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Understanding Medical Surgical Nursing Ch 27


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anterior bleeds (originating from Kiesselbach plexus) most common
Which of the following positions is recommeded for a pt experiencing a nosebleed?

a. lying down w/feet elevated

b. sitting up w/neck fully extended

c. lying down w/a small pillow under the head

d. sitting up le
d. sitting up leaning slightly forward
Which of the following is the best explanation by a nurse for why a physician did not prescribe antibiotics for influenza?

a. "Most cases of influenza are caused by antibiotic resistant bacteria."

b. "Influenza is cau
b. "Influenza is caused by viruses."
Which of the following responses is correct when a pt asks why her physician didn't order that new antiviral drug for her flu?

a. "The antiviral drugs are for AIDS, not the flu."

b. "The side effects of the antiviral
d. "These drugs only work if you start them within 48 hours after flu symptoms start."
After a laryngectomy, which of the following assessments takes priority?

a. Airway patency

b. Nutritional status

c. Lung sounds

d. Patient acceptance of surgery
a. Airway patency
Which of the following communication methods will not work for the pt w/a laryngectomy?

a. placing a finger over the stoma

b. providing a special valve that diverts air into the esophagus

c. obtaining a picture board
a. placing a finger over the stoma
Which of the following statements best explains why the nurse is careful when administering narcotics to a laryngectomee?

a. Most laryngectomees have been drug addicts in the past.

b.Even low doses of narcotics may cause respiratory
c. Narcotics can depress the cough reflex
Other causes of epistaxis are . . .
- trauma

- hypertension

- anticoagulants
Treatment options for epistaxis include:
- sit in chair & lean forward

- pressure to nares for 5 to 10 min

- ice packs to nose area

- local application of vasoconstrictive agent

- electrical cauterizing

- nasal packing for 2-4 days

- nasal balloon catheter
nasal polyps
grapelike clusters of mucosa in nasal passages

usually benign but can obstruct nasal passage

more common in people w/allergies

"triad dx" = nasal polyps + asthma + ASA allergy
Symptoms of a deviated septum include:
- stuffy nose

- blocked sinus drainage

- headaches

- epistaxis
incision made through mucous membrane covering septum

deviated portion of septum removed

AKA submucous resection (SMR)
surgical reconstruction of the nose
inflammation of the mucosa of one or more sinuses

maxillary & ethmoid sinuses usually affected

most common infecting organisms are Streptococcus pneumoniae & Haemophilus influenzae
Treatment for sinusitis includes:
- decongestants

- hot packs

- saline irrigation

- humidification

- surgical drainage

- antibiotics
viral rhinitis
(AKA common cold)
S/S are congestion, sneezing discharge

treat symptoms
inflammation of the pharynx

usually related to bacterial/viral infection

most commonly caused by beta-hemolytic streptococci (strep throat)

if not treated, can lead to rheumatic fever
S/S of pharyngitis include:
- sore throat

- dysphagia

- red, swollen throat

- exudate may be present (usually means bacteria present)

- fever

- malaise
difficulty swallowing
drainage or pus
inflammation of the mucous membrane lining the larynx

S/S cough, dysphagia, fever, hoarseness
occurs when filtering function of tonsils becomes overwhelmed w/a virus or bacteria & infection results

most common organisms are Streptococcus species, Staphylococcus aureus, Haemophilus influenzae, & Pneumococcus species
S/S of tonsillitis include:
- sore throat

- fever

- pain on swallowing

- exudate

- malaise

- myalgia
muscle pain
viral infection of respiratory tract

transmitted via droplets or physical contact from infected individuals or objects

incubation period from time of exposure to onset of symptoms is 1 to 3 days
influenza prevention

-who needs it?

-how is it done?
who? people 50+ yrs old - residents of extended care facilities - those w/chronic illness

how? shot - immunization doesn't have live virus - 2 wks for antibodies to develop - 4 months until effective
Cancer of the larynx usually develops in the 1_____ 1_____. It is usally a 2_____ cancer and can spread to the 3_____, 4_____, or 5_____ 5_____. The prognosis for a patient with laryngeal cancer is often poor because 6_____ may have occurred prior to pat
1 mucosal epithelium
2 primary
3 lungs
4 liver
5 lymph nodes
6 metastasis
S/S of cancer of the larynx:
- hoarseness

- change in voice

- pain

- dysphagia

- airway obstruction
Acute Pain Related to Infections Process

- assess for cause of discomfort

- offer pain relief

- encourage rest
Hyperthermia Related to Infectious Process

- monitor temp (q4h if febrile)

- monitor for dehydration

- encourage oral fluids

- give antipyretic if temp higher than 102.5 F
Risk for Infection: Transmission to Others Related to Presence of Infectious Disease

- teach good handwashing

- assess pt's understanding of infection transmission

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