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complete solution - Eastwick College
Focus Points:
Sinusitis
● Etiology
- Sinusitis, often called rhinosinusitis, is an inflammation of
the mucous membranes of one or more of the sinuses,
usually the maxillary or frontal sinus. Swelling of the
mucosa can block the drainage of secretions, which can
cause a sinus infection.
- Sinusitis often occurs after rhinitis and can be associated
with a deviated nasal septum, nasal polyps, inhaled air
pollutants or cocaine, facial trauma, dental infections, or
loss of immune function.
- The infection is often caused by a virus, Streptococcus
pneumoniae, Haemophilus influenzae, diplococcus,
and bacteroides.
Medications
Nasal decongestants, such as phenylephrine, are used to
reduce swelling of the mucosa.
,Client education
- Begin over-the-counter decongestant use at the first
manifestation of sinusitis.
- Manifestations of rebound nasal congestion can occur if
decongestants are used for more than 3 to 4 days.
- Broad-spectrum antibiotics, such as amoxicillin, are
used on a limited basis for a confirmed causative
bacterial pathogen.
- Pain relief medications include NSAIDs, acetaminophen, and
aspirin.
Therapeutic Procedures
- Deviated septum repair
- Surgical excision of nasal polyps
● Viral vs bacterial treatments for sinusitis
The most common sinus infection are viral and account
for ~90% of cases. These viral pathogens are often caused
by the common cold virus or influenza virus.
Viral infections will typically resolve on their own and DO
NOT need antibiotics. Viral infections usually resolve with a
few weeks w/o antibiotics.
Nursing Interventions:
Treat the symptoms with NSAID, Saline or corticosteroid nasal
sprays, decongestants, and
, antihistamines.
Surgery may be required if sinusitis becomes a chronic condition
(greater than 3 months).
Sinus infections can also be caused by bacterial pathogens, but
less common (10% of cases). Usually occur due to unresolved
viral infections.
The bacteria comes from the nose and throat. Antibiotics may be
need to the infection.
Most common bacterial pathogen is Step Pneumoniae and
Hemophilus Influenzae Oral antibiotics used to treat
bacterial sinus infections: Amoxicillin, Doxycycline,
Levofloxacin. Azithromycin “Z-pack” is overprescribed and not
general not recommended due to antibiotic resistance.
Sinusitis can also be caused by allergic “allergic sinusitis” and
fungal infections although rare.
Questions:
1.
Q: A nurse is providing care to a client who reports facial pain,
including dental pain in the upper teeth. Which of the following
additional symptoms would lead the nurse to suspect sinusitis as
the source of the pain?
A:The client has nasal congestion that does not significantly
improve with over-the-counter decongestants or antihistamines.
Explanation: The client has nasal congestion that does not
significantly improve with over-the-counter decongestants or