Nursing Care of
Clients with Upper
Respiratory Disorders
Nursing Care of Patients with Upper
Airway Disorders
• Upper airway disorders may be minor, treated
outside health care setting
– Or may be severe, life threatening
• Require good assessment skills, understanding
of variety of disorders that affect upper
airway, impact those disorders may have on
patient
• Patient teaching is important aspect of care
Specific Disorders
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Infections
Rhinitis
Sinusitis: acute, chronic
Pharyngitis: acute, chronic
Tonsillitis, adenoiditis
Peritonisillar abscess
Laryngitis
Upper Respiratory Tract
Disorders and Risk Factors
• Influenza
– Highly contagious viral respiratory disease
– Usually occurs in epidemics or pandemics
– Avian influenza: possible pandemic
• Sinusitis
– Sterile air-filled cavities in the facial bones
– Sinusitis
Viral Upper
Respiratory Infection
• Pathophysiology
– Local inflammatory response
– Swelling of mucous membranes of nasal passages
– Hyperactivity of mucus-secreting glands
– Immunity produced only to individual virus
Rhinitis and Sinusitis
Pharyngitis
Viral Upper
Respiratory Infection
• Manifestations
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Nasal congestion
Profuse nasal discharge (coryza)
Sneezing
Coughing
Sore throat
Low-grade fever
Headache
Malaise
Muscle aches
Viral Upper
Respiratory Infection
Sinusitis
• Pathophysiology
– Sinus opening obstruction, impaired drainage
• Manifestations
– Pain and tenderness
– Headache, fever, and malaise
– Nasal congestion
– Purulent nasal discharge
– Bad breath
Influenza
• Medications
– Prophylaxis
– Treatment to reduce severity
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Amantadine
Rimantadine
Zanamivir
Oseltamivir
Ribavirin
– Symptom relief also include
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ASA
Acetaminophen
NSAIDs
Antitussives
Antibiotics are not indicated
Sinusitis
• Medication Therapy
– Antibiotics
– Oral or topical decongestants
– Antihistamines
– Saline nose drops or sprays
– Systemic mucolytic agents
Nursing Process: Care of Patients with
Upper Respiratory Infections Assessment
• Health history
• Signs and symptoms: headache, cough,
hoarseness, fever, stuffiness, generalized
discomfort and fatigue
• Allergies
• Inspection of nose, neck, throat
– Include palpation of lymph nodes
Nursing Process: Care of Patients with
Upper Respiratory Infections Diagnosis
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Ineffective airway clearance
Acute pain
Impaired verbal communication
Deficient fluid volume
Deficit of knowledge related to prevention,
treatment, surgical procedure, postoperative
care
Nursing Process: Care of Patients with
Upper Respiratory Infections Planning
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Maintenance of patent airway
Relief of pain
Maintenance of effective communication
Normal hydration
Knowledge to how to prevent upper airway
infections
• Absence of complications
Interventions
• Interventions to maintain patent airway
• Promote comfort
– Analgesics
– Gargles for sore throat
– Use of hot packs for sinus congestion or ice collar
to reduce swelling, bleeding post tonsillectomy
and adenoidectomy
Interventions (cont’d)
• Rest
• Refrain from speaking, use alternative
communication
• Encourage liquids; 2 to 3 L a day, appropriate
foods
Patient Education
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Prevention of upper airway infections
Emphasize frequent hand washing
When to contact health care provider
Need to complete antibiotic treatment
regimen
• Annual influenza vaccine for those at risk
Potential Complications
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Sepsis
Meningitis
Peritonsillar abscess
Otitis media
Sinusitis
Health Promotion
Activities
Viral Upper Respiratory Infection
• Maintaining good general health
• Stress-reducing activities
• Limiting exposure to crowds
• Good handwashing
Influenza
• Immunization education
• Risk reduction activities
– Avoiding crowds
– Avoiding those who are ill