1. Nursing Care of
Clients with Upper
Respiratory Disorders

2. 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

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

4. 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

5. 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

6. Rhinitis and Sinusitis

7. Pharyngitis

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

10. 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

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

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

13. 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

14. 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

15. 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

16. 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

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

18. 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

19. Potential Complications
Sepsis
Meningitis
Peritonsillar abscess
Otitis media
Sinusitis

20. 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