Nasal Fractures and Epistaxis Overview

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Questions and Answers

What is a direct consequence of inhibiting COX-1?

Increased platelet aggregation

Enhanced kidney function

Reduced vasodilation

Decreased renal protection (correct)

Which condition is primarily caused by elevated ammonia levels due to COX-1 inhibition?

Liver failure

Platelet dysfunction

Kidney damage

Brain swelling (correct)

What adverse effect is specifically noted when aspirin (ASA) is given and COX-1 is inhibited?

Bleeding risk (correct)

Increased risk of stroke

Enhanced platelet production

Nausea and vomiting

Which of the following drugs is indicated to prolong the effects of ASA?

Ibuprofen Signup and view all the answers

Why should ASA not be given if platelet counts are less than 100?

Risk of excessive bleeding Signup and view all the answers

What is one of the significant black box warnings associated with NSAIDs?

Potential for serious bleeding Signup and view all the answers

How do NSAIDs affect the clotting time in the body?

They can prolong the clotting time Signup and view all the answers

What is a possible consequence of vasodilation when COX-1 is inhibited?

Decreased arterial pressure Signup and view all the answers

What is the recommended daily dosage for adults to maintain secondary prevention, assuming they weigh at least 150 lbs?

4g/day Signup and view all the answers

Which of the following conditions is a contraindication for using NSAIDs?

Peptic ulcer disease Signup and view all the answers

What is a possible consequence of chronic alcohol consumption when taking acetaminophen?

Severe liver injury/hepatotoxicity Signup and view all the answers

In the context of acetaminophen overdose, which of the following treatments is appropriate?

Acetylcysteine Signup and view all the answers

What is a common risk associated with using NSAIDs in patients with chronic kidney disease (CKD)?

Worsening renal function Signup and view all the answers

Which of the following medications are commonly contraindicated with other pain relievers like Tylenol?

NSAIDs Signup and view all the answers

Among patients using NSAIDs, which of the following concerns should healthcare providers monitor for?

Gastrointestinal bleeding Signup and view all the answers

What should be considered when administering acetaminophen to avoid dangerous interactions?

Existing medications the patient is taking Signup and view all the answers

Which of the following statements about oral phenylephrine is true?

It has been deemed ineffective by the FDA. Signup and view all the answers

What is a potential side effect of using opioids as antitussives?

Respiratory depression. Signup and view all the answers

Which non-opioid antitussive acts directly on the cough center in the brain?

Dextromethorphan. Signup and view all the answers

What is a contraindication for the use of benzontate?

Paradoxical excitation. Signup and view all the answers

Which of the following is NOT an effect of prolonged use of non-opioid antitussives?

Increased urination. Signup and view all the answers

What should be avoided when using benzontate?

Use with opioids. Signup and view all the answers

Which symptom can be caused by the use of opioids as antitussives?

Drowsiness. Signup and view all the answers

What is a notable feature of intranasal use of phenylephrine?

It produces effective results within minutes. Signup and view all the answers

What is a specific caution when prescribing non-opioid antitussives to teenagers?

Possibility of abuse leading to hallucinatory effects. Signup and view all the answers

Which of the following is an effect of hydrocodone when used as an antitussive?

Reduction of dry cough. Signup and view all the answers

What is a significant nursing consideration when administering cephalosporins to patients with a history of penicillin allergy?

There is a 1-7% chance they will also be allergic to cephalosporins. Signup and view all the answers

Which side effect is specifically associated with the use of cefotetan?

Increased risk of bleeding tendencies Signup and view all the answers

Which cephalosporin should be taken with food to improve its absorption?

Cephalexin Signup and view all the answers

Which of the following is true regarding the classification of cephalosporins?

They start with the prefix 'cef' or 'ceph' indicating their beta-lactam structure. Signup and view all the answers

What is a primary nursing consideration concerning the storage of oral suspensions of cephalosporins?

Refrigeration is required to maintain stability. Signup and view all the answers

Which of the following statements is false regarding the uses of cephalosporins?

They are primarily used for viral infections. Signup and view all the answers

Which of the following conditions would contraindicate the use of ceftriaxone?

Bleeding disorders Signup and view all the answers

What are common side effects of cephalosporins that nurses should monitor for?

C-Diff induced diarrhea, fatigue, and GI complaints Signup and view all the answers

What is the primary reason production of 'black hairy tongue' occurs in patients taking Penicillin?

Irritation of the glossal surface Signup and view all the answers

Which of the following side effects is most commonly associated with Penicillin?

Allergic skin reactions Signup and view all the answers

What is an essential nursing consideration when administering Amoxicillin?

Give it on an empty stomach for optimal absorption Signup and view all the answers

Why should Penicillin be given with a full glass of water?

To minimize gastrointestinal side effects Signup and view all the answers

Which of the following is NOT a consideration for Penicillin administration?

Timing the dose to coincide with meals Signup and view all the answers

What type of infections is Penicillin commonly the drug of choice for?

Sinus and upper respiratory infections Signup and view all the answers

Which statement about the absorption of Amoxicillin compared to Ampicillin is correct?

Amoxicillin is more easily absorbed Signup and view all the answers

What is a potential consequence of the antibiotic action of Penicillin regarding red blood cells?

Destruction of some red blood cells leading to anemia Signup and view all the answers

What is a recommended practice for patients taking antibiotics such as Penicillin to prevent gastrointestinal discomfort?

Taking probiotics concurrently Signup and view all the answers

Which of the following side effects is NOT a complication of Penicillin use?

Severe dehydration Signup and view all the answers

What must be done with doses of medications primarily excreted in urine for patients with renal insufficiency?

Doses must be decreased. Signup and view all the answers

Which macrolide antibiotic is noted for its effectiveness against streptococcal organisms?

Azithromycin Signup and view all the answers

What is a common gastrointestinal side effect associated with Erythromycin?

Nausea Signup and view all the answers

How does the treatment duration of Azithromycin compare to that of Erythromycin for certain infections?

Azithromycin is often prescribed for 5 days instead of 10 days. Signup and view all the answers

What effect does Azithromycin have on hearing, and when does this occur?

Usually reversible once the medication is stopped Signup and view all the answers

Why is Erythromycin's use in pediatric patients complicated?

It requires frequent dosing and has a lengthy treatment period. Signup and view all the answers

Which of the following is a major risk associated with the use of macrolides?

Diarrhea induced by C. difficile Signup and view all the answers

What is a characteristic of Erythromycin's dosing schedule?

It necessitates multiple daily doses. Signup and view all the answers

For which condition is Azithromycin typically an alternative treatment?

Streptococcal pharyngitis Signup and view all the answers

What needs to be considered when taking Erythromycin to minimize gastrointestinal side effects?

It is recommended to take it with or after food. Signup and view all the answers

Study Notes

Nasal Fractures

Simple fractures involve one or both sides, with little or no displacement
Complex fractures may involve facial damage
Complications include airway obstruction, nosebleeds, meningeal tears (CSF leakage), septal hematoma, cosmetic deformity
Basilar skull fracture can cause raccoon eyes, bruising behind the ear, increased CSF leakage
Maintain airway, reduce swelling/pain, prevent complications
Keep patient sitting upright
Apply ice to nose (10-20 minutes) to reduce swelling/pain
Avoid blowing nose, hot showers, or alcohol (48 hours) to avoid increasing swelling
Antibiotics are used depending on the fracture and disruption to mucosa
Septoplasty corrects a deviated septum

Epistaxis

Nosebleeds frequent in adults over 50
Causes include trauma, low humidity, URI, allergies, sinusitis, foreign bodies, chemical irritants, nasal/facial surgery, or tumors, use of decongestants
Anterior bleeds usually stop with pressure, while posterior bleeds are more serious in older adults with health problems and often occur near the throat, harder to manage.
Position patient upright, leaning slightly forward
Apply direct pressure to the nostrils for 5-15 minutes
Seek medical help if bleeding doesn't stop
Avoid lying flat, warm compresses, or tilting head back
Posterior bleeding often requires packing and antibiotics for infection risk

Rhinoplasty

Surgical nose reconstruction
Outpatient procedure
Patients discontinue aspirin and NSAIDs 5-2 weeks before surgery
Post-operative care includes monitoring airway and respiratory status, pain management, and observation of surgical site, bleeding, and swelling.
Patients need to avoid nose blowing, heavy lifting, and swimming for up to a year

Rhinitis

Inflammation of the nasal lining

Sinusitis

Inflammation of the sinus tissues

Rhinorrhea

Runny nose, mucus dripping out of the nose

Nasopharyngitis ("Common Cold")

Inflammation of nasal passages and pharynx

Pharyngitis

Sore throat, inflammation of the pharynx

Otolaryngologists

Doctors specializing in the ears, nose, and throat (ENT).

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Description

This quiz covers essential information about nasal fractures and epistaxis, including types of fractures, potential complications, and treatment methods. It highlights the importance of maintaining airway integrity and managing nosebleeds, especially in older adults. Test your knowledge on these critical topics in nasal health.