Ch 22 Management of Patients with Upper Respiratory Tract Disorders

How much fluid is typically present between the pleurae to prevent friction rub?

20-25 mL of fluid or less. This helps lubricate the visceral and parietal pleura

Pain subsides in how many days post op tonsillectomy/adenoidectomy?

3 to 5 days (sore throat, stiff neck, minor ear pain, and vomiting may occur in the first 24 hours)

Cases involving laryngeal infection symptoms often last how many days after completion of antibiotic therapy?

A week to 10 days

Rhinitis can be caused by..

Allergens (food & enviornmental), Medication

Antibiotic of choice for acute rhinosinusitis caused by a bacterial organism?

Amoxicillin-clavulanic acid (Augmentin)

Wound drains inserted during surgery are usually removed if the nurse observes..?

Drainage less then 30mL/day for 2 consecutive days

With severe respiratory distress in a status post adenoidectomy the nurse would suspect?

Edema of the upper airway.

76 year old presents to the ED reporting "laryngitis". The triage nurse should ask whether the client has a medical history that included??

GERD. Laryngitis is common in older adults and my be secondary to GERD

Discharge instructions for pt following a tonsillectomy..

Gargle with warm salt solution. It will help remove thick mucus and halitosis

What is an early indicator for a patient being examined for cancer of the larynx?

Hoarseness of more than 2 weeks duration with a persistent cough or sore throat, affected voice sounds

A client is being assessed for acute laryngitis. What are the signs?

Hoarseness or aphonia and severe cough

If rhinitis is due to allergies treatment would be..

Identify the possible allergens

Which clinical manifestation of hemorrhage is related to carotid artery rupture?

Increase pulse rate, decreased BP, rapid deep respirations

What does it mean when there is clear fluid draining from either nostil?

It suggest a fracture of the cribriform plate with leakage of cerebrospinal fluid

URIs happen when?

Microorganisms such as viruses and bacteria are inhaled.

Postoperative tonsillectomy, pt vomits large amount of dark blood or bright-red blood, rise in pulse rate and temperature and pt is restless, what should the nurse do?

Notify the surgeon immediately

TEP (tracheoesophageal puncture)

Requires the insertion of a prosthesis into the trachea

Once the pt is cleared for food intake, what should the nurse do?

Stay with the pt. during inital oral feedings and keep a suction setup at the bedside

Initial interventions for epistaxis include...

Telling the client to sit upright with the head tilted forward to prevent swallowing and aspiration of blood

When caring for a client with head trauma, a nurse notes a small amount of clear, watery fluid oozing from the client's nose. What should the nurse do first?

Test the nasal drainage for glucose. CSF contains glucose

If there is enough force to break a nose, emergency medical team must consider?

The possibility of a cervical spine fracture. (Ensure a patent airway)

What is the purpose of having the head of the bed elevated 45* following a throat related procedure?

When the client is fully awake decreases surgical edema and increases lung expansion

Atrophic pharyngitis is characterized by..

a membrane that is thin, white, glistening, and at times wrinkled

A total laryngectomy will result in...

a permanent stoma and total loss of voice

Edema cause by Peritonsillar abscess can cause..

airway obstruction and can be life threatening.

URI is defined as

an infection of the mucous membranes from the nose down to the respiratory tree or bronchi

Rhinosinusitis is

an inflammation of the paranasal sinuses and nasal cavity (can be caused by bacterial or viral infection)

If rhinitis is due to bacterial infection treatment would be..

antimicrobial agent

Hypertrophic pharyngitis is characterized as..

general thickening and congestion of the pharyngeal mucous membrane

Repetitive apneic events result in..

hypoxia and hypercapnia which triggers a sympathetic response (increased HR, decreased tone and contractility of smooth muscle)

Late complications of radiation therapy are..

laryngeal necrosis, edema, and fibrosis

If rhinitis is viral treatment would be..

medications to relieve symptoms

Potential complications of acute bacterial rhinosinusitis are..

nuchal rigidity and severe headache

Chronic granular pharyngitis is characterized by..

numerous swollen lymph follicles on the pharyngeal wall.

Acute Pharyngitis (Sore Throat) is..

painful inflammation of the pharynx, back portion of the throat (posterior third of the tongue, soft palate, tonsils)

A partial laryngectomy is often used for...

patients in the early stages of cancer in the glottis area when only one vocal cord in involved

Tonsillitis treatment (bacterial causes)..

penicillin or cephalosporins

Hypoxia may cause..

resltessness and initial rise in BP. If not treated immediately are life threatening

Symptoms of peritonsillar abscess..

severe sore throat, fever, trismus (inability to open the mouth), drooling

Symptoms of tonsillitis include..

sore throat, fever, snoring, and difficulty swallowing.

Tonsillitis treatment (viral causes)..

supportive measures, increased fluid intake, analgesics, salt-water gargles, and rest

Nose fracture reductions have better outcomes when preformed within..

the first 3 hours after injury.( 3-7 days if it cant be done due to edema)

Most cases of acute pharyngitis are caused by..

viral infections (adenovirus, influenza virus, Epstein-Barr, herpes simplex)