Rasmussen College: NUR 2502 MDC 3 Exam 2 Study Guide: Modules 4, 5, and 6_LATEST 2024/2025,100% CORRECT

Rasmussen College: NUR 2502 MDC 3 Exam 2 Study Guide: Modules 4, 5, and 6_LATEST 2024/2025,100% CORRECT Module 4 – Upper Respiratory Disorders Head & Neck • Assessment Findings o Pain o Lump in mouth, throat, or neck o Difficulty swallowing o Color changes in mouth or tongue to red, white, gray, dark brown, or black o Oral lesions or sore that does not heal in 2 weeks o Persistent or unexplained oral bleeding o Numbness of the mouth, lips, face o Change in the fit of dentures o Burning sensation when drinking citrus juices or hot liquids o Persistent or recurrent sore throat o Shortness of breath o Anorexia & weight loss • Treatment o Radiation therapy o Chemotherapy o Biotherapy o Laryngectomy o Tracheotomy o Oropharyngeal cancer resection • Nursing Care o Maintaining a patent airway by suctioning the patient. o Monitor patient for complications of surgery such as hemorrhage, airway obstruction, wound breakdown, and possible infection. o Implement nutritional support to meet the patient’s needs. A feeding tube is generally inserted at the time of surgery to provide nutritional support since oral intake is not possible. o Consult speech and language pathologist to assist patient with communication needs. Nasal Fractures • Assessment Findings o Bruising o Pain o Nasal deviation o Crepitus o Blood or clear fluid draining (CSF) from the nose Epistaxis – Position pt. upright and leaning forward • Causes o Trauma o Hypertension o Leukemia o Inflammation o Tumor o Decreased humidity o Nose blowing/picking o Chronic cocaine use o Nasal procedure • Diagnostics o X-ray (to rule out disorders of the nose) • Assessment Findings o Nose bleeding/discharge • Treatment o Capillary cauterization o Silver nitrate o Electrocautery o Nasal packing o Epistaxis catheters • Nursing Interventions o Management of bleeding by applying direct lateral pressure to the nose for 10 minutes and application of ice or cool compresses. If bleeding does not cease, nasal packing may be applied. o Implement standard precautions. o Educate the patient to maintain an upright position, such as leaning forward to prevent aspiration. o Monitor blood pressure to prevent periods of hypertension, which could increase the chance of bleeding. o Instruct the patient not to blow his or her nose for 24 hours to prevent clot disruption. Facial Trauma • Assessment Findings o Stridor o SOB o Dyspnea o Anxiety o Restlessness o Hypoxia o Hypercarbia o Decreased O2 saturation o Cyanosis o Loss of consciousness o Pain o Discharge from nose and ears o Bruising Sleep Apnea - Obstructive sleep apnea (OSA) is a condition in which the patient experiences cyclical patterns of breathing disruption for periods of 10 seconds that occurs at least five times in an hour due to upper airway obstruction. • Causes o Obesity o Large uvula o Short neck o Smoking o Enlarged tonsils or adenoids o Oropharyngeal edema • Treatment o Noninvasive positive-pressure ventilation o BiPAP o Auto-titrating positive airway pressure (APAP) o CPAP o Tracheostomy Upper Airway Obstruction • Diagnosis o Sleep study • Assessment Findings o Diaphoresis o Tachycardia o Elevated blood pressure o Anxiety o Sternal retractions