upper airway infection
TRANSCRIPT
Prepared by; John Micahel Orias SN UM
Sinusitis, Laryngitis, and
pharyngitis
Objectives: Within 30 mins. Of my discussion, my co-student nurse
will be able to: To discuss what is sinusitis and its types and according
to its location To know what are the primary causes of sinusitis To discuss what is the pathophysiology sinusitis Know the difference between laryngitis and pharyngitis To discuss what are the pathophysiology of laryngitis
and pharyngitis And to discuss its primary causes To know what are the medical management and its
prevention
Sinusitis
What are sinuses? The sinuses are cavities, or air-filled pockets,
near the nasal passage. Like the nasal passage, the sinuses are lined with mucous membranes. There are four different types of sinuses
four different types of sinuses:
ethmoid sinus - located inside the face, around the area of the bridge of the nose. This sinus is present at birth, and continues to grow.
maxillary sinus - located inside the face, around the area of the cheeks. This sinus is also present at birth, and continues to grow.
frontal sinus - located inside the face, in the area of the forehead. This sinus does not develop until around 7 years of age.
sphenoid sinus - located deep in the face, behind the nose. This sinus does not develop until adolescence
What is sinusitis?
Sinusitis is an infection of the sinuses near the nose. These infections usually occur after a cold or after an allergic inflammation.
There are four types of sinusitis:
acute - symptoms of this type of infection last less than four weeks and get better with the appropriate treatment.
subacute - this type of infection does not get better with treatment initially, and symptoms last four to eight weeks.
chronic - this type of infection happens with repeated acute infections or with previous infections that were inadequately treated. These symptoms last eight weeks or longer.
recurrent - three or more episodes of acute sinusitis a year
Acute sinusitisPathophysiology
An infection of the paranasal sinuses. Because there is unresolved viral or bacterial
infection, or exacerbation of allergic rhinitis it frequently develop.
Nasal congestion, caused by inflammation, edema and transudation of fluids, leads to obstruction of the sinus cavities
Signs and symptoms
Facial pain Pressure in the affected
sinus area Nasal obstruction Fatigue Purulent Nasal discharge Fever Headache Ear pain or fullness
Dental pain Cough Decreased sense of
smell Sore throat Eyelid edema Facial congestion of
fullness
How is sinusitis diagnosed?
sinus x-rays computed tomography (Also called CT
or CAT scan.) cultures from the sinuses
Treatment for sinusitis:
antibiotics (antibiotics are usually given for at least 14 days)
Amoxicillin Antihistamines acetaminophen (for pain or discomfort) a decongestant (i.e., pseudoephedrine
[Sudafed®]) and/or mucus thinner (i.e., guaifenesin [Robitussin®])
cool humidifier in your child's room nasal spray to reduce inflammation
surgery
Surgery should be considered only if other treatments have failed.
endoscopic sinus surgery
Complication
Meningitis Brain abscess Ischemic infarction osteomyelitis
Chronic sinusitis
An inflammation of the sinuses that persists for more than 3 weeks in an adult and 2 weeks in a children.
It is estimated that 32 million people a year develop chronic sinusitis
Pathopysiology
Narrowing or obstruction in the ostia of the frontal, maxillary and anterior ethmoid sinuses. preventing adequate drainage to the nasal passage.
The combined is known as the osteomeatal complex.
The blockage that persists for greater than 3 weeks because infection, allergy, or structural abnormalities.
Signs and symptoms
Impaired mucociliary clearnce and ventilation Cough chronic hoarseness Chronic headaches in the periorbital area Fatigue, nasal stuffiness, decrease smell and
taste Usually in the morning
prevention
Perform hand hygiene often Use disposable tissues Avoid crowds during the flu season Avoid individuals with colds or respiratory infection Obtain influenza vaccination, if recommended Practice good health habits Eat nutritious foods Get plenty of sleep and rest Avoid or reduce stress if possible
Exercise appropriately Avoid smoking or second-hand smoke and
excessive intake of alcohol Increase humidity of the house Practice adequate hygiene Avoid allergens are associated with upper
respiratory infections
Reduced irritants (dust, chemical, tabacco smoke) when possible
Limit exposure to animals and house pets
Laryngitis
An inflammation of the larynx, often occurs as a result of voice abuse or exposure to dust, chemicals, smoke, and other pollutant.
It may also caused by isolated infection involving only the vocal cords
Causes:
Temperature changes Dietary deficiencies Malnutrition Immunosuppressed state Acute laryngitis: Viral infection such as those cause a cold Vocal strain, caused by yelling or over using
of voice Bacterial infections
Chronic Laryngitis: Inhaled irritants, such as chemicals fumes,
allergens and smoking Acid reflux, also called gastro esophageal
reflux disease GERD Chronic sinusitis Excessive alcohol abuse Habitual overuse of your voice Smoking
Clinical manifestation: Tickling sensation and rawness of your throat Sore throat Dry throat Dry cough Acute: Hoarseness and aphonia Chronic: Severe cough
Medical Management: Resting of voice Avoiding or smoking cessation Inhaling cool steam or an aerosol Avoiding second-hand smoking Topical corticosteroids (vanceril) Nursing management: Instruct the patient to rest the voice Maintain well humidified environment If secretion is present: expectorant Increase oral fluid intake up to 3L/day
Medication
Antibiotics
Corticosteroids
Test and Diagnosis
Laryngoscopy
Biopsy
Nursing Diagnosis;
Impaired verbal communication Hypertermia Impaired swallowing Imbalance nutrition less than
bodyrequirments
Acute Pharyngitis
- Is an infection or inflammation in the throat, usually caused by a viral organism.
- Common in patient younger than 25 years old
Pathophysiology
The inflammatory response results in the throat, with pain, fever, vasodilatation, edema, and tissue damage (redness and swelling, in the tonsillar pillars, uvula, and soft palate ).
Pharyngitis caused by streptococcus is a more severe illness because of dangerous complications
Signs and Symptoms
Feiry red pharyngeal membrane and tonsils. Lymphoid follicles swollen and freckled with
white-purple exudate Cervical lymph nodes enlarged and tender Fever, malaise, and sore throat Hoarseness
Diagnostic Methods
Rapid screening test for streptococcal antigens
optical immunoassay Steptolysin titers Throat cultures nasal swabbing and blood cultures
Medical Management
Antibiotic agents- to treat pharyngitis caused by bacteria.(Penicillin and Cephalosphorin)
Analgesic and antitussive medications liquid or soft diet is recommended IV fluid is given if patient cannot swallow
Nursing Management Encourage bed rest during febrile stage of
illness Implement secretion precautions to prevent
spread of infection Administer warm saline gargles or irrigations to
ease pain. Performed mouth care to prevent fissures of lips
and inflammation of the mouth Inform patient and family of symptoms to watch
for that may indicate development of complications, including nephritis and rheumatic fever.
Chronic Pharyngitiscommon in: Adults who work or live in dusty surrounding Use their voices to excess Chronic cough Habitually use alcohol and tobacco
Signs and Symptoms
Constant sense of irritation or fullness in the throat.
Mucous that collects in the throat and is expelled by coughing
Difficulty swallowing
Medical Management
Treatment is based on symptoms relief, avoidance of exposure to irritants
Nasal sprays- to relieve nasal congestion Aspirin or Acetaminophen- to control
inflammation and relieve discomfort
Nursing Management Advise patient to avoid contact with others until
fever has subsided completely to prevent infection from spreading
Instruct patient to avoid alcohol, tobacco, secondhand smoke, exposure to cold, and environmental and occupational pollutant.
Suggest to wear disposable mask for protection Encourage to increase OFI and encourage
gargling with warm salt water to relieve throat discomfort
Nursing Diagnoses
hyperthermia Impaired oral mucous membrane Impaired swallowing
PrognosisA sore throat usually goes away quickly on its own. If you
have had a sore throat for more than a week, or you have a fever, swollen lymph nodes, or a rash, you should call your doctor right away. Fever, swollen lymph nodes, or a rash may indicate strep throat or a complication such as rheumatic fever
Nursing process: Assessment With upper airway infection; sinusitis,
laryngitis, and pharyngitis A health assessment may reveal sign and
symptoms: Head ache Sore throat Pain around the eyes on either side of the
nose Difficulty of swallowing Cough
Hoarseness Fever Stuffiness Generalized discomfort Fatigue
Inspection may reveal: Swelling, redness, ulceration, lesion,
evidence of drainage, enlargement, asymmetry of the nose as well as bleeding or discharge
Palpation Tenderness Inflammation Enlargement of the lympnodes
Nursing Diagnosis:
Ineffective airway clearance related to excessive mucus production secondary to retained secretion and inflammation
Acute pain related to upper airway irritation secondary to infection
Impaired verbal communication related to physiologic changes and upper airway irritation secondary to infection or swelling
Deficient fluid volume related to increase fluid loss secondary to diaphoresis associated with fever
Deficient knowledge regarding prevention of the upper respiratory infection treatment regimen, surgical procedure, of post operative
Planning goals:
Maintenance of a patent airway Relief of pain Maintenance of effective means of
communication Normal hydration Knowledge of how to prevent upper airway
infection Absence of complications
Nursing intervention:
Maintaining a patent airway Promoting comfort Promoting communication Encouraging fluid intake Health teaching
Evaluation
Maintains a patent airways by managing secretions
Reports of felling more comfortable Demonstrate ability to communicate needs
and wants, level of discomfort Maintains adequate fluid intake Identifies strategies of preventions Free from sig and symptoms
thank you for listening!!!!