UPPER

RESPIRATOR
Y TRACT
INFECTIONS
Learning Outcome:

Describe each of the upper airway infections

listed. Explain the incidence, cause, clinical
manifestations, and preventive health care for
each.
Describe the use of the nursing process when
caring for patients with upper respiratory
disorders.
Identify its
parts
Allergic Rhinitis Rhinitis Viral Rhinitis
( Common Colds)
(hay fever)
 Pollens, allergens, (seasonal)  Rhinovirus
 indoor, animals, chemical Runny nose, nasal (80%)corona viruses,
(perninneal) congestion, influenza,
sneezing, post
nasal drip, allergic  person to person, airborne,
 Antihistamines,decongesta
conjunctivitis, itchy close contact
nts,leukotriene
inhibitors,intranasal throat,  Virus can survive in surface
glucocorticosteroids, anti odynophagia, in 2-4 hours
pyretics, Tylenol, headache, hay
antitussive fever cough  Rest, fluids, proper
disposal of tissues, limit
Patient Focus: exposure, vit c zinc,
 Avoid Allergens handwashing,warm water
Prevention and
Health Promotion salt, NSAIDS for pain
Question:
What does the nurse teach the patient with intermittent allergic rhinitis
is the most effective way to decrease allergic symptoms?
A. Undergo weekly immunotherapy.
B. Identify and avoid triggers of the allergic reaction.
C. Use cromolyn nasal spray prophylactically year round.
D. Use over-the-counter antihistamines and decongestants during an
acute attack.
Rhinosinusitis (Sinusitis)
 acute bacterial rhinosinusitis (ABRS) or acute viral
rhinosinusitis (AVRS)

 Viral (common colds) and pathogens

 Streptococcus pneumoniae, Haemophilus
influenzae,
 Headache, fever nasal congestion, orbital pressure,
facial pain when tilt forward, poor sense of smell,
 Warm compress, saline sprays, decongestants,
antihistamine,
 Amoxicillin–clavulanic acid (Augmentin) is the
antibiotic of choice
 nasal saline lavage and decongestants
Pharyngitis (sore throat/ strep
throat)
 streptococcus pneumonia
 diagnosed with culture or antigen tests
 Penicillin (TOC/Cephalosporins
 ephedrine sulfate or phenylephrine
(congestion)
 Nutrition: soft diet, cool beverages
 Warm saline gargles, mouth care
 Patient Education: avoidance of alcohol,
tobacco, secondhand smoke, and exposure to
cold or to environmental or occupational
Question:
Is the following statement true or false?

Acute pharyngitis of a bacterial nature is

most commonly caused by group A beta-
hemolytic streptococci
Question:
A patient with an acute pharyngitis is seen at the clinic with fever and
severe throat pain that affects swallowing. On inspection, the throat is
reddened and edematous with patchy yellow exudates. The nurse
anticipates that interprofessional management will include
A. treatment with antibiotics.
B. treatment with antifungal agents.
C. a throat culture or rapid strep antigen test.
D. treatment with medication only if the pharyngitis does not resolve
in 3 to 4 days.
Tonsillitis and Adenoiditis
Manifestations: sore throat,
fever, snoring, and difficulty
swallowing.

penicillin (first-line therapy)

cephalosporins.
Tonsillectomy, prone post op,
Question:
During assessment of the patient with a viral upper respiratory
infection, the nurse recognizes that antibiotics may be indicated
based on what finding?
A. Cough and sore throat
B. Copious nasal discharge
C. Temperature of 100° F (38° C)
D. Dyspnea and severe sinus pain
Laryngitis
• Most common cause: viral,
bacterial secondary
• hoarseness or aphonia (loss
of voice) and severe cough
• resting the voice, avoiding irritants
(including smoking), cool steam or
an aerosol, fluids
• Corticosteroids, such as
beclomethasone
Nursing Process- Assessment
• Health history
• Signs and symptoms: headache, cough,
hoarseness, fever, stuffiness, generalized
discomfort, and fatigue
• Allergies
• Inspection of nose, neck, throat, and palpation
of lymph nodes
 Assessment for URTI
• Cough
• Sore throat
• Runny nose (Rhinorrhea)
• Nasal congestion
• Headache
• Low-grade fever
• Facial pressure
• Sneezing
• Malaise
• Myalgias
Question:
What should the nurse palpate when assessing
for an upper respiratory tract infection?
A. Neck lymph nodes
B. Nasal mucosa
C. Tracheal mucosa
D. All of the above
Nursing Process-Nursing Dx
Ineffective Airway Clearance
Acute Pain
Impaired Verbal Communication
Fluid Volume Deficit
Knowledge Deficit related to prevention,
treatment, surgical procedure, postoperative care
Nursing Process-Planning
• Airway management, reduce risk of aspiration
• Pain management
• Effective communication strategy
• Increase hydration
• Patient teaching: self-care, prevention, and health
promotion
• Home care, if indicated
Nursing Process- Interventions
Elevate head
Ice collar to reduce inflammation and bleeding
Hot packs to reduce congestion
Analgesics for pain

Gargles for sore throat

Use alternative communication
Encourage liquids; at least 2 to 3 L/day
Soft bland diet
Rest
Obstruction and Trauma of
the Upper Respiratory
Airway
• Obstructive sleep apnea—S/S:; Tx: CPAP, BiPAP, oxygen therapy, surgery
• Epistaxis
• Nasal obstruction—S/S: deviated septum, turbinate hypertrophy, polyps
• Fractures of the nose—S/S: traumatic obstruction; Tx: reduction of fracture,
control epistaxis and edema
• Laryngeal obstruction—S/S: edema,; Tx: subcutaneous epinephrine, tracheotomy
Question:
A patient develops epistaxis upon removal of a
nasogastric tube. What action should the nurse
take?
A. Pinch the soft part of the nose.
B. Position the patient on the side.
C. Have the patient hyperextend the neck.
D. Apply an ice pack to the back of the neck.
Question:
The nurse receives an evening report on a patient who
underwent posterior nasal packing for epistaxis earlier in
the day. What is the first patient assessment the nurse
should make?
A. Patient's temperature
B. Level of the patient's pain
C. Drainage on the nasal dressing
D. Oxygen saturation by pulse oximetry
 Laryngeal Cancer
Cause: carcinogens, smoking, alcohol, pollutants
Assessment: persisntent, progressive hoarseness , selling or lump in the
neck
Dysphagia, weight loss

Dx: Larygoscopy, biopsy, ct scan, MRI,

Mgt: chemotherapy, radiation therapy, Larygectomy
Nsg Mgt: assess fof the manifestations, hoarseness, dysphagia, burning
in throat, anxiety level, coping strategies, ability to communbicate