Nursing Care of Clients with Upper Respiratory Disorders Chapter 22

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

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

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

Tonsillitis

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

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

Epistaxis

Nasal Trumpets - Epistaxis

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

Treatment of Epistaxis

Nasal trauma - dog bite

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

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

Laryngeal Obstruction - Polyp

Vocal Cord Polyp

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

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

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

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

The Larynx

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

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

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

Laryngeal Carcinoma Nursing Care Altered Body Image Teaching Trach Care