Professional Documents
Culture Documents
Respiratory Function
Inflammatory Process
Hypersecretion of mucous
Infection
Assessment
Pain
Maxillary : Cheek, upper teeth
Frontal : Above the eyebrows
Ethmoid: in and around the eyes
Sphenoid: behind the eye, occiput, top of
the head
General Malaise
Headache
Fever
Stuffy nose
post nasal drip
Cough
Nursing Interventions
Rest
Increase fluid intake
Hot wet packs
Codeine, avoid ASA- increases
the risk of developing nasal
polyps
Amoxicillin or other anti-
infectives (acute- 7-10 days;
chronic- upto 21 days)
Nasal decongestants eg
Sudafed, Dimetspp (used for 72
hours)
Surgical Management
Functional Endoscopic Sinus
Surgery (FESS)
Caldwell- Luc Surgery (Radical
Antrum Surgery)
Do not chew on affected side
Caution with oral hygiene
Do not wear dentures for 10 days
Do not blow nose or sneeze for 2
weeks after removal of packing
Ethmoidectomy
Sphenoidotomy/ Ethmoidotomy
Osteoplastic flap surgery for
frontal sinusitis.
Tonsilitis/ Adenoiditis
Assessment:
Sore throat
Frequent head colds
Fever
Snoring
Dysphagia
Mouth-breathing
Earache
Frequent Head Colds
Bronchitis
Foul Breath
Voice impairment
Noisy Respiration
Draining Ears
Nursing Interventions
Promote Rest
Increase Fluid Intake
Warm saline gargle
Analgesic as ordered
Antimicrobial as ordered
Surgery: Tonsillectomy/
adenoidectomy (indicated if
tonsillitis recurs 5-6 times a
year)
PRE-OP care
Assess for URTI- coughing and
sneezing post-op may cause
bleeding
Check PT. Bleeding is a common
post-op complication
POST-OP care
Prone, head turned to side, or lateral
position
When awake, semi-fowler’s position
Predisposing Factors:
Cigarette Smoking
Alcohol Abuse
Voice Abuse
Environmental pollutants
Chronic Laryngitis
Semi-fowler’s position
Bronchopneumonia
Patchy and scattered , often
favoring the lower lobes
Common in the immobile and the
elderly
Early signs include dullness to
percussion and barely perceptible
fine crackles which persist despite
deep breathing.
Lobar Pneumonia
CBC
Creatinine
Chest x-ray
PA-L
Sputum G/S and C/S
Sputum AFB 3x (for TB suspect)
Manifestations of Commonly
Encountered Pneumonia
Streptococcal p. (streptococcus
pneumoniae)
History of previous infections
Sudden onset, shaking and chills
Cough, rusty or green (purulent
sputum)
Pleuritic chest pain, chest dull to
percussion, crackles, bronchial breath
sounds
Treated with: Pen G, erythromycin,
clinamycin, cephalosphorins,
Cotrimoxazole
Complications: shock, pleural effusion,
superinfections, pericarditis, otitis
media.
Staphylococcal Pneumonia
(Staphylococcus aureus)
Prior history of viral infection
Insidious onset of cough, yellow,
bloode-streaked mucous
Fever, pleuritic chest pain, varied
pulse rate, may be slow in proportion
to temperature
Treated with: Nafcillin, methicillin,
clindamycin, vancomycin, cephalotin
Complications: effusion/
pneumothorax, lung abscess,
empyema, meningitis
Klebsiella pneumonia
(Klebsiella pneumoniae)
Sudden high fever, chills,
pleuritic pain, hemoptysis
Dyspnea, cyanosis
Dark brown, gelatinous sputum
Treated with: gentamicin,
cefazolin, tobramycin
Complications: lung abscesses
with cyst formation, empyema,
pericarditis
Mycoplasma pneumonia
(Mycoplasma pneumoniae)
Gradual onset, severe
headache
Irritating hacking cough, scanty
mucoid sputum
Anorexia, malaise, fever,
congestion, sore throat
Treated with : erythromycin,
tetracycline
Viral pneumonia
Pharmacologic Therapy
IV: Clindamycin (Cloecin)
meropenem (Merrem)
piperacillin/tazobaqctam (Zosyn)
Mixed asthma
Extrinsic Intrinsic
(allergic) (infectious /
miscellaneous)
Exercise
Car exhaust
Exercise
Premenstruation
Pollen
Smoking
Warm blooded pets
Weather
Sputum analysis
-may appear purulent
-reveal Curschmann’s spirals
Preventexacerbations
Teaching:
Positioning
Pursed-lip exercises