Epistaxis
3 common causes of Epistaxis.
What is trauma, HTN, low humidity, URI, allergies, sinusitis, foreign bodies, chemical irritation, overuse of decongestant nasal sprays, facial or nasal surgery, tumors, anatomic malformations, bleeding disorders, drugs (ASA, NSAIDS, warfarin, other anticoagulant drugs.
3 ways influenza can be transmitted.
What is infected droplet, inhalation of aerosolized particles, direct contact with contaminated surfaces.
2 most common causes of sinusitis
What is infections and inflammation
4 risk factors for head and neck cancers.
What is tobacco use, excessive alcohol intake, over age 50, infection with human papilloma virus, sun exposure radiation therapy to head/neck, asbestos exposure, poor oral hygiene, industrial carcinogen exposure
Inflammation of the nasal mucosa in response to a specific allergen.
What is Allergic rhinitis.
3 most common nursing interventions to treat epistaxis,
What is:
1. Calm the patient
2. Place in a sitting position, leaning slightly forward with head tilted forward
3. Apply direct pressure by squeezing the soft lower portion of the nostrils together for 5-15 minutes. You can also use ice pack.
3 S&S found in influenza not present in viral rhinitis (common cold)
What is:
Abrupt onset 3-6 hrs
High fever 102-104 F
Severe HA
fatigue and weakness for 2-3 weeks
3 common assessment findings in the patient with sinusitis.
What is:
pain/tenderness over the affected sinus, purulent nasal drainage, nasal obstruction, congestion, fever, malaise, edematous mucosa, enlarged turbinates, halitosis (bad breath), reccurent HA that changes intensity with position changes or when secretions drain
3 S&S that might indicate a cancer of the head or neck.
What is white or red mouth patches, ulcer that does not heal, change in fit of dentures, lump in the throat, change in voice quality, hoarseness greater than 2 weeks, sore throat unresponsive to tx, otalgia (ear pain), neck swelling or lump, coughing blood, unintentional wt loss, difficulty chewing/swallowing, difficulty moving tongue or jaw, breathing difficulty, airway obstruction.
Another name for Acute viral rhinitis
What is the common cold or acute coryza.
The most common medical treatment for epistaxis uncontrolled by direct pressure.
What is:
Nasal Packing
Other tx: cauterization (silver nitrate, thermal)
3 common complications of influenza
what is:
Ear/sinus infections, Bronchitis, pneumonia, acute respiratory failure
3 common nursing interventions for sinusitis
What is:
Oral or topical decongestants - use no longer than 4-5 days to prevent rebound congestion
intranasal corticosteroids
analgesics
saline nasal spray
symptoms longer than 1 week - antibiotic therapy with Amoxicillin for 10-14 days. No response - Fluoroquinolone or broad spectrum cephalosporins..
Radical neck dissection involves what?
What is laryngectomy, tracheostomy, excision of the lymph nodes and their channels, may involve muscles of neck, and jugular vein, mandible and spinal accessory nerve.
Immunoglobulin responsible for allergic rhinitis.
What is immunoglobulin E (IgE)
A priority complication of nasal packing.
What is Respiratory Impairment - monitor LOC, HR & rhythm, O2 Sats, Resp.Assess, difficulty swallowing.
Infection - most common is staph aureus
Pain - tx with mild opiod analgesia (Tylenol with codeine)
Time frame in which antiviral medications must be started to be effective.
What is within 2 days of onset of symptoms.
3 important teaching items for the patient with sinusitis.
What is: rest, 6-8 glasses of water/day, hot showers 2x day, bedside humidifier, saline nasal spray, warm damp towels to sinuses, sleep with HOB elevated, report temps 100.4F, take prescribed meds as ordered, nasal saline washes bid, no smoking/smoke exposure.
Disability for the patient undergoing a radical head and neck surgery is related to what?
What is loss of voice, disfigurement, and social consequences
3 common early symptoms of all types of rhinitis.
What is sneezing, itching-watering eyes and nose, rhinorrhea, nasal and sinus congestion
Important patient discharge teaching.
What is:
Nasal packing in place 2-3 days
Use saline nasal spray and/or humidifier
Sneeze with mouth open
Avoid ASA and NSAID drugs
Avoid vigorous nose blowing, lifting, strenous activity or straining for 4-6 weeks
3 effective strategies for managing influenza.
Influenza vaccination
Supportive therapy: rest, hydration, analgesics, antipathetics for symptom relief.
Antiviral medications MUST be started in the first 2 days of symptoms to be effective.
Identify/locate the four pairs of sinuses in the face.
What is: frontal, ethmoidal, maxillary, sphenoidal
Treatment options for head and neck cancer.
Surgical intervention, radiation therapy, chemotherapy, targeted therapy, combination of any of the above.
First line drug to treat allergic rhinitis.
What is nasal corticosteroid spray.
See table 26-2 for drugs to treat rhinitis and sinusitis.