Unit 1 Sinusitis

1. Unit 1Sinusitis PRESENTED BY: REVIEWED BY: Ms. Pavithra K Mr. Jobin Lecturer, MSN dept Asst. Professor, MSN dept

2. LEARNING OBJECTIVES At the end of the class students will be able to • define Sinusitis • Enlist the causes of Sinusitis • list down the clinical features of Sinusitis • enumerate the management of Sinusitis

3. Definition • Rhinosinusitis • Symptomatic inflammation of the paranasal sinuses • the maxillary sinus which gets involved

7. Types • Acute – less than 4 weeks • Subacute – 4-12 weeks • Chronic – 12 week

8. Acute sinusitis Definition : • The acute inflammation of the sinus mucosa commonly follows an attack of acute rhinitis as in common cold or influenza when the bacteria invades secondary organisms

9. Causes • Micro-organisms • Viruses • Bacteria • Fungi • Pollutants

10. previous respiratory tract infections • nasal polyps, or small growths • weakened immunity • an allergic reaction to substances such as dust, pollens • structural problems

11. Pathophysiology Due to the viral and bacterial infection of upper respiratory tract Microorganisms will spread and affect the Para nasal air sinuses Inflammation ,edema, and exudate Leads to obstruction of sinus cavity

12. Pathophysiology- chronic Blockage that persists for greater than 3weeks Results in stagnant secretions A narrowing or obstruction in the Ostia of the all sinus

13. Clinical manifestations • Purulent nasal drainage • Nasal congestion • Facial pain • Difficulty breathing • Red , edematous nasal mucosa • Anosmia

14. Fever • Cough • Maxillary dental pain • Fatigue

15. Management Goals : • Treat the infection • Shrink the sinus • Relieve pain

16. Medical management • Antibiotic therapy • The course of treatment is usually 10-14days • First line antibiotics includes amoxicillin , trimethoprim , sulfamethoxazole and erythromycin • Second line antibiotics includes • Antibiotics with broad spectrum includes azithromycin, clarithromycin

17. Use of oral and topical decongestant agents may decrease mucosal swelling of nasal polyps • Antihistamines such as diphenhydramine • If the patient continues to have s/s after 7 to 10 day, may need to be irrigated and hospitalization may be required

18. Surgical management Sinus Antrum puncture : • This procedure is done to irrigate sinus cavity with sterile normal saline • Intranasal • Oro-Antral

19. Balloon sinuplasty : Clogged sinus is opened with the help of balloon It facilitated drainage.

22. Nursing management • Advice the client to use steam inhalation to promote drainage • Increase fluid intake • Apply moist heat by warm, wet towel against face .this will relieve sinus pressure and help open sinus passages.

23. Prevention • Keep the nose as moist as possible with frequent use of saline sprays. • Avoid upper respiratory tract infections • Minimize contact with people who have colds • Avoid exposure to irritants such as cigarette smoke

24. EVALUATION • What is Sinusitis. • What are the causes of Sinusitis. • Eneumerate the pathophysiology of Sinusitis. • Enlist the clinical features of Sinusitis. • Explain the management of Sinusitis

25. REFERENCE • Smeltzer – Brunner & Suddharth Textbook of Medical Surgical Nursing, Wolterskluwer publishers, 12th edition 2009. • Black – Medical Surgical Nursing, Elsevier publishers, 8th edition 2009. • Nettina – Lippincott manual of Nursing Practice, Wolterskluwer publishers, 7th edition 2014. • Lewis – Medical Surgical Nursing, Elsevier publishers, 10th edition, 2017