Upper Airway Disorders 2024 PDF

Gas Exchange and Respiratory Function Upper Airway Disorders SUE CAGIR DNP,MS, RN, CNE 1 Student Learning Outcomes Describe the nursing management of patients with upper airway disorders Compare and contrast the upper respiratory tract infections according to caus...

Gas Exchange and Respiratory Function Upper Airway Disorders SUE CAGIR DNP,MS, RN, CNE 1 Student Learning Outcomes Describe the nursing management of patients with upper airway disorders Compare and contrast the upper respiratory tract infections according to cause incidence, clinical manifestations, management, and the significance of preventive healthcare Use the nursing process as a framework for the care of patients with upper airway infection Describe the nursing management of the patient with epistaxis Use the nursing process as a framework for care of the patient undergoing laryngectomy Abnormal Adventitious Sounds Discontinuous Sounds- discrete Continuous Sounds- connected crackling sounds musical sounds Wheezes- High-pitched musical Fine Crackles (rales)- High pitched instrument with more than one type of crackling sounds (like fire crackling or sound quality (polyphonic) – air moving Velcro coming apart) – due to previously through a narrow airway- Asthma, deflated airways that are popping back Bronchitis, Chronic Emphysema open Stridor- High-pitched whistling or Course Crackles (rales)- Low pitched gasping with harsh sound quality wet bubbling sounds- inhaled air Disturbed airflow in the larynx or colliding with secretions in the trachea trachea or large bronchi – usually seen in Airway obstruction – emergency medical pneumonia, depressed cough reflex attention  Upper Respiratory Tract Disorders Pathology Symptoms Treatment Rhinitis Inflammation of the mucous membrane Runny Nose Saline or steroid nasal sprays in the nose Nasal Congestion Antihistamines Can be nonallergic or allergic Nasal Discharge Decongestants Sneezing Headache Sinusitis Inflammation of the tissue lining the Runny and stuffy nose Viral: supportive measures sinuses Pressure and Pain in the face Bacterial: Antibiotics s (Sinus Infection) Headache Nasal saline irrigation Post-nasal drip Corticosteroids Mucus dripping down the Antihistamines throat- sore throat Tonsillitis Inflammation of the tonsils Sore Throat Fluids Fever Saltwater gargles Snoring Rest Difficulty Swallowing Humidified Air Tonsil Stones Tonsillectomy (Surgical removal of the tonsils) Sinusitis – rhinosinusitis Tonsillitis Surgery Tonsillectomy – Monitor for bleeding- Frequent swallowing – vomiting dark or bright red blood  Upper Respiratory Tract Disorders Pathology Symptoms Treatment Laryngitis Inflammation of the larynx Horse voice Rest Voice Aphonia (loss of voice) Avoid smoking and alcohol Cough Avoid whispering and Dry Sore Throat clearing throat (irritation) Symptoms worsening with Humidified air and adequate cold air or cold liquid hydration Pharyngitis (back Inflammation of the pharynx Sore Throat Viral: supportive measures of the throat) (Strep Throat) Red and Swollen pharyngeal Bacterial: antibiotics membrane and tonsils Rest Swollen lymph nodes Saltwater gargles White exudate Fever Laryngeal Cancer Malignant cells occurring in the Manifestations mucosal tissue of the larynx Hoarseness extending longer than 2 More common in men between the weeks ages of 55 to 70 Dysphagia Contributing Factors Dyspnea Smoking Cough Radiation Exposure Persistent Sore Throat Chronic laryngitis and/or straining of Hard, immobile lymph nodes in the vocal cords neck Weight loss, anorexia Laryngeal Cancer Diagnostic Procedure Nursing Interventions MRI Maintain patent airway Direct laryngoscopy with biopsy Swallowing precautions X-ray and CT Emotional support Bone scan and positron emission Nutrition tomography (PET) Scan Pain Management Administer medications as elixir when possible  Laryngeal Cancer Therapeutic Measures Partial or total laryngectomy Radiation Therapy Client Education and Referral Communication Method – voice prosthesis Stoma Care –tracheostomy or Stoma Swallowing Maneuvers Speech Therapy Tracheostomy Works as a Voice box 'TEP' voice prosthesis https://www.tracheostomy.org.uk/healthcare-staff/vocalisation/using-a-tep-voice- prosthesis-for-speech-after-laryngectomy Nutrition IV therapy Post OP Tube Feed or TPN for nutrition Can try food via the mouth in 3-6 days depending on the patient Monitor Albumin Levels (protein – nutrition) Monitoring and Preventing Complications After Laryngectomy Respiratory Distress Hemorrhage Infection Wound breakdown Aspirations Tracheostoma Stenosis Obstructive Sleep Apnea Pathophysiology Nasopharyngeal tissue contraction Airway obstruction Etiology Obesity is the greatest risk factor Epidemiology More common in males Obstructive Sleep Apnea: Impact on Overall Health Physiological/Psychosocial Systemic hypertension, cardiac arrhythmias, heart failure, stroke Motor vehicle accidents due to daytime drowsiness Depression Aging Adult Comorbidities: stroke, dementia, heart failure, edema Sleepiness overlooked as due to aging process Obstructive Sleep Apnea: Clinical Presentation Manifestations Snoring Breathing ceases for 10 seconds or longer Daytime sleepiness Lab Testing and Diagnostic Studies Polysomnographic test Obstructive Sleep Apnea: Role of the Nurse Environmental Factors Effective sleep environment Safety Considerations Medications that cause sleepiness Client Education Compliance with CPAP at night Avoid risk factors: smoking, alcohol, sedatives  Epistaxis (Nosebleed) Signs and symptoms Medical management Pressure Silver nitrate and gel foam Electrocautery Topical vasoconstrictors Nursing management Vitals – high B/P Assurance Education References Brunner & Suddarth's Textbook of Medical Surgical Nursing(15th ed.). (2022). Philadelphia, PA: Wolters Kluwer. Content mastery series review model: RN Adult Medical Surgical Nursing (11.0 ed.). (2019). ATI Nursing Education.