Chapter 18: Management of Patients with Upper Respiratory Tract Disorders

A patient is diagnosed as being in the early stage of laryngeal cancer of the glottis with only 1 vocal cord involved. For what type of surgical intervention will the nurse plan to provide education? Total laryngectomy Cordectomy Vocal cord stripping d. Partial laryngectomy

A partial laryngectomy (laryngofissure-thyrotomy) is often used for patients in the early stages of cancer in the glottis area when only one vocal cord is involved.

The nurse is to make a room assignment for a client diagnosed with an upper respiratory infection. The other clients with empty beds in the room are listed in the accompanying chart. The best room assignment for the new client would be with Client A B C D

B

The nurse is teaching a group of new parents about common colds. Which of the following should be included as treatment options? a. Antihistamines b. Anitbiotics c. Opiods d. Bronchodilators

a. Antihistamines Antihistamines are the first group of medications recommended for treating sneezing, pruritus, rhinorrhea, and nasal congestion associated with the common cold. Common colds are caused by viruses and antibiotics are not effective. Over the counter analgesics may be used, not opiods which are prescribed for severe pain. Bronchodilators are used to treat long-term conditions causing a narrowing or inflammation of the airway.

The nurse is caring for a patient who had a total laryngectomy and has drains in place. When does the nurse understand that the drains will most likely be removed? a. When the patient has less than 30 mL for 2 consecutive days When the patient states that there is discomfort and requests removal When the drainage tube comes out In 1 week when the patient no longer has serous drainage

a. When the patient has less than 30 mL for 2 consecutive days Wound drains, inserted during surgery, may be in place to assist in removal of fluid and air from the surgical site. Suction also may be used, but cautiously, to avoid trauma to the surgical site and incision. The nurse observes, measures, and records drainage. When drainage is less than 30 mL/day for 2 consecutive days, the physician usually removes the drains.

The nurse is caring for a respiratory client who uses a noninvasive positive pressure device. Which medical equipment does the nurse anticipate to find in the client's room? A ventilator A face mask A rigid shell A nasal cannula

b. A face mask A face mask or other nasal devices are found in the client's room as this type of ventilation does not require intubation or a ventilator. A rigid shell is used with a negative pressure chamber and is not frequently used today. A nasal cannula is not used with the positive pressure device.

The nurse is caring for a client who is demonstrating signs of increased respiratory distress related to laryngeal obstruction. The nurse is calling the physician to report on the client's condition. Which of the following will the nurse report? Select all that apply. a. A decreased respiratory rate b. Arterial blood gases reporting a PaCO2 of 48 and a PaO2 of 84 c. Nasal flaring with abdominal retractions d. Administration of a corticosteroid inhaler for quick relief e. Lung sounds of wheezing f. Increased respiratory effort

b. Arterial blood gases reporting a PaCO2 of 48 and a PaO2 of 84 c. Nasal flaring with abdominal retractions e. Lung sounds of wheezing f. Increased respiratory effort The nurse would be calling to report signs of respiratory distress. This includes nasal flaring with abdominal retractions, stridor and an increased respiratory effort. Also arterial blood gases with an elevated CO2 and lower oxygen level indicates respiratory compromise. An increased respiratory rate occurs in respiratory compromise. Administration of a corticosteroid decreases inflammation over a period of time.

The nurse is caring for a client who is demonstrating signs of increased respiratory distress related to laryngeal obstruction. The nurse is calling the physician to report on the client's condition. Which of the following will the nurse report? Select all that apply. a. A decreased respiratory rate b. Oxygen saturation of 76% c. Nasal flaring with abdominal retractions d. Nuchal rigidity e. Lung sounds of wheezing f. Increased respiratory effort

b. Oxygen saturation of 76% c. Nasal flaring with abdominal retractions e. Lung sounds of wheezing f. Increased respiratory effort