INTERVENYION FOR CLIENTS WITH NONINFECTIOUS PROBLEMS OF UPPER AND LOWER RESPIRATORY TRACT

1. INTERVENYION FOR CLIENTS WITH NONINFECTIOUS PROBLEMS OF UPPER AND LOWER RESPIRATORY TRACT

4. Fracture of the Nose • Displacement of either the bone or cartilage of the nose can cause airway obstruction or cosmetic deformity and is a potential source of infection. • Cerebrospinal fluid could indicate skull fracture. • Interventions: • Rhinoplasty • Nasoseptoplasty

6. Epistaxis • Nosebleed is a common problem. • Interventions if nosebleed does not respond to emergency care: • Affected capillaries are cauterized with silver nitrate or electrocautery and the nose is packed. • Posterior nasal bleeding is an emergency. (Continued)

9. Nasal Polyps • Benign, grapelike clusters of mucous membranes and connective tissue • May obstruct nasal breathing, change character of nasal discharge, and change speech quality • Surgery: treatment of choice

12. Cancer of the Nose and Sinuses • Cancer of the nose and sinuses is rare and can be benign or malignant. • Onset is slow and manifestations resemble sinusitis. • Local lymph enlargement often occurs on the side with tumor mass. • Radiation therapy is the main treatment; surgery is also used.

13. Facial Trauma • Le Fort I nasoethmoid complex fracture • Le Fort II maxillary and nasoethmoid complex fracture • Le Fort III combination of I and II plus an orbital-zygoma fracture, often called craniofacial disjunction • First assessment: airway

14. Facial Trauma Interventions • Anticipate the need for emergency intubation, tracheotomy, and cricothyroidotomy. • Control hemorrhage. • Assess for extent of injury. • Treat shock. • Stabilize the fracture segment.

15. Disorders of the Larynx • Vocal cord paralysis • Vocal cord nodules and polyps • Laryngeal trauma

17. Vocal cord paralysis

18. Upper Airway Obstruction • Life-threatening emergency in which an interruption in airflow through the nose, mouth, pharynx, or larynx occurs. • Early recognition is essential to prevent further complications, including respiratory arrest.

19. Upper Airway Obstruction Inverventions • Interventions include: • Assessment for cause of the obstruction • Maintenance of patent airway and ventilation • Cricothyroidotomy • Endotracheal intubation • Tracheostomy

20. Ineffective Breathing Pattern • Interventions include: • Treatment goal: to remove or eradicate the cancer while preserving as much normal function as possible • Nonsurgical management • Radiation therapy • Chemotherapy

21. Risk for Aspiration • Interventions include: • Dynamic swallow study • Enteral feedings • Routine reflux precautions • Elevation of the head of bed • Strict adherence to tube feeding regimen • No bolus feeding at night • Checking residual feeding

22. Anxiety Interventions • Interventions include: • Team conference • Explore reason for anxiety • Teaching • Antianxiety drugs such as diazepam administered with caution because of the possibility of respiratory depression • Lorazepam

23. Asthma • Intermittent and reversible airflow obstruction affects only the airways, not the alveoli. • Airway obstruction occurs due to inflammation and airway hyperresponsiveness.

37. Interventions • Client education: asthma is often an intermittent disease; with guided self-care, clients can co-manage this disease, increasing symptom-free periods and decreasing the number and severity of attacks. • Peak flow meter can be used twice daily by client. • Drug therapy plan is specific.