Adult 1 Quiz 2: Upper Respiratory System Disorders

  1. Deviated Septum
    • Deflection of normally straight nasal septum
    • Concern = air movement, epistaxis, and infection
    • Treat with nasal allergy control or surgery
  2. Nasal Fracture
    • Unilateral, Bilateral, Complex
    • S/S: depend on severity (ecchymosis, edema, bleeding)
    • Need to check for clear drainage * determine whether drainage is nasal secretion or CSF by checking for glucose - CSF contains glucose & nasal secretions should not
    • Ice to face, surgery
  3. Nursing & Collaborative Management: Nasal Surgery
    • Respiratory status:
    • * Positioning: want to support drainage - HIGH FOWLER'S or SEMI-FOWLER'S
    • * Assess airway: pulse ox, respirations, auscultate lung sounds, look for accessory muscle use, labored breathing, anxiety/restlessness
    • Pain management: agents such as morphine (* keep in mind respiratory depression)
    • Hemhorrage:
    • * check for frequent swallowing
    • * avoid Valsalva maneuvers - laxatives .. increases intracranial pressure
    • * sneeze with mouth open .. closed mouth increases intracranial pressure
    • * avoid blowing nose
    • Edema
    • Ecchymosis
    • Antibiotics
  4. Epistaxis - Measures to Control Bleeding
    • If tubes are used ... observe for respiratory distress, humidified oxygen, bedrest, pain management, hydration & oral care
    • Prevent bleeding after tubes are removed:
    • * nasal salin & humidification
    • * AVOID: vigorous nose blowing, NSAIDs or Aspirin, strenuous activity
  5. Rhinitis
    • Inflammation and infection of the nose and paranasal sinuses
    • Typically does not interfere with a person's ability to maintain oxygenation or adequate tissue perfusion
    • Inflammation of the nasal mucosa caused by a variety of sources
    • Allergic rhinitis
    • Acute viral rhinitis ("common cold")
  6. Allergic Rhinitis ("hay fever, allergies")
    • Triggered by a sensitivity reaction to airborne allergens
    • "Seasonal" or "Chronic"
  7. Acute Viral Rhinitis ("Common Cold")
    • Viruses invade upper respiratory system
    • Spread by droplet
    • Increased in the winter months
    • Risk factors: overcrowding/staying indoors, compromised immune system, stress
    • Manifestations similar to those of allergic rhinitis - usually no fever with allergic
  8. Clinical Manifestations of Acute Rhinitis
    • Nasal irritation, sneezing
    • Post-nasal tickling
    • Copious secretions
    • Obstructed nasal passages
    • Watery eyes
    • Elevated temperature
    • Headache
  9. Nursing & Collaborative Management of Acute Viral Rhinitis
    • Rest, fluids, diet, analgesics
    • Treated symptomatically
    • Antihistamine and decongestant therapy (* warn about sedation with histamines)
    • Recognize symptoms of secondary bacterial infection (if left untreated may turn into a sinus infection)
    • Prevention: avoid crowds, good hand washing, no sharing of cups, etc.
  10. Sinusitis
    • Exit (ostia) from sinus is narrowed or blocked by inflammation or hypertrophy (swelling) of the mucosa
    • Secretions build up behind the obstruction
    • Excellent medium for growth of organisms, leading to infection
  11. Acute Sinusitis: Etiology
    • * all cause inflammation and retention of secretions
    • Upper respiratory infection
    • Allergic rhinitis
    • Swimming
  12. Chronic Sinusitis: Etiology
    • Acute sinusitit - irreversible loss of normal ciliated epithelium lining the sinus cavity
    • Allergies
    • Polyps
  13. Acute Manifestations of Sinusitis
    • Pain over affected sinus
    • Purulent nasal drainage
    • Nasal obstruction
    • Congestion
    • Fever
    • Malaise
    • Dental Pain
    • Headaches * will cause discomfort with change of position
  14. Sinusitis Physical Exam (acute)
    • Pain/tenderness upon palpation of sinus
    • Edematous mucosa
    • Enlarged turbunates
    • Change in headache change?
  15. Management (acute) of Sinusitis
    • Control underlying cause (i.e., allergies)
    • Antibiotics * avoided unless absolutely necessary
    • Decongestants
    • Nasal corticosteroids (* teach patient to look down when using nasal sprays)
    • Avoid antihistamines (* using antihistamines can over dry the area, restricting drainage)
    • Increase fluids
    • Humidifier
    • Nasal cleaning techniques
    • Avoid smoking and exposure to smoke
  16. Pharyngitis
    • "Sore throat"
    • Inflammation fo the mucus membranes of the pharynx
    • Often occurs with rhinitis and sinusitis
    • Caused by: bacteria, viruses, trauma, dehydration, irritants, alcohol
    • Group A beta-hemolytic Streptococcus - most common strain of bacterial that causes infection
    • Most adults experience viral pharyngitis
    • Late fall and spring
    • Important to treat if bacterial - to prevent complications such as Rheumatic fever
  17. Manifestation of Pharyngitis
    • Throat pain
    • Odynophagia
    • Dysphagia
    • Hyperemia
    • Possible exudate
    • Fever
    • Often difficult to distinguish viral from bactrial without a culture
    • Bacterial - usually abrupt onset
  18. Pharyngitis: Diagnosis & Collaborative Care
    • Diagnosis: Rapid stress test, throat cultures
    • Supportive therapy: fluids, rest, analgesics, warm gargles
    • Antibiotics for bacterial infection
    • Should be re-evaluated if no improvement after 3 days
    • ENTIRE does of antibiotics MUST BE COMPLETELY FINISHED
    • Return to work or school after taking 24 hours of antibiotics and afebrile for 24 hours
    • If bacterial - change toothbrush
Card Set
Adult 1 Quiz 2: Upper Respiratory System Disorders
upper respiratory disorders