Nursing Care of Clients with Upper Respiratory Disorders

1. Nursing Care of Clients with Upper Respiratory Disorders Chapter 22

2. Influenza • Viral, highly contagious, airborne droplet and direct contact • Clinical Manifestations • Respiratory • cough, substernal chest pain, sore throat • Systemic • fever, chills, malaise, muscle aches, fatigue

3. Influenza • Collaborative Care • immunization of at-risk persons • Diagnosis • based on client history • Pharmacology • vaccine, aspirin, tylenol

5. Tonsillitis • Acute inflammation of tonsils • usually bacterial infection • spread by droplet • Clinical Manifestations • pain, difficulty swallowing • fever • enlarged and tender lymph nodes • tonsils appear bright red and edematous

6. Tonsillitis

7. Tonsillitis • Interdisciplinary Care • usually self-limiting • Antipyrectic and mild analgesics • Penicillin for group A streptococci • Tonsillectomy for recurrent infections

8. The Client with Epistaxis • Precipating factors • trauma • dryness • systemic infection • hypertension • bleeding disorders - thrombocytopenia

9. Epistaxis

10. Nasal Trumpets - Epistaxis

11. The Client with Epistaxis • Interdisciplinary Care • first aid measures - apply pressure • Nasal packing • 1/4 inch petroleum gauze • leave in for up to 3 days • Surgical cautery

12. Treatment of Epistaxis

13. Nasal trauma - dog bite

14. Nasal Trauma • Nasal fracture/deviated septum • epistaxis • deformity • displacement to one side • crepitus • periorbital edema • Treatment • reduction, plaster • rhinoplasty

15. Laryngeal Obstruction • Life-threatening emergency- Food or laryngospasm. • Clinical Manifestations • coughing, choking, gagging, difficulty breathing • Treatment • Heimlich maneuver • Medications such • As epinepherine, ET.

16. Laryngeal Obstruction - Polyp

17. Vocal Cord Polyp

18. Sleep Apnea • Absence of airflow through upper airways for 10 or more seconds • 30 episodes per night • Contributing factors • obesity • age • male gender

19. Sleep Apnea • Clinical Manifestations • loud cyclic snoring • cessation of breathing during sleep • restlessness, thrashing during sleep • daytime fatigue • headache, personality changes, depression

20. Sleep Apnea • Interdisciplinary Care • weight loss • Continuous positive airway pressure (CPAP) • tight fitting mask • air compressor blows air into the back of the throat • Surgery • tonsillectomy and adenoidectomy

21. Upper Respiratory Tumors and Cancers • Laryngeal Carcinoma • accounts for 1-3% of all cancer • curable if early detection • Risk Factors • ETOH, smoking, poor nutrition • Affects men more than women 9:1

22. The Larynx

23. Laryngeal Carcinoma • Clinical Manifestations • hoarseness • change in voice • painful swallowing, earache • dyspnea • palpable lump in neck • foul breath

24. Laryngeal Carcinoma • Interdisciplinary Care • laryngoscopy • direct visualization • biopsy • Chemotherapy, radiation, surgery • Laryngectomy • removal of the larynx • Radical neck dissection - nodes, neck and mandible removal

25. Laryngeal Carcinoma • Nursing Care • Impaired Verbal Communication • Ineffective Airway Clearance • Impaired Swallowing • Pain • Altered Nutrition:Less than Body Requirements • Anxiety

26. Laryngeal Carcinoma • Nursing Care • Altered Body Image • Teaching • Trach Care