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are the illnesses caused by an acuteinfection which involves the upper respiratory tract: nose, sinuses, pharynx or larynx.

This commonly includes: tonsillitis, pharyngitis, laryngitis, sinusitis, oti tis media, and thecommon cold. Infections of the upper airway.

Aphonia - impaired ability to use ones voice due to disease or injury to the larynx Apnea cessation of breathing. Dysphagia difficulties in swallowing. Epistaxis hemorrhage from the nose due to rupture of tiny, distended vessels in the mucous membrane of any area in the nose. Laryngitis- inflammation of the larynx; may be caused by voice abuse, exposure to irritants or infectious organisms. Laryngectomy removal of all or part of the larynx and surrounding structures. Nuchal rigidity stiffness of the neck or inability to bend the neck. Pharyngitis inflammation of the throat, usually viral or bacterial in origin. Rhinitis- inflammation of the mucous membranes of the nose; may be infectious, allergic or inflammatory in origin. Rhinorrhea drainage of a large amount of fluid from the nose. Sinusitis inflammation of sinuses; may be acute or chronic may be viral, bacterial, or fungal in origin. Tonsillitis inflammation of the tonsils, usually due to an acute infection. Xerostomia dryness of the mouth from a variety of causes.

Rhinitis - Inflammation of the nasal mucosa Rhinosinusitis or sinusitis - Inflammation of the nares and paranasal sinuses, including frontal, ethmoid, maxillary, and sphenoid Nasopharyngitis (rhinopharyngitis or the common cold) Inflammation of the nares, pharynx,hypopharynx, uvula, and tonsils Pharyngitis - Inflammation of the pharynx, hypopharynx, uvula, and tonsils Epiglottitis (supraglottitis) - Inflammation of the superior portion of the larynx and supraglottic area Laryngitis - Inflammation of the larynx Laryngotracheitis - Inflammation of the larynx, trachea, and subglottic area Tracheitis - Inflammation of the trachea and subglottic area

also cold coryza is inflammation in the nasal mucous membranes. The release of histamine and other substances causes vasodilatation and edema, which result in symptoms. It may occur as a reaction to allergens (hay fever) such as pollen, dust, molds, or some foods, or it may be caused by viral or bacterial infection. Viral rhinitis is another name for a common cold.

Nasal congestion Localized itching Sneezing rhinorrhea Nasal discharge Scratchy or sore throat Viral or Bacterial rhinitis may also be accompanied by fever and malaise.

If allergic rhinitis is suspected, skin testing may be done t determine the offending allergens. Blood test for IgE antibodies may be also be done to determine if allergies are the cause.

Provide adequate fluid intake. Encourage rest. Prevent chilling. Use expectorants as needed. Warm salt, and non-t water gargle soothe the sore throat. Aspirin and ibuprofen, relieve the aches, pains, and fever in adults. Antihistamines to relieve sneezing, rhinorrhea, and nasal congestion. Topical nasal decongestant agents must be used with caution.

Treatment is symptomatic Teach patient that rest and fluids are most effective. Acetaminophen can be used for generalized discomfort. Antihistamines may help control symptoms by inhibiting the histamine response. Decongestants cause vasoconstriction which reduces the swelling and congestion. Severe allergies may be treated with desensitization (allergy shots)

Commonly referred as flu, an acute, highly contagious respiratory tract infection Usually occurs seasonally in epidemics. Easily transmitted via droplets from coughs and sneezes of infected individuals, or it may be transmitted by physical contact with a person or object that harbors the virus. The incubation period from time of exposure to onset of symptoms is 1 to 3 days.

Respiratory manifestations: Sinusitis Dyspnea Sore throat Nasal stuffiness Nasal discharges Dry cough

Abrupt onset of chills, myalgia (muscle pain) , sore throat, cough, general malaise lasting up to several weeks.

1.) Influenza results from one of three types of myxovpirus influenzae: type a, type b or type c. 2.) The elderly are at particular risk for and even death from influenza because of preexisting chronic disease and compromised immune function.

Persons age > years with comorbid ( the presence of one or more disorders (or diseases) conditions. Residents of long term care facilities Persons age 2 to 64 years with comorbid conditions Children aged 6 to 23 months Pregnant women Health care personnel who provide direct patient care Household contacts and out-of-home caregivers of children aged < 6months

The most common complicated is PNEUMONIA. Which may be caused the same virus as the flue or by a secondary bacterial infection. This should be considered if the patient experiences: Persistent fever Shortness of breath If the lungs develop crackles and whizzes

Viral cultures of throat or nasal swabbing can be down to identify influenza, but results may takes to 5-10 days. Rapid tests can identify the presence of virus in less than 30 minutes. Cultures may also be done to rule out the bacterial infection. Once influenza has been identified in a geographical area, lab test will be less often and tat based on symptopms.

Treatment is symptomatic. Acetaminophen is given for fever, headache and myalgia. Aspirin is avoided in children because it increases the risk for Reyes syndrome (children given aspirin when they have influenza and varicella (chicken pox) can develop a severe liver and brain disease called reyes syndrome. Rest and fluids are essential. Antibiotics are used only if a secondary bacterial infection is present.

Assess lung sounds and signs for every 4 hours, and monitor for dehydration. Encourage rest and fluids ( if not contraindicated), and provide comfort measures. Educate patients about avoiding aspirin to treat influenza symptoms to prevent Reyes syndrome.

Inflammation of the sinuses It frequently develops as a result of an upper respiratory infection, such as an unresolved viral or bacterial infection, or an exacerbation of allergic rhinitis. Nasal congestion, caused by inflammation, edema, and transudation of fluid leads to an obstruction of the sinus cavities.

1.) Pain a. Frontal headache - frontal sinusitis b. In and around eyes ethmoidal sinusitis. c. Lateral and nose upper teeth maxillary sinusitis. d. Occipital headache spinoidal sinusitis. 2.) Nasal congestion/discharges may or may not be present. 3.) Mild fever 4.) Acute suppurative infection if frontal sinusitis is involved this can be a serious problem because it may rupture posteriorly and lead to brain abscess. 5.) Nasal mucosa may be red and edematous.

Meningitis Brain abscess Ischemic infarction

Medical Management
a.) non surgical drainage of the sinus b.) instill vasoconstictor. c.) antihistamines.

A suppurative, inflammation of the sinuses with chronic irreversible changes in the mucosa and sinus bony area. Is an inflammation of the sinuses that perishes more than 3 weeks in an adult and 2 weeks in a child.

Impaired mucociliary clearance and ventilation. Cough Chronic hoarseness. Chronic headaches. Facial pain. Fatigue and nasal stuffiness Decrease in smell and taste and fullness of ears for some.

Antihistamine, analgesic, antibiotic Repair of stuctural deformities Draining of sihmoinuses CALDWELL LUC procedure, functional endoscopic, sinus surgery, external sphenoethmoidalectomy.

Encourage bed rest with head of bed elevated to promote drainage of secretions. Apply warm, moist compression at least 4X a day or stream inhalation or nebulisation. Monitor vital signs, esp. the temperature. Watch for, and report increase in headaches, blurred vision, chills or vomiting. Give analgesic, antihistamine as ordered Administer antibiotics as ordered.

Acute pharyngitis is an inflammation or infection in the throat, usually causing symptoms of a sore throat.

Fiery eyed pharyngeal membrane and tonsils. Lymphoid follicles that are swollen and flecked with white purple exudate Enlarged and tender cervical lymph nodes. Annoying tickling cough. Fever, malaise and sore throat may be present. Throat pain may prevent swallowing or difficulty of breathing.

Elimination of infection, lowers fever and avoid complications. Early intervention with chemotherapeutic agent to prevent acute rheumatic fever and glumerulonephritis. Penicillin for the first 24 hours If throat culture is positive, continue penicillin for 10 days.

Maintain bed rest during the acute phase. Provide throat irrigation such as warm saline gargle. Give analgesics as ordered, assess and document effectiveness. Administer antibiotics as ordered.

Is a persistent inflammation of the pharynx. Common in adults who work or live in dusty surroundings, use their voice to excess, suffer from chronic cough, or habitually use alcohol or tobacco.

Hypertrophic: characterized by general thickening and congestion of the pharyngeal mucous membrane. Atrophic: probably a late state of the (type (the membrane is thin, whitish, glistening, and at times wrinkled.) Chronic granular (clergyman or sore throat) characterized by swollen lymph follicles on the pharyngeal wall.

Constant sense of irritation of fullness in the throat. Mucus collects in throat and can be expelled by coughing. Difficulty in swallowing. A sore throat that is worse with swallowing in the absence of pharyngitis suggests the possibility of throiditis and patients with this symptoms are referred for evaluation for possible thyroiditis.

Avoiding exposure to irritants Correcting any upper respiratory, pulmonary, or cardiac condition that may be responsible for chronic cough. Nasal congestion may be relieved by shortterm use of nasal sprays. Dimetapp or drixoral- (anhistamine decongest medications) for patients with history of allergy Acetaminophen recommended for its antiinflammatory and analgesic properties.

To prevent infections from spreading, instruct patient to avoid contact with others until the fever subsides. Avoid alcohol, tobacco, second-hand smoke and exposure to cold or to environmental or occupational pollutants. Minimize exposure to pollutants by wearing a disposable facemask. Encourage the patient to drink plenty of fluids. Gargling with warm saline solution may relieve throat discomfort Lozenges will keep the throat moistened.

Tonsils are composed of lymphatic tissue and are situated at each side of the oropharynx. The faucionsillitis is less common al or palatine fauces and tongue, respectively. They frequently serve as the site of acute infection (tonsillitis). Acute tonsillitis can be confused with pharyngitis. Chronic tonsillitis is less common and may be mistaken for other disorder such as allergy, asthma and sinuses Adenoids or pharyngeal tonsil of lymphatic tissue near the center of the posterior wall of the nasopharynx. Infection of the adenoids frequently accompanies acute tonsillitis. Group A beta-hemolytic streptococcus (GABS) is the most common organism associated with tonsillitis and adenoiditis. Often thought of as an childhood disorder, tonsillitis can also occur in adults.

Symptoms of tonsillitis includes:


Sore throat Fever Snoring Difficulty in swallowing.

Enlarged adenoids may cause mouth breathing, ear ache, draining ears, frequent head colds, bronchitis, foul smelling breath, voice impairment, and noisy respiration.

A thorough physical examination is performed and a careful history is obtained to rule out related or systemic conditions. The tonsillar site is cultured to determine the presence of bacterial infection. In adenoiditis, if recurrent episodes of suppurative otitis media in result in hearing loss, the patient should be given a comprehensive audiometric exam.

Increase fluid intake. Analgesics. Salt water gargles Rest Bacterial infections are treated with penicillin as first line-therapy. Viral infections are not effectively treated by antibiotic therapy. Tonsillectomy or adenoidectomy is indicated if the patient has had repeated episodes of tonsillitis despite antibiotic therapy.

Continuous observation is required in the immediate postoperative and recovery periods because of the significant risk of hemorrhage. Most comfortable position is prone with head turned to side to allow drain from the mouth and pharynx. (position post operative) The nurse must not remove the oral airway until the patients gag reflex and swallowing reflexes have returned. Apply ice collar to the neck and a basin and tissues are provided for the expectoration of the blood and mucus. Pain is effectively controlled by analgesics.

An inflammation of the larynx. Often occurs as a result of voice abuse of exposure to dust, chemicals, smoked, other pollutants, or as part of an upper respiratory tract infection. May be also caused by isolated infection involving only the vocal chords. The cause of infection is almost always a virus. Bacterial invasion may be secondary. Common in winter and is easily transmitted.

Hoarseness Aphonia ( complete loss of voice) Severe cough.

Resting the voice Avoid smoking, resting and inhaling cool steam of aerosol. Eliminating any other respiratory disorder. Avoid second-hand smoke.

Instruct patient to rest the voice. Maintain a well-humidified environment. Expectorant agents are suggest if there are laryngeal secretions present during acute episodes. Daily fluid intake of 3 Liters

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