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

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. 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. Cerebrospinal fluid could indicate skull fracture. Interventions: Interventions: Rhinoplasty Rhinoplasty Nasoseptoplasty Nasoseptoplasty

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

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

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

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

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

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

Vocal cord paralysis

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

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

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

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

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

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

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. 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. Peak flow meter can be used twice daily by client. Drug therapy plan is specific. Drug therapy plan is specific.