NURS 6501 Week 3 Test

NURS 6501 Week 3-NURS 6501

Classification of acute sinusitis - ✔✔Symptoms < 4 week

Classification of subacute sinusitis - ✔✔Symptoms 4-12 weeks

Classification of chronic sinusitis - ✔✔Symptoms > 12 weeks

Classification of recurrent sinusitis - ✔✔3+ events/year without symptoms in between
and last < 2 weeks

What percentage of cases of sinusitis receive antibiotics? How many cases recover on
their own without antibiotics? - ✔✔80%
70%

What is an uncomplicated sinusitis? - ✔✔No clinical evidence of extension of infection
outside of paranasal sinuses and nasal cavity without neurological, ophthalmologic, or
soft tissue involvement

What is the most common site of sinusitis? - ✔✔maxillary sinuses (largest sinuses)

Risk factors of sinusitis - ✔✔-History of allergic rhinitis
-History of asthma, CF, chronic respiratory syndrome
-First or 2nd hand cigarette smoke
-Small nasal passages

Common viral causes of sinusitis - ✔✔-Influenza
-Rhinovirus
-Parainfluenza
-RSV
-Adenovirus

Common bacterial causes of sinusitis - ✔✔-Strep pneumonia
-H flu
-Moraxella catarrhalis
-Staph aureus

Fungal sinusitis is ________ and typically seen in _______________ - ✔✔Rare
Immunosuppressed patients

Symptoms of acute rhinosinusitis - ✔✔-Purulent anterior nasal dx
-Purulent or discolored posterior nasal discharge

,-Nasal congestion or obstruction
-Facial congestion, fullness
-Hyposmia, anosmia
-Fever
-HA
-Ear pain, pressure, fullness
-Halitosis
-Dental pain
-Fatigue

3 cardinal symptoms of bacterial sinusitis - ✔✔1) Mucopurulent discharge
2) Nasal obstruction
3) Facial pain, pressure

4 cardinal symptoms of chronic sinusitis - ✔✔1) Mucopurulent discharge
2) Nasal obstruction
3) Facial pain, pressure
4) Decreased or loss of smell > 12 weeks

Infectious Disease Society of American (IDSA) classification of bacterial sinusitis - ✔✔-4
weeks of purulent nasal discharge with nasal obstruction
-Facial pain for 3 days

Clinical presentation of bacterial sinusitis - ✔✔-Fever > 101.5-102F
-Duration > 10 days
-Severe HA
-Skin infection
-Purulent nasal discharge > 4 weeks
-Facial pain/pressure/fullness/dental pain (no improvement for 10 days)
-Decreased smell
-Cough
-Fatigue
-Ear pain

Important PMH to illicit when assessing a patient presenting with sinusitis - ✔✔-History
of sinus infection
-History of nasal polyps
-Recent head injury

Sinusitis PE - ✔✔-VS, recent fevers?
-Allergic shinier, periorbital edema
-Nasal edema, erythema, discharge, septal deviation, polyps
-Throat PND, erythema, lymphoid hypertrophy
-Dental abscess, gingivitis
-Lymph node palpation
-Percussion of frontal, maxillary sinuses

, -Eye exam (ophthalmoscope)
-Ear exam (otoscope)

When should you consider a facial CT when a patient presents with signs of sinusitis? -
✔✔-Recurrent bacterial sinusitis
-Orbital or soft tissue involvement
-Comborbidities (immunodeficiency, diabetes, labs)
-Facial trauma

Presentation of trigeminal neuralgia - ✔✔Unilateral facial pain around the 5th cranial
nerve

Differential diagnosis for sinusitis presentation - ✔✔-Common cold
-Dental abscess
-Trigeminal neuralgia
-Optic neuritis
-Meningitis
-Orbital cellulitis
-Allergic rhinitis
-Migraine or cluster HA
-Foreign body
-Tumor
-Nasal polyps
-Head injury
-Fungal infection

Treatment for sinusitis (symptom relief) - ✔✔-Analgesics (NSAIDs, acetaminophen)
-Saline nasal irrigation
-Antitussive (weak evidence)
-Mucolytics/expectorants (guaifenesin; thins mucus)
-Decongestants (3-5 days_
-Oxymetazoline
-Nasal steroid
-Hydration
-Rest
-Humidified air

When doing the "watchful waiting" approach for treating acute sinusitis, when you
should have patient follow to assess if antibiotics need to be started? - ✔✔after 7 days
of no improvement with supportive therapy

Oxymeetazoline use for sinusitis - ✔✔(Neo-Synnephrine)
-Decreases nasal congestion, edema
-Promotes drainage