Care of Clients with Problems In Oxygenation, Fluids and Electrolytes, Metabolism and Endocrine (NCM103) Patients With Respiratory

Alterations III

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Nursing Care of Clients With Upper Respiratory Infection

Sinusitis

Topics Discussed Here Are: 1. Sinusitis 2. Pharyngitis 3. Laryngitis

Inflammation of the sinus Caused by accumulation of secretions in the sinuses Many of the cases are viral Management - Decongestants / Mucolytics - Corticosteroids - Humidification - Analgesics - Antral Irrigation Sinus Ostia = Drainage of secretions in sinuses

Medical Management Topical and systemic vasoconstriction Surgical Treatment 1. Functional Endoscopic Sinus Surgery 2. External Sphenoethmoidectomy Nursing Management: - For clients post surgical intervention 1. Observe for profuse bleeding 2. WOF: Respiratory distress 3. Ecchymosis 4. Periorbital and facial edema 5. HOB to 45 6. 7. Analgesics administration 8. Encourage to OFI 9. Instruct to avoid blowing the nose for 7 10 days 10. Nasal saline spray for 3 5 days 11. Limit Physical Exercise, lifting and straining

Pharyngitis
Painful inflammation of the pharynx Caused by bacterial / viral infection Complications will include sinusitis, Otitis media, peritonsillar abscess, mastoiditis, and cervical adenitis Patient may complain of sore throat, difficulty in swallowing and fever, malaise and WBC Can be transmitted via inhalation of droplet particle

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Clinical Manifestation Red pharyngeal membrane and tonsils Enlarged and tender cervical lymph nodes Fever 38.3C Malaise and sore throat Painful sore throat Bad breath is common Medical Management - Pain Analgesics, acetaminophen - Viral case Support management - Bacterial Cause Anti-infective agents o Penicillin o Cephalosporin o Macrolides Nursing Responsibility - Pharyngeal culture - Administration of appropriate medications - Reinforce meticulous handwashing - Bed rest for 24 28 hours - Warm saline gargle and irrigation - Analgesics Nursing Management Assess for any symptoms of sore throat, fever and other manifestations During the acute** Cool beverage, flavored frozen dessert can be administered Encourage the client to drink at least 2 3 L of water per day Administer antibiotics Assess for any allergies to antibiotic to do skin test to IV medications antibiotics Instruct the patient to have bed rest during the acute phase Reinforce universal precaution and meticulous handwashing Teach about warm saline gargle May apply ice collar Meticulous mouth care Instruct client to stay at home for 1st 24 hours of antibiotic therapy Instruct patient to complete the course therapy

Laryngitis
Common as a result of voice abuse or exposure to dust, chemicals and smoke and other pollutants The pathogen are often associated the cause of Pharyngitis Clinical Manifestations - Aphonia - Severe Cough Can be dry worsens in the MORNING (CM) - Sore Throat Worse at the EVENING (TE) - Complain of tickle in the throat Medical Management - Conservative treatment - Treat the causative agent by using antibiotic agents - Administer expectorants for secretions - Topical corticosteroid through inhalation

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Nursing Management - Assess the respiratory rate - Instruct patient to rest his/her voice - Administer medications as ordered - Encourage to drink at least 2 3 L of fluids per day - WOF signs and symptoms such as loss of voice with sore throat that makes swallowing difficult, Hemoptysis and noisy breathing

FOR PATIENTS WITH UPPER RESPIRATORY INFECTION

Assess for signs and symptoms that will induce infection Assess the precipitating factors Inspect for the condition of the mouth, nasal mucosa, throat, tonsils and respiration Palpate the sinus, trachea, lymph nodes area for swelling and tenderness, and the neck for any palpable mass

POSSIBLE NURSING DIAGNOSES

Ineffective airway clearance r/t production of excessive mucous, retained secretions Knowledge deficit ** *

PLAN OF CARE
To promote patent airway To gain knowledge on the prevention of upper airway infection and prevention of complication

GENERAL INTERVENTION
Maintain a patent airway Promote comfort Encourage oral fluid intake Providing health teaching and continuing of care Monitor and management of potential complication

EVALUATION
Maintain patent airway as manifested by Report decreased congestion Assume best position to facilitate drainage Report relief of pain Demonstrate adequate knowledge regarding

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