Nursing Care of Clients with Upper Respiratory Disorders

1. Nursing Care of Clients with Upper Respiratory Disorders

2. Nursing Care of Patients with Upper Airway Disorders • Upper airway disorders may be minor, treated outside health care setting • Or may be severe, life threatening • Require good assessment skills, understanding of variety of disorders that affect upper airway, impact those disorders may have on patient • Patient teaching is important aspect of care

3. Specific Disorders • Infections • Rhinitis • Sinusitis: acute, chronic • Pharyngitis: acute, chronic • Tonsillitis, adenoiditis • Peritonisillar abscess • Laryngitis

4. Upper Respiratory Tract Disorders and Risk Factors • Influenza • Highly contagious viral respiratory disease • Usually occurs in epidemics or pandemics • Avian influenza: possible pandemic • Sinusitis • Sterile air-filled cavities in the facial bones • Sinusitis

5. Viral Upper Respiratory Infection • Pathophysiology • Local inflammatory response • Swelling of mucous membranes of nasal passages • Hyperactivity of mucus-secreting glands • Immunity produced only to individual virus

6. Rhinitis and Sinusitis

7. Pharyngitis

9. Viral Upper Respiratory Infection • Manifestations • Nasal congestion • Profuse nasal discharge (coryza) • Sneezing • Coughing • Sore throat • Low-grade fever • Headache • Malaise • Muscle aches

10. Viral Upper Respiratory Infection Sinusitis • Pathophysiology • Sinus opening obstruction, impaired drainage • Manifestations • Pain and tenderness • Headache, fever, and malaise • Nasal congestion • Purulent nasal discharge • Bad breath

11. Influenza • Medications • Prophylaxis • Treatment to reduce severity • Amantadine • Rimantadine • Zanamivir • Oseltamivir • Ribavirin • Symptom relief also include • ASA • Acetaminophen • NSAIDs • Antitussives • Antibiotics are not indicated

12. Sinusitis • Medication Therapy • Antibiotics • Oral or topical decongestants • Antihistamines • Saline nose drops or sprays • Systemic mucolytic agents

13. Nursing Process: Care of Patients with Upper Respiratory Infections - Assessment • Health history • Signs and symptoms: headache, cough, hoarseness, fever, stuffiness, generalized discomfort and fatigue • Allergies • Inspection of nose, neck, throat • Include palpation of lymph nodes

14. Nursing Process: Care of Patients with Upper Respiratory Infections - Diagnosis • Ineffective airway clearance • Acute pain • Impaired verbal communication • Deficient fluid volume • Deficit of knowledge related to prevention, treatment, surgical procedure, postoperative care

15. Nursing Process: Care of Patients with Upper Respiratory Infections - Planning • Maintenance of patent airway • Relief of pain • Maintenance of effective communication • Normal hydration • Knowledge to how to prevent upper airway infections • Absence of complications

16. Interventions • Interventions to maintain patent airway • Promote comfort • Analgesics • Gargles for sore throat • Use of hot packs for sinus congestion or ice collar to reduce swelling, bleeding post tonsillectomy and adenoidectomy

17. Interventions (cont’d) • Rest • Refrain from speaking, use alternative communication • Encourage liquids; 2 to 3 L a day, appropriate foods

18. Patient Education • Prevention of upper airway infections • Emphasize frequent hand washing • When to contact health care provider • Need to complete antibiotic treatment regimen • Annual influenza vaccine for those at risk

19. Potential Complications • Sepsis • Meningitis • Peritonsillar abscess • Otitis media • Sinusitis

20. Health Promotion Activities Viral Upper Respiratory Infection • Maintaining good general health • Stress-reducing activities • Limiting exposure to crowds • Good handwashing Influenza • Immunization education • Risk reduction activities • Avoiding crowds • Avoiding those who are ill