Epistaxis
Influenza
Sinusitis
Head/Neck Cancer
Rhinitis
100

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.   

100

3 ways influenza can be transmitted.

What is infected droplet, inhalation of aerosolized particles, direct contact with contaminated surfaces.

100

2 most common causes of sinusitis

What is infections and inflammation

100

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 

100

Inflammation of the nasal mucosa in response to a specific allergen.  

What is Allergic rhinitis.

200

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.

200

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

200

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

200

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. 

200

Another name for Acute viral rhinitis

What is the common cold or acute coryza.

300

The most common medical treatment for epistaxis uncontrolled by direct pressure.  

What is:

Nasal Packing

Other tx:  cauterization (silver nitrate, thermal)

300

3 common complications of influenza

what is:

Ear/sinus infections, Bronchitis, pneumonia, acute respiratory failure

300

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..


300

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. 

300

Immunoglobulin responsible for allergic rhinitis.

What is immunoglobulin E (IgE)

400

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)


400

Time frame in which antiviral medications must be started to be effective.

What is within 2 days of onset of symptoms. 

400

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.  

400

Disability for the patient undergoing a radical head and neck surgery is related to what? 

What is loss of voice, disfigurement, and social consequences 

400

3 common early symptoms of all types of rhinitis.

What is sneezing, itching-watering eyes and nose, rhinorrhea, nasal and sinus congestion

500

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

500

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. 

500

Identify/locate the four pairs of sinuses in the face.  

What is:  frontal, ethmoidal, maxillary, sphenoidal

500

Treatment options for head and neck cancer.

Surgical intervention, radiation therapy, chemotherapy, targeted therapy, combination of any of the above.  

500

First line drug to treat allergic rhinitis.

What is nasal corticosteroid spray.


See table 26-2 for drugs to treat rhinitis and sinusitis.