Transcript Ch 30 Canvas 16

Chapter 30
Nursing Care of
Patients with Upper
Respiratory Tract
Disorders
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2015. F.A.
Davis F.A.
Company
Copyright
© 2015.
Davis Company
Learning Outcomes
 Explain the pathophysiologies of disorders of
the upper respiratory tract.
 Describe etiologies, signs, and symptoms of
disorders of the upper respiratory tract.
 Describe current therapeutic measures for
disorders of the upper respiratory tract.
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Learning Outcomes (cont’d)
 Plan nursing care for the patient with an
upper respiratory disorder.
 Discuss how you will know if your care has
been effective.
 Identify the special needs of the patient who
has undergone a laryngectomy.
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Epistaxis
 Causes
‒ Trauma
‒ Hypertension
‒ Hemophilia
‒ Medications
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Epistaxis
 Therapeutic Interventions
‒ Positioning- lean forward
‒ Direct Pressure
‒ Ice
‒ Nasal Packing
‒ Nasal Balloon Catheter
‒ Vasoconstrictive Agent
‒ Electrocautery
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Nasal Polyps
 Usually Benign
 Occur More Often with Allergies
 Treatment
‒ Control Allergies
‒ Surgery
‒ Avoid Aspirin Post-op
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Deviated Septum
 Symptoms
‒ Stuffy Nose
‒ Blocked Sinus
Drainage
‒ Headaches
 Treatment
‒ Nasoseptoplasty
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Nursing Care Post
Nasoseptoplasty
 Monitor Vital Signs/Bleeding
 Report Excess Swallowing
 Monitor Dressing
 Teach
‒ Avoid Activities that Increase Pressure
‒ Avoid Aspirin
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Sinusitis
 Inflammation of Sinus Mucosa
‒ Bacterial
‒ Allergic
 Signs and Symptoms
‒ Pain Over Affected Sinus
-maxillary sinus-pain over cheek and upper teeth
-ethmoid sinus- pain between and behind the eyes
-frontal sinus- pain in the forehead
‒ Fever
‒ Nasal Discharge
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Sinusitis
 Therapeutic Interventions
‒
‒
‒
‒
‒
Saline Irrigation
Intranasal Corticosteroids
Decongestants
Hot Packs
Acetaminophen/ Ibuprofen
‒
‒
‒
‒
‒
Humidification
Oral Fluids
Positioning
Antibiotics
Surgical Drainage
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Obstructive Sleep Apnea
 Apnea During Sleep
 Risk Factors
‒ Obesity
‒ High Palate
‒ Receded Mandible
‒ Smoking
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Obstructive Sleep Apnea
 Complications
‒
‒
‒
‒
Heart Disease
Hypertension
Stroke
Diabetes
 Signs and Symptoms
‒
‒
‒
‒
Snoring
Daytime Sleepiness
Headache
Memory and
Attention Problems
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Obstructive Sleep Apnea
 Diagnosis
‒ Nocturnal Polysomnography
 Treatment
‒ Avoid HS Sedatives
‒ Lose Weight
‒ Nasal Patch
‒ NIPPV
‒ Surgery
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Infectious Disorders
 Rhinitis
 Pharyngitis
 Laryngitis
 Tonsillitis
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Prevention of Influenza
 Yearly Vaccination
 Handwashing
 Avoidance of Infected People
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Influenza
 Signs and Symptoms  Therapeutic
Interventions
‒ Fever
‒
‒
‒
‒
‒
‒
Chills
Myalgia
Sore Throat
Cough
Malaise
Headache
‒
‒
‒
‒
‒
Acetaminophen
Avoid Aspirin
Antiviral Agents
Rest
Fluids
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New Viruses
 Bird Flu
 SARS
 Swine Flu (H1N1)
 West Nile
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Nursing Diagnoses:
Upper Respiratory Infection
 Impaired Comfort
 Hyperthermia
 Risk for Infection: Transmission to Others
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Cancer of the Larynx
 Pathophysiology
‒ Primary Tumor of Mucosal Epithelium
‒ Metastasizes to Lungs, Liver, Lymph Nodes
 Etiology
‒ Associated with Smoking, Alcohol
‒ More Common in Men
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Cancer of the Larynx
 Signs and Symptoms
‒ Hoarseness
‒ Change in Voice
‒ Pain
‒ Dyspnea
‒ Cough
‒ Dysphagia
‒ Airway Obstruction
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Cancer of the Larynx
 Diagnosis
‒ Laryngoscopy
‒ CT
‒ MRI
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Cancer of the Larynx
 Therapeutic Interventions
‒ Radiation
‒ Chemotherapy
‒ Laryngectomy
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Cancer of the Larynx
 Postoperative Nursing Diagnoses
‒ Ineffective Airway Clearance
‒ Acute Pain
‒ Impaired Verbal Communication
‒ Imbalanced Nutrition
‒ Impaired Swallowing
‒ Grieving
‒ Disturbed Body Image
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Speech
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Review Question
Ice packs are used for epistaxis for which
reason?
1.
2.
3.
4.
Promote comfort
Promote vasoconstriction
Reduce swelling
Reduce congestion
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Review Question Answer
Ice packs are used for epistaxis for which
reason?
1.
2.
3.
4.
Promote comfort
Promote vasoconstriction
Reduce swelling
Reduce congestion
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Review Question
What nursing instructions should be provided
following septoplasty?
Select all that apply.
1. Maintain semi-Fowler’s position
2. Take stool softeners as prescribed
3. Use ice for swelling
4. Blow nose gently to remove clots
5. Expect a low grade fever for 3 days
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Review Question Answer
What nursing instructions should be provided
following septoplasty?
Select all that apply.
1. Maintain semi-Fowler’s position
2. Take stool softeners as prescribed
3. Use ice for swelling
4. Blow nose gently to remove clots
5. Expect a low grade fever for 3 days
Copyright © 2015. F.A. Davis Company
Review Question
Which nursing intervention is appropriate
for a sore throat?
1.
2.
3.
4.
Warm moist pack
Hot tea
Bedrest
Salt water gargle
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Review Question Answer
Which nursing intervention is appropriate
for a sore throat?
1.
2.
3.
4.
Warm moist pack
Hot tea
Bedrest
Salt water gargle
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Review Question
Which patient is most at risk for
complications of influenza?
1.
2.
3.
4.
46
19
78
32
year
year
year
year
old
old
old
old
teacher
student
retiree
factory worker
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Review Question Answer
Which patient is most at risk for
complications of influenza?
1.
2.
3.
4.
46
19
78
32
year old teacher
year old student
year old retiree
year old factory worker
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Review Question
What are common risk factors for laryngeal
cancer?
Select all that apply.
1. Female
2. Smoker
3. Obesity
4. Alcohol abuse
5. Diet low in fruits and vegetables
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Review Question
What are common risk factors for laryngeal
cancer?
Select all that apply.
1. Female
2. Smoker
3. Obesity
4. Alcohol abuse
5. Diet low in fruits and vegetables
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