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)
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| 90% of URI's are d/t | Viral infection
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| Drugs causing Drug-induced Rhinitis | Antihypertensive agents, Oral contraceptives, Chronic use of nasal decongestants
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| Rhinitis(Common cold) d/t inflamed | Mucous membranes
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| Sinusitis d/t | Mucous secretions filling and occluding sinus cavities
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| Time b/w Nasal spray administrations | At least 1 minute, Clean spray after each use
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| Women vs. Men r/t Rhinitis susceptibility | Women are more susceptible
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| Three major time periods r/t Rhinitis | September(school begins), Late January, End of April
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| Cold temperatures and exposure to rainy weather r/t Incidence/severity of Common colds | No relationship
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| Antibiotic usage r/t Rhinitis | Contraindicated b/c they do not effect viruses
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| Most effective measure to prevent transmission of organisms | Handwashing
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| 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
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| Determining acute bacterial sinusitis | Four or more symptoms must be present
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| Rebound congestion r/t Decongestant spray dependence | When decongestant is stopped, nasal passages close and congestion occurs
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| Pt's susceptible to fungal sinusitis | Immunocompromised Pt's
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| Time period in which periorbital edema is most pronounced | Awakening in morning
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| Head position r/t Rhinitis/Sinusitis drainage promotion | Head elevated & Fowler's positions
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| Most cases of acute pharyngitis d/t | Viral infections
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| Strep throat is acute pharyngitis is caused by | Bacterial infections
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| S/Sx r/t Acute pharyngitis | Fiery-red pharyngeal membrane and tonsils, Lymph structures swollen w/white-purple exudate, No cough
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| Areas swabbed r/t Rapid Strep Test(RST)- Both tonsils & posterior pharyngeal wall | (blank)
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| 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
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| Signs r/t Acute laryngitis | Hoarseness/aphonia & sever cough
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| Aphonia | Complete loss of voice
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| Improving throat pain r/t Acute laryngitis | Warmer climates and later time of day
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| Factors of increased fluid loss d/t URI's | Increased respiratory rate leads to increased insensible loss, Fever increases metabolic rate and diaphoresis
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| 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
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| Obstructive sleep apnea(OSA) characteristics | Snoring w/breathing cessation at least 5x per hour
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| Epistaxis | Hemorrhage from nose(nosebleed)
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| 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
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| Most common fracture r/t Face & body | Nasal fracture
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| Clear fluid draining from nasal fracture indicates | Leakage of CSF
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| Test determing CSF leakage | dipstick(Dextrostix)
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| Initial hand placement r/t Abd Thrust Maneuver | Thumb side of fist above navel & below xiphoid process
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| Fowler's positions r/t Laryngectomy | Promotes patent airway and lung expansion, Decreases surgical edema
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| Early ambulation prevents | Atelectasis, Pneumonia, DVT
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| Time schedule r/t Changing/cleaning inner cannula | Every 8 hours
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| Time schedule r/t Stoma cleaning | Daily
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| Large amounts of musous are coughed up through stoma until | Tracheobronchial mucosa adapts to altered physiology
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| 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
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| Sweet foods r/t Adequate hydration & nutrition | Avoid b/c they increase salivation and suppress appetite
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| S/Sx r/t Respiratory distress/hypoxia | Restlessness, Irritation, Agitation, Confustion, Tachypnea, Accessory muscle usage, Decreased oxygen saturation
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| ADL special precautions r/t Laryngectomy | Shower, Swimming not recommended, Haircuts, No strenous exercise
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| Exercise r/t Laryngectomy | All exercise may be enjoyed except strenous exercise
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