Nursing 211

N211: Health Differences Across the Lifespan I of 148 is to be expected for approximately one week postoperatively. Teach client to avoid strenuous activity for one week, client can return to school in 10 days when operative site is adequately healed. 2.33 Sinusitis Sinusitis is the result of passageways from the sinuses that are blocked by swelling, inflammation, or structural abnormality of the nose. Chronic sinusitis may be due to nasal obstruction caused by polyps, while acute sinusitis usually follows a viral or bacterial upper respiratory infection. Secretions drain from the sinus cavity, and because they are such a good medium for growth of bacteria, viruses and fungi, infections develop in the sinuses and proliferate. Nursing Assessment Includes fever, headache, local tenderness, pain over the affected sinus, purulent nasal discharge, facial pain, nasal congestion, may mimic symptoms of allergies. Diagnostics Include x-rays or CT scan of sinuses, nasal endoscopy to examine sinuses, obtain a culture and open passageways to restore normal drainage. Nursing Interventions Used to treat the underlying cause. Decongestants and mucolytics to decrease inflammation. Topical corticosteroids to decrease inflammation. Antibiotics for bacterial infections. Increase fluids, hot showers in the morning or evening to cleanse nasal passageways or nasal irrigation. 2.34 Rhinitis Rhinitis may be allergic or acute viral. Allergic rhinitis is a reaction to a specific allergen that involves the nasal mucosa. Seasonal rhinitis usually occurs each year at about the same time, when offending allergens are at high levels. Acute viral rhinitis is the “common cold”. It is the result of viral invasion of the upper respiratory tract. It is spread person to person through airborne droplets and is the most common infectious disease in humans. Nursing Assessment Includes nasal congestion, sneezing, thin, watery nasal discharge, itchy eyes and nose. Nasal turbinates’ are swollen and enlarged. Nasal turbinates’ may block sinus drainage and result in sinusitis. Client may also present with cough, hoarseness and snoring. Symptoms of acute viral rhinitis are irritation or tickling of throat, sneezing, nasal secretions and obstruction secondary to dried secretions, watery scratchy eyes, fever, malaise and headache. ©2012 Achieve Page 78

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