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bones), exudate, swollenSinusesTendernessMouthTHRUSH, ULCERS, MALNUTRITIONTonsilsRed, swollen, pus pockets
DiagnosticsXRAY MRIContraindications for CT/MRICTLabsCultures from nasal passageCultures from throatCBC Pulse OximetryA noninvasive method to monitor the oxygen saturation of the blood.Does not replace ABGsNormal level is 95% to 100%.May be unreliableMOST IMPORTANT FOR DETECTING CHANGESCyanosis (p. 474)Examination of Lymph nodesPalpate lymph nodesUpper Respiratory Infections•Most common reason for seeking healthcare-COLDSbeing the most frequently occurring.•May be minor, acute, chronic, severe, or lifethreatening•Treated in community settings: doctor offices, urgent care clinics, long-term care facilities, or self-care at home •Early detection of signs and symptoms and appropriate interventions can avoid unnecessary complications•Patient teaching focus on prevention and health promotion
Rhinitis and RhinosinusitisSpecial considerations for older adults (Chart 22-1) Rhinitis and rhinosinusitis: acute, chronic, (refer to Fig. 22-1 and Table 22-1) •Rhinitis –inflammation and irritation of the mucous membranes of the nose•Rhinosinusitis –inflammation of the paranasal sinuses and nasal cavity•Acute, subacute, and chronicIncidence –affects 10%-30% population worldwide annuallyCan a change in weather cause rhinitis?What medications can cause rhinitis?Clinical manifestationsLonger than 10 days = infectionsFacial tenderness, headacheFever, achySore throat, coughSneezing, runny/stuffy nose (rhinorrhea), runny eyes Can a change in weather cause rhinitis?What medications can cause rhinitis?Clinical manifestations•Longer than 10 days = infections•Facial tenderness, headache•Fever, achy•Sore throat, cough•Sneezing, runny/stuffy nose (rhinorrhea), runny eyes Prevention•Hygiene•Flu vaccine•Long term medical management•Avoid allergens•Allergy testing/desensitizing•Steroids
Pharmacological Management•Antihistamine verses decongestant•NSAIDS, gargles, guaifenesin•Nasal decongestants•Antivirals•Nasal agents•Mast cell stabilizers•Steroids•Intranasal ipratropium (Atrovent)•Leukotriene modifiersOther Upper Respiratory InfectionsPharyngitis: acute, chronic (refer to Fig. 22-2)•Definition –sudden painful inflammation of the pharynx•Incidence –USA app 11 million annually•Cause•Viral –adenovirus, influenza, Epstein-Barr•Bacterial –group A strep•Clinical manifestationsPreventive health careTonsillitis, adenoiditis•Definition•Tonsillitis—infection of tonsils•Adenoiditis—infection of adenoids •Cause –GABHS, Epstein-Barr virus•Clinical manifestations•Sore throat, fever, snoring, difficulty swallowing, swollen lymph nodes, nausea and vomiting •Health care (p.547)
Strep ThroatSudden onset1-5 days after exposure20% ATB resistantVery serious if left untreatedDiagnosis throat swabScarlet fever, or scarlatina •Is often accompanied by:•Rash with urticaria-begins on face and spreads downward•Strawberry tongue•N/V, abdominal pain•Red lines in folds of skin