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Upper Respiratory ProblemsMedical Surgical Nursing

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Question Answer
T/F Hypertension increases the risk of epistaxis.
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False, but it does make bleeding (if it occurs) more difficult to control
Children and young adults tend to develop anterior or posterior nosebleeds.
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Anterior
Older adults typically have anterior or posterior nasal bleeding (epistaxis)?
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Posterior
Which type of nosebleed, anterior or posterior, may require medical treatment?
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Posterior (Anterior typically resolves spontaneously)
What measures should a nurse take initially to control a nosebleed?
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-Keep the patient quiet -Place them in a sitting position, or high Fowler's if they can't sit upright -Pinch the entire lower portion of the nose for 10-15 minutes -Insert a small gauze pad into the bleeding nostril and hold in place if pinching doesn'
A nurse is assisting a patient who has nosebleed. She knows that she needs to pinch the lower portion of the nose for ________ minutes as a first measure.
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10-15 minutes
What vasoconstrictive agents are typically used on a nasal tampon to stop epistaxis?
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Cocaine or oxymetazoline
A patient has had anterior packing of his nostril because of a resistant nosebleed. You know that he needs to return in ______ hours to have it removed.
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48-72 hours
You have an elderly patient that is experiencing a posterior nosebleed. Posterior packing is required. The doctor admits the patient to the hospital. You know this is because...
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Nasal packing may alter respiratory status, especially in elderly patients. Hypoventilation/hypoxemia may result in cardiac dysrhythmias or respiratory arrest.
Where, specifically, is a posterior packing for a nosebleed placed?
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Behind the soft palate in the posterior nasopharynx
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Nasal packing predisposes a patient to a bacterial infection from __________, which is normally present in the nasal cavity.
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Staph aureus
A patient is having posterior packing of a nosebleed removed after three days. Prior to the procedure, you...
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Administer ordered medications for pain, removing the packing is very uncomfortable
The most common surgical procedure for controlling posterior epistaxis involves ligation of the _________ artery performed through an incision under the upper lip to gain access to the artery.
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Internal maxillary artery
A patient has had radiologic embolization performed to stop a posterior nosebleed. What activities should the patient avoid?
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For 4-6 weeks, the patient should avoid vigorous nose-blowing, strenous activity, lifting or straining.
How should a patient be taught to sneeze after nasal surgery?
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With their mouth open to reduce pressure
What medications should a patient avoid after nasal surgeries, including posterior packing?
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NSAIDs or aspirin containing products.
________ rhinitis means that nasal symptoms are present less than 4 days a week or less than 4 weeks a year.
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Intermittent rhinitis
________ rhinitis means that the symptoms are present more than 4 days a week and for more than 4 weeks per year.
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Persistent rhinitis
When do intermittent rhinitis attacks typically occur?
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In spring and fall
What are the typical triggers for intermittent rhinitis?
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Pollen from trees, flowers, or grasses
What immunoglobulin is involved in persistent rhinitis?
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IgE
  
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