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Which of the following is a common assessment finding in a client with rhinitis?
What is the primary pathophysiological change that occurs in rhinitis?
Which medication is NOT typically included in the medical management of sinusitis?
What postoperative complication should a nurse observe for in a client who has undergone sinus surgery?
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What nursing management technique is recommended for clients with sinusitis to enhance comfort?
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Which activity should be avoided for 10 to 14 days after sinus surgery?
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What symptom is associated with both rhinitis and sinusitis?
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What is the focus of nursing management in clients with rhinitis?
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Which of the following is NOT considered a standard treatment for sinusitis?
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What is the primary assessment that should be performed after upper respiratory tract surgery?
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Which symptom is commonly associated with pharyngitis?
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What complication can arise from untreated strep throat?
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Which management approach is NOT typically recommended for tonsillitis?
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What findings indicate a severe case of tonsillitis or adenoiditis?
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What should a nurse prioritize in the nursing diagnosis for a client with acute pharyngitis?
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Which of the following pathogens is primarily responsible for strep throat?
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What is a common cause of a peritonsillar abscess?
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Which of the following is NOT an assessment finding for a peritonsillar abscess?
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What is a primary medical management approach for a peritonsillar abscess?
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Which of the following is a potential sign of laryngeal cancer?
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What is a common method of management for epistaxis?
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Which assessment finding is most indicative of epistaxis?
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Which of the following is NOT a nursing management intervention for a peritonsillar abscess?
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What is a common risk factor for developing epistaxis?
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What should be avoided in treating a nosebleed?
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Which is a common assessment finding for nasal obstruction?
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What is the recommended nursing management for nasal trauma?
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Which procedure is considered a surgical option for severe obstructive sleep apnea?
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What common symptom might indicate laryngeal cancer?
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What is a primary nursing consideration for a patient with a tracheostomy?
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Which of the following is NOT a typical assessment finding in obstructive sleep apnea?
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What is the primary goal during the medical management of laryngeal trauma?
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What is the first component of nursing management for a patient undergoing endotracheal intubation?
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What does a tracheostomy require for long-term management?
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Which method of communication is used after a laryngectomy?
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What action should the nurse take for a patient experiencing anxiety related to laryngeal cancer?
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What should NOT be included in the nursing management for obstructive sleep apnea?
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In the context of nasal packing, what is essential nursing management?
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What is the primary cause of a peritonsillar abscess?
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Which of the following is a key symptom of laryngitis?
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What is a common treatment approach for managing epistaxis?
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Which finding would indicate the need for laryngoscopy in a patient with hoarseness?
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What nursing management technique is recommended for a patient with a peritonsillar abscess?
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Which of the following statements about the medical management of laryngitis is true?
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Which assessment finding suggests a severe case of epistaxis?
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What is a common risk factor for developing a peritonsillar abscess?
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Which symptom is commonly associated with rhinitis?
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What is a typical assessment finding in a patient experiencing acute sinusitis?
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Which of the following medical treatments is most appropriate for managing sinusitis?
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During postoperative care for sinus surgery, what should a nurse assess to monitor for potential complications?
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What is an important nursing management strategy for a client with sinusitis?
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Which activity should be avoided during the recovery period following sinus surgery?
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What assessment finding suggests a possible acute inflammation in clients suffering from sinusitis?
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Which medication is most commonly used for managing symptoms of rhinitis?
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Which statement about common treatments for sinusitis is accurate?
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What complication can arise from untreated pharyngitis?
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What symptom is typically associated with tonsillitis?
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After upper respiratory tract surgery, which assessment should be prioritized?
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What is a common treatment method for chronic tonsillitis?
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Which of the following is NOT a typical assessment finding in acute pharyngitis?
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What does a nursing diagnosis of 'Risk for Aspiration' pertain to?
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Which of the following represents a medical management approach for pharyngitis?
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What should be done to manage a nosebleed effectively?
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What is a key symptom of obstructive sleep apnea?
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Which statement about the management of laryngeal cancer is incorrect?
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How should a nurse address anxiety in patients with laryngeal cancer?
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Which of the following is NOT a common cause of nasal obstruction?
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What is a primary nursing management technique for a patient with a tracheostomy?
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What is a potential risk factor for developing epistaxis?
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Which management strategy is specifically indicated for obstructive sleep apnea?
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What is not a recommended intervention for managing a nosebleed?
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In managing nasal trauma, what is an essential initial assessment?
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Which action should be part of the nursing management for endotracheal intubation?
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What type of surgical procedure creates an opening into the trachea?
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Which is a common psychosocial issue that may arise post-laryngectomy?
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Study Notes
Rhinitis
- Inflammation of the nasal mucous membranes, acute, chronic, or allergic.
- Symptoms include: sneezing, nasal congestion, rhinorrhea, sore throat, watery eyes, cough, low-grade fever, headache, aching muscles, and malaise.
- Treatment includes: antipyretics, decongestants, antitussives, saline gargles, saline spray, and antihistamines.
Sinusitis
- Inflammation of the sinuses, specifically the maxillary sinus.
- Symptoms include: headache, fever, pain over the affected sinus, nasal congestion, and pressure around the eyes.
- Treatments include: saline irrigation, antibiotic therapy, vasoconstrictors, nasal corticosteroids, and surgical procedures such as Caldwell–Luc procedure and external sphenoid ethmoidectomy.
Postoperative Care for Sinus Surgery
- Monitor for repeated swallowing, which could indicate hemorrhage.
- Assess optic nerve function.
- Monitor temperature every 4 hours and check for pain over the involved sinuses.
- Administer analgesics as indicated and apply ice compresses.
- Nasal packing and dressings under nares ("moustache" or drop pad) should be in place.
- Avoid blowing the nose, lifting more than 5 to 10 lbs, and air travel for 10 to 14 days after surgery.
Pharyngitis
- Inflammation of the throat, often associated with rhinitis and other upper respiratory infections (URIs).
- Group A streptococci, causing "strep throat," is a common cause.
- Complications include: endocarditis, rheumatic fever, and glomerulonephritis.
- Highly contagious, transmission occurs through inhalation or direct contamination with droplets.
- Symptoms include: sore throat, dysphagia, fever, headache, white or exudate patch over the tonsillar area, and swollen glands.
- Management includes: throat culture, antibiotic treatment (e.g., erythromycin).
Tonsillitis and Adenoiditis
- Can be primary or secondary.
- Chronic tonsillar infection may lead to partial upper airway obstruction.
- Chronic adenoidal infection is linked to otitis media.
- Symptoms include: sore throat, difficulty swallowing, fever, malaise, enlarged adenoids causing nasal obstruction, and snoring.
- Management includes: antibiotic therapy, analgesics, saline gargles and surgical procedures such as tonsillectomy and adenoidectomy.
Pre- and Postoperative Care for Tonsillectomy and Adenoidectomy
- Perform laboratory tests including hematocrit, platelet count, clotting time, and assess for aspirin or NSAID use in client's history.
- Nursing diagnoses include: Risk for Aspiration, Risk for Impaired Tissue Integrity, and Acute Pain.
Peritonsillar Abscess
- Develops in connective tissue between tonsil and pharynx.
- Often caused by streptococcal or staphylococcal tonsillar infection.
- Symptoms include: difficulty and pain with swallowing, fever, malaise, ear pain, and difficulty talking.
- Diagnostic findings include sensitivity studies and culture.
- Treatment includes: antibiotic therapy, needle aspiration, surgical incision and drainage.
- Nursing management includes: semi-Fowler position, preventing aspiration, applying ice collar, topical anesthetics, throat irrigations, encouraging fluid intake, and observing for respiratory obstruction and excessive bleeding.
Laryngitis
- Inflammation and swelling of the mucous membrane of the larynx.
- Causes include: URIs, excessive use of voice, allergies, and smoking.
- Symptoms include: inability to speak above a whisper (aphonia), throat irritation, and dry, nonproductive cough.
- Hoarseness lasting longer than 2 weeks should prompt laryngoscopy.
- Persistent hoarseness is a potential sign of laryngeal cancer.
- Management includes: voice rest, treatment or removal of the underlying cause, and antibiotic therapy if bacterial infection is present.
Epistaxis
- Rupture of tiny capillaries in the nasal mucous membrane (Kiesselbach plexus).
- Risk factors include: trauma, systemic infections (e.g., rheumatic fever), local infections, dry nasal mucosa, hypertension, aspirin use, nasal tumors, blood dyscrasias, and cocaine abuse/inhaled drugs.
- Assessment findings involve using a nasal speculum and tongue blade to visualize bleeding.
- Management includes: direct continuous pressure, ice packs, topical vasoconstrictor, nasal packing, and surgical interventions such as cauterization, electrocautery, and balloon-inflated catheter.
- Nursing management includes: monitoring vital signs, assessing for ongoing bleeding, providing humidification, applying nasal lubricant, and advising the client to avoid vigorous nose blowing or picking.
Nasal Obstruction
- Causes include: deviated septum, nasal polyps, and hypertrophied turbinates.
- Symptoms include: history of sinusitis, difficulty breathing out of one nostril, and frequent nosebleeds.
- Management includes: steroidal nasal spray, surgical procedures such as submucous surgical resection, septoplasty, rhinoplasty, and nose reconstruction.
- Nursing management includes: managing nasal packing, assisting with mouth breathing, positioning the client in semi-Fowler's position, monitoring vital signs, and providing oral hygiene.
Fractures of the Nose
- Caused by trauma.
- Symptoms include: swelling/edema of soft tissue, external and internal bleeding, nasal deformity, nasal obstruction, and potential cerebrospinal fluid leakage (CSF)—Dextrostix testing useful.
- Management involves applying pressure, cold compresses, and surgical intervention for complex fractures.
- Nursing management includes: elevating the head of the bed, applying ice, administering analgesics, assessing for airway obstruction, checking pupillary responses and level of consciousness, monitoring for periorbital edema, and addressing anxiety.
Laryngeal Trauma and Obstruction
- Causes include: motor vehicle accidents, blunt trauma in the neck region.
- Symptoms include: neck swelling, bruising, and tenderness, stridor, dysphagia, hoarseness, cyanosis, and hemoptysis.
- Diagnostic studies involve laryngoscopy and x-ray.
- Management focuses on securing a patent airway, potentially utilizing the Heimlich maneuver.
- Nursing management includes: monitoring for airway obstruction, assessing respiratory pattern, checking for nasal swelling and bleeding, and observing for laryngeal edema.
Obstructive Sleep Apnea
- Characterized by recurrent and frequent episodes of upper airway obstruction and reduced ventilation during sleep.
- Classifications include: central, obstructive, and complex (mixed).
- Symptoms include: loud snoring, cessation of breathing for at least 10 seconds, awakening suddenly with a loud snort, daytime fatigue, morning headache, inability to concentrate, sore throat, enuresis (bedwetting), and erectile dysfunction.
- Management includes: weight loss, smoking cessation, eliminating alcohol, using special pillows, Continuous Positive Airway Pressure (CPAP), Auto-titrating Continuous Positive Airway Pressure (APAP), Bilevel Positive Airway Pressure (BIPAP), and surgical procedures like uvulopalatopharyngoplasty and tracheostomy.
- Nursing management involves: reassurance, providing adequate instruction and explanations, connecting with self-help groups, and offering counseling.
Laryngeal Cancer
- Causes include: carcinogens like tobacco, alcohol, and pollutants.
- Symptoms include: persistent, progressive hoarseness, swelling or lump in the throat or neck, dysphagia, and weight loss.
- Diagnostic studies include: laryngoscopy, biopsy, CT, MRI, and PET.
- Management includes: chemotherapy, radiation therapy, and laryngectomy.
- Nursing management focuses on: assessing for hoarseness, dysphagia, dyspnea, burning in the throat, evaluating anxiety levels, identifying coping strategies, and supporting communication abilities.
Alternative Measures of Communication
- Used after laryngectomy:
- Esophageal speech: Regurgitation of swallowed air used to form words with lips.
- Artificial (electric) larynx: Throat vibrator held against the neck to project sound into the mouth.
- Tracheoesophageal puncture (TEP): Surgical insertion of a prosthesis, such as the Blom–Singer device.
- Psychosocial issues are common, including social isolation.
- Nursing management addresses psychosocial aspects by promoting positive self-esteem, encouraging social relationships, and facilitating access to support services.
Tracheotomy and Tracheostomy
- Tracheotomy: Surgical procedure creating an opening into the trachea.
- Tracheostomy: Surgical opening into the trachea into which a tracheostomy or laryngectomy tube is inserted.
- Can be temporary or permanent.
- Nursing management involves:
- Risk for Ineffective Airway Clearance: Monitoring vital signs, breath sounds, skin color, level of consciousness, mental status, and ensuring airway patency.
- Risk for Infection: Monitoring the stoma, providing routine tracheostomy care, and positioning the client appropriately.
- Risk for Ineffective Management of Therapeutic Regimen: Supporting adherence to therapeutic regimen.
Endotracheal Intubation and Mechanical Ventilation
- Uses: Respiratory difficulties, comatose clients, and general anesthesia.
- Types of mechanical ventilation: Negative pressure and positive pressure.
- Nursing management includes:
- Monitoring vital signs, ABGs, SpO2, and mental status.
- Assessing for confusion, agitation, and auscultating lung sounds.
- Providing suctioning and humidification, and facilitating communication.
Rhinitis
- Inflammation of nasal mucous membranes; acute, chronic, or allergic
- Symptoms include sneezing, nasal congestion, rhinorrhea, sore throat, watery eyes, cough, low-grade fever, headache, aching muscles, and malaise
- Treatments include antipyretics, decongestants, antitussives, saline gargles, saline spray, and antihistamines
Sinusitis
- Inflammation of the sinuses; commonly affects the maxillary sinus
- Symptoms include headache, fever, pain over affected sinus, nasal congestion, and pressure around eyes
- Treatment includes saline irrigation, antibiotic therapy, vasoconstrictors, and nasal corticosteroids
- Surgical options include Caldwell–Luc procedure and external sphenoid ethmoidectomy
Postoperative Sinus Surgery Care
- Observe for repeated swallowing, which may indicate hemorrhage
- Assess optic nerve function
- Monitor temperature every 4 hours
- Administer analgesics as indicated and apply ice compresses
- Nasal packing and dressing will be in place under the nares
- Avoid blowing the nose, lifting more than 5 to 10 lb, and airplane travel for 10 to 14 days
Pharyngitis
- Inflammation of the throat; often associated with rhinitis and other upper respiratory infections
- Group A streptococci is the cause of strep throat
- Complications include endocarditis, rheumatic fever, and glomerulonephritis
- Highly contagious through inhalation or direct contamination with droplets
Pharyngitis (Continued)
- Symptoms include sore throat, dysphagia, fever, headache, white or exudate patch over the tonsillar area, and swollen glands
- Treatment includes a throat culture and antibiotic therapy, such as erythromycin
Tonsillitis and Adenoiditis
- Chronic tonsillar infection can cause partial upper airway obstruction
- Chronic adenoidal infection can lead to otitis media
- Symptoms include sore throat, difficult or pain on swallowing, fever, malaise, and enlarged adenoids
- Enlarged adenoids can cause nasal obstruction and snoring
- Treatment includes antibiotic therapy, analgesics, and saline gargles
- Tonsillectomy and adenoidectomy are surgical options
Tonsillitis and Adenoiditis (Continued)
- Nursing management includes pre- and post-operative care, lab results, and managing potential complications
- Nursing diagnoses include Risk for Aspiration, Risk for Impaired Tissue Integrity, and Acute Pain
Peritonsillar Abscess
- Develops in the connective tissue between the tonsil and pharynx
- Commonly caused by streptococcal or staphylococcal tonsillar infection
- Symptoms include difficulty and pain with swallowing, fever, malaise, ear pain, and difficulty talking
- Diagnosis is through sensitivity studies and culture
Peritonsillar Abscess (Continued)
- Treatment includes antibiotic therapy
- Surgical management options include needle aspiration, surgical incision, and drainage
- Nursing management includes semi-Fowler positioning to prevent aspiration, ice collar, topical anesthetics, throat irrigations, increased fluid intake, and observation for respiratory obstruction or bleeding
Laryngitis
- Inflammation and swelling of the mucous membrane
- Causes include upper respiratory infections, excessive use of voice, allergies, and smoking
- Symptoms include inability to speak above a whisper, aphonia, throat irritation, and dry, nonproductive cough
- Persistent hoarseness for more than 2 weeks should prompt a laryngoscopy
- Persistent hoarseness may be a sign of laryngeal cancer
Laryngitis (Continued)
- Treatment includes voice rest, addressing the underlying cause, and antibiotic therapy if bacterial
- Smoking cessation is crucial
Epistaxis
- Rupture of tiny capillaries in the nasal mucous membrane; commonly occurs in the Kiesselbach plexus
- Risk factors include trauma, systemic infections, local infections, dry nasal mucosa, hypertension, aspirin, nasal tumors, blood dyscrasias, and cocaine abuse
- Assessment includes using a nasal speculum and tongue blade to visualize bleeding
Epistaxis (Continued)
- Treatment includes direct continuous pressure, ice packs, topical vasoconstrictors, and nasal packing.
- Surgical management options include cauterization, electrocautery, and balloon-inflated catheter
- Nursing management requires monitoring vital signs, assessing for continued bleeding, providing humidification and nasal lubricant, and avoiding vigorous nose blowing or picking
Nasal Obstruction
- Obstruction of the nasal passage due to a deviated septum, nasal polyps, or hypertrophied turbinates
- Symptoms include a history of sinusitis, difficulty breathing out of one nostril, and frequent nosebleeds
- Treatment includes steroidal nasal spray
- Surgical options include submucous surgical resection, septoplasty, rhinoplasty, and nose reconstruction
Nasal Obstruction (Continued)
- Nursing management includes nasal packing, assisting with mouth breathing, placing the patient in a semi-Fowler position, and monitoring vital signs
Fractures of the Nose
- Result from trauma
- Symptoms include swelling/edema of soft tissue, external and internal bleeding, nasal deformity, nasal obstruction, and potential cerebrospinal fluid leakage
- Treatment includes pressure application and cold compresses
- Surgical management is necessary for complex fractures
Fractures of the Nose (Continued)
- Nursing management includes elevating the head of the bed, applying ice, administering analgesics, and assessing for airway obstruction, pupillary responses, level of consciousness, and periorbital edema
Laryngeal Trauma and Obstruction
- Results from motor vehicle accidents or blunt trauma in the neck region
- Symptoms include neck swelling, bruising, and tenderness; stridor; dysphagia; hoarseness; cyanosis; and hemoptysis
- Diagnosis is confirmed through laryngoscopy and x-ray
- Treatment includes ensuring a patent airway, performing the Heimlich maneuver, and potential mechanical ventilation
Laryngeal Trauma and Obstruction (Continued)
- Nursing management includes monitoring vital signs, assessing respiratory patterns, and observing for nasal swelling, bleeding, and laryngeal edema
Obstructive Sleep Apnea
- Recurrent episodes of upper airway obstruction and reduced ventilation during sleep
- Classifications include central, obstructive, and complex (mixed)
- Symptoms include loud snoring, cessation of breathing for at least 10 seconds, awakening suddenly with a loud snort, daytime fatigue, morning headache, inability to concentrate, sore throat, enuresis, and erectile dysfunction
Obstructive Sleep Apnea (Continued)
- Treatment includes weight loss, smoking cessation, alcohol elimination, and special pillows
- Non-invasive ventilation options include continuous positive airway pressure (CPAP), auto-titrating continuous positive airway pressure (APAP), and bilevel positive airway pressure (BIPAP)
- Surgical management options include uvulopalatopharyngoplasty and tracheostomy
- Nursing management involves reassurance, providing adequate instructions and explanations, and referring patients to self-help groups and counseling
Laryngeal Cancer
- Causes include carcinogens such as tobacco, alcohol, and pollutants
- Symptoms include persistent, progressive hoarseness; swelling or lump in the throat or neck; dysphagia; and weight loss
- Diagnosis is confirmed through laryngoscopy, biopsy, CT scan, MRI, and PET scan
- Treatment includes chemotherapy, radiation therapy, and laryngectomy
Laryngeal Cancer (Continued)
- Nursing management includes assessing for hoarseness, dysphagia, dyspnea, burning in the throat, anxiety level, coping strategies, and ability to communicate
Alternative Measures of Communication (Following Laryngectomy)
- Esophageal speech utilizes the regurgitation of swallowed air to form words with the lips
- An artificial (electric) larynx is a throat vibrator held against the neck to project sound into the mouth
- Tracheoesophageal puncture (TEP) involves the surgical insertion of a prosthesis, like the Blom–Singer device
Alternative Measures of Communication (Continued)
- Psychosocial issues such as social isolation are common after laryngectomy
- Nursing management focuses on promoting positive self-esteem, encouraging social relationships, and providing support services
Tracheotomy and Tracheostomy
- Tracheotomy is a surgical procedure that creates an opening in the trachea
- Tracheostomy is a surgical opening in the trachea that allows the insertion of a tube (either temporary or permanent)
- Nursing management focuses on maintaining a patent airway, preventing infection, and ensuring proper therapeutic regimen management
Tracheotomy and Tracheostomy (Continued)
- Nursing diagnoses include Risk for Ineffective Airway Clearance, Risk for Infection, and Risk for Ineffective Management of Therapeutic Regimen
Endotracheal Intubation and Mechanical Ventilation
- Endotracheal intubation inserts a tube directly into the trachea. It's used to support breathing during emergencies or surgical procedures
- Mechanical ventilation assists with breathing. Types include negative pressure and positive pressure ventilation
- Nursing management involves monitoring vital signs, ABGs, SpO2, and mental status.
- It also includes assessing for signs of confusion, agitation, auscultating breath sounds, suctioning and humidifying the airway, and facilitating communication
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Description
Test your knowledge on rhinitis and sinusitis, including symptoms, treatment options, and postoperative care following sinus surgery. This quiz covers key concepts related to nasal and sinus inflammation, helping you understand management strategies.