Nursing Care of Clients with Upper Respiratory Disorders

Nursing Care of Patients with Upper Airway Disorders Upper airway disorders may be minor, treated outside health care setting Or may be severe, life threatening Require good assessment skills, understanding of variety of disorders that affect upper airway, impact those disorders may have on patient Patient teaching is important aspect of care

Specific Disorders Infections Rhinitis Sinusitis: acute, chronic Pharyngitis: acute, chronic Tonsillitis, adenoiditis Peritonisillar abscess Laryngitis

Upper Respiratory Tract Disorders and Risk Factors Influenza Highly contagious viral respiratory disease Usually occurs in epidemics or pandemics Avian influenza: possible pandemic Sinusitis Sterile air-filled cavities in the facial bones

Viral Upper Respiratory Infection Pathophysiology Local inflammatory response Swelling of mucous membranes of nasal passages Hyperactivity of mucus-secreting glands Immunity produced only to individual virus

Rhinitis and Sinusitis

Pharyngitis

Viral Upper Respiratory Infection Manifestations Nasal congestion Profuse nasal discharge (coryza) Sneezing Coughing Sore throat Low-grade fever Headache Malaise Muscle aches

Viral Upper Respiratory Infection Sinusitis Pathophysiology Sinus opening obstruction, impaired drainage Manifestations Pain and tenderness Headache, fever, and malaise Nasal congestion Purulent nasal discharge Bad breath

Influenza Medications Prophylaxis Treatment to reduce severity Amantadine Rimantadine Zanamivir Oseltamivir Ribavirin Symptom relief also include ASA Acetaminophen NSAIDs Antitussives Antibiotics are not indicated

Sinusitis Medication Therapy Antibiotics Oral or topical decongestants Antihistamines Saline nose drops or sprays Systemic mucolytic agents

Nursing Process: Care of Patients with Upper Respiratory Infections - Assessment Health history Signs and symptoms: headache, cough, hoarseness, fever, stuffiness, generalized discomfort and fatigue Allergies Inspection of nose, neck, throat Include palpation of lymph nodes

Nursing Process: Care of Patients with Upper Respiratory Infections - Diagnosis Ineffective airway clearance Acute pain Impaired verbal communication Deficient fluid volume Deficit of knowledge related to prevention, treatment, surgical procedure, postoperative care

Nursing Process: Care of Patients with Upper Respiratory Infections - Planning Maintenance of patent airway Relief of pain Maintenance of effective communication Normal hydration Knowledge to how to prevent upper airway infections Absence of complications

Interventions Interventions to maintain patent airway Promote comfort Analgesics Gargles for sore throat Use of hot packs for sinus congestion or ice collar to reduce swelling, bleeding post tonsillectomy and adenoidectomy

Interventions (cont’d) Rest Refrain from speaking, use alternative communication Encourage liquids; 2 to 3 L a day, appropriate foods

Patient Education Prevention of upper airway infections Emphasize frequent hand washing When to contact health care provider Need to complete antibiotic treatment regimen Annual influenza vaccine for those at risk

Potential Complications Sepsis Meningitis Peritonsillar abscess Otitis media Sinusitis

Health Promotion Activities Viral Upper Respiratory Infection Maintaining good general health Stress-reducing activities Limiting exposure to crowds Good handwashing Influenza Immunization education Risk reduction activities Avoiding crowds Avoiding those who are ill