Term
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Definition
| An inflammatory process involving the paranasal sinuses and nasal cavity. |
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Term
| What does rhino sinusitis usually follow? |
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Definition
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Term
| What can rhino sinusitis be classified as? |
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Definition
| Can be classified as acute bacterial or acute viral |
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Term
| What are the risk factors for rhino sinusitis? |
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Definition
Enviromental hazards
Obstructed sinus drainage |
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Term
| What are the manifestations of bacterial rhino sinusitis? |
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Definition
| Purulent nasal drainage, nasal obstruction, facial pain/pressure, facial fullness. |
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Term
| What are the manifestations of viral rhino sinusitis? |
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Definition
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Term
| How is rhino sinusitis managed? |
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Definition
| General: hydration, steam inhalation, saline irrigation, saline nose drops, sleep w/ head of bed elevated, decongestants, antibiotics if bacterial |
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Term
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Definition
| A sudden inflammation of the pharynx involving the back portion of the tongue, soft palate, and tonsils. |
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Term
| What is the usual cause of pharyngitis? |
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Definition
| Usually viral in nature, although can be bacterial |
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Term
| What are the risk factors for pharyngitis? |
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Definition
| <25 y/o, dusty surroundings, chronic cough, alcohol/tobacco use, use voice to excess |
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Term
| What is the treatment for pharyngitis? |
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Definition
Viral - supportive measures
Bacterial - penicillin |
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Term
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Definition
| The inability to produce voice or weak/hoarse voice, can be caused by laryngitis. |
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Term
| What is the treatment for aphonia? |
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Definition
| Resting the voice, avoiding irritants, cool steam/aerosol. |
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Term
A nursing student is caring for a patient with viral pharyngitis. What principle should the student integrate into the patient’s care plan?
Teaching should include the importance of taking all the antibiotics prescribed
Teaching should emphasize the need for temporary fluid restriction
The focus of nursing care will be symptom management
The focus of care will be resting the patient’s voice |
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Definition
| The focus of nursing care will be symptom management |
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Term
| What are the major goals of treatment of upper respiratory infections? |
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Definition
#1 Maintenance of a patent airway
Pain relief
Maintenance of effective communication
Hydration
Knowledge of how to prevent upper airway infections
Absence of complications |
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Term
Is the following statement true or false?
The most important measure for preventing the spread of URIs is the administration of prophylactic antibiotics. |
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Definition
False
Rationale: Most URIs have a viral etiology. Even in the management of those caused by bacteria, prophylactic antibiotics are not normally used to prevent spread. |
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Term
An obese man arrives in a clinic with complaints of excessive daytime sleepiness and frequent, loud snoring. What is the patient most likely exhibiting manifestations of?
Rhinosinusitis
Chronic nasal obstruction
Obstructive sleep apnea |
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Definition
C. Obstructive sleep apnea
Rationale: OSA is often accompanied by daytime fatigue and loud snoring. Obesity is a major risk factor for the disease. Nasal obstructions and rhinosinusitis do not have this clinical presentation. |
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Term
| When is a laryngectomy done? |
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Definition
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Term
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Definition
| Removal of the larynx. Can be partial, supraglottic, hemilaryngetcomy, total. |
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Term
| What else is done for larynx cancer? |
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Definition
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Term
| What is a supraglottic laryngectomy? |
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Definition
| The hyoid bone, glottis and false vocal cords are removed. |
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Term
| What is a hemilaryngectomy? |
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Definition
| The thyroid cartilage of the larynx is split in the midline of the neck and the portion of the vocal cord (1 true and 1 false) are removed with the tumor. |
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Term
| What is the important nursing care for a laryngectomy patient? |
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Definition
- pre op teaching
- reducing anxiety and depression
- maintaing a patent airway after surgery
- promoting alternative communication measures
- promoting adequate nutrition and hydration
- promoting positive body image and self esteem
- promoting self care |
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Term
| What are the complications from laryngectomy? |
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Definition
- Respiratory distress
- Hypoxia
- Hemorrhage
- Infection
- Wound break down
- Aspiration
- Tracheostomal Stenosis |
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Term
| The highest priority in the care of a patient who has undergone a laryngectomy is establishing and maintaining the patency of the patient’s airway. |
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Definition
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Term
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Definition
| Difficulty swallowing that accompanies esophageal obstruction |
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Term
| What is obstructive sleep apnea? |
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Definition
| Is a disorder characterized by recurrent episodes of upper airway obstruction and a reduction in ventilation during sleep. |
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Term
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Definition
| A cessation of breathing, in sleep for this disorder, usually caused by repetitive upper airway obstruction |
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Term
| What are the risk factors for OSA? |
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Definition
Older
Overweight
Obesity around the neck
Elderly
Structural changes to throat |
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Term
| What is the medical management of OSA? |
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Definition
Weight loss
Avoidance of alcohol/hypnotic stuff
Oral appliances that reposition the jaw and tongue |
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Term
| What is Noninvasive positive-pressure ventilation? |
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Definition
| CPAP machine! This is for those suffering from hypoxemia with severe carbon dioxide retention. |
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Term
| What does the CPAP machine do? |
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Definition
| Provides positive pressure to the airways through-out the respiratory cycle preventing collapse. An air source generates the air flow that is used with a leak proof mask to keep the alveoli open, thereby preventing respiratory failure. |
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Term
| What must the patient have the ability to do to use a CPAP/BiPaP? |
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Definition
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Term
| What is the surgical alternative for treatment for OSA? |
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Definition
| Uvulopalatopharyngoplasty. surgical resection of pharyngeal soft tissue/uvula. Only used if CPAP is unsuccessful |
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Term
| What is the nursing management of the OSA patient? |
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Definition
| The nurse explains the disorder, and relates the symptoms (daytime sleepiness, morning headaches, heartburn, insomnia, storing), The nurse also instructs the pt about treatments like weight loss, avoiding alcohol, and the correct use of CPAP. |
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Term
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Definition
| An artificial airway. 2 types - endotracheal tube and a tracheostomy tube. |
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Term
| When is a tracheostomy tube used? |
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Definition
| If the patient will be intubated for longer than 21 days. |
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Term
| What are the disadvantages of intubation? |
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Definition
-discomfort
-cough reflex hindered
-secretions thicker
-swallowing inhibited
-mechanical trauma
-aspiration risk |
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Term
| What is an endotracheal tube? |
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Definition
| A temporary means of providing an airway for patients who cannot maintain an adequate one on their own, for patients needing mechanical ventilation, and for suctioning secretions from the pulmonary tree. |
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Term
| What does the ETT pass through? |
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Definition
| Through the mouth or nose into the trachea. |
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Term
| What is the cuff for on an ETT? |
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Definition
| A cuff is inflated to prevent air from leaking out around the outer part of the tube, to minimize the possibility of subsequent aspiration, and to prevent movement of the tube. |
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Term
| What does low cuff pressure do? |
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Definition
| Increase risk of aspiration pneumonia |
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Term
| What does high cuff pressure do? |
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Definition
| Cause tracheal bleeding, ischemia, and possibly necrosis. |
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Term
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Definition
| A surgical procedure in which an opening is made into the trachea, an indwelling tube is inserted into the trachea. |
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Term
| What is a tracheostomy used for? |
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Definition
| To bypass the upper airway obstruction, allow the removal of tracheobronchial secretions, to permit the long term use of mechanical ventilation, to prevent aspiration of oral/gastric secretions, and to replace an ETT. |
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Term
| What are the 3 types of tracks? |
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Definition
1.) Cuffed
2.) Fenestrated
3.) Uncuffed |
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Term
| What are the complications of a tracheostomy? |
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Definition
-bleeding
-pneumothorax
-air embolism
-aspiration
-subcutaneous or mediastinal emphysema
-recurrent laryngeal nerve damage
-posterior tracheal wall penetration
-airway obstruction r/t secretions
-protrusion of the cuff over the opening of the tube
-infection, rupture of the innominate artery
-dysphagia
-tracheoesophageal fistula
-tracheal dilation
-tracheal ischemia/necrosis |
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Term
| WHat is the nursing management of a tracheostomy? |
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Definition
1.) Suctioning
2.) Managing the cuff
3.) Constant monitoring/assessment
4.) Semi-fowler's position
5.) analgesics/sedatives |
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Term
| What are the major goals of nursing care of the tracheostomy? |
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Definition
-Allevaite apprehension
-Provide effective means of communication
-Prevent infection |
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Term
| When is suctioning performed? |
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Definition
| When adventitious breath sounds occur or whenever secretions are obviously present. |
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Term
| Why is unnecessary suctioning bad? |
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Definition
| Causes bronchospasm and mechanical trauma |
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Term
| What equipment must be sterile? |
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Definition
| Anything that comes into contact with the patient's lower airway. |
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Term
| How far does the suctioning tube go down? |
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Definition
| The length of the ETT or tracheostomy tube |
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Term
| What are the steps to care of the tracheostomy tube? |
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Definition
-Get equipment
-Teaching
-Preform hand hygiene
-Explain procedure
-Gloves
-Prepare sterile supplies
-Put on STERILE gloves
-Cleanse the wound and the plate of the teacheostomy tube with sterile stuff
-Soak inner canula
-Replace inner canula
-Place clean twill tape to secure the tracheostomy tube
-Remove old tape and discard
-Use a sterile dressing if necessary |
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Term
| What are the steps of performing OPEN suctioning? |
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Definition
-Explain procedure
-Perform hand hygiene
-Gloves, gown, etc.
-Secure end of the suction tubing to suction device
-Place open end within reach in prep for connection the suction catheter
-Turn on suction 120-150
- Open kit on clean surface
-Using the inside of the wrapping as a sterile field
-Suction catheter should be less than had the internal lumen length
-Put on sterile gloves
-Pick up suction catheter
-Secure the suction catheter to tubing
-Hyperoxygenate before suctioning
-With suction OFF, insert tube
-Place non dominant thumb over control vent of the suction and apply intermediate suction
-Reoxygenate pt |
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Term
The nurse is proving preoperative teaching of th pt who is to undergo a total laryngectomy. Which nursing intervention is most important?
a.) Having the pt restrict food and fluid
b.) Teaching the care required for the trachea tube
c.) Assessing the patient's ability to read/write
d.) Demonstrating cough and deep breathing exercises |
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Definition
| B. Teaching the care required for the trachea tube |
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Term
A patient who has just had a total laryng. for cancer has just been discharged. What statement indicates that pt needs further teaching?
a.) Avoid getting objects in stoma
b.) I can take a shower when i get home
c.) i can learn to speak with an electric larynx
d.) I need to clean around my stoma everyday |
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Definition
| B. I can take a shower when I get home |
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Term
Which statement indicates the need for further teaching of OSA?
a.) The CPAP machine will help me be more awake during the day.
b.) If I exercise and lose weight, I may not need the CPAP.
c.) I will use the CPAP machine only when I really need to sleep well.
d.) The CPAP helps keep my airway open while sleeping |
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Definition
| C.) Only use when need good sleep |
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Term
The nurse would assess the pt with acute pharyngitis for what s/s of GAS pharyntgitis?
A. pain, spasm of the lower leg muscle
b. Gross hematuria, edema, HTN
c. Reduced visual fields, blurred vision
d. Insomnia, heartburn, and abdominal distention |
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Definition
| B. Gross hematuria, edema, HTN |
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Term
A pt will be going home with a tracheal stoma. Teaching?
a.) Water sports are permitted
b.) Wear a med ID bracelet
c.) Mouth to mouth ventilation
d.) Fifteen minutes of strenuous exercise will improve strength |
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Definition
| B.) wear a medical ID bracelet |
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