Summary NUR 282 Exam 3 Study Guide

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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