LARYNGITIES

Definifion:
It is an inflammation and irritation of the voice
box or larynx.
The inflammation causes narrowing of the upper
airways which leads to a horseness of the voice, in some
circumstance aphonia.
Types of laryngitis
 Acute laryngitis

 Chronic laryngitis

Acute laryngitis: It is the acute inflammation of larynx which

lasts less than a few days and leads to edema of laryngeal
mucosa.
 Most cases of acute laryngitis are temporary and improve

after the underlying causes

Chronic laryngitis: laryngitis that lasts more than 3 weeks is

known as chronic laringitis.
 It usually is painless and has no significant sign of infection.
Risk factors:
 respiratory infection such as cold ,bronchitis, sinusitis,

pneumonia.
 Exposure to irritants such as smoke, stomach acid.
 Exposure to irritants distributed by air conditioning

systems such as mold, pollen and pollutants, and dust.

 Extremely cold weather
 Excess alcohol consumption.
Etiological factors:
 Bactireal such as H.influenzae, pneumoniae
 Viral laringitis is common in the winter and easily
transmitted to others
 Voice abuse or misuse
 Smoking
 Allergies
 Larynx cancer
 Tumor
 Alcohol consumption
 GERD: It is a disorder which acidic fluids from the
stomach flow backward into the oesophagus and throat,
irritating larynx
Signs and symptoms:
 Hoarseness
 A low, raspy voice, voice loss
 tickling sensation and rawness in throat
 Dry throat
 Sore throat
 Difficulty swallowing
 Cold or flu
 Fever swollen lymph nodes in the neck
 A constant urge to clear the throat
 Heavy mucus in the throat
 Chronic cough
 Dysphagia coughing
 Dyspnea
 Felling fullness in the throat or neck
Diagnosis:
 Complete history collection
 Physical examination
 X-ray of the neck and chest
 CBC
 Laryngoscopy
 Biopsy
Management:
P/M:
 Antibiotic:
 Steroids: e.g.. Prednisone, dexamethasone
 H2 blocker: e.g.. Zantac, for gastro esophageal reflux.
 Analgesic: acetaminophen ibuprofen

NP/M:
 voice rest
 Steam inhalation
 Avoid smoking
 Fluid intake
 Voice rehabilitation
 Humidification
 Increase intake of fluids
 Reduction of high impact stress to vocal card
Complication:
 Painful talking, voice loss and dysphonia
 Spread of infection to lower respiratory tract.
 Obstruction of airway
 Laryngeal stenosis, laryngeal necrosis are rare

complications.
Nursing management:
 Teach patient and significant others about laryngitis

 Assess respiratory status of the patient

 Monitor vital signs

 Place important objects within reach.

 Provide instructions on the administration of medication

 Instruct the patient to avoid exposure to individual with

upper respiratory infection.

 Elevate head of bed and provide supplemental

humidification.
 Provide comfort measures. Eg: ice collar and throat

humidification.
 advice patient to avoid shouting or screaming.
 Advice patient to avoid exposure to chemicals or

allergens such as pollens, dust etc.

 Encourage patient to rest his/ her voice as much as

possible.
 Consult a speech therapist for additional help.
Nursing care plan
Nursing assessment:
 Assess the pain level
 Monitor vital signs
 Enquire about swallowing difficulty and breathing

problems.
 Enquire about oral bleeding, oral hygiene and ulcer.
 Enquire about eating pattern and bowel elimination.
Nursing diagnosis:
1. Acute pain related to inflammatory process
2. Ineffective airway clearance related to thick mucus
and hoarseness.
3. Ineffective breathing pattern related to inflammation
and laryngo tracheobronchial obstruction.
4. Fever related to infection process.