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69 Cards in this Set
- Front
- Back
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Types of Rhinitis |
-acute viral rhinitis (common cold) -allergic rhinitis (hay fever) -vasomotor rhinitis (etiology unknown) -atrophic rhinitis (chronic changes in nasal mucus membranes) |
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Viral Upper Respiratory Infection causes |
-rhinoviruses -adenoviruses -parainfluenza viruses -coronaviruses -RSV -peak incidences September and January |
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The Common Cold Pathophysiology |
-redness and swelling of nasal mucus membranes -hyperactivity of mucus-secreting glands -highly contagious |
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The Common Cold Manifestations |
-nasal congestion -profuse nasal discharge -sneezing -coughing -sore throat -low-grade fever -malaise -muscle aches |
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Cold medications |
-decongestants -antihistamines |
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Cold Treatment |
-treatment to reduce severity: warm salt water gargles, throat lozenges, mild analgesics -complementary therapies: Echinacea, Vitamin C and Zinc; aromatherapy; acupressure, acupuncture, chinese herbs |
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RSV overview (Respiratory Syncytial Virus) |
-common virus in younger children -common in older children and adults, but less severe -can cause severe illness or death in immune-compromised individuals -incubation period 4-6 days -in older adults, can present as lower respiratory infection, pneumonia or fever |
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RSV Treatment |
-Treatment symptomatic -Aerosolized ribavirin (Virazole) may be prescribed for immunocompromised patients with RSV pneumonia (not indicated for adults) |
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Cold prevention |
-maintain good general health -stress-reducing activities -limit exposure to crowds -good hand hygiene |
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Complication of Nasal Spray use |
relieves nasal congestion, but may lead to dependence or rebound congestion if used for more than a few days
-use as directed |
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Recipe for salt-gargle |
1 tsp. salt to 8 oz. warm water |
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dehydration--signs to watch for in children |
-sunken eyes/fontanels -sticky mucous membranes -no tears -no wet diapers in 6 hours, or very dark concentrated urine -irritability -cool, dry skin |
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RSV nursing care for adult |
teach self care identification of complications |
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Influenza |
-highly contagious viral respiratory disease -usually occurs in epidemics/pandemics |
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the avian flu |
-potential pandemic threat -not spread between humans -infected from birds -mortality rate >50% |
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Flu |
-3 major strains: influenza A, B, C viruses. A is most severe, B less so, C even less -spread by airborne droplet and direct contact -incubation period 18-72 hours -virus invades respiratory epithelium, rapidly spreads to neighboring cells -inflammation leads to necrosis and shedding of serous and ciliated cells of respiratory tract -rapid onset |
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Flu Manifestations |
-abrupt onset of chills and fever -malaise -muscle aches -headache -dry cough -sore throat -substernal burning -coryza -acute symptoms subside within 2-3 days -fever can last a week -cough can be severe and productive, last for days or several weeks |
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Flu Complications |
-secondary bacterial infections -sinusitis -otitis media -tracheobronchitis -increased risk for pneumonia developing -Reye's syndrome potentially fatal complication of influenza, associated with influenza B |
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Flu immunization recommended for who? |
-over 65 -nursing home residents -chronic cardiopulmonary disorders -chronic metabolic disease -health care workers |
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Flu meds |
-Amantadine or rimantadine (prophylaxis for unvaccinated exposed people) -Tamiflu and Relenza -OTC drugs such as ASA, acetaminophen -NSAIDs--symptomatic relief -Antitussives can decrease cough (Tessalon perles) -Antibiotics not indicated |
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Sinusitis treatment (mild) |
-promote nasal drainage -encourage liberal fluid intake -judicious use of nasal decongestants -treat any obstructive process |
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Sinusitis Manifestations |
-pain and tenderness (may feel like tooth pain) -headache, fever, malaise -nasal congestion -purulent nasal discharge -bad breath |
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Sinusitis Treatment (severe) |
-endoscopic sinus surgery -antral irrigation (Neti pot) -Caldwell-Luc procedure -external sphenoethmoidectomy (removes diseased tissue from the sphenoid and ethmoid tissue) |
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Pharyngitis/Tonsillitis |
-acute inflammation of pharynx -caused by viral illness (often gradual) -could be caused by bacterial infection (usually abrupt onset) -spread by droplet nuclei -incubation periods of a few hours to several days, depending on causative organism -symptoms typically resolve in 3-10 days |
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Streptococcal pharyngitis manifestations |
-manifests abruptly -high fever -severe sore throat -dysphagia -malaise -arthralgias (joint pain) -myalgias (muscle pain) -enlargement of anterior lymph nodes |
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Strep throat complications |
-abscess -scarlet fever -toxic shock syndrome -rheumatic fever -acute post-streptococcal glomerulonephritis |
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Viral pharyngitis manifestations |
-low-grade fever -sore throat -mild hoarseness -headache -rhinorrhea -tender, enlarged cervical lymph nodes |
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Pharyngitis/Tonsillitis Medications |
-antibiotics for bacterial -antipyretics -mild analgesics -fluids -soft/liquid diet -rest -warm saline gargles and ice collar |
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recipe for making your own ice pack |
2 parts water, 1 part rubbing alcohol in a ziploc bag
freeze it for about an hour |
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Epiglottitis |
-rapidly progressive cellulitis -base of tongue and epiglottis -medical emergency, airway could be threatened |
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Epiglottitis Manifestations |
-1-2 day history of sore throat -painful swallowing -dyspnea -drooling -stridor |
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Epiglottitis Medications |
antibiotics for infection |
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Laryngitis pathophysiology |
-inflammation of the larynx -occurs alone or with another URI -can be acute or chronic |
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Laryngitis manifestations |
-change in voice quality -sore, scratchy throat -dry, harsh cough |
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Laryngitis treatment |
-no specific treatment -reducing exposure to precipitating factors -voice rest -steam inhalation -spray throat with antiseptic solution |
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Diphtheria Pathophysiology |
-acute, contagious disease -uncommon in the US -tonsils/pharynx common site of infection -thick, grayish, rubbery pseudomembrane forms over posterior pharynx/trachea |
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Diphtheria Manifestations |
-fever -malaise -sore throat -bad breath -lymphadenopathy -stridor -cyanosis -gray rubbery pseudomembrane |
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Diphtheria Medications |
-antitoxin (after skin test for sensitivity) -antibiotics are administered (PCN or EES) |
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Diphtheria Treatment |
-Intensive nursing care required -monitor for airway obstruction, cardiac manifestations, CNS complications -nutrition/fluid balance closely managed -IMMEDIATELY reported to local health dept and CDC |
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Pertussis |
-Whooping cough -highly contagious -bacterial |
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Pertussis Manifestations |
-predictable pattern -begins with typical URI symptoms -1-2 weeks cough becomes more frequent -bursts of rapid coughs -vomiting commonly follows coughing episode |
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Pertussis antibiotic |
-Erythromycin given prohpylactically to all household and contacts of infected patient -respiratory isolation maintained until five days after antibiotic therapy begins -REPORTABLE to CDC |
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Epistaxis |
-nosebleed, could indicate bleeding disorder -90% arise from anterior nasal septum -posterior more serious |
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Epistaxis commonly associated with which disorders? |
blood dyscrasias, HTN, diabetes |
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Anterior nosebleeds manifestations |
-obvious bleeding from nares -bleeding into posterior nasal and oral pharynx |
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Epistaxis nursing care |
-assess for respiratory distress and for tolerance of packing or tubes -airway may be obstructed if packing slips -administer humidification, oxygen, bedrest, antibiotics, pain meds |
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Nasal Trauma manifestations |
-epistaxis -hematomas -periorbital edema and ecchymoses -bony crepitus -bilateral fractures: flattened appearance to the nose, an S or C configuration from deviation |
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Possible Complications of Nasal Fx |
-septal hematomas -abscess formation -septal perforation or deviation -CSF leakage -obstruction can occur |
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Nasal Trauma Treatments |
-maintain patent airway and prevent deformity -reduction and external splint application -ice -nasal packing for epistaxis |
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Nasal Surgery done for: |
-complex nasal fractures -nasal septal deviation -persistent CSF leakage -rhinoplasty -deviation of the septum repair -endoscopic repair |
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Laryngeal Obstruction--Anaphylaxis treatment |
epinephrine administered to reduce edema |
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Laryngeal Obstruction--foreign body |
-Heimlich maneuver -endotracheal intubation -cricothyrotomy or tracheostomy might be necessary |
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Laryngeal Obstruction nursing care |
-measures to prevent food aspiration -CPR teaching -identify/provide rapid intervention for anphylaxis |
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Laryngeal trauma manifestations |
-subcutaneous emphysema or crepitus -voice changes -dysphagia -painful swallowing -inspiratory stridor -hemoptysis (bloody sputum) -cough |
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Obstructive Sleep Apnea |
-most frequent type of sleep apnea -all ABG's go down, except PCO2 -asphyxia causes brief arousal from sleep -episodes can occur hundreds of times a night -pharynx collapse during inspiration -tongue pulls against posterior pharyngeal wall |
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Obstructive Sleep Apnea Manifestations |
-loud snoring during sleep -excessive daytime drowsiness -morning headache -irritability -restless sleep |
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Obstructive Sleep Apnea Treatment |
-weight loss -alcohol abstinence -improve nasal patency -avoid prone sleeping position |
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CPAP |
Nasal continuous positive airway pressure is the treatment of choice for sleep apnea |
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BiPAP |
ventilator provides less resistance to exhaling. Treatment for obstructive sleep apnea |
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Nasal Polyps |
-benign, grape-like clusters of mucous membranes and connective tissue -usually bilateral -may obstruct breathing, change character of nasal discharge and change speech quality, and smell -surgery is treatment of choice, but polyps may grow back |
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Nasal Polyps medications |
-topical corticosteroid nasal sprays -low-dose corticosteroids
polyps continue to enlarge when you discontinue steroid therapy |
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Laryngeal Tumors that are benign |
papillomas, nodules, polyps |
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Papilloma |
small, wart-like growth (laryngeal tumor), viral in origin
nodules occur as paired lesions on free edge of vocal cords |
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Malignant Laryngeal Tumor types |
-squamous-cell carcinoma (most common) -leukoplakia (white, patchy, precancerous lesions. Red, velvety patches thought to be later stage) -carcinoma in situ (will develop into squamous cell cancer if untreated) |
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Laryngeal Tumor Manifestations |
-painful swallowing -sore throat, lump in throat -dyspnea -foul breath -pain that radiates to ear--later manifestation |
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Laryngeal tumor risk factors |
-tobacco use -alcohol use -poor nutrition -HPV infection -exposure to asbestos -race |
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Treatment of Laryngeal Cancer |
chemoradiotherapy very effective
determined by the staging of the cancer |
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Procedures for Treatment of Laryngeal Cancer |
-laser laryngoscopy -laryngectomy (if tumor is localized, voice can be preserved) -radial neck dissection -modified neck dissection |
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Speech Rehabilitation Techniques |
-necessary if entire larynx is removed -tracheoesophageal puncture with placement of a one-way shunt valve -esophageal speech -use of speech generators -artificial speech aid -encourage fluids to thin out mucus
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