Nursing Care of Clients with Upper Respiratory Disorders Chapter 22.
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Transcript of Nursing Care of Clients with Upper Respiratory Disorders Chapter 22.
Nursing Care of Clients Nursing Care of Clients with Upper Respiratory with Upper Respiratory
DisordersDisorders
Chapter 22Chapter 22
InfluenzaInfluenza
Viral, highly contagious, airborne droplet Viral, highly contagious, airborne droplet and direct contactand direct contact
Clinical ManifestationsClinical Manifestations
RespiratoryRespiratory• cough, substernal chest pain, sore throatcough, substernal chest pain, sore throat
SystemicSystemic• fever, chills, malaise, muscle aches, fatiguefever, chills, malaise, muscle aches, fatigue
InfluenzaInfluenza
Collaborative CareCollaborative Care immunization of at-risk personsimmunization of at-risk persons
DiagnosisDiagnosis based on client historybased on client history
PharmacologyPharmacology vaccine, aspirin, tylenolvaccine, aspirin, tylenol
TonsillitisTonsillitis
Acute inflammation of tonsilsAcute inflammation of tonsils usually bacterial infectionusually bacterial infection spread by dropletspread by droplet
Clinical ManifestationsClinical Manifestations pain, difficulty swallowingpain, difficulty swallowing feverfever enlarged and tender lymph nodesenlarged and tender lymph nodes tonsils appear bright red and edematoustonsils appear bright red and edematous
TonsillitisTonsillitis
TonsillitisTonsillitis
Interdisciplinary CareInterdisciplinary Care usually self-limitingusually self-limiting Antipyrectic and mild analgesicsAntipyrectic and mild analgesics Penicillin for group A streptococciPenicillin for group A streptococci Tonsillectomy for recurrent infectionsTonsillectomy for recurrent infections
The Client with EpistaxisThe Client with Epistaxis
Precipating factorsPrecipating factors traumatrauma drynessdryness systemic infectionsystemic infection hypertensionhypertension bleeding disorders - thrombocytopeniableeding disorders - thrombocytopenia
EpistaxisEpistaxis
Nasal Trumpets - EpistaxisNasal Trumpets - Epistaxis
The Client with EpistaxisThe Client with Epistaxis
Interdisciplinary CareInterdisciplinary Care first aid measures - apply pressurefirst aid measures - apply pressure Nasal packingNasal packing
• 1/4 inch petroleum gauze1/4 inch petroleum gauze• leave in for up to 3 daysleave in for up to 3 days
Surgical cauterySurgical cautery
Treatment of Epistaxis Treatment of Epistaxis
Nasal trauma - dog biteNasal trauma - dog bite
Nasal TraumaNasal Trauma
Nasal fracture/deviated septumNasal fracture/deviated septum epistaxisepistaxis deformity deformity displacement to one sidedisplacement to one side crepituscrepitus periorbital edemaperiorbital edema
TreatmentTreatment reduction, plasterreduction, plaster rhinoplastyrhinoplasty
Laryngeal ObstructionLaryngeal Obstruction
Life-threatening emergency- Food or Life-threatening emergency- Food or laryngospasm. laryngospasm.
Clinical ManifestationsClinical Manifestations coughing, choking, gagging, difficulty breathingcoughing, choking, gagging, difficulty breathing
TreatmentTreatment Heimlich maneuverHeimlich maneuver Medications such Medications such As epinepherine, ET.As epinepherine, ET.
Laryngeal Obstruction - PolypLaryngeal Obstruction - Polyp
Vocal Cord PolypVocal Cord Polyp
Sleep ApneaSleep Apnea
Absence of airflow through upper airways Absence of airflow through upper airways for 10 or more secondsfor 10 or more seconds
30 episodes per night30 episodes per night Contributing factorsContributing factors
obesityobesity ageage male gendermale gender
Sleep ApneaSleep Apnea
Clinical ManifestationsClinical Manifestations
loud cyclic snoringloud cyclic snoring cessation of breathing during sleepcessation of breathing during sleep restlessness, thrashing during sleeprestlessness, thrashing during sleep daytime fatiguedaytime fatigue headache, personality changes, depressionheadache, personality changes, depression
Sleep ApneaSleep Apnea
Interdisciplinary CareInterdisciplinary Care weight lossweight loss Continuous positive airway pressure (CPAP)Continuous positive airway pressure (CPAP)
• tight fitting masktight fitting mask• air compressor blows air into the back of the throatair compressor blows air into the back of the throat
SurgerySurgery• tonsillectomy and adenoidectomytonsillectomy and adenoidectomy
Upper Respiratory Tumors and Upper Respiratory Tumors and CancersCancers
Laryngeal CarcinomaLaryngeal Carcinoma accounts for 1-3% of all canceraccounts for 1-3% of all cancer curable if early detectioncurable if early detection Risk FactorsRisk Factors
• ETOH, smoking, poor nutritionETOH, smoking, poor nutrition Affects men more than women 9:1Affects men more than women 9:1
The LarynxThe Larynx
Laryngeal CarcinomaLaryngeal Carcinoma
Clinical ManifestationsClinical Manifestations hoarsenesshoarseness change in voicechange in voice painful swallowing, earachepainful swallowing, earache dyspneadyspnea palpable lump in neckpalpable lump in neck foul breathfoul breath
Laryngeal CarcinomaLaryngeal Carcinoma
Interdisciplinary CareInterdisciplinary Care laryngoscopylaryngoscopy
• direct visualizationdirect visualization• biopsybiopsy
Chemotherapy, radiation, surgeryChemotherapy, radiation, surgery• LaryngectomyLaryngectomy
removal of the larynxremoval of the larynx
• Radical neck dissection - nodes, neck and Radical neck dissection - nodes, neck and mandible removalmandible removal
Laryngeal CarcinomaLaryngeal Carcinoma
Nursing CareNursing Care Impaired Verbal CommunicationImpaired Verbal Communication Ineffective Airway ClearanceIneffective Airway Clearance Impaired SwallowingImpaired Swallowing PainPain Altered Nutrition:Less than Body Altered Nutrition:Less than Body
RequirementsRequirements AnxietyAnxiety
Laryngeal CarcinomaLaryngeal Carcinoma
Nursing CareNursing Care Altered Body ImageAltered Body Image TeachingTeaching
• Trach CareTrach Care