NUR2502 Exam 2 Focused Review
Neck cancer
S/S-Hoarseness, change in voice quality, ear pain unilateral, persistent or recurrent sore
throat, anorexia, weight loss, neck pain.
Treatment- radiation, chemo,
Nursing interventions- Adequate nutrition, educate patient on what and what not to
expect, adequate liquids, protecting skin when outside, avoid shaving, support groups,
avoid acidic foods, Consulting speech therapy to assist the patient with communication,
gargling with saline, sucking on ice, and use of mouthwash and throat sprays. Sitting
upright in reclining chair may promote more comfortable breathing
Nasal fractures
S/S-Pain,Displaced bone and/or cartilage (nasal septum),Changes in the appearance
(shape) of the nose, Nosebleed.Difficulty breathing through the nose.Collection of blood
(septal hematoma),Swelling and bruising of nose and eyelids.
Treatments-Rhinoplasty (nasal reconstruction) after surgery never blow your nose,
GIVE LAXATIVE TO EASE bm Maintaining a semi-Fowler’s position to reduce
swelling, Application of cool compresses. AVOID NSAID aspirin
Nursing interventions- educate patient to AVOID straining to have a BM because it can
increase nasal pressure, monitor nasal packing
Rhinosinusitis- Inflammation of sinus mucous membranes
Usually caused by Streptococcus pneumoniae, Haemophilus influenzae, Diplococcus,
Bacteroides
S/S-Nasal swelling, Congestion,Headache,Facial pressure,Pain,Tenderness to touch over
involved region, Low-grade fever,Cough,Purulent or blood nasal drainage
Diagnosis- Patient history, endoscopic exam and CT
Treatment- broad spectrum antibiotics (amoxicillin), decongestants (phenylephrine),
antipyretics, surgery to relieve obstruction and promote drainage
Complications- meningitis, cellulitis, abscess they are close in proximity so they can
cause each other
Differentiating drainage:
CSF Drainage- Glucose, yellow halo when dried, clear
Nasal drainage- yellow when dried, clear
COPD
S/S- barrel chest, dyspnea
diagnosed by pulmonary function test
, Treatment- inhalers, Adequate nutrition, oxygen maintain drive
o Airway maintenance = most important focus
§ Apply oxygen as prescribed
§ Intubation & mechanical ventilation may be needed for patients in
respiratory failure
o Breathing techniques
§ Diaphragmatic or abdominal & pursed lip breathing
o Positioning
§ Place patient in upright position with head of bed elevated can help
alleviate dyspnea
o Effective Coughing
§ Teach patient to cough on arising in the morning to eliminate mucus
that collected during the night
§ Coughing before bedtime may help clear lungs for less interrupted night
sleep
● Teach patient to plan biggest meal when they’re most hungry & well rested
§ 4-6 small meals/day preferred
§ Use pursed lip & abdominal breathing
§ Used prescribed bronchodilator 30 min before meal to reduce
bronchospasm
§ Urge patient to eat high calorie, high protein foods 1st
Obstructive sleep apnea- (OSA)- 10 second interruptions in breathing that occur at least
5 times in one hour
S/S- Snoring, excessive daytime sleepiness, inability to concentrate, and irritability,
waking up tired.
Cause - obesity, Large uvula, Short neck, Smoking, Enlarged tonsils or adenoids,
Oropharyngeal edema, history of HBP, neck circumference >40 cm
Treatment- Bipap, CPAP, weight loss, change sleeping position
Neck cancer
S/S-Hoarseness, change in voice quality, ear pain unilateral, persistent or recurrent sore
throat, anorexia, weight loss, neck pain.
Treatment- radiation, chemo,
Nursing interventions- Adequate nutrition, educate patient on what and what not to
expect, adequate liquids, protecting skin when outside, avoid shaving, support groups,
avoid acidic foods, Consulting speech therapy to assist the patient with communication,
gargling with saline, sucking on ice, and use of mouthwash and throat sprays. Sitting
upright in reclining chair may promote more comfortable breathing
Nasal fractures
S/S-Pain,Displaced bone and/or cartilage (nasal septum),Changes in the appearance
(shape) of the nose, Nosebleed.Difficulty breathing through the nose.Collection of blood
(septal hematoma),Swelling and bruising of nose and eyelids.
Treatments-Rhinoplasty (nasal reconstruction) after surgery never blow your nose,
GIVE LAXATIVE TO EASE bm Maintaining a semi-Fowler’s position to reduce
swelling, Application of cool compresses. AVOID NSAID aspirin
Nursing interventions- educate patient to AVOID straining to have a BM because it can
increase nasal pressure, monitor nasal packing
Rhinosinusitis- Inflammation of sinus mucous membranes
Usually caused by Streptococcus pneumoniae, Haemophilus influenzae, Diplococcus,
Bacteroides
S/S-Nasal swelling, Congestion,Headache,Facial pressure,Pain,Tenderness to touch over
involved region, Low-grade fever,Cough,Purulent or blood nasal drainage
Diagnosis- Patient history, endoscopic exam and CT
Treatment- broad spectrum antibiotics (amoxicillin), decongestants (phenylephrine),
antipyretics, surgery to relieve obstruction and promote drainage
Complications- meningitis, cellulitis, abscess they are close in proximity so they can
cause each other
Differentiating drainage:
CSF Drainage- Glucose, yellow halo when dried, clear
Nasal drainage- yellow when dried, clear
COPD
S/S- barrel chest, dyspnea
diagnosed by pulmonary function test
, Treatment- inhalers, Adequate nutrition, oxygen maintain drive
o Airway maintenance = most important focus
§ Apply oxygen as prescribed
§ Intubation & mechanical ventilation may be needed for patients in
respiratory failure
o Breathing techniques
§ Diaphragmatic or abdominal & pursed lip breathing
o Positioning
§ Place patient in upright position with head of bed elevated can help
alleviate dyspnea
o Effective Coughing
§ Teach patient to cough on arising in the morning to eliminate mucus
that collected during the night
§ Coughing before bedtime may help clear lungs for less interrupted night
sleep
● Teach patient to plan biggest meal when they’re most hungry & well rested
§ 4-6 small meals/day preferred
§ Use pursed lip & abdominal breathing
§ Used prescribed bronchodilator 30 min before meal to reduce
bronchospasm
§ Urge patient to eat high calorie, high protein foods 1st
Obstructive sleep apnea- (OSA)- 10 second interruptions in breathing that occur at least
5 times in one hour
S/S- Snoring, excessive daytime sleepiness, inability to concentrate, and irritability,
waking up tired.
Cause - obesity, Large uvula, Short neck, Smoking, Enlarged tonsils or adenoids,
Oropharyngeal edema, history of HBP, neck circumference >40 cm
Treatment- Bipap, CPAP, weight loss, change sleeping position
