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29 Cards in this Set
- Front
- Back
Nasal fractures account for what percentage of bone injuries in cases of facial tauma?
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40%
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What is epistaxis?
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NOSEBLEED
cause - trauma, foreign bodies, topical corticosteroid use, nasal spray abuse, street drug use,anatomic malformation, allergic rhinitis, & tumors WATCH FOR ASPIRATION! continue to check levels of consciousness. hypertension doesn't cause epistaxis but makes it hard to manage. |
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what medications could prolonge bleeding?
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aspirin or NSAIDs
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Nursing management for epistaxis?
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Pinch nose for 10-15 minutes to stop bleeding, apply ice, have the patient suck on ice, DO NOT TILT HEAD BACK. insert small gauze pads and apply pressure if bleeding continues.
nurse should closely monitor respiratory rate, heart rate and rhythm, oxygen saturation w/pulse oximetry, level of consciousness and observe signs of aspiration discharge teaching - taught about home care, instructed to avoid vigorous nose blowing, strenuous activity, lifting, and straining for 4 to 6 weeks, taught to sneeze w/mouth open and to avoid aspirin products or NSAIDs |
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What is Influenza?
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it is a virus.
there are 2 types - A and B. clinical manifestations: cough, fever, myalgia, headache, sore throat,common cold symptoms. IS HARD TO TREAT get annual vaccine in the fall 70-90% effective. get to prevent secondary infections to others. uncomplicated cases resolve w/in 7 days watch for hypersensitivity to EGGS = Guillain-Barre syndrome, because vaccine is produced in eggs. |
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Most common complication of the flu?
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pneumonia.
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Drug therapy for influenza
Anti-viral agents |
Flumadine & symmetrel - decrease signs of flu
they stop the cells from budding and duplicating. should be given within 2 days of initial onset to work. has GI side effects (heartburn, reflux) newer drugs - Relenza & Tamiflu |
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What are nasal polyps?
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Benign mucous membrane masses that form slowly in response to repeated inflammation of the sinus.
They can be removed. Can cause obstruction. clinical manifestations - nasal obstruction, nasal discharge, & speech distortion. |
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What is allergic rhinitis?
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The reaction of the nasal mucosa to a specific allergin.
Clinical manifestations: sneezing, watery & itchy eyes &nose, altered sense of smell, and thin watery discharge that can lead to a more sustained nasal congestion. Nasal turbinates appear pale, boggy & swollen. |
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Two types of allergic rhinitis?
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Intermittent - syptoms are present <4 days/wk or <4 wks/yr. (usually occur in spring & fall)
Persistant - symptoms are present >4 days/wk or >4 wks/yr |
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Complication that could arise from allergic rhinitis?
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Sinusitis
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Steps to manage allergic rhinitis?
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1. Identify and avoid triggers of allergic reactions. Keep a diary of times when the allergic reaction occurs and the cause.
Taking medications to reduce inflammation & reduce nasal symptoms. -Antihistamine-Corticosteriods- |
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What is important to tell a patient who is taking antihistamines?
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drink plenty of fluids to reduce adverse symptoms.
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What is the therapeutic use for nasal corticosteroid sprays?
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to decrease inflammation locally with little absorption in the systemic circulation.
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What is immunotherapy?
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"allergy shot"
is used when drugs are not tolerated or effective and when the allergin is known. expose the patient to a small amount of allergin weekly in hopes to decrease sensitivity. |
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DRUG THERAPY ALLERGIC RHINITIS & SINUSITIS
Corticosteroids - Nasal Spray |
Flonase
Nasocort Rhinocort Vancenase Inhibits inflammatory response side effects: nasal burning & stinging teach: correct use, begin 2wk before pollen season starts and use thru out pollen season. *low systemic effect = low side effects |
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DRUG THERAPY ALLERGIC RHINITIS & SINUSITIS
Mast cell stabilizer |
NasalCrom
inhibits degranulation of sensitized mast cells, which occurs after exposure to specific antigens. effects: occasional burning or nasal irritation. teach: correct use, begin 2wk before pollen season starts and thru out it |
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DRUG THERAPY ALLERGIC RHINITIS & SINUSITIS
Anticholinergic - Nasal Spray |
Atrovent
blocks hypersecretory effects by competing for binding sites on the cell. Reduces rhinorrhea(runny nose) in the common cold & nonallergic reactions. side effects: dryness of mouth & nose teach: correct use |
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DRUG THERAPY ALLERGIC RHINITIS & SINUSITIS
Antihistamine |
Relieves acute symptoms of allergic response (itching,sneezing,secretions)
binds with H1 receptors on target cells, blocking histamine. side effects: sedation, restlessness, nervousness, insomnia, loss of appitite, epigastric distress. |
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DRUG THERAPY ALLERGIC RHINITIS & SINUSITIS
Decongestants |
Sudafed
Stimulate adrenergic receptors on blood vessels, Promote vasoconstriction & reduce nasal edema and rhinorrhea side effets: CNS stimulation causeing insomnia, excitation, heachache, irritability, increased BP, dysuria, palpitations, tachycardia teach: don't take if patient has cardiovascular disease, hypertension, diabetes, glaucoma, hepatic & renal disease. |
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What is Sinusitis?
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develops when the ostia (exit) from the sinuses are narrowed or blocked by inflammation or hypertrophy (swelling) of mucosa.
-the secretions that form behind the blockage cause a good enviroment for growth of bacteria, viruses, and fungi - all will cause an infection. |
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Sinusitis can either be __________ , ____________
or ___________ |
Bacterial, Viral or Fungal
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Bacterial Sinusitis is caused by what?
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-Streptococcus pneumoniae
-Haemophilus influenzae -Moraxella catarrhalis |
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What is a common cause of Viral Sinusitis?
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Usually follows an upper respiratory infection in which virus penetrates the mucous membranes and decreases ciliary transport.
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Clinical manifestations of sinusitis
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Pain over affected sinus, purulent nasal drainage, nasal obstruction, congestion, fever, malaise (just don't feel good)
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Management of Sinusitis
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Treat if symptoms persist longer than 7 days
Antibiotics - for bacterial infection (amoxicillin is first choice for 10-14 days, if symptoms do not resolve, change the antibiotic to a broader specrum one like Bactrim or erythromycin) Decongestants - to promote drainage Nasal corticosteroids - to decrease inflammation Mucolytics - to promote mucous flow encourage patient to DRINK DRINK DRINK!!! |
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What is acute pharyngitis?
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an acute inflammation of the pharyngeal walls. May include tonsils, palate, and uvula.
caused by: viral, bacterial or fungal infection. (70% are viral) Acute follicular pharyngitis = STREP THROAT Fungal pharyngitis (candidiasis) can developed with prolonged use of antibiotics or inhaled corticsteroids. |
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Clinical manifestations of acute pharyngitis
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range from scratchy throat to severe pain when swallowing.
Both viral and strep infections appear red and edematous with or without patchy yellow exudates. Rapid strep test is taken to establish cause and direct appropriate management. **inadequate treatment of acute streptococcal pharyngitis can result in RHEUMATIC HEART DISEASE*** |
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Management of Pharyngitis
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infection control, symptomatic relief, and prevention of secondary complications.
Candida infections are treated with Nystatin (anti-fungal antibiotic). Should be swished in mouth as long as possible before it is swallowed & treatment should continue until symptoms are gone. ***Pateint Taking inhaled corticosteroids are at risk for candida infection.*** |