CP-_URTI.pdf

MANAGEMENT OF PATIENTS WITH UPPER RESPIRATORY TRACT INFECTIONS Respiratory Infections and Inflammations EPISTAXIS Causes: ▪ Trauma ▪ Hypertension ▪ Rheumatic heart disease ▪ Cancer ▪ Medications EPISTAXIS ◦ Nursing Interventions: ✔ Sit up, lean forward, head tipped ✔ Pressure over th...

MANAGEMENT OF PATIENTS WITH UPPER RESPIRATORY TRACT INFECTIONS Respiratory Infections and Inflammations EPISTAXIS Causes: ▪ Trauma ▪ Hypertension ▪ Rheumatic heart disease ▪ Cancer ▪ Medications EPISTAXIS ◦ Nursing Interventions: ✔ Sit up, lean forward, head tipped ✔ Pressure over the soft tissues of the nose 5mins ✔ Cold compress/ice pack ✔ Nasal pack with neosenephrine (3-5days) ✔ Liquid diet, then soft diet ✔ Avoid oral temperature taking ✔ Do not blow nose for 2days after removal of nasal pack ✔ Notify MD if recurrent SINUSITIS ◦ Acute / Subacute / Chronic ◦ Most commonly affected: maxillary, ethmoid ◦ Causes: allergies, fungal infection, or intubation with a nasotracheal or nasogastric tube. ◦ C.A: Acute: Streptococcus pneumoniae and Haemophilus influenzae Chronic: Peptostreptococcus, Fusobacterium, Streptococcus, S. Aureus SINUSITIS ◦ Assessment ✔ Pain ✔ Maxillary: cheek, upper teeth ✔ Frontal: above eyebrows ✔ Ethmoid: in & around the eyes ✔ Sphenoid: behind eye, occiput, top of the head ✔ General malaise ✔ Stuffy nose ✔ Headache ✔ Post-nasal drip ✔ Persistent cough ✔ fever SINUSITIS ◦ Nursing interventions ✔ Rest ✔ Increase fluid intake ✔ Hot wet packs ✔ Codeine, AVOID ASA ✔ Antimicrobials ✔ Nasal decongestants ✔ Irrigation of maxillary sinuses with warm NSS SINUSITIS ◦ Surgery ◦ FESS ◦ Caldwell-Luc surgery (Radical Antrum Surgery) ✔ Do not chew on affected side ✔ Caution with oral hygiene ✔ Do not wear dentures for 10days ✔ Do not blow nose for 2wks after removal of packing ◦ Ethmoidectomy ◦ Sphenoidotomy/Ethmoidotomy ◦ Osteoplastic flap surgery (Frontal sinusitis) SINUSITIS ◦ Complications b. Meningitis c. Brain abscess d. CVA infarct e. Osteomyelitis f. Visual problems/ loss of sight g. Potts puffy Tumor – infection of the facial bones and forehead RHINITIS ⚫ Causes ◦ environmental factors such as changes in temperature or humidity, odors, or foods; ◦ infection; ◦ age; ◦ systemic disease ◦ Drug induced: RHINITIS ⚫ Assessment ✔ Rhinorrhea ✔ Nasal congestion, discharge, itchiness ✔ Sneezing ✔ Headache ✔ sorethroat RHINITIS ⚫ Nursing Management ✔ Avoid or reduce exposure to allergens or irritants ✔ Rest as much as possible ✔ Increase Oral Fluid Intake ✔ Perform Handwashing frequently Pharmacotherapy ✔ Antihistamines ✔ Oral decongestants ✔ Intranasal corticosteroids UPPER RESPIRATORY TRACT INFECTIONS ⚫ Classification : a. Acute- rapid onset b. Chronic – long term condition ⚫ Causes: 1. Virus 2. Bacteria 3. Allergen VIRAL RHINITIS – “ common cold” or ”coryza” ⚫ Shed the virus 2 days before symptoms occur and during the first part of the symptomatic phase ⚫ Medical Management: 1. Pharmacologic Therapy based on the cause and symptoms 2. Allergy Test PHARYNGITIS ⚫ Most common between 5 to 15 tears old ⚫ Primary symptom : sore throat ⚫ Airborne and droplet ⚫ Cause: Group A B Streptococci bacteria Strep throat Endocarditis RHD PHARYNGITIS ⚫ Assessment ⚫ Rapid Identification 1. “ fiery red pharyngeal Method membrane and 1. Strep A optical tonsils” immunoAssay (OIA) 2. Sorethroat 2. Culture and Sensitivity 3. Dysphagia Test 4. Fever 3. Rapid Strep Test (RST) 5. Chills 6. Headache 7. Body malaise 8. Tonsillar exudates PHARYNGITIS MANAGEMENT: ⚫ Chronic Pharyngitis 1. Hypertrophic – 1. Pharmacologic therapy characterized by general – symptomatic thickening and congestion measures of pharyngeal membranes ⚫ 2. Atrophic – membrane is 2. Nutritional Therapy thin, whitish, Glistening and a. Liquid or Soft Diet at times wrinkled ⚫ 3. Chronic granular – b. Cool beverages c. warm (clergyman’s sore throat) liquids characterized by numerous d. flavored frozen swollen lymph follicles on the pharyngeal wall desserts Pharyngotonsillitis – includes tonsillitis TONSILLITIS / ADENOIDITIS ⚫ Group A beta ◆ ADENOIDITIS hemolytic ✔ Mouth breathing streptococcus ✔ Earache ◆ TONSILLITIS ✔ Draining ears ✔ Fever ✔ Head colds ✔ Snoring ✔ Bronchitis ✔ Dysphagia ✔ Foul smelling breath ✔ Sore throat ✔ Voice impairment TONSILLITIS / ADENOIDITIS Management: 1. Supportive 2. Pharmacologic Therapy 3. Increase OFI 4. Rest 5. Surgical Measures a. Tonsillectomy b. Adenoidectomy TONSILLITIS / ADENOIDITIS ⚫ PRE-OP CARE ⚫ POST-OP CARE ✔ Assess for URTI ✔ Prone, head turned to ✔ Check Prothrombin side/lateral time Awake: semi-fowler’s ✔ Oral airway until swallowing reflex returns ✔ Monitor for hemorrhage ✔ Promote comfort ✔ Foods/fluids TONSILLITIS / ADENOIDITIS ⚫ Avoid clearing of throat ⚫ Avoid coughing, sneezing, blowing nose for 1-2wks ⚫ 2-3L of fluids/day until mouth odor disappears ⚫ Avoid hard/scratchy foods until throat is healed ⚫ Report s/sx of bleeding ⚫ Throat discomfort bet 4th-8th post op day ⚫ Plenty of rest for 2wks ⚫ Avoids 3 Cs-colds, crowded places, coughing LARYNGITIS ⚫ Assessment 1. Aphonia 2. Hoarseness of voice 3. Severe cough 4. Sore throat 5. “tickle” in the throat 6. Noisy respirations 7. Hemoptysis 8. dyspagia  LARYNGITIS ⚫ MANAGEMENT 1. Resting of voice 2. Avoid irritants 3. Cool steam inhalation 4. 4. Pharmacologic Support (antibiotics, expectorants) ⚫ NURSING MANAGEMENT ⚫ Health Teaching ⚫ Answer patient’s questions : S/Sx ⚫ Report if persists > 5days TRACHEOBRONCHITIS ⚫ Inflammation of the windpipe and bronchi ⚫ composed of tracheitis and bronchitis ⚫ Causes: virus, bacteria, chemical or physical irritants, allergen inhalation  TRACHEOBRONCHITIS Assessment: ✔ Dry and non productive cough ✔ Productive cough (phlegm or blood) ✔ High grade Fever of 3-5 days TRACHEOBRONCHITIS ⚫ MANAGEMENT 1. Pharmacologic Treatment 2. Rest 3. Avoid irritants