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Exam 3
Upper Respiratory Tract (Chapter 22)
Upper Airway Infections
Rhinitis
o Inflammation of mucous membranes of the nose
o Can be acute or chronic
o Lots of causes
Temperature or humidity; odors; infections;
o age; systemic disease; use of OTC and
prescribed nasal decongestants; and the
presence of a foreign body
Over the counter medications work well
o Limit nasal sprays to 3 days
Causes rebound congestion
Causes rebound hypertension
Only exception is saline spray
o Manifestations
Rhinorrhea
Excessive nasal drainage, runny nose
Nasal congestion
Nasal discharge
Sneezing
o Treatments
Vary depending on severity
Antihistamines
Given for sneezing, pruritis (itching), and rhinorrhea
Decongestants
Saline spray
Can act as a mild decongestant and can liquefy mucus to prevent crusting
Viral Rhinitis (common cold)
o Caused by lots of viruses
The term cold refers to an infectious, acute inflammation of the mucous membranes of the nasal cavity characterized by
nasal congestion, rhinorrhea, sneezing, sore throat, and general malaise
o Usually self-limiting
o Highly contagious Because virus is shed for about 2 days before symptoms appear and during the first part of the symptomatic phase
Wash your hands
Cough in your elbow
o
o Colds caused by rhinoviruses tend to occur in the early fall and spring
o Manifestations
Similar to rhinitis
Nasal congestion Low grade fever
Halitosis (bad breath)
Rhinorrhea Sore throat
Nasal discharge Chills
sneezing Headache
Scratchy watery eyes For some people, the virus intensifies herpes simplex (cold sore)
Cough
Muscle aches
General malaise
A general feeling of discomfort, illness, or uneasiness
o Treatments
Rest
Hydration (adequate fluid intake) Antimicrobial agents (antibiotics)
should NOT be used, for Viral
Rhinitis
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Exam 3
Salt-water gargles
Soothe the sore throat
Antihistamines
Used to relieve sneezing, rhinorrhea, and nasal congestion
Expectorants
Makes you cough used to promote removal of secretions
Nasal decongestants
Reduces swelling
Rhinosinusitis
o Inflammation of paranasal sinuses and nasal cavity
o Can be acute, subacute or chronic
Acute (less than 4 weeks)
Subacute (4-12 weeks)
Chronic (more than 12 weeks)
o Usually follows an Upper Respiratory Infection (URI)
[or cold]
o Manifestations
Nasal drainage
Nasal obstruction
Nasal congestion, caused by inflammation, edema,
and transudation of fluid secondary to URI, leads to
obstruction of the sinus cavities (provides an
excellent medium for bacterial growth)
Pain-pressure in the face
Fever [102F(if bacterial)
Fatigue
Nasal secretion can be colored, cloudy
Cloudy or colored nasal discharge congestion, blockage, or stuffiness
Dental pain
Cough
Fullness in the ear (because nose, ears, and throat are all connected)
o Treatments
Varies, depending on cause
Nasal lavage (neti-pot)
Nasal saline spray
Decongestants
If sinusitis does not get better in 7-10 days, go to the doctors and you will be prescribed antibiotics
Amoxicillin- first drug of choice
o Complication
Meningitis
(inflammation of the brain and spinal cord membrane)
All the same symptoms but with meningitis you also get a stiff neck
Pharyngitis (strep throat)
o Painful inflammation of the pharynx
o Lots of causes
o If uncomplicated, it usually resolves in 3-10 days
o Manifestations
Red, hot, angry looking pharyngeal membrane and tonsils
White purple excaudate
Fever [higher than 101F]
Malaise
NO cough for pharyngitis (strep)
o Treatments
Viral self-limiting (let it run its course- will treat itself eventually)
Bacterial antibiotics
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Exam 3
Penicillin V
Soft diet
Hard foods can irritate the throat
Cool or warm drinks
Cool drinks also help by numbing the throat
Cool beverages, warm liquids, and flavored frozen desserts such as ice pops are soothing
Saline gargles
o Diagnosed by:
Rapid antigen detection testing (RADT)
Results come out fast
Laryngitis (loss of voice)
o Inflammation of the larynx (voice box)
o Usually from voice abuse or exposure to pollutants (dust, chemicals, smoke)
o Manifestations
Aphonia (loss of voice)
Severe cough
o Treatments
Rest the voice
Avoid the irritants (including smoking)
Hydration
Influenza
o Acute viral respiratory infection
o Caused by several viruses
o Must get a yearly flu shot
o Manifestations
Fever
Muscle ache
Headache
Fatigue
Sore throat
Agitation
Abnormal lung sounds
Nasal congestion
Coughing
o Treatments
Rest
Hydration
Supportive therapy
Antitussives
o Cough suppressant
Decongestants
Antipyretics
Brings down your fever
o Influenza medications
If diagnosed early: administer antiviral medication
Give within 2-3 days of onset of symptoms
Examples:
o Amantadine (Symmetrel)
o Oseltamivir (Tamiflu)
o Rimantadine (Flumadine)
o Zanamivir (Relenza)
o These patients are on droplet isolation in the hospital
Hemorrhage from the nose, is caused by the rupture of tiny,
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Exam 3
Epistaxis distended vessels in the mucous membrane of any area of the nose
o Commonly called a nosebleed
o Usually caused by trauma
For little kids, it can be caused by picking your nose
o Have the patient sit up and lean head forward and apply pressure
Should resolve in 5-10 minutes! But if it doesn’t resolve within 5-10 minutes, you need to use other
treatments
Sit upright with the head tilted forward to prevent swallowing and aspiration of blood and pinch the soft outer portion
of the nose for 5-10 minutes continuously
o Sometimes a nasal tampon is used
o Gauze with decongestants
Decongestant agents may be used before the gauze packing is inserting
o Other Treatments
Nasal tampon
Stuffing the nose to stop the bleeding
Silver nitrate (cream)
If pressure is ineffective Visible bleeding sites may be cauterized with silver nitrate or
Electrocautery electrocautery (high frequency electrical current)
Cauterizing
o Surgery to remove unwanted or harmful tissues
o Can be used to burn and seal blood vessels
o Helps reduce or stop bleeding during surgery or after an injury
Balloon-inflated catheter
Need to keep a close eye on breathing, O2 sat because it can compromise the airway
Lower Respiratory Tract Disorders
Atelectasis
o Collapse of the alveoli
o Very common, especially postoperatively
o Lungs sounds are diminished
Cannot hear atelectasis in lungs and are diminished
