Rhinitis and Sinusitis Care Quiz

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Questions and Answers

Which of the following is a common assessment finding in a client with rhinitis?

Pain over the affected sinus

Temperature spikes

Vision changes

Rhinorrhea (correct)

What is the primary pathophysiological change that occurs in rhinitis?

Increased nasal polyps

Inflammation of the nasal mucous membranes (correct)

Infection of the sinuses

Thickening of the nasal epithelium

Which medication is NOT typically included in the medical management of sinusitis?

Analgesics

Antibiotics

Antacids (correct)

Nasal corticosteroids

What postoperative complication should a nurse observe for in a client who has undergone sinus surgery?

Repeated swallowing indicating potential hemorrhage Signup and view all the answers

What nursing management technique is recommended for clients with sinusitis to enhance comfort?

Mouthwashes Signup and view all the answers

Which activity should be avoided for 10 to 14 days after sinus surgery?

Blowing the nose Signup and view all the answers

What symptom is associated with both rhinitis and sinusitis?

Nasal congestion Signup and view all the answers

What is the focus of nursing management in clients with rhinitis?

Minimizing potential complications Signup and view all the answers

Which of the following is NOT considered a standard treatment for sinusitis?

Applying ice packs on the nose Signup and view all the answers

What is the primary assessment that should be performed after upper respiratory tract surgery?

Ensuring a patent airway Signup and view all the answers

Which symptom is commonly associated with pharyngitis?

Dysphagia Signup and view all the answers

What complication can arise from untreated strep throat?

Rheumatic fever Signup and view all the answers

Which management approach is NOT typically recommended for tonsillitis?

Administration of steroids Signup and view all the answers

What findings indicate a severe case of tonsillitis or adenoiditis?

Enlarged adenoids with snoring Signup and view all the answers

What should a nurse prioritize in the nursing diagnosis for a client with acute pharyngitis?

Acute Pain Signup and view all the answers

Which of the following pathogens is primarily responsible for strep throat?

Streptococcus pyogenes Signup and view all the answers

What is a common cause of a peritonsillar abscess?

Streptococcal or staphylococcal tonsillar infection Signup and view all the answers

Which of the following is NOT an assessment finding for a peritonsillar abscess?

Cough with sputum Signup and view all the answers

What is a primary medical management approach for a peritonsillar abscess?

Antibiotic therapy Signup and view all the answers

Which of the following is a potential sign of laryngeal cancer?

Hoarseness lasting longer than 2 weeks Signup and view all the answers

What is a common method of management for epistaxis?

Direct continuous pressure Signup and view all the answers

Which assessment finding is most indicative of epistaxis?

Nasal bleeding revealed by speculum Signup and view all the answers

Which of the following is NOT a nursing management intervention for a peritonsillar abscess?

Encourage vigorous throat clearing Signup and view all the answers

What is a common risk factor for developing epistaxis?

Dry nasal mucosa Signup and view all the answers

What should be avoided in treating a nosebleed?

Flushing the nose with warm water Signup and view all the answers

Which is a common assessment finding for nasal obstruction?

Difficulty breathing out of one nostril Signup and view all the answers

What is the recommended nursing management for nasal trauma?

Keep head elevated Signup and view all the answers

Which procedure is considered a surgical option for severe obstructive sleep apnea?

Uvulopalatopharyngoplasty Signup and view all the answers

What common symptom might indicate laryngeal cancer?

Persistent progressive hoarseness Signup and view all the answers

What is a primary nursing consideration for a patient with a tracheostomy?

Assess for ineffective airway clearance Signup and view all the answers

Which of the following is NOT a typical assessment finding in obstructive sleep apnea?

Extreme weight gain Signup and view all the answers

What is the primary goal during the medical management of laryngeal trauma?

Ensure a patent airway Signup and view all the answers

What is the first component of nursing management for a patient undergoing endotracheal intubation?

Monitor vital signs Signup and view all the answers

What does a tracheostomy require for long-term management?

Routine tracheostomy care Signup and view all the answers

Which method of communication is used after a laryngectomy?

Esophageal speech Signup and view all the answers

What action should the nurse take for a patient experiencing anxiety related to laryngeal cancer?

Promote positive self-esteem Signup and view all the answers

What should NOT be included in the nursing management for obstructive sleep apnea?

Frequent use of sedatives Signup and view all the answers

In the context of nasal packing, what is essential nursing management?

Monitor for bleeding Signup and view all the answers

What is the primary cause of a peritonsillar abscess?

Bacterial infection from streptococcus or staphylococcus Signup and view all the answers

Which of the following is a key symptom of laryngitis?

Inability to speak above a whisper Signup and view all the answers

What is a common treatment approach for managing epistaxis?

Direct continuous pressure and ice packs Signup and view all the answers

Which finding would indicate the need for laryngoscopy in a patient with hoarseness?

Hoarseness lasting over 2 weeks Signup and view all the answers

What nursing management technique is recommended for a patient with a peritonsillar abscess?

Maintaining a semi-Fowler position Signup and view all the answers

Which of the following statements about the medical management of laryngitis is true?

Voice rest is essential for recovery. Signup and view all the answers

Which assessment finding suggests a severe case of epistaxis?

Continued bleeding despite pressure application Signup and view all the answers

What is a common risk factor for developing a peritonsillar abscess?

Infection from streptococcal or staphylococcal pathogens Signup and view all the answers

Which symptom is commonly associated with rhinitis?

Nasal congestion Signup and view all the answers

What is a typical assessment finding in a patient experiencing acute sinusitis?

Pain over affected sinus Signup and view all the answers

Which of the following medical treatments is most appropriate for managing sinusitis?

Antibiotic therapy Signup and view all the answers

During postoperative care for sinus surgery, what should a nurse assess to monitor for potential complications?

Optic nerve function Signup and view all the answers

What is an important nursing management strategy for a client with sinusitis?

Increased fluid intake Signup and view all the answers

Which activity should be avoided during the recovery period following sinus surgery?

Blowing the nose Signup and view all the answers

What assessment finding suggests a possible acute inflammation in clients suffering from sinusitis?

Rhinorrhea Signup and view all the answers

Which medication is most commonly used for managing symptoms of rhinitis?

Nasal corticosteroids Signup and view all the answers

Which statement about common treatments for sinusitis is accurate?

Decongestants can be taken on a schedule ordered by a doctor. Signup and view all the answers

What complication can arise from untreated pharyngitis?

Endocarditis Signup and view all the answers

What symptom is typically associated with tonsillitis?

Swollen lymph nodes Signup and view all the answers

After upper respiratory tract surgery, which assessment should be prioritized?

Check for a patent airway Signup and view all the answers

What is a common treatment method for chronic tonsillitis?

Use of antibiotics for infection control Signup and view all the answers

Which of the following is NOT a typical assessment finding in acute pharyngitis?

Excessive sweating Signup and view all the answers

What does a nursing diagnosis of 'Risk for Aspiration' pertain to?

Clients with difficulty swallowing Signup and view all the answers

Which of the following represents a medical management approach for pharyngitis?

Throat culture and antibiotics Signup and view all the answers

What should be done to manage a nosebleed effectively?

Tilt the head forward and pinch the nose. Signup and view all the answers

What is a key symptom of obstructive sleep apnea?

Loud snoring followed by silence. Signup and view all the answers

Which statement about the management of laryngeal cancer is incorrect?

Surgery always involves complete removal of the larynx. Signup and view all the answers

How should a nurse address anxiety in patients with laryngeal cancer?

Encourage social relationships and offer support services. Signup and view all the answers

Which of the following is NOT a common cause of nasal obstruction?

Frequent sinus infections. Signup and view all the answers

What is a primary nursing management technique for a patient with a tracheostomy?

Routine tracheostomy care and monitoring the stoma. Signup and view all the answers

What is a potential risk factor for developing epistaxis?

Use of anticoagulants. Signup and view all the answers

Which management strategy is specifically indicated for obstructive sleep apnea?

Implementation of CPAP therapy. Signup and view all the answers

What is not a recommended intervention for managing a nosebleed?

Encouraging the patient to blow their nose regularly. Signup and view all the answers

In managing nasal trauma, what is an essential initial assessment?

Assessing for airway obstruction. Signup and view all the answers

Which action should be part of the nursing management for endotracheal intubation?

Monitor vital signs and mental status closely. Signup and view all the answers

What type of surgical procedure creates an opening into the trachea?

Tracheotomy. Signup and view all the answers

Which is a common psychosocial issue that may arise post-laryngectomy?

Social isolation resulting from communication barriers. Signup and view all the answers

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.