Please enable JavaScript.
Coggle requires JavaScript to display documents.
CH 30- Disorders of the Upper Respiratory Tract (Sinusitis (Tx (Surgery…
CH 30- Disorders of the Upper Respiratory Tract
Anatomy
Throat
Oropharynx, Nasopharynx, Larynx
Sinuses
spaces in the bones of the skull; they are lined with mucous membrane and filled with air
Age-Related Changes
Epistaxis (nosebleed)
Weakened esophageal sphincter allows gastric contents to flow back into the throat when the patient lies down
Aspiration precaution
Decline in the sense of smell
After Nasal Surgery Care
Check back of throat for bleeding
Inspect vomitus and stool for blood
Bright-red, "coffee ground" emesis
red, maroon, black stools
Sinusitis
Inflammation of the sinuses
often the maxillary and frontal sinuses
Chronic sinusitis is a permanent thickening of the mucous membranes in the sinuses after repeated infections
S/S
Purulent drainage from the nose
Affected maxillary sinuses
Feels like toothache
Common organisms
taphylococcus pneumoniae, Haemophilus influenzae, diplococcus, and bacteroides
Tx
Twice-daily hot showers, increased fluid intake, humidifier
Antibiotics for acute Sinusitis
decongestants, nasal corticosteroids, analgesics, and antipyretics
Surgery for chronic sinusitis
Antral packing left in place 36-72 hrs
Do not blow nose or strain; will cause bleeding and tissue damage
Caldwell-Luc procedure to remove irreversibly damaged mucosa of the maxillary sinus
Nasal sprays may be ordered 3-5 days to moisten nasal mucosa
possibility of brain infection exists because of location of sinuses in the skull
Nasal Polyps
Swollen masses of sinus or nasal mucosa and connective tissue that extend into the nasal passages
Exact cause is unknown, but pts usually have a hx of allergic rhinitis or infection
Nasal polyps tend to recur
Tx
Corticosteroids
Surgery
Do not take aspirin, may induce bleeding
Removal of allergens
Allergic Rhinitis
“Hay fever”: acute (seasonal) or chronic (perennial)
Acute caused by pollens
Triggered by overuse of decongestants
Nasal mucosa usually pale, can be red or bluish
w/ chronic symptoms, pt must keep diary describing episodes
may identify possible allergens
Tx
antihistamines & decongestants
allergist applies solutions of common allergens to the skin
Desensitizing injections
"allergy shots"
dilute solutions of the allergens to which the person reacts
Strength of solution increased as tolerance builds up
Acute Viral Coryza
"the common cold"
can be caused by 30+ virus
droplet infection
most contagious during the first 2-3 days after symptoms appear
The very young, the very old, and those with weakened immune systems (HIV) should be protected
Tumors
S/S
lesions on external nose start as small, painless ulcers that don't grow
benign or malignant
Sinus malignancies are more common among people in certain occupations—notably furniture makers
External usually basal cell or squamous cell carcinomas