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?

<p>Ibuprofen (B)</p> Signup and view all the answers

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

<p>Risk of excessive bleeding (A)</p> Signup and view all the answers

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

<p>Potential for serious bleeding (D)</p> Signup and view all the answers

How do NSAIDs affect the clotting time in the body?

<p>They can prolong the clotting time (C)</p> Signup and view all the answers

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

<p>Decreased arterial pressure (A)</p> 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?

<p>4g/day (B)</p> Signup and view all the answers

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

<p>Peptic ulcer disease (D)</p> Signup and view all the answers

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

<p>Severe liver injury/hepatotoxicity (A)</p> Signup and view all the answers

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

<p>Acetylcysteine (B)</p> Signup and view all the answers

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

<p>Worsening renal function (D)</p> Signup and view all the answers

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

<p>NSAIDs (A)</p> Signup and view all the answers

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

<p>Gastrointestinal bleeding (C)</p> Signup and view all the answers

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

<p>Existing medications the patient is taking (B)</p> Signup and view all the answers

Which of the following statements about oral phenylephrine is true?

<p>It has been deemed ineffective by the FDA. (A)</p> Signup and view all the answers

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

<p>Respiratory depression. (B)</p> Signup and view all the answers

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

<p>Dextromethorphan. (B)</p> Signup and view all the answers

What is a contraindication for the use of benzontate?

<p>Paradoxical excitation. (B)</p> Signup and view all the answers

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

<p>Increased urination. (B)</p> Signup and view all the answers

What should be avoided when using benzontate?

<p>Use with opioids. (C)</p> Signup and view all the answers

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

<p>Drowsiness. (D)</p> Signup and view all the answers

What is a notable feature of intranasal use of phenylephrine?

<p>It produces effective results within minutes. (C)</p> Signup and view all the answers

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

<p>Possibility of abuse leading to hallucinatory effects. (C)</p> Signup and view all the answers

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

<p>Reduction of dry cough. (C)</p> Signup and view all the answers

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

<p>There is a 1-7% chance they will also be allergic to cephalosporins. (B)</p> Signup and view all the answers

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

<p>Increased risk of bleeding tendencies (A)</p> Signup and view all the answers

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

<p>Cephalexin (B)</p> Signup and view all the answers

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

<p>They start with the prefix 'cef' or 'ceph' indicating their beta-lactam structure. (A)</p> Signup and view all the answers

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

<p>Refrigeration is required to maintain stability. (C)</p> Signup and view all the answers

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

<p>They are primarily used for viral infections. (A)</p> Signup and view all the answers

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

<p>Bleeding disorders (A)</p> Signup and view all the answers

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

<p>C-Diff induced diarrhea, fatigue, and GI complaints (A)</p> Signup and view all the answers

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

<p>Irritation of the glossal surface (D)</p> Signup and view all the answers

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

<p>Allergic skin reactions (B)</p> Signup and view all the answers

What is an essential nursing consideration when administering Amoxicillin?

<p>Give it on an empty stomach for optimal absorption (B)</p> Signup and view all the answers

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

<p>To minimize gastrointestinal side effects (D)</p> Signup and view all the answers

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

<p>Timing the dose to coincide with meals (A)</p> Signup and view all the answers

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

<p>Sinus and upper respiratory infections (D)</p> Signup and view all the answers

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

<p>Amoxicillin is more easily absorbed (C)</p> Signup and view all the answers

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

<p>Destruction of some red blood cells leading to anemia (B)</p> Signup and view all the answers

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

<p>Taking probiotics concurrently (C)</p> Signup and view all the answers

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

<p>Severe dehydration (C)</p> Signup and view all the answers

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

<p>Doses must be decreased. (B)</p> Signup and view all the answers

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

<p>Azithromycin (A)</p> Signup and view all the answers

What is a common gastrointestinal side effect associated with Erythromycin?

<p>Nausea (D)</p> Signup and view all the answers

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

<p>Azithromycin is often prescribed for 5 days instead of 10 days. (A)</p> Signup and view all the answers

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

<p>Usually reversible once the medication is stopped (A)</p> Signup and view all the answers

Why is Erythromycin's use in pediatric patients complicated?

<p>It requires frequent dosing and has a lengthy treatment period. (B)</p> Signup and view all the answers

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

<p>Diarrhea induced by C. difficile (C)</p> Signup and view all the answers

What is a characteristic of Erythromycin's dosing schedule?

<p>It necessitates multiple daily doses. (D)</p> Signup and view all the answers

For which condition is Azithromycin typically an alternative treatment?

<p>Streptococcal pharyngitis (C)</p> Signup and view all the answers

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

<p>It is recommended to take it with or after food. (B)</p> Signup and view all the answers

Flashcards

COX-1 inhibition

Blocking COX-1, a protective enzyme, can lead to undesirable effects like bleeding, gastric upset, and reduced kidney function.

Adverse effects of ASA and ibuprofen

Side effects of ASA and ibuprofen, mainly due to COX-1 inhibition, include bleeding, stomach issues, and kidney problems.

Platelet count and ASA

Do not give Aspirin (ASA) if platelet count is below 100, as it can increase bleeding risk.

NSAID effects on clotting

Nonsteroidal anti-inflammatory drugs (NSAIDs) can prolong blood clotting time.

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Increased ICP/Brain damage

Blocking COX-1 can lead to increased intracranial pressure (ICP) and brain damage.

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Ammonia levels & renal protection

COX-1 inhibition can lead to increased ammonia levels, impacting renal protection (kidney function).

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Vasodilation and bronchodilation

COX-1 inhibition can cause vasodilation (widening of blood vessels) and bronchodilation (widening of airways).

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4g/day NSAIDs

A daily dosage of 4 grams of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) that may be appropriate for secondary prevention of cardiovascular disease (CVD) in adults weighing at least 150lbs. Consideration for chronic conditions, like atherosclerosis, and existing medications is important.

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NSAID Contraindications

Conditions like peptic ulcer disease and chronic kidney disease (CKD) are contraindications to NSAID use. It's crucial to weigh the potential benefits against these risks.

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Acetaminophen Contraindications

People with pre-existing chronic liver issues, heavy alcohol consumption, are contraindicated to take Acetaminophen. Other conditions like CKD and severe liver problems may necessitate avoiding Acetaminophen.

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Acetaminophen Overdose Treatment

Treatment for acetaminophen overdose often involves oral or intravenous acetylcysteine.

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Acetaminophen Potential for Liver Injury

Acetaminophen, when taken in excess or by individuals with pre-existing liver conditions, has a notable risk of causing severe liver injury or hepatotoxicity.

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Oral Phenylephrine Ineffective

The FDA has announced that oral phenylephrine is no longer effective as a nasal decongestant.

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Intranasal Phenylephrine

Intranasal phenylephrine produces an effective response within a few minutes.

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Opioid Cough Suppressants

Opioids like codeine and hydrocodone suppress cough but can cause constipation and respiratory depression making them potentially addictive.

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Non-Opioid Cough Suppressants

Non-opioid cough suppressants, like dextromethorphan, act directly on the cough center of the brain, but can cause drowsiness, GI upset, and, paradoxically, excitation or euphoria.

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Benzonatate Action

Benzonatate anesthetizes lung stretch receptors, suppressing the cough reflex in dry, hacking coughs, but can cause dry mouth and constipation.

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Cough Suppressant Caution

Use cough suppressants with caution due to potential for abuse and dependence, especially in teens. Avoid use with alcohol, opioids, or CNS depressants.

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Cephalosporins

A group of broad-spectrum antibiotics, specifically Beta-Lactam antibacterial agents, with similar mechanisms of action to Penicillins.

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Cephalosporin Uses

Used to treat bacterial infections, targeting gram-positive & gram-negative organisms.

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Cephalosporin Side Effects

Potential side effects include allergic reactions (especially in PCN allergy patients), diarrhea (including C-Diff), and kidney toxicity.

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Cephalosporin Storage

Store oral suspensions of cephalosporins in the refrigerator.

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Cephalosporin Administration

Administer with food to reduce GI upset.

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Cephalosporin in Pregnancy

Generally safe during pregnancy.

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Cephalosporin in Breastfeeding

Generally safe during breastfeeding.

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Penicillin (PCN)

A broad-spectrum antibiotic, often the first choice for sinus, respiratory, and genitourinary infections.

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Examples of Penicillins

Amoxicillin and Ampicillin are examples of penicillin antibiotics.

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Uses of PCN

Treats sinus infections, upper respiratory tract, and genitourinary tract infections.

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Side effects of PCN

Common side effects include allergies (rash, itching), as well as GI discomfort (nausea, vomiting, diarrhea) and can cause hemolytic anemia.

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Best time to take PCN

Take on an empty stomach (1 hour before or 1 hour after a meal) with a full glass of water for optimum absorption and to avoid stomach discomfort

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PCN safety

Generally safe during pregnancy and breastfeeding, but check with a doctor.

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Amoxicillin vs Ampicillin

Amoxicillin is often preferred over Ampicillin for oral use due to better absorption and fewer GI side effects; Ampicillin may be prescribed for other routes of administration

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Macrolide Antibiotics

A group of antibiotics that target bacteria, often used as alternatives to penicillin.

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Erythromycin

A macrolide antibiotic commonly used for bacterial infections, like strep throat.

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Azithromycin (Zithromax)

A macrolide antibiotic, often preferred over erythromycin due to its longer half-life and fewer daily doses.

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Renal Insufficiency

A condition where the kidneys are not functioning properly, requiring adjustments in medicine doses for excreted drugs.

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Dosage Adjustment

A change in medicine dosage given to patients who have problems with kidney function, to prevent toxicity.

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Side Effects of Macrolides

Can include gastrointestinal issues like upset stomach, diarrhea, and abdominal pain.

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Ototoxicity

Potential damage to the hearing and balance systems, especially with macrolide use.

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C-Diff

Clostridium difficile, a type of bacteria that can cause diarrhea.

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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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Unit 4 Class Notes Nasal Fractures, Epistaxis, Facial Trauma - PDF

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.

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