corticosteroids Oral / Nasal spray
RN Mgt/Care Allergic Rhinitis: -avoid allergens -Rx education & read OTC @ Rx-Rx -Saline spray to sooth membranes -proper nasal spray admin (p520)
RN Mgt/Care Infectious Rhinitis: -same as allergic + -teach hand hygiene -encourage yearly flu vaccine
COMMON NAME FOR VIRAL RHINITIS COMMON COLD
3 MOST COMMON TIMES VIRAL RHINITIS EPIDEMICS: -September / start of school (fall) -late January (winter) -late April (spring)
S/S VIRAL RHINITIS: -low grade fever -all symptoms of 'allergies' -cough -herpes simplex (cold sores) in some pts
RN Mgt of Viral Rhinitis: -fluid intake -rest -prevention of chills -expectorants PRN -warm salt water for throat -NSAID's for pain/fever -antihistamines -teach hand hygiene & breaking infection chain
ABRS AVRS Acute Bacterial RhinoSinusitis Acute Viral RhinoSinusitis
Patients with NG or NASOTRACHEAL tubes are at risk for developing... NG OR NT tubes = risk for SINUS INFECTION Remove tube as soon as permitable
RN mgt of Acute Rhinosinusitis -promote sinus drainage, humidifier, warm compresses, decongestants -avoid swimming, diving, air travel -correct admin of nasal spray -Rx for pain -complete antibiotic regimen
GABHS / GAS common name... Strep throat (bacterial/streptococcal)
most Acute Pharyngitis cause is... viral: adenovirus, influenza, epstein-barr, herpes simplex
RSAT = RAPID STREPTOCOCCAL ANTIGEN TEST
S/S ACUTE PHARYNGITIS -Sore throat -Fiery red pharyngeal membrane -Swollen tonsils/pillars -Fever w/o chills -nausea / vomiting -headache
RX for Acute Pharyngitis Viral / Bacterial Viral - treat sysmptoms - resolves itself 5-10 days Bacterial - oral Penicillin V potassium X 5days OR Azithromycin 3-10 days
RN mgt Acute Pharyngitis -bed rest while fever -teach hygiene -assess for Rash -warm saline or saltwater gargles -mouth care -complete antibiotic therapy -replace toothbrush
Trismus inability to open mouth
odynophagia severe sensation of burning squeezing pain while swallowing
otalgia pain in the ear
Peritonsillar Abscess "quinsy" most common major suppurative complication of sore throat. May develop after tonsilitis. Can progress to life threatening state.
s/s peritonsillar abscess -appears acutely ill -sore throat, fever, trismus, drooling, dysphagia, otalgia, rancid breath -purulent tonsil, eyrthema oropharynx
Med treatment of peritonsillar abscess: -antibiotics/corticosteroids -needle aspiration or incision & draining
RN mgt peritonsillar abscess: -surgical prep/support -assists with topical anesthetics -throat irrigations/ gargles -encourage cool fluids -recovery/discharge instructions
Laryngitis inflammation of the larynx assoc. with GERD sometimes May be viral, bacterial, or occupational
aphonia complete loss of voice
s/s laryngitis -hoarseness, aphonia, severe cough -may be sudden onset, worse by cold/wind -worse in morning or evening -tickle in throat
Treatment of laryngitis: if bacterial = antibiotics resting voice/throat eliminating irritants (smoking, etc)
RN mgt of laryngitis: -instruct pt to rest voice -use humidifier -encourage fluids (expectorant if indicated) -resolves 7-10 days
RN intervention to maintain patent airway with URI -increase fluids = thin mucus -room vaporizor -encourage position for drainage
RN intervention to promote comfort/reduce pain with URI -encourage analgesics as prescribed -hot packs relieve congestion & promote drainage -warm water gargles relieve throat -promote good hygiene
Complications of URI: -Sepsis -Meningitis -brain abscess (from severe peritonsillar abscess) -otitis media & rhinosinusitis
S/S of Obstructive Sleep Apnea (OSA) -excessive daytime sleepiness -frequent nocturnal wakening -insomnia / loud snoring -morning headaches -personality changes / irritability -systemic hypertension -dysrhythmias / polycythemia / enuresis
CPAP BiPAP CONTINUOUS POSITIVE AIRWAY PRESSURE BILEVEL POSITIVE AIRWAY PRESSURE
CPAP is used to prevent... airway collapse, thereby preventing apnea
RN mgt of OSA -educate pt @ condition and risk of untreated OSA -encourage, eval therapy adherence
Most common body fracture? Nasal fracture is the most common facial and body fracture
Dextrostick 'dipstick' used to verify leakage of CSF
1/2 of all head and neck cancers are what type/location? Larynx cancer / squamous cell carcinoma
Created by: rtcdavis