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URTD
URTD
INFECTIONS
ALLERGIC RHINITIS
Symptoms often wane in older adults, but may develop or persist at any
Sleep disorders
Fatigue
Learning problems
The Allergic Reaction
How are the symptoms
caused?
➘ Irritation of endings
➘ Rhinorrhoea
➘ Vasodilation
➘ Congestion
➘ Edema
Clinical Manifestations
Nasal congestion
Postnasal drainage
Nasal pruritus
Ear symptoms
Watery rhinorrhea
Eye symptoms
Repetitive sneezing
Diagnosis of AR
History
LaboratoryTesting
Skin Prick Test
Rhinomanometry
Management of AR
Allergen Avoidance
Pharmacotherapy
Immunotherapy
Medications used to treat
allergic rhinits:
Antihistamines – chlorpheneramine
Decongestants – oxymetaxoline
AH--D combinations
Corticosteroids – beclomethasone
MastCell stabilizers
Cromolyn sodium
Anticholinergics
Antileukotrienes
Antihistamines
chlorpheniramine cetrizine
diphenylhydramine azelastine
fexofenadine
loratadine
VIRAL RHINITIS
Adenovirus
Rhinnorea
Sneezing
Nasal congestion
Sore throat
Lethargy
Fatigue
Complications
Pharyngitis
Sinusitis
Otitis media
Tonsilitis
Chest infections
RHINOSINUSITIS
Facial pain-pressure-fullness
( - ) cough
Malaise
Sore throat
Diagnosis of AP
RSAT
Medical Management
Bacterial:
Antibiotics
Penicillin
Cephalosporins
Macrolides (clarithromycin, azithromycin)
Analgesics
Aspirin, acetaminophen
Nursing Management
Dyspnea
Drooling
Inability to swallow
Risk Factors:
Dusty surroundings
People who use their voice to excess, suffer from chronic cough
Habitual use of alcohol and tobacco
Medical Management
Surgery
TONSILLITIS AND
ADENOIDITIS
Epstein-Barr, Cytomegalovirus
Administer analgesics
Salt-water gargles
Promote rest
Surgery
Tonsillectomy
Adenoidectomy
Pharmacologic therapy
Penicillin
Cephalosphorins
PERITONSILLAR ABSCESS
Epidemiology:
Accumulation of pus between the tonsillar capsule and the
surrounding tissues.
Also called ”quinsy”
More common in adolescents than in children
Greatest risk to airway – Spontaneous rupture
of abscess
SIGNS & SYMPTOMS
Uvular deviation
Marked soft palate displacement
Severe trismus
Airway compromise
Localized areas of fluctuance
Treatment
Commonly, viral
Hoarseness
Aphonia
Severe cough
OBSTRUCTION AND
TRAUMA OF THE
UPPER
RESPIRATORY
AIRWAY
OBSTRUCTION DURING
SLEEP
Obesity
Male
Postmenopausal stage
Advanced age
Clinical Manifestations
Gasping
Choking
Diagnosis of OSA
Surgery:
Tonsillectomy
Uvulopalatopharyngoplasty
Nasal septoplasty
Tracheostomy
Pharmacologic Therapy
Modafinil (Provigil)
Protriptyline (Triptil)
Acetazolamide (Diamox)
EPISTAXIS (NOSEBLEED)
Causes:
Trauma
Infection
Hypertension
Blood dyscracisa, nasal tumor, cardio diseases
Management
Two major components of the nasal passages are the septum and the
turbinates.
Causes
Surgical
Functional Rhinoplasty
Pharmacologic
Nasal corticosteroids
Leukotriene inhibitors
Antibiotics
Astringent (for hypertrophied turbinates)
Nursing Management
Oral hygiene
Bones of the nose are broken more often than any other facial
bone.
Pain
Bleeding from the nose (Externally and Internally into the pharynx)
Periorbital ecchymosis
Nasal obstruction
Deformity
Assessment & Diagnosis
X-ray
LARYNGEAL OBSTRUCTION
Patient’s history
Pharmacologic
Epinephrine
Corticosteroid
It can develop in any part of the larynx. Most begin in the glottis
Etiology: Unknown
Risk Factors
Gender. Men
Smoking.
Alcohol.
Problems in breathing
Bad breath
An earache
Weight loss
Diagnosis
Physical exam
Indirect laryngoscopy
Direct laryngoscopy
CT scan
Biopsy
Medical Management
Radiation therapy
Radiation therapy combined with surgery
Radiation therapy combined with chemotherapy
Surgery
Total laryngectomy
Partial laryngectomy (hemilaryngectomy)
Supraglottic laryngectomy: The surgeon takes out the supraglottis, the top part
of the larynx.
Cordectomy: The surgeon removes one or both vocal cords.
Chemotherapy
Nursing Management
Pre-operative
Provide the patient pre-operative teachings
Clarify misconceptions
Tell that the natural voice will be lost
Teach communication alternatives
Reduce anxiety
Provide opportunities for patient and family to ask questions
Referrals to previous patients with LA and cancer groups
Post-operative:
Administer antibiotics
Avoid swimming
Cover the stoma with hands or plastic bib over the opening
Advise beauty salons to avoid hair sprays, powders and loose hair near
the opening
Frequent oral hygiene