N215F Nursing Therapeutics In General Nursing (2024-25) PDF

N215F Nursing Therapeutics in General Nursing (2024-25) Respiratory Nursing (2a):  Upper Respiratory Tract Infection  Acute Tracheobronchitis stigation Caroline Yang 12 Sep 2024 1100 – 1300 Learning Outcomes Describe the definition,...

N215F Nursing Therapeutics in General Nursing (2024-25) Respiratory Nursing (2a):  Upper Respiratory Tract Infection  Acute Tracheobronchitis stigation Caroline Yang 12 Sep 2024 1100 – 1300 Learning Outcomes Describe the definition, aetiology, pathophysiology, clinical features, investigation, diagnosis, and management of common upper respiratory tract disorders. Integrate knowledge of pathophysiology and pharmacology to develop effective nursing care plans for clients with upper respiratory tract disorders. Identify and apply essential nursing considerations in the care of clients with upper respiratory tract disorders. Develop and evaluate nursing care plans tailored for clients with upper respiratory tract disorders. 2 Upper Respiratory Tract Infection (URTI) Infections of upper respiratory tract triggers inflammatory response Affected areas Name of diagnosis if infection Nasal cavity Infectious rhinitis/ Nasopharyngitis/ (Rhin - "Nose") Common cold Sinuses Rhinosinusitis/ Sinusitis Pharynx Pharyngitis Tonsils Tonsilitis Larynx Laryngitis Epiglottis Epiglottitis The infections are interrelated and usually occur together or once condition may lead to another  secondary bacterial infection Common causative organisms: Virus  infection from self-limited cold to life-threatening pneumonia 3 Common Cold A viral infection of the upper respiratory tract Prevalence: Most frequent respiratory tract infection Causes: Can cause by single virus or multiple viruses Common pathogen: Most Common: I Rhinovirus Other virus include: I Parainfluenza viruses Respiratory syncytial virus (RSV) Human metapneumovirus (hMPV) ! Coronaviruses Adenoviruses 4 Common Cold: Aetiology The season of the year I Age > - child + elderly Affects the susceptibility to infections and Immunological state severity of symptoms Prior exposure 5 Common Cold: Pathogenesis Cold virus spread rapidly from person to person, particularly children Primary source of spread: Fingers (Contact transmission) Other mode of transmission: Droplet Aerosol Indirect contact Common entry points: nasal mucosa and conjunctival surface Highest contagious period: Within the first 3 days after symptoms begin Incubation period: 5 days 6 (Leung, 2021) 7 Clinical Manifestations of Common Cold Dryness and stuffiness in the nasopharynx. Excessive nasal secretions and tearing (rhinitis). Secretions are clear and watery. Reddened and swollen mucous membranes. Postnasal dripping soreness and hoarseness. Possible headache and general malaise. Severe cases may include chills, fever, and exhaustion. Typically lasts 5 to 6 days. Respiratory viruses cause 40% to 75% of acute otitis media in children. 8 Treatment of Common Cold Self-limited in healthy individuals Symptomatic treatment: Rest Sufficient and effective Antipyretics Medications: 1 Antihistamine: dry nasal secretions I Decongestants:  swelling 4 WTE Antibiotics: Ineffective against viruses 9 Rhinosinusitis Inflammation of nasal passages and paranasal sinuses  obstruction of drainage Most cases usually precede with URTI (either viral or bacterial infection) Can develop by allergic rhinitis (Non-infectious) Causes: Common viral pathogen Common bacterial strains Rhinovirus Streptococcus pneumoniae Caused by common cold Parainfluenza virus Haemophilus influenzae Influenza virus Caused by flu Moraxella catarrhalis Some bacterial rhinosinusitis develops as a secondary infection during or after a viral infection due to blockage of normal sinus drainage, such as from a deviated septum. 10 Deviated septum 11 Rhinosinusitis: Pathogenesis Classified as: Acute, Subacute and Chronic Classification Onset of symptoms lasted Common pathogen Acute can be viral, bacterial, or mixed Rhinovirus Symptoms lasts 5 to 7 days (viral infection) Parainfluenza virus Symptoms up to 4 weeks (bacterial Streptococcus infection) pneumoniae Subacute Symptoms from 4 weeks to < 12 weeks Streptococcus Staphylococcus aureus Peptostreptococcus Chronic Symptoms persists beyond 12 weeks Pseudomonas aeruginosa 12 · Rhinosinusitis: Clinical Manifestations Acute Subacute Chronic Facial pain (maxillary pain)   Headache when bending    forward, coughing, sneezing Purulent nasal discharge    Sense of smell Fever   Nasal obstruction   Fullness in ears  Postnasal drip  Hoarseness  Chronic cough  Loss of taste/ smell  Epithelial mucosal changes Reversible Reversible irreversible 13 Rhinosinusitis: Diagnosis & Treatment Diagnosis Treatment Physical exam: Depends on causes for appropriate Inspection of nose & throat use of antibiotics Typical headache when bending Mucolytic agents 14 forward, coughing, sneezing Turbinate oedema Oral and topical decongestants # 4 Nasal crust # Topical corticosteroids may be used Purulence Turulent nasal cavity (Green discharge) to  inflammation ELE >X inflammation - CT scans/ MRI for chronic Nonpharmacologic measures: rhinosinusitis or to exclude Saline nasal sprays complications Nasal irrigation Surgical intervention: Removal of nasal polyps and obstructive nasal deformities 14 Rhinosinusitis: Complications Can lead to complications due to the sinuses’ proximity to the brain and orbital wall Most common: Orbital wall complications (Most common) Abscess formation Intracranial complications Clinical manifestation of orbital wall Clinical manifestation of intracranial abscess abscess Chemosis EEF High fever Proptosis EE Severe headache Tenderness and restriction of eye Nausea and vomiting moment Neck stiffness 14  Impair visual acuity Altered mental state 15  A Pharyngitis & Tonsilitis Pharyngitis Tonsilitis An inflammation of throat or pharynx An inflammation of the palatine tonsils Any particles breach the defense Sometimes accompanied by: mechanisms of the pharynx and irritate Adenoiditis (inflammation of adenoid the epithelial layer covers the pharynx tonsils in nasopharynx) Pharyngitis (inflammation of throat or pharynx) Commonly caused by virus or bacteria and fungi (rare) Non-infectious cause: foreign particles, e.g. allergens, cigarette smoke, irritation from acid reflux, dry and cold air, or intubation 16 17 Pharyngitis & Tonsilitis: Aeitology & Pathogenesis Mode of transmission: Droplets: Droplets land in the eyes, nose, or moths of people nearby Contact: Contaminated surface, prior to washing hands, touch the eyes, nose or mouth Pathogens: Common viruses Less common viruses Common bacterial strains Rhinovirus Coxsackievirus Streptococcus pyogenes Parainfluenza virus Herpes simplex virus Group A streptococcus  strep throat Influenza virus Epstein-Barr virus Adenovirus (Infectious Respiratory syncytial mononucleosis) virus (RSV) HIV Coronaviruses Symptoms are less severe (compared with bacteria Symptoms are more severe infection 18 Risk Factors of Pharyngitis & Tonsilitis 5 to 15 years of age Have frequent contact with children Close contact with infected individuals Being in a small space with large group of people Prolonged or inappropriate use of antibiotics Inhaled corticosteroids Patients with immunosuppressed 19 Pharyngitis & Tonsilitis: Clinical Manifestations & Diagnosis Common clinical manifestations Diagnosis Sore throat Clinical symptoms Dysphagia Physical assessment: Painful in swallowing Pharynx red and swollen Tonsils may have patchy exudates Hoarseness and pain when talking Enlarge cervical lymph nodes Dyspnoea Rapid antigen detection test Malaise Throat culture of throat swab Ear pain Fever Running nose Cough Headache 20 Pharyngitis & Tonsilitis: Treatment For viral infection for pharyngitis For bacterial infection for & tonsilitis (Supportive) pharyngitis & tonsilitis (Standard) Adequate hydration Antibiotics e.g. penicillin Antipyretic drugs, e.g. paracetamol Allergic to penicillin Non-steroidal anti-inflammatory Cephalosporins, e.g. ceftriaxone drugs Macrolides, e.g. azithromycin For recurrent tonsillitis ( 7 episodes in a year) or enlarged tonsils  difficult breathing may treat by surgical intervention Tonsillectomy 21 Pharyngitis & Tonsilitis: Complications (1) Patients with Group A streptococcus pharyngitis (Strip throat) or tonsillitis may cause complications Suppurative complications (build up pus) Peritonsillar abscess Upper airway obstruction Parapharyngeal abscess *Life-threatening* 22 Pharyngitis & Tonsilitis: Complications (2) Patients with Group A streptococcus pharyngitis (Strip throat) or tonsillitis may cause complications Non-suppurative complications Rheumatic fever: antibodies are made against streptococcal proteins, once the infection is resolve, these antibodies mistakenly attack the heart valves, joints, skin, and brain  permanent damage to heart valves 23 Pharyngitis & Tonsilitis: Complications (3) Patients with Group A streptococcus pharyngitis (Strip throat) or tonsillitis may cause complications Non-suppurative complications Post-streptococcal glomerulonephritis: immune system attacks the glomeruli in kidneys  haematuria  kidney function  urine output, hypertension and oedema 24 Infectious mononucleosis: Epstein-Barr virus Primarily caused by the Epstein-Barr virus (EBV) human herpesvirus-4 AKA kissing disease Spreads through contact with saliva kissing, sharing utensils drinking from the same glass Viral latency Many exposed in childhood without symptoms After exposure, the virus remains dormant in the body for life Can be intermittently shed in saliva, potentially spreading it to others, and may spread through other bodily fluids > - weakened immune systems > - Affect nervous system haematological system , , cancer Common in adolescents & young adults (Age 15-24) 25 Infectious mononucleosis: Clinical Manifestations, Diagnosis, Treatment Clinical Manifestations Diagnosis Most young children: no symptoms Signs and symptoms Symptoms appear 4 to 8 weeks after Blood test for EBV-specific antibodies exposure Nuclear antigen Fever Sore throat Treatment Enlarged lymph nodes in neck Symptom control for pain and fever Fatigue Antipyretic drugs Muscle aches Non-steroidal anti-inflammatory drugs  Enlargement of spleen Rest Symptoms of rupture (Rare): Sharp abdominal pain, particularly Increase fluid intake on left side Avoiding contact sports or heavy lifting to prevent splenic rupture 26 Influenza Major cause of acute URTI but also affect the lower respiratory tracts High infection rate among children and older adults  serious illness and death in those aged > 65 3 groups of influenza virus: Type A (most prevalent) Type B Type C The viruses mutate constantly, prevent effective immune defense for prolonged time periods Flu differs from common cold with sudden, acute onset of illness, may lead to viral pneumonia 27 Differences Between Flu & Common Cold Feature Influenza (Flu) Common Cold Overview Contagious respiratory illness Contagious respiratory illness cause by caused by influenza viruses (types various viruses A and B). Causative Agents Influenza A virus Rhinoviruses Influenza B virus Parainfluenza viruses Seasonal coronaviruses Onset of Symptoms Appear suddenly, often within few Gradually develops over a few days hours Symptom Severity More severe and exhausting Generally mild and manageable Common symptoms High fever or chills (common) Low grade fever Persistent dry cough Runny or stuffy nose Severe sore throat Sneezing Muscle aches Mild cough Intense headaches Profound fatigue 28 Differences Between Flu & Common Cold Feature Influenza (Flu) Common Cold Complications Can lead to serious complications, Usually self-limiting, complications are e.g. pneumonia, acute otitis rare media, bronchiolitis Diagnosis May involve rapid tests or PCR Based on clinical symptoms and patient test for confirmation history Contagiousness High contagious Contagious Can spread 1 day before Can spread in the first few days symptoms and up to 7 days after 29 Influenza: Treatment & Prevention Symptomatic and supportive unless a bacterial infection occurs Medications: NSAID Antipyretic drugs: paracetamol Non-steroidal anti-inflammatory drugs: ibuprofen Antihistamine Antitussive Expectorant & mucolytics Antiviral drugs: may reduce symptoms and duration, lower the risk of spreading the virus Prevention: Influenza vaccination If influenza develops after immunization, it is typically a mild infection. Immunity develops about 2 to 3 weeks after vaccination. 30 Epiglottitis Acute infection primarily caused by H. influenzae type B Affected population Common in children aged 3 to 7 years Symptoms Rapid onset of fever and sore throat Inspiratory stridor present Child refuses to swallow Child appears anxious and pale Drooling of saliva FAC Needs to setting with mouth open, struggling to breath Physical signs: Swelling of larynx, supraglottic area, and epiglottis Epiglottis appears as a round, red ball obstructing the airway 31 Normal Epiglottis Vs Epiglottitis 32 Epiglottitis Examination Caution: Care needed during laryngeal examination to avoid reflex spasm and total airway obstruction Treatment Administer oxygen and antimicrobial therapy Intubation or tracheotomy may be necessary if airway obstruction occurs 33 Acute Tracheobronchitis Terms often used interchangeable with bronchitis Key differences: different sites of inflammation occurs and symptoms Tracheobronchitis Bronchitis Inflammation of both the trachea and the Inflammation of the bronchi alone bronchi Can be acute or chronic Usually acute Causes: Viral or bacterial infection Can cause by irritants, e.g. cigarette smoke, air pollution Viral bronchitis pathogens Bacterial bronchitis pathogens Influenza Chlamydiae pneumoniae Rhinovirus Mycoplasma pneumoniae Respiratory syncytial virus Bordetella pertussis Adenovirus 34 Acute Tracheobronchitis: Clinical Manifestations Symptoms Severe cough with productive sputum Fatigue Nasal congestion Nausea Sore throat  can cause stridor Vomiting Shortness of breath: unable to take deep breath Cyanosis Physical Exam Stridor may be heard in auscultation due to obstructed airflow in the airway  present with cyanosis 35 Acute Tracheobronchitis: Diagnosis & Treatment Diagnosis Treatment Clinical signs and symptoms Generally self-limiting with BP/P/RR supportive treatment Temperature Medications: Oxygen saturation Antipyretics Blood for complete blood count Analgesics (CBC) Antihistamines Nasal secretions, sputum, blood Decongestants for cultures may consider Cough suppressants Bronchodilators CXR: Normal without infiltrate or Antibiotics in cases of bacterial consolidation infection 36 Acute Bronchitis An infection or inflammation of tracheobronchial tree or large bronchi Causes: Primarily caused by viruses Bacterial bronchitis is less common, usually following a viral infection Viral bronchitis pathogens Bacterial bronchitis pathogens Influenza Chlamydiae pneumoniae Rhinovirus Mycoplasma pneumoniae Respiratory syncytial virus Bordetella pertussis Adenovirus Secondary infection: can occur after a viral infection, usually caused by Streptococcus pneumoniae and Haemophilus influenzae More common in patients with chronic obstructive pulmonary disease (COPD) Noninfectious causes: Less frequent and include irritant inhalation, e.g. smoke, pollution, marijuana and allergic reactions 37 Acute Bronchitis: Clinical Manifestations Symptoms: Cough, fever, chills, malaise Airway may narrow  wheezing, may be intermittent Shortness of breath Viral bronchitis Bacterial bronchitis Nonproductive cough, aggravated by cold or Productive cough dry air Musculoskeletal chest pain often occurs due to Possible purulent sputum with some viral cough infections Physical exam: Oropharynx erythema Wheezing may present with rhonchi and Neck lymphadenopathy crackles 38 Acute Bronchitis: Diagnosis & Treatment Diagnosis Treatment Clinical signs and symptoms Generally self-limiting with Blood for complete blood count supportive treatment (CBC) Medications: Nasal secretions, sputum, blood Antipyretics for cultures may consider Analgesics Antihistamines CXR: Normal without infiltrate or Decongestants consolidation Cough suppressants Bronchodilators Antibiotics in cases of bacterial infection 39 Common Medications for URTI 40 Overview of Medications for URTI Classifications Therapeutic Purpose Indications Examples Antihistamines Treatment of Hypersensitivity Chlorpheniramine maleate FILE allergies reactions (Piriton) Fir E Diphenhydramine (Benadryl) Cetrizine (Zyrtec) Nasal Relieve nasal Symptomatic relief of Phenylephrine (Neo-Synephrine), Decongestants obstruction and nasal or Oxymetazoline (Afrin) 4 Ex discharge nasopharyngeal congestion Antitussives Suppress cough Cough due to allergies Codeine phosphate or common cold Dextromethorphan Expectorants  viscosity of Productive cough Ammonia and ipecacuanha bronchial secretions mixture (MES) Mucolytics Loosen thick, viscous Productive cough Acetylcysteine (Flumucil) bronchial secretions Antidote for Bromhexine (Bisolvon) paracetamol overdose 41 Antihistamines Histamine: A chemical mediator of inflammation which causes symptoms of allergic rhinitis Can cause symptoms of: Itching  Mucus secretion Nasal congestion Bronchoconstriction Oedema Hypotension Antihistamine: Mechanism of action Block histamine at the H1 receptor  alleviating allergic symptoms Induce anticholinergic effects  dry mucus membranes,  nasal congestion and tearing eyes 42 Antihistamines Class 1st generation antihistamines 2nd generation antihistamines Drug name Chlorpheniramine (Piriton) Loratadine (Claritin, Alavert) Diphenhydramine (Benadryl) Cetirizine (Zyrtec) Characteristics Have central effect that cause drowsiness Less central effect Can used as sedatives Primarily uses as antiallergic drugs Indications Allergic rhinitis Common cold Allergic rhinitis Common cold Allergic Nausea and vomiting Allergic conjunctivitis Motion sickness conjunctivitis Urticaria Insomnia Urticaria Anaphylaxis Anaphylaxis Route(s) of administration PO Topical IV IMI Common side effects Anticholinergic side effects; dry mouth, blurred vision, urinary retention, constipation Sedation Orthostatic hypotension Drowsiness Irritability Contraindication & Pregnancy, breastfeeding, newborns Renal or hepatic disease Cautions Narrow-angle glaucoma, benign prostatic hyperplasia < 2 years of age (Respiratory depression) 43 Antihistamines: Nursing Considerations Assessment & Monitoring Assess symptoms Types of symptoms, e.g. sneezing, nasal congestion , runny nose, itchy Frequency: occasional, seasonal, environmental Laboratory results: liver and renal function tests Medical history: Pregnancy, breastfeeding Advanced age Prostatic enlargement Physical assessment: Vital signs, lung sounds Side effects Therapeutic effects: reduction of symptoms, improve quality of life Patient education Identify and reduce exposure to allergens Purpose of medication Self-administration, take as directed Management of side effects Sedation: caution with activities requiring alertness or concentration Avoid alcohol and other sedating medications Anticholinergic effects Dry mouth: sips of water, sugarless gum or hard candy Constipation: increase fluid, fiber and physical activity 44 Nasal Decongestants Also known as sympathomimetic: drugs that activate the sympathetic nervous system Nasal decongestants: Mechanism of action Acts directly on adrenergic receptors to produces vasoconstriction which shrinks nasal mucosa membranes   nasal congestion, swelling,  blood flow to nasal mucosa Oral and topical decongestants are available 45 Nasal Decongestants Drug name Oxymetazoline (Afirn nasal spray) fluticasone (Flonase) pseudoephedrine (Sudafed) Indications Rhinitis Nasal congestion Route(s) of administration PO Topical (nasal spray) Common side effects Anxiety Rebound nasal congestions (Topical) Tremors A condition characterized by Insomnia hypersecretion of mucus and worsening Hypertension nasal congestion once the drug effects Increased blood glucose wear off Can lead to cycle of  drug use as the condition worsens  prefer for short- term use (3-5 days) Contraindication & Cautions Hypertension Cardiac disease Hyperthyroidism Diabetes mellitus 46 Nasal Decongestants: Nursing Considerations Assessment & Monitoring Assess respiratory status, vital signs, and lung sounds before and after administration Monitor for side effects Evaluate therapeutic response Patient education Intranasal decongestions Assessment and monitoring Assess nasal passages before administration Gently blow nose before administration Report adverse effects, including systemic effects like hypertension or tachycardia * Tolerance and dependence can develop; use medication for the prescribed duration ↳ F 47 Antitussives Used to dampen the cough reflex, use in treating coughs due to allergies or common cold Suppress cough by depress the cough centre in medulla oblongata or the cough receptors in throat, trachea, or lungs 2 types of antitussives Narcotics (Opioid) Non-narcotics (non-opioid) With opioid (most effective) Without opioid Codeine and hydrocodone: most No abuse potential as opioids frequently used Overdose of opioid cough remedies  respiratory depression 48 Antitussives Drug name Codeine Dextromethorphan (Robitussin), Benzonatate (Tessalon Perles) Indications Non productive cough Route(s) of administration PO Common side effects Non-opioid: Opioids: Dizziness Respiratory depression Sedation Addictive potential Dry mouth Nausea Constipation Contraindication & Cautions Chronic productive cough Opioids: ↳ x(-1 Pregnancy Non-opioid: Breastfeeding Children - GI upset Oropharyngeal irritation Contraindication & Cautions Chronic cough Acetylcysteine - Asthma Nursing considerations Assessment and monitoring Assess respiratory status, vital signs, and lung sounds before and after administration Monitor for side effects Evaluate therapeutic response Patient education Small, frequent meals can decrease GI Store dornase alfa in the refrigerator, discomfort protected from light Take as directed for short duration of time 52 Nursing Care for Patients with URTI Assessment Health history: Known exposure to pathogen Onset and duration Current symptoms: Presence of dyspnoea Facial pain Chest pain Current medication Productive cough History of chronic disease Physical General appearance assessment Vital signs Lung sounds Chest, ear, nose and throat exam Laboratory results CXR Sputum/ throat swab culture RAT results 53 Nursing Care for URTI & Acute Tracheobronchitis 54 Nursing Care for Patients with URTI & Acute Tracheobronchitis Assessment Health history: Known exposure to pathogen Onset and duration Current symptoms: Presence of dyspnoea Facial pain Chest pain Current medication Productive cough History of chronic disease Physical General appearance assessment Vital signs Lung sounds Chest, ear, nose and throat exam Laboratory results CXR Sputum/ throat swab culture RAT results 55 Nursing Care for Patients with URTI & Acute Tracheobronchitis Plan and carry out the nursing interventions according to the patient’s conditions Problems Nursing interventions Airway clearance Monitor the effectiveness of cough and ability to remove secretions Maintain adequate hydration  humidity of inspired air at bedside by using a humidifier Teach coughing technique Apply suction if necessary Coordinator care with allied healthcare care, e.g. chest physiotherapy for postural drainage Administer mucolytics as prescribed and monitor the therapeutic effects Breathing pattern Monitor RR and pattern Elevate the head of the bed to promote comfort Assist in daily living activities to prompt rest 56 Chest Physiotherapy A technique can be performed by trained therapist (physiotherapist) for people suffering from impair mucus clearance Indication: COPD, bronchitis, cystic fibrosis Goal: Help patients to clear excessive mucus secretions from lungs to prevent complications Mucus plugs, infections, atelectasis Care tips: Equipment: PPE, pillow, suction equipment, oxygen therapy as necessary Frequency varies Last 20-40 minutes for each therapy Best schedule: in the morning or at night to clear lung before bedtime Observe and monitor changes in breathing pattern, client’s comfort and tolerance Observe sputum and document 57 Chest Physiotherapy: Postural Drainage Different positions 10 to 15 minutes, using gravity to help clear lungs secretions Example: 58 Chest Physiotherapy: Percussion & Vibration Percussion: Vibration Clap on the patient’s chest wall with Both hands over area hand cupped (2-5 mins), from Fine shaking movement elbows to wrists 15 seconds or 5 exhalations Forcefully cough 59 Nursing Care for Patients with URTI & Acute Tracheobronchitis Problems Nursing interventions Mucous membrane Observe abnormal lesions of mouth, tongue, and cheeks integrity Administer medication, as indicated Provide regular oral care Use warm saline gargles or throat lozenges for symptomatic relief Use soft-bristle brush, sponge applicators to clean teeth and tongue Maintain adequate fluid Fever Identify the underlying cause Monitor body temperature regularly Provide optimal hydration Administer antipyretic medication Encourage sleep/ rest Provide comfort measures 60 Nursing Care for Patients with URTI & Acute Tracheobronchitis Problems Nursing interventions Allergic reactions Instruct the patient to keep a diary of times when the allergic reactions occurs preventions and the activities that precipitate Maintain good personal hygiene Avoid crowd, smoke and alert to intermittent exposure to allergen, e.g. pets Administer anti-histamine as prescribed Pain Assess pain level Pharmacological interventions: Administered medication as prescribed or as necessary Non-pharmacological interventions, e.g. hot/cold pad, saline spray, gargle with warm water Adjust patient to a comfortable position Hydration & diet Increase fluid intake and monitor intake and output Avoid cold, spicy food Provide easily ingest foods (soft diet or liquid diet) 61 Nursing Care for Patients with URTI & Acute Tracheobronchitis Problems Nursing interventions Prevention of Use standard precaution transmission Apply appropriate prevention measures according to clinical conditions of patients Promote hand hygiene among healthcare staff, patients, and visitors at correct moments Adhere to the infection control measures of the institutions, e.g. wear PPE, isolation policies Administer medications as prescribed Monitor patient signs and symptoms Advocate clients to receive flu vaccines yearly Sleep Assess sleep patterns using subjective and objective information Provide a comfortable environment Provide medications, e.g. antipyretic/ analgesic medication promptly to promote comfort 62 Questions? Please contact the teaching team if you have any questions. Dr YANG Wai Lam Caroline (Email: [email protected]) 63 Reference: Chatzinakis, V., & Georgalas, C. (2023). Complications of Rhinosinusitis. In A. C. Swift, S. Carrie, & C. de Souza (Eds.), Contemporary Rhinology: Science and Practice (pp. 355-367). Springer International Publishing. https://doi.org/10.1007/978-3-031-28690-2_29 Chatzinakis, V., & Georgalas, C. (2023). Complications of Rhinosinusitis. In A. C. Swift, S. Carrie, & C. de Souza (Eds.), Contemporary Rhinology: Science and Practice (pp. 355-367). Springer International Publishing. https://doi.org/10.1007/978-3-031-28690-2_29 Dlugasch, L., Story, L., & Story, L. (2021). Applied pathophysiology for the advanced practice nurse. Jones & Bartlett Learning. Grant, A. B. P. F. (2024). Front Matter. In A. B. P. F. Grant (Ed.), Ross & Wilson Pathophysiology (pp. iii-iii). https://doi.org/http://dx.doi.org/10.1016/B978-0-7020-7771-5.01001-0 Hubert, R. 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