Nursing Care of Patients With Upper Respiratory Tract Disorders PDF

Chapter 30 Nursing Care of Patients With Upper Respiratory Tract Disorders Copyright ©2019 F.A. Davis Company  Epistaxis ▪ More commonly...

Chapter 30 Nursing Care of Patients With Upper Respiratory Tract Disorders Copyright ©2019 F.A. Davis Company  Epistaxis ▪ More commonly known as a nosebleed ▪ Causes Dry, cracked mucous membranes Trauma Hypertension Hemophilia Medications Copyright ©2019 F.A. Davis Company  Epistaxis (continued) ▪ Therapeutic interventions Positioning Direct pressure Ice Nasal packing Nasal balloon catheter Vasoconstrictive agent ‒ phenylephrine Electrocautery Copyright ©2019 F.A. Davis Company  Nasal Polyps ▪ Usually benign ▪ Occur more often with allergies ▪ Therapeutic interventions Control allergies Surgery Avoid aspirin post-op Copyright ©2019 F.A. Davis Company  Deviated Septum ▪ The septum dividing the nasal passages is slightly deviated in most adults ▪ May result from nasal trauma or have no known cause ▪ Some septa may be so deviated that it blocks sinus drainage and interferes with breathing Copyright ©2019 F.A. Davis Company  Deviated Septum (continued) ▪ Symptoms Stuffy nose Blocked sinus drainage Headaches ▪ Therapeutic intervention Nasoseptoplasty ‒ Monitor vital signs/bleeding. ‒ Report excess swallowing. ‒ Monitor dressing. ‒ Teach post-op care: Avoid activities that increase pressure; avoid aspirin. Copyright ©2019 F.A. Davis Company  Sinusitis ▪ Inflammation of sinus mucosa Bacterial Allergic ▪ Signs and symptoms Pain over affected sinus Fever Nasal discharge Copyright ©2019 F.A. Davis Company  Sinusitis (continued) ▪ Therapeutic interventions Saline irrigation Humidification Intranasal Oral fluids corticosteroids Positioning Decongestants Antibiotics Hot packs Surgical drainage Acetaminophen/ ibuprofen Copyright ©2019 F.A. Davis Company  Obstructive Sleep Apnea (OSA) ▪ Apnea during sleep ▪ Risk factors Obesity High palate Receded mandible Smoking Copyright ©2019 F.A. Davis Company  Obstructive Sleep Apnea (continued) ▪ Signs and symptoms ▪ Complications Snoring Heart disease Daytime sleepiness Hypertension Headache Stroke Memory and attention Diabetes problems Copyright ©2019 F.A. Davis Company  Obstructive Sleep Apnea (continued) ▪ Diagnostic test Nocturnal polysomnography ▪ Treatment Avoid sedatives. Lose weight. Nasal patch Noninvasive positive-pressure ventilation (NIPPV) Surgery Copyright ©2019 F.A. Davis Company  Infectious Disorders ▪ Viral rhinitis Another name for common cold ▪ Pharyngitis Inflammation of the pharynx Caused by beta-hemolytic streptococci, commonly referred to as strep throat ▪ Laryngitis Inflammation of mucous membrane of the larynx ▪ Tonsillitis Infection of tonsils Copyright ©2019 F.A. Davis Company  Influenza ▪ Commonly called the flu ▪ Transmitted by coughing and sneezing ▪ Prevention Yearly vaccination Handwashing Avoidance of infected people Copyright ©2019 F.A. Davis Company  Influenza (continued) ▪ Signs and symptoms ▪ Therapeutic Fever interventions Chills Acetaminophen Myalgia Avoid aspirin Sore throat Antiviral agents Cough Rest Malaise Fluids Headache Copyright ©2019 F.A. Davis Company  Other Respiratory Viruses ▪ West Nile Transmitted by mosquitoes ▪ Avian influenza (bird flu) ▪ Severe acute respiratory syndrome (SARS) ▪ Swine flu (H1N1) Copyright ©2019 F.A. Davis Company  Cancer of the Larynx ▪ Pathophysiology Primary tumor of mucosal epithelium Metastasizes to lungs, liver, lymph nodes ▪ Etiology Associated with smoking, alcohol More common in men Copyright ©2019 F.A. Davis Company  Cancer of the Larynx (continued) ▪ Signs and symptoms Hoarseness Change in voice Pain Dyspnea Cough Dysphagia Airway obstruction Copyright ©2019 F.A. Davis Company  Cancer of the Larynx (continued) ▪ Diagnostic tests Laryngoscopy Computed tomography scan Magnetic resonance imaging Copyright ©2019 F.A. Davis Company  Cancer of the Larynx (continued) ▪ Therapeutic interventions Radiation Chemotherapy Laryngectomy − (A) Before laryngectomy − (B) After laryngectomy Copyright ©2019 F.A. Davis Company  Devices to Aid Speech (A) UltraVoice – Placed Inside (B) Blom-Singer Voice Prosthesis – Denture or Retainer; Patient Helps Form Tracheoesophageal Speaks Into Small Microphone. Speech. (Courtesy of InHealth (Courtesy of UltraVoice Ltd., Newtown Technologies, Carpinteria, C A) Square, P A) Copyright ©2019 F.A. Davis Company  Review Question 1 Ice packs are used for epistaxis for which reason? 1. Promote comfort 2. Promote vasoconstriction 3. Reduce swelling 4. Reduce congestion Copyright ©2019 F.A. Davis Company  Review Question 2 What nursing instructions should be provided following a nasoseptoplasty? Select all that apply. 1. Maintain semi-Fowler position. 2. Take stool softeners as prescribed. 3. Use ice for swelling. 4. Blow nose gently to remove clots. 5. Expect a low-grade fever for 3 days. Copyright ©2019 F.A. Davis Company  Review Question 3 Which nursing intervention is appropriate for a sore throat? 1. Warm moist pack 2. Hot tea 3. Bedrest 4. Salt water gargle Copyright ©2019 F.A. Davis Company  Review Question 4 Which patient is most at risk for complications of influenza? 1. 46-year-old teacher 2. 19-year-old student 3. 78-year-old retiree 4. 32-year-old factory worker Copyright ©2019 F.A. Davis Company  Review Question 5 What are common risk factors for laryngeal cancer? Select all that apply. 1. Female 2. Smoker 3. Obesity 4. Alcohol abuse 5. Diet low in fruits and vegetables Copyright ©2019 F.A. Davis Company