Nursing Care of Clients with Upper Respiratory Disorders

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Nursing Care of Clients with Upper Respiratory
Disorders

• Chapter 22

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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

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Influenza

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

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Tonsillitis

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

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Tonsillitis
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Tonsillitis

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

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The Client with Epistaxis

• Precipating factors
• trauma
• dryness
• systemic infection
• hypertension
• bleeding disorders - thrombocytopenia

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Epistaxis
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Nasal Trumpets - Epistaxis
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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

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Treatment of Epistaxis
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Nasal trauma - dog bite
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Nasal Trauma

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

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Laryngeal Obstruction

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

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Laryngeal Obstruction - Polyp
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Vocal Cord Polyp
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Sleep Apnea

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

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Sleep Apnea

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

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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

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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 91

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The Larynx
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Laryngeal Carcinoma

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

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Laryngeal Carcinoma

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

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Laryngeal Carcinoma

• Nursing Care
• Impaired Verbal Communication
• Ineffective Airway Clearance
• Impaired Swallowing
• Pain
• Altered NutritionLess than Body Requirements
• Anxiety

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Laryngeal Carcinoma

• Nursing Care
• Altered Body Image
• Teaching
• Trach Care