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Management of Patients with Conditions of the Upper Respiratory Tract

Management of Patients with Conditions of the Upper Respiratory Tract. Lecture 3 Chapter 22 Brunner’s. Common Cold. AKA: Rhinitis Viral rhinitis Pathophysiology Rhinovirus “Infection with acute inflammation of the mucous membrane of the nasal cavity”. Common Cold. Etiology Airborne

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Management of Patients with Conditions of the Upper Respiratory Tract

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  1. Management of Patients with Conditions of the Upper Respiratory Tract Lecture 3 Chapter 22 Brunner’s

  2. Common Cold AKA: • Rhinitis • Viral rhinitis Pathophysiology • Rhinovirus • “Infection with acute inflammation of the mucous membrane of the nasal cavity”

  3. Common Cold Etiology • Airborne • Peak Times • Sept, Jan & April • Duration • 5-14 days

  4. Common Cold Clinical Manifestations • Nasal congestion • Runny nose • Sore throat • Sneezing • Malaise • Afibrile • H/A • Cough

  5. Common Cold Dx exams & Procedures • S&S • Culture

  6. Common Cold Tx methodology • Focus – relief • Tx not shorten • Fluids • Warm, moist air • Medications • OTC

  7. Common Cold Medications • Antihistamines • Action • H1 blockers  inhibits action • X push off  • Take early • Allergies

  8. Common Cold Medications • Antihistamines • Rx effect • Prevents salivary, gastric, lacrimal and bronchial secretions • Relieves • Sneezing • Rhinorrhea • Nasal congestion

  9. Common Cold Medications • Antihistamines • Side effects • Drowsiness • Drying • Examples • Allergra • Claritin • Benadryl

  10. Common Cold Medications • Decongestants • Rx Actions • Shrink engorged nasal mucus membranes • Side Effects • Rebound congestion • Insomnia

  11. Common Cold Medications • Decongestants • Examples • Sudafed • Vicks inhaler • Afrin

  12. Common Cold Medications • Anti-tussives • Rx Action • Side effects • Example

  13. Common Cold Medications • Analgesics • Tylenol (Acetomenaphen) • Motrin (ibuprofen) • NSAID • Non-narcotic

  14. Common Cold Medications • Vitamin C

  15. Common Cold Medications • Antibiotics • Prophylactic • Examples • Sulfonamides • Penicillins • Cephalosporins • Tetrcyclines • Aminglycosides • Quinolones • Macrolides • Vancomycin

  16. Common Cold Medications • Anti-biotic • Side-effects • N/V • Yeast infections • Resistance

  17. Common Cold Medications • Echinacea • Action • Stim. immune system • Anti-bacterial • Anti-inflammatory • Use • 10-14 days • Long tem use • i immune system

  18. Common Cold Nrs Managements • See MD > 2 wks • Prevention How do you prevent the cold from getting you? • Hand wash • Cover mouth • Throw away tissue • Avoid crowds • Vaccine • Eat right • Sleep • Stress • Exercise • Smoking • Allergens • Animals • Carpet

  19. Common Cold Complications • Bronchitis • Pneumonia • Conjunctivitis

  20. Sinusitis: sinus infection Pathophysiology • Inflammation of the mucus membrane of one or more sinuses • Blocks the egress of sinuses

  21. Sinusitis: sinus infection Etiology • Bacterial or viral? • #1 bacterial • Tooth abscess • Allergies • Structural abnormalities

  22. Sinusitis: sinus infection Clinical manifestations • Pain • Maxillary • Over cheek and upper teeth • Ethmoid • Btw & behind eyes • Frontal • Forehead • Ethmoid sinusitis

  23. Sinusitis: sinus infection Clinical manifestations • Anosnia • H/A • Fever? • Fatigue? • Foul breath?

  24. Sinusitis: sinus infection Dx • S&S • X-ray, CT, MRI • C & S

  25. Sinusitis: sinus infection Med Tx • Antibiotics • Analgesics • No aspirin • Nasal decongestants • Mucolytic agents • Surgery

  26. Sinusitis: sinus infection NRS interventions • Fluids • h • Position • HOB h • Activity • Rest • Moist hot-packs • Cleaning techniques • Irrigate nose

  27. Sinusitis: sinus infection Prevention • Avoid contributing factors: • Cold • Smoking • Fatigue • URI • Dentist

  28. Sinusitis: sinus infection Complications • Osteomylitis • Cellulitis of the orbit • Abscess • Meningitis

  29. Sinusitis: sinus infection • Surgery • Post-op care • Position • Side lying  • semi-fowler • Ice • Monitor for • Bleeding • i visual acuity • Pain • S&S of infection • Oral care • Packing x 48 hrs • No blowing • Tarry stools • Avoid constipation

  30. Acute Pharyngitis Pathophysiology • AKA: sore throat, strep throat • Inflammation of the throat

  31. Acute Pharyngitis Etiology • 70% • Viral • Bacterial • Streptococcus

  32. Acute Pharyngitis Clinical manifestations • Sore throat • Febrile • Dysphagia • Exudate • Lymphnoids • Malaise* • Hoarseness* • Cough* • Rhinitis*

  33. Acute Pharyngitis Dx exams • Throat culture • Rapid screening

  34. Acute Pharyngitis - Tx • Viral • Supportive • Like a cold • Bacterial • Antibiotics • Diet • Liquid/soft • Analgesics • Tylenol • Anti-tussive

  35. Acute Pharyngitis - Nrs • Rest • Rashes? • Communicable disease • Warm saline gargles • Temp 105-110 F • Diet • Liquid • Fluids • h • Ice collar • Oral care

  36. Acute Pharyngitis Complications • Sinusitis • Ottis media • Peritonsillar abscess • Scarlet fever • Rheumatic Fever • 2-3 wk /p subsides • Heart damage • Mital valve damage

  37. Tonsillitis & Adenoiditis Pathophysiology • Tonsils • Location • Oropharynx • Lymph tissue • Adenoids • Location • Nasopharynx

  38. Tonsillitis & Adenoiditis Etiology • Streptococcus • Low resistance • Children

  39. Tonsillitis & Adenoiditis – S&S • Sore throat • Febrile & chills • Snoring • Dysphagia • Adenoids • Mouth breathing • Duration • 1-2 wks

  40. Tonsillitis & Adenoiditis - Dx Dx • Visualize • C&S • Mono

  41. Tonsillitis & Adenoiditis Post-op care • Hemorrhaging • Coffee ground emeses • Bright red emeses • Pulse • h • Temp • h • Restlessness • Tarry stool • h swallowing

  42. Tonsillitis & Adenoiditis Post-op • Position • Prone/side lying until… • Gag returns • Semi-fowler’s • Pain control • Ice collar • Acetaminophen • Not aspirin

  43. Tonsillitis & Adenoiditis Post-op • Diet • Ice cold fluids • Adv. To normal ASAP • 2-3 days • Milk products • i • Avoid • Spicy • Hot • Acidic • Rough

  44. Tonsillitis & Adenoiditis • Post-op • Pt education • S&S of hemorrhaging • Mouthwash good • Avoid • Coughing • Sneezing • Vigorous nose blow • Vigorous gargling • Rough foods • Expect black tarry stools • Normal activity ASAP

  45. Peritonsillar Abscess Pathophysiology • Pus & blood filled sacs on tonsil Etiology • Complication of strep throat

  46. Peritonsillar Abscess S&S • Pain • Local • Radiates  ear • Dysphagia • drooling • Dysphasia • Fever • Red throat

  47. Peritonsillar Abscess Tx • Antibiotics • Incision & drain • Lanse • Warm saline irrigation • Hydrogen peroxide • Analgesics • Topical • Tylenol • No aspirin • ? narcotics • Ice collar • No smoking • Ventilator?

  48. Laryngitis • Pathophysiology • Inflammation of the mucous membrane lining the larynx • With edema of the vocal cords

  49. Laryngitis • Etiology • Viral • Voice abuse • Dust

  50. Laryngitis • Risk factors • Airborne irritants • Cold • Resent RTI • Smoking

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