1. Nursing Care of Clients with Upper Respiratory Disorders
Chapter 22

2. 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

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

5. 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

6. Tonsillitis

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

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

9. Epistaxis

10. Nasal Trumpets - Epistaxis

11. 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

12. Treatment of Epistaxis

13. Nasal trauma - dog bite

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

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

16. Laryngeal Obstruction - Polyp

17. Vocal Cord Polyp

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

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

20. 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

21. 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

22. The Larynx

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

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

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

26. Laryngeal Carcinoma Nursing Care Altered Body Image Teaching
Trach Care