RESPIRATORY SYSTEM

PART TWO
2- Disorders of the Respiratory System
 Rhinitis

 Definition: inflammation and irritation of mucous membranes of

the nose
 Etiology
 allergic or nonallergic - often called "hay fever"
 caused by a variety of factors including environmental
exposures, infection, age, systemic disease, drugs, or
presence of foreign object
 Findings
 excessive nasal drainage
 nasal congestion
 purulent nasal discharge if the cause is bacterial
 nasal itchiness and sneezing
 watery eyes
 sore throat, general malaise, fever, chills, and headache in
cases of viral rhinitis (common cold)
 Rhinitis

 Diagnostics - history of findings, type / color of drainage

 Management
 identify the cause
 relieve findings (NSAIDS, antihistamines, decongestants
 antiinfectives for infectious causes
 desensitizing immunizations for allergic causes
 common cold treatment includes:
 encourage more fluids
 rest
 the use of salt water gargles, vitamin c, zinc
 Nursing interventions
 administer prescribed medications for symptom relief
 reinforce client teaching regarding:
 to avoid irritants
 specific medication instructions
 handwashing to avoid the spread of the common
cold
 Sinusitis

 Definition: inflammation of
one or more of the paranasal
sinuses often occurring
during an upper respiratory
infection when a nasal
infection spreads to the
sinuses.
 Etiology
 upper respiratory infection
 tooth infection
 allergy
 infectious diseases such
as pneumonia and
measles
 structural defects of the
nose
 underwater swimming
 Sinusitis

 Findings
 pain over affected areas especially when palpated or percussed
 purulent nasal drainage and congestion
 nasal obstruction
 fever
 malaise
 headache

 Diagnostics - X-ray or CT shows fluid in sinuses and mucous

membrane swelling
 Sinusitis

 Management
 antibiotics, decongestants, and antihistamines are most often
prescribed
 surgery to drain and open sinuses
 antral irrigation (sinus irrigation)
 Caldwell-Luc procedure
 Nursing interventions
 reinforce teaching regarding avoiding things that precipitate
sinusitis (allergens)
 administer prescribed medications
 decongestants
 nasal corticosteroids
 mucolytics
 antihistamines
 antibiotics
 encourage fluid intake of six to eight glasses, eight ounces, daily
 hot showers twice daily following nose blowing
 nasal irrigation PRN
 Upper airway obstruction

 Complete or partial
 Etiology
 food or foreign body
 laryngeal edema secondary to hypersensitivity response
 trauma
 Findings
 stridor (harsh vibration sound) during inspiration
 use of accessory muscles
 restlessness
 tachycardia
 skin color changes (pallor, cyanosis)
 inability to talk with complete obstruction
 Diagnostics - observations at time of occurance
 Upper airway obstruction

 Management - emergency
treatment

 Heimlich
maneuver
 cricothyrotomy
(cut cricoid
cartilage)
 tracheotomy/
 tracheostomy
 Nursing interventions - BCLS
guidelines for obstructed
airway
 Pharyngitis

 Definition: inflammation of mucous membranes of pharynx

 Etiology: bacterial, viral, fungal, environmental causes
 Findings
 scratchy throat
 throat pain, especially with swallowing
 pharynx can appear red and edematous with or without patchy
yellow exudates
 Diagnostics - cultures may show bacterial causes
 Management
 antiinfectives
 symptomatic relief
 prevent secondary complications

 Nursing interventions
 administer prescribed medications
 encourage increased fluid intake
 provide cool, bland liquids and gelatin

 have client avoid citrus juices

 Tonsillitis and adenoiditis
 Definition: inflammation and infection of tonsils
 Etiology: acute form is usually bacterial
 Findings
 sore throat - may be recurrent
 fever
 difficulty swallowing
 enlarged tonsils and adenoids
 foul smelling breath
 noisy respirations - snoring loudly during sleep if
enlarged adenoids
 recurrent ear infections
 Diagnostics - positive throat cultures for causative
microbes
 Management
 antiinfectives, antipyretics, analgesics
 tonsillectomy and/or adenoidectomy if indicated
Tonsillitis and adenoiditis
 Vocal cord disorders

 Laryngitis
 inflammation of vocal cords and surrounding mucous
membranes
 cause: something irritates the larynx
 occurs in viral and bacterial infections
 in children, called croup (larynx blocked by edema,
spasm or both)
 treat findings, rest voice, remove irritants
 Vocal cord paralysis
 injury, trauma or disease of larynx, laryngeal nerves
or vagus nerve
 determine how well client can protect airway
 can be surgically treated with Teflon injection
 Cancer of the larynx

 Etiology
 most tumors of the larynx are squamous cell carcinoma
 more common among men, age 50 to 65
 cigarette smoking and alcohol consumption are associated with
cancer of the larynx
 Findings
 sore throat
 dyspnea, dysphasia
 increasing hoarseness
 weight loss
 enlarged cervical lymph nodes
 Cancer of the larynx

 Diagnostics - X-ray, biopsies

 Management
 radiation therapy
 chemotherapy
 surgery: removal of all or part of the larynx to treat cancer
 thyrotomy
 total laryngectomy: no voice, permanent stoma at the base of
the neck
 radical neck dissection: when cancer has metastasized to
surrounding tissues
 Nursing interventions - post laryngectomy
 assist clients with larnygectomies to meet with support groups
 establish a method for communication, before surgery, to use
after surgery
 know that aspiration from upper airway is not possible
 maintain airway with suction equipment at bedside for PRN use;
will usually have tracheostomy tube in surgical site to maintain
airway
 assist with period of grieving for loss of voice and usual physical
looks
 provide routine tracheostomy care
 Disorders in which lung tissue
collapses

 Definition: There are a number of disorders

in which the pleural space is abnormally
occupied by air or fluid. The result is
pressure on lung tissue reducing lung
capacity.
 pneumothorax: air between the pleurae
 open pneumothorax: hole in the
chest wall, communicating with
lung
 closed pneumothorax: hole in
lung, chest wall intact
 tension pneumothorax - a
medical emergency
 closed pneumothorax
 air is forced into pleural
space, pressure builds up
 shifts mediastinum and
trachea away from affected
side and compresses heart
 treated with chest tube
insertion