Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic.
pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic.
pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. A variety of organisms, including bacteria, viruses and fungi, can cause pneumonia.
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
Pneumonitis is a more general term that describes the inflammatory process in the lung tissue that may predispose and Pneumonia is an inflammation of the lung parenchyma that is caused by a microbial agent.
place the patient at risk for microbial invasion.
Pneumonia is classified into four: community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), pneumonia in the immunocompromised host, and aspiration pneumonia.
Rhinitis, also known as coryza, is irritation and inflammation of the mucous membrane inside the nose. Common symptoms are a stuffy nose, runny nose, sneezing, and post-nasal drip. The inflammation is caused by viruses, bacteria, irritants or allergens
Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side. Signs and symptoms of tonsillitis include swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck
Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic
Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses.
Pneumonitis is a more general term that describes the inflammatory process in the lung tissue that may predispose and Pneumonia is an inflammation of the lung parenchyma that is caused by a microbial agent.
place the patient at risk for microbial invasion.
Pneumonia is classified into four: community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), pneumonia in the immunocompromised host, and aspiration pneumonia.
Rhinitis, also known as coryza, is irritation and inflammation of the mucous membrane inside the nose. Common symptoms are a stuffy nose, runny nose, sneezing, and post-nasal drip. The inflammation is caused by viruses, bacteria, irritants or allergens
Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side. Signs and symptoms of tonsillitis include swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck
A detailed and accurate presentation on the Dental Management of Respiratory and Adrenal Disorders.
Presentation deals specifically what a dental health care professional should care for himself and the patient while managing Respiratory and Adrenal disorders.
presentation by Dr. Ishaan Adhaulia
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. Sinusitis
Sinus :- mucus membrane lined cavities filled with air
that normally drain into nose .
Sinusitis is infection and inflammation of the para-
nasal sinus. It develop as a result of upper respiratory
infections.
6. Pathophysiology
due to risk factor and etiological factors
Inflammation and edema
Nasal congestion
Obstruction of nasal sinus
Provide medium for bacterial growth
Symptoms and signs will appear
9. Diagnostic evaluation
History taking
Physical examination( affected areas will be trans
luminated)
Sinus x- rays ( to detect, sinus opacity, mucosal
thickness and bone distruction)
Computer tomography:- to rule out local or systematic
defects
11. Management
Goals
1. To treat infection
2. To shrink nasal mucus membrane inflammation
3. To relieve pain
Note :- choice of medication should be made after
identification of micro-organism
12. Pharmacological therapy
First line antibiotics (e.g. amoxicillin, trimethoprim,
erythromycin)
Second line antibiotics( e.g.:- cephalosporin, ceprozil,
amoxicilline clavulanate{augmentin)
Broad spectrum antibiotics(macrolides, azithromycin)
Quinolones such as ciprofloxin, levofloxin( used if patient is
severely allergic to penicillin.
Treatment course will be 10-14days
Oral and topical decongestant(oxymetazolin) can be used to
reduce swelling
Heated saline irrigation
Mucolytic agents may be effective in reducing nasal congestion
Antihistamines such as diphenylhydramine, cetrizine if allergic
component is suspected
13. Nursing management
Teach the patient about methods of drainage such as
steam inhalation.
Instruct regarding increased fluid intake.
Demonstrate the medication administration.
Must be taught regarding side effects of nasal sprays
and rebound congestion..
Nurses must stressed on recommended regimen of
antibiotics
14. Chronic sinusitis
Chronic sinusitis is an inflammation of the sinuses that persists for more
than 3 weeks in an adult and 2 weeks in a child.
CAUSES
A narrowing or obstruction in the ostia of the frontal, maxillary, and anterior
ethmoid sinuses usually causes chronic sinusitis, preventing adequate
drainage to the nasal passages.
. This results in stagnant secretions, an ideal medium for infection. The
organisms that cause chronic sinusitis are the same as those implicated in
acute sinusitis.
Immunocompromised patients, however, are at increased risk for
developing fungal sinusitis.(Aspergillus fumigatus)
15. CLINICAL MANIFESTATION
impaired mucociliary clearance and ventilation,
cough (because the thick discharge constantly drips
backward into the nasopharynx)
Chronic hoarseness
chronic headaches in the periorbital area
Facial pain.
These symptoms are generally most pronounced on
awakening in the morning.
Fatigue
nasal stuffiness
In addition, some patients experience a decrease in smell
and taste and a fullness in the ears.
16. Assessment and Diagnostic Findings
History taking
Physical examination
CT
MRI
Nasal endoscopy may be indicated to rule out underlying
diseases such as tumors and sinus mycetomas (fungus
balls).
The fungus ball is usually a brown or greenish-black
material with the consistency of peanut butter or cottage
cheese.
Nasal/ sinus culture
Allergy test
18. MEDICAL MANAGEMENT
The antimicrobial agents of choice include amoxicillin
clavulanate (Augmentin) or ampicillin (Ampicin).
Clarithromycin (Biaxin)
third-generation cephalosporins such as cefuroxime
axetil (Ceftin), cefpodoxime (Vantin), and cefprozil
(Cefzil) have also been effective.
Levofloxacin (Levaquin), a quinolone, may also be
used. The course of treatment may be 3 to 4 weeks.
Decongestant agents, antihistamines, saline sprays,
and heated mist may also provide some symptom
relief.
19. SURGICAL MANAGEMENT
Excising and cauterizing nasal polyps,
correcting a deviated septum, incising and draining the
sinuses, aerating the sinuses, and removing tumors are
some of the specific procedures performed.
When sinusitis is caused by a fungal infection, surgery is
required to excise the fungus ball and necrotic tissue and
drain the sinuses.
Oral and topical cortico- steroids are usually prescribed.
Antimicrobial agents are administered before and after
surgery.
Some patients with severe chronic sinusitis obtain relief
only by moving to a dry climate.
20. NURSING MANAGEMENT
NURSING TEACHING :-
The nurse teaches the patient how to promote sinus
drainage by increasing the environmental humidity
(steam bath, hot shower and facia sauna)
increasing fluid intake
applying local heat (hot wet packs).
The nurse also instructs the patient about the
importance of following the medication regimen.
23. ACUTE PHARYNGITIS
Acute pharyngitis is an inflammation or infection
in the throat, usually causing symptoms of a sore
throat.
24. RISK FACTORS
Immunocompromised
Young children
Allergic rhinitis
Smoking (second hand smokers)
In GERD
Indotracheal intubation
Low immunity
25. Causes
Viral ( viral usually which cause common cold)
1. Rhinovirus
2. Adenovirus
3. Herpes simplex virus
4. Epstein bar virus
5. HIV infector
Bacterial
1. e.g. group A beta-hemolytic streptococcus
2. Neisseria gonorrhea
3. Corynebacterium diptheria
26. PATHOPYSIOLOGY
DUE O EETIOLOGICAL FACTORS BODY TRIGGER
A INFLAMMATORY RESPONSE
PAIN, FEVER, VASODILATION, EDEMA, AND
TISSUE DAMAGE(SYMPTOMS)
REDNESS AND SWELLING IN THE TONSILLAR
PILLARS, UVULA, AND SOFT PALATE(SIGNS)
A CREAMY EXUDATE MAY BE PRESENT IN THE
TONSILLAR PILLARS
27. CLINICAL MANIFESTATION
The signs and symptoms of acute pharyngitis include
1. a fiery-red pharyngeal membrane and tonsils,
2. lymphoid follicles that are swollen and flecked with
white-purple exudates
3. enlarged and tender cervical lymph nodes
4. no cough.
5. Fever
6. malaise
7. sore throat also may be present.
28. DIAGNOSTIC EVALUATION
History taking
Physical examination
Rapid screening tests for streptococcal antigens such as the latex
agglutination (LA) antigen test and solid-phase enzyme
immunoassays
(ELISA), optical immunoassay (OIA)
streptolysin titers,
throat cultures are used to determine the causative organism,
Nasal swabs
blood cultures may also be necessary to identify the organism
29. Management
Viral pharyngitis is treated with supportive measures since
antibiotics will have no effect on the organism.
Bacterial pharyngitis is treated with a variety of antimicrobial
agents.
Antibiotics are used in case of bacterial causes e.g penicillin
A beta-hemolytic streptococci and most S. aureus organisms are
resistant to penicillin and erythromycin), cephalosporins ,
macrolides (clarithromycin and azithromycin) may be used.
Antibiotics are administered for at least 10 days to eradicate the
infection from the oropharynx.
Corticosteroid e.g.:- dexamethasone and prednisone
Antifungal :- e.g. mycostatin
Analgesics :- acetaminophen and NSAID’s can be used to relieve
pain
30. NUTRITIONAL THERAPY
A liquid or soft diet is provided during the acute stage
of the disease.
Occasionally, the throat is so sore that liquids cannot
be taken in adequate amounts by mouth.
In severe situations, fluids are administered
intravenously.
The patient is encouraged to drink as much fluid as
possible.
32. NURSING MANAGEMENT
Provide bed rest to the patient.
Hot saline solution gargles will be effective
Ice collar make the patient comfortable
Mild anasthetics also can be used to decrease local
soreness
Advise bed rest during febrile stage
Examine skin daily for dryness and rash because it may
also progress to some communicable diseses such as
rubella.
33. CHRONIC PHARYNGITIS
Chronic pharyngitis is a persistent inflammation of
the pharynx.
Risk factors and etiology :-
1. It is common in adults who work or live in dusty
surroundings,
2. use their voice to excess
3. suffer from chronic cough
4. Habitually use alcohol and tobacco.
34. Types
Hypertrophic: characterized by general thickening and
congestion of the pharyngeal mucous membrane
Atrophic: probably a late stage of the first type (the
membrane is thin, whitish, glistening, and at times
wrinkled)
Chronic granular:- (“clergyman’s sore throat”):
characterized by numerous swollen lymph follicles on
the pharyngeal wall
35. CLINICAL MANIFESTATION
Constant sense of irritation or fullness in the throat,
Mucus collects in the throat
Productive cough
Difficulty swallowing
36. Treatment
Treatment of chronic pharyngitis is based on relieving
symptoms,
Avoiding exposure to irritants, and correcting any
upper respiratory, Pulmonary, or cardiac condition
that might be responsible for a chronic cough.
37. PHARMACOLOGICAL TREATMENT
Nasal congestion may be relieved by short-term use of
nasal sprays or medications containing ephedrine
sulfate (Kondon’s Nasal) or phenylephrine
hydrochloride (Neo-Synephrine).
If there is a history of allergy, one of the antihistamine
decongestant medications, such as Drixoral ,is taken
orally every 4 to 6 hours.
Aspirin or acetaminophen is recommended for its
anti-inflammatory and analgesic properties.
38. Nursing management
To prevent the infection from spreading, the nurse
instructs patient to avoid contact with others until the fever
subsides.
Alcohol, tobacco, second-hand smoke, and exposure to
cold are avoided, as are environmental or occupational
pollutants if possible.
The patient may minimize exposure to pollutants by
wearing a disposable facemask.
The nurse encourages the patient to drink plenty of fluids.
Gargling with warm saline solutions may relieve throat
discomfort.
Lozenges will keep the throat moistened.
39. Nursing diagnosis
Ineffective breathing related to oro-pharyngeal edema
manifested by oropharyngeal examination and
checking vital signs.
Impaired swallowing related to edema and pain of
pharynx manifested by verbalization
Pain related to infection of the oropharynx manifested
by verbalization
Infection related to invasion of bacteria in pharynx
41. The tonsils are
composed of
lymphatic tissue
and are situated
on each side of
the oropharynx.
The palatine
tonsils and
lingual tonsils are
located behind
the pillars of
fauces and
tongue
respectively.
ANATOMY OF THE TONSILS
42. TONSILITIS
It is inflammation of tonsils
Or
It is inflammation of palatine tonsils. The onset is
sudden and common among the childrens
43. Types
Acute :- can be bacterial or viral in origin
Recurrent /sub acute :- caused by bacteria.
Chronic :- which will last for longer period of time.
The cause will be bacterial.
44.
45. CAUSES
Risk factors :- droplet and direct contact with affected
person is a main risk factor for it .
Etiology :-
1. Group A-beta streptococci
2. Herpes simplex virus
3. Streptococcus pyogenes
4. Epstein bar virus
5. Cytomegalo virus
6. Adeno virus
7. Measles virus
47. CLINICAL MANIFESTATION
The symptoms of tonsillitis include
sore throat,
fever,
snoring,
difficulty swallowing.
Pain
Irritation and discomfort
Redness
Fever, chills
48. Contd….
Otalgia
Purulent exudate
Elevated temperature
Cervical lymph-adenopathy
Dysphagia, drooling
Bad breath order, foul taste
Sensation having foreign object into throat
White plaque into the pharynx.
50. Management
Lozenges
Advise to take plenty of fluids orally
Prescribe warm saline solution for throat irritation
Administer anti-biotics to control bacterial infection
Acetylsalicylic acid can administer to relieve pain and
inflammation.
Apply an ice collar.
Prescribe liquid diet until sore throat begins to recover
Advise to take blend diet
52. SURGICAL MANAGEMENT
Tonsillectomy(cold knife {steel} dissection can be
performed, cauterization
Pre-operative care :-
1. Check and perform required investigation
2. Check vital signs every 4 hourly
3. Ensure written formed consent for operation
4. General anesthesia is required for children and local for
adults
5. Mild sedatives can be given to reduce anxiety and to
induce sleep.
6. Patient is sent to OT in clean hospital clothes
accompanied by health personnel
53. Contd…
Post operative interventions
1. Patient to be received on post-operative bed
2. Place the patient on semi-prone position(head should be
turned to one side.
3. Vital signs must be checked frequently according to
hospital policy.
4. Observe bleeding from the throat if its dark red it will be
normal but in case of fresh bleeding inform to concerned
physician.
5. Regulate the flow of IV fluid and also maintain I/O
charts
54. Routine care
When consciousness return the shift patient in supine
position
Encourage client to take cold feeds such as ice cream
Do not give hot drinks
Analgesics and antibiotic must be administer acording
to prescription.
In normal conditions patient can be discharge upto 5
days .
56. Advise on discharge
Remain indoor
Avoid exposure to sun, hard games, vigrous cleaning of
throat, nose blowing.
Avoid infect with respiratory infection
Follow the follow up regimen
57. adenoiditis
adenoids or pharyngeal tonsils consist of lymphatic
tissue near the center of the posterior wall of the
nasopharynx.
Infection of the adenoids frequently accompanies
acute tonsillitis.
Group A beta-streptococcus is the most common
organism associated with tonsillitis and adenoiditis
59. Clinical manifestation
The symptoms of tonsillitis include :-
1. sore throat
2. Fever
3. snoring,
4. difficulty swallowing
5. Enlarged adenoids may cause mouth-breathing,
6. Earache
7. draining ears
8. frequent head colds
9. bronchitis,
60. Cond…………
1. foul-smelling breath
2. voice impairment
3. noisy respiration.
4. Unusually enlarged adenoids fill the space behind the
posterior nares, making it difficult for the air to travel
from the nose to the throat and resulting in a nasal
obstruction.
5. Infection can extend to the middle ears by way of the
auditory (eustachian) tubes and may result in acute otitis
media, which can lead to spontaneous rupture of the
eardrums
6. extension of the infection into the mastoid cells, causing
acute mastoiditis
61. DIAGNOSTIC EVALUATION
History taking
Physical examination
Tonsillar site is cultured to determine the presence of
bacterial infection.
Audiometric examination
63. SURGICAL MANGEMENT
Adenoidectomy is indicated only if the patient has had any of the
following problems
1. Hypertrophy of the tonsils and adenoids that could cause
obstruction and obstructive sleep apnea
2. Repeated attacks of purulent otitis media
3. Suspected hearing loss due to serous otitis media that has
occurred in association with enlarged tonsils and adenoids; and
some other conditions, such as an exacerbation of asthma or
rheumatic fever.
4. Appropriate antibiotic therapy is initiated for patients
undergoing tonsillectomy or adenoidectomy.
5. The most common antimicrobial agent is oral penicillin, which
is taken for 7 days. Amoxicillin and erythromycin are
alternatives.
64. Nursing management
Post operative interventions for patient who is undergoing
(Tonsillectomy or adenoidectomy)
1. Continuous nursing observation is required in the
immediate postoperative and recovery period because of
the significant risk of hemorrhage.
2. In the immediate postoperative period, the most
comfortable position is prone with the head turned to the
side to allow drainage from the mouth and pharynx.
3. The nurse must not remove the oral airway until the
patient’s gag and swallowing reflexes have returned.
4. The nurse applies an ice collar to the neck, and a basin and
tissues are provided for the expectoration of blood and
mucus.
65. Contd…
Hemorrhage is a potential complication after a
tonsillectomy and adenoidectomy. If the patient
vomits large amounts of dark blood or bright-red
blood at frequent intervals, or if the pulse rate and
temperature rise and the patient is restless, the nurse
notifies the surgeon immediately.
suture or ligation of the bleeding vessel is required. In
such cases, the patient is taken to the operating room
and given general anesthesia. After ligation,
continuous nursing observation and postoperative
care are required, as in the initial postoperative period
66. Contd………
If there is no bleeding, water and ice chips may be
given to the
patient as soon as desired. The patient is instructed to
refrain
from too much talking and coughing because these
activities can
produce throat pain.
67. Nursing diagnosis
Pre-operative
1. Pain related to inflammation and infection manifested by
verbalization
2. Impaired swelling related to edema and pain
3. Impaired nutritional pattern less than body requirements
related to inability to swallow manifested by intake output
charts or verbalization.
4. Anxiety related to discomfort and treatment modalities
manifested by verbalization.
5. Knowledge deficit related to disease progress and treatment
options manifested by verbalization or questioning .
6. Risk for spread of infection related presence of micro-
organism manifested by examination.
68. Contd…
Post-operative nursing diagnosis
1. acute pain related to surgical incision
manifested by verbalization.
2. High risk of infection related invasive procedure
manifested by observation.
3. Impaired skin integrity related to invasion to
skin structure/altered fluid level/ altered
nutritional metabolism manifested by
observation
4. Knowledge deficit regarding home care or post
operative care manifested by verbalisation.
69. PERITONSILLAR ABSCESS
A peritonsillar abscess is a collection of purulent
exudate between the tonsillar capsule and the
surrounding tissues, including the soft palate.
Etiology :-
1. Exact cause is unknown
2. It is believed to develop after an acute tonsillar
infection, which progresses to a local cellulitis and
abscess.
70.
71.
72. CLINICAL MANIFESTATION
usual symptoms of an infection are present, together with
1. local symptoms as a raspy voice
2. Odynophagia (a severe sensation of burning, squeezing
pain while swallowing),
3. Dysphagia (difficulty swallowing)
4. Otalgia (pain in the ear)
5. Drooling .
6. An examination shows marked swelling of the soft palate,
often occluding almost half of the opening from the
mouth into the pharynx,
7. Unilateral tonsillar hypertrophy
8. Dehydration
73. Diagnostic evaluations
History taking
Physical examination
Aspiration of purulent material (pus) by needle
aspiration is required to make the appropriate
diagnosis. The aspirated material is sent for culture
and Gram’s stain.
A CT scan is performed when it is not possible to
aspirate the abscess.
74. Management
Pharmaceutical :- Antibiotics (usually penicillin) are extremely
effective in controlling the infection in peritonsillar abscess.
Surgical management not required can be controlled with
antibiotic therapy. If treatment is delayed, the abscess is
evacuated as soon as possible.
The mucous membrane over the swelling is first sprayed with a
topical anesthetic and then injected with a local anesthetic.
Single or repeated needle aspirations are performed to
decompress the abscess. The abscess may also be incised and
drained. These procedures are performed best with the patient in
the sitting position to make it easier to expectorate the pus and
blood that accumulate in the pharynx.
75. Nursing management
Considerable relief may be obtained by the use of
topical anesthetic agents and throat irrigations or
the frequent use of mouthwashes
gargles, using saline or alkaline solutions at a
temperature of 105°F to 110°F (40.6°C to 43.3°C).
The nurse instructs the patient to gargle at intervals
of 1 or 2 hours for 24 to 36 hours.
Liquids that are cool or at room temperature are
usually well tolerated.
79. Definition
Laryngitis, an inflammation of the larynx, often
occurs as a result of voice abuse or exposure to dust,
chemicals, smoke, and other pollutants, or as part of
an upper respiratory tract infection
80. Risk factors
Exposure to sudden temperature changes,
Dietary deficiencies
Malnutrition
Immuno-suppressed state
Laryngitis is common in the winter and is easily
transmitted.
81. ETIOLOGY
The cause of infection is almost always a virus.
Bacterial invasion may be secondary.
Laryngitis is usually associated with allergic
rhinitis or pharyngitis.
82. CLINICAL MANIFESTATION
Signs of acute laryngitis include hoarseness or
aphonia (complete loss of voice)
severe cough
Chronic laryngitis is marked by persistent hoarseness.
Laryngitis may be a complication of upper respiratory
infections.
83. MANAGEMENT
acute laryngitis includes resting the voice
Avoiding smoking, resting
inhaling cool steam or an aerosol.
If the laryngitis is part of a more extensive respiratory
infection due to a bacterial organism or if it is severe,
appropriate antibacterial therapy is instituted.
The majority of patients recover with conservative
treatment; however, laryngitis tends to be more severe
in elderly patients and may be complicated by
pneumonia
84. CONTD……..
For chronic laryngitis, the treatment includes resting
the voice, eliminating any primary respiratory tract
infection, eliminating smoking, and avoiding second-
hand smoke.
Topical corticosteroids, such as beclomethasone
dipropionate (Vanceril) inhalation, may also be used.
These preparations have no systemic or long-lasting
effects and may reduce local inflammatory reactions.
85. CONTD..
Reduce intake of caffeine and alcohol intake
Stopping smoking
Limiting throat clearance
86. NURSING PROCESS FOR UPPER
RESPIRATORY INFECTIONS
Assessment (subjective and objective data)
1. Reveal signs and symptoms of headache, sore throat,
pain around the eyes and on either side of the nose,
difficulty in swallowing, cough, hoarseness, fever,
stuffiness, and generalized discomfort and fatigue.
Determining when the symptoms began, what precipitated
them, what if anything relieves them, and what aggravates
them is part of the assessment.
Inspection may reveal swelling, lesions, or asymmetry of
the nose as well as bleeding or discharge.
The nurse palpates the frontal and maxillary sinuses for
tenderness, which suggests inflammation, and then
inspects the throat by having the patient open the mouth
wide and take a deep breath.
87.
88. Planning of goals
The major goals for the patient may include
1. Maintenance of a patent airway,
2. Relief of pain
3. Maintenance of effective means of communication
4. Normal hydration
5. Knowledge of how to prevent upper airway
infections
6. Absence of complications.
89. NURSING DIAGNOSIS FOR URTI
Ineffective airway clearance related to excessive mucus
production secondary to retained secretions and
inflammation
Acute pain related to upper airway irritation secondary to
an infection
Impaired verbal communication related to physiologic
changes and upper airway irritation secondary to infection
or swelling
Deficient fluid volume related to increased fluid loss
secondary to diaphoresis associated with a fever
Deficient knowledge regarding prevention of upper
respiratory infections, treatment regimen, surgical
procedure, or postoperative care.
90. Nursing interventions
Maintaining a patent airway
Promote comfort
Promote communication
Monitoring and managing potential complication
Encourage fluid intake
Continue routine care
91. EXPECTED PATIENT OUTCOMES
Expected patient outcomes may include:
1. Maintains a patent airway by managing secretions
a. Reports decreased congestion
b. Assumes best position to facilitate drainage of secretions
2. Reports feeling more comfortable
a. Uses comfort measures: analgesics, hot packs, gargles,
rest
b. Demonstrates adequate oral hygiene
3. Demonstrates ability to communicate needs, wants, level
of comfort
a. Maintains adequate fluid intake
92. Contd…
5. Identifies strategies to prevent upper airway infections and
allergic reactions
a. Demonstrates hand hygiene technique
b. Identifies the value of the influenza vaccine
6. Demonstrates an adequate level of knowledge and
performs self-care adequately
7. Becomes free of signs and symptoms of infection
a. Exhibits normal vital signs (temperature, pulse,
respiratory rate)
b. Absence of purulent drainage
c. Free of pain in ears, sinuses, and throat
93. Upper respiratory obstructions
OBSTRUCTION DURING SLEEP:-.
Sleep apnea syndrome is defined as cessation of breathing
(apnea) during sleep.
Pathophysiology
Sleep apnea is classified into three types:
1. Obstructive—lack of air flow due to pharyngeal
occlusion
2. Central—simultaneous cessation of both air flow and
respiratory movements
3. Mixed—a combination of central and obstructive apnea
within one apneic episode.
94. Etiological factors
mechanical factors a(reduced diameter of the upper
airway)
Dynamic changes (activity of the tonic dilator muscles of
the upper airway is reduced during sleep. These sleep
related changes may predispose the patient to increased
upper)
Airway collapse with the small amounts of negative
pressure generated during inspiration.
Obstructive sleep apnea may be associated with obesity
and with other conditions that reduce pharyngeal muscle
tone (eg, neuromuscular disease, sedative/ hypnotic
medications, acute ingestion of alcohol).
95. CLINICAL MANIFESTATION
As per manifestation criteria:- Obstructive sleep apnea is defined
as frequent and loud snoring and breathing cessation for 10
seconds or more for five episodes per hour or more, followed by
awakening abruptly with a loud snort as the blood oxygen level
drops
Other manifestation may include :-
Excessive daytime sleepiness,
Morning headache,
Sore throat,
Intellectual deterioration,
Personality changes,
Behavioral disorders,
Enuresis,
Obesity
Complaints by the partner that the patient snores loudly or is
unusually restless during sleep
97. DIAGNOSTIC EVALUATION
The diagnosis of sleep apnea is made based on clinical
features
History taking
Physical examination
Polysomnographic findings (sleep test), in which the
cardiopulmonary status of the patient is monitored
during an episode of sleep.
98. Management
upplemental oxygen via nasal cannula
bilevel positive airway pressure therapy(biPAP is similar to
CPAP {Contineous positive airway pressure})
SURGICAL PROCEDURE:-
Surgical procedures (eg:-uvulopalatopharyngoplasty
{UPPP}) may be performed to correct the obstruction:-
This is surgical procedure which is used to remove tissues{
tonsils, adenoids) and remodel tissues(uvula, soft palate,
pharynx)
Tracheostomy :- is performed to bypass the obstruction if
the potential for respiratory failure or life-threatening
dysrhythmias exists.
99. PHARMACOLOGICAL THERAPY
Protriptyline (Triptil) { non sedative trycyclic
drug}given at bedtime is thought to increase the
respiratory drive and improve upper airway muscle
tone.
Non pharmacological measure
Administration of low-flow nasal oxygen at night can
help relieve hypoxemia in some patients but has little
effect on
the frequency or severity of apnea.
100. Contd……..
In mild cases, the patient is advised to avoid alcohol
and medications that depress the upper airway and to
lose weight.
101. EPISTAXIS
A hemorrhage from the nose, referred to as epistaxis,
is caused by the rupture of tiny, distended vessels in
the mucous membrane of any area of the nose. Most
commonly, the site is the anterior septum,
102. ETIOLOGY
Trauma
Infection
inhalation of illicit drugs
cardiovascular diseases
nasal tumors
low humidity
foreign body in the nose
deviated nasal septum
Vigorous nose blowing
nose picking
103. GENERAL INTERVENTION
Initial treatment may include applying direct pressure
The patient sits upright with the head tilted forward to
prevent swallowing and aspiration of blood.
Advise to pinch the soft outer portion of the nose
against the midline septum for 5 or 10 minute.
rea may be treated with a silver nitrate applicator or
gelfoam.
Topical vasoconstrictors such as adrenaline (1:1,000),
cocaine (0.5%), and phenylephrine may be prescribed
104. Contd.
If bleeding is occurring from the posterior regions
cotton pledgets soaked in a vaso-constricting solution may be inserted into the nose
to reduce the blood flow
improve the examiner’s view of the bleeding site
Suction may be used to remove excess blood and clots from the field of inspection
When location not identified :-
the nose may be packed with gauze impregnated with petrolatum jelly or antibiotic
ointment
a topical anesthetic spray and decongestant agent may be used prior to inserting the
gauze packing, or a balloon-inflated catheter may be used.
The packing may remain in place for 48 hours or up to 5 or 6 days if necessary to
control bleeding.
Antibiotics may be prescribed because of the risk of iatrogenic sinusitis and toxic
shock syndrome(duev to toxic perrduced by staphylococcus aureus .
105. Nursing management
Nurse monitors the vital signs, assists in the control of
bleeding,
Provides tissues and an emesis basin to allow the
patient to expectorate any excess blood