Adult Health 1 Exam 3 AI GENERATED Flashcards from notes/book/lecture

What is obstructive sleep apnea (OSA)?

A sleep-related disorder caused by partial or complete airway collapse that interrupts ventilation, causing hypoxia and lack of sleep.

What are common symptoms of obstructive sleep apnea?

Fatigue, daytime sleepiness, headaches, waking gasping/choking, difficulty concentrating, irritability, depression, and memory problems.

What conditions are associated with obstructive sleep apnea?

Hypertension, other cardiovascular disorders, insulin resistance, stroke, and cognitive impairment such as dementia.

What are nonsurgical treatments for obstructive sleep apnea?

Change sleep position, elevate HOB, weight loss, positive-pressure ventilation, and position-fixing devices.

What is UPPP?

Uvulopalatopharyngoplasty; a collection of procedures used to remodel the posterior oropharynx to resolve OSA.

What can happen with a displaced nasal fracture?

Airway obstruction, cosmetic deformity, or infection.

What drainage from the nose after a nasal fracture may indicate a serious injury?

Clear fluid may be CSF and can indicate a skull fracture.

How can CSF drainage from the nose be identified?

CSF contains glucose and tests positive with a glucose dipstick; when dried on filter paper, it produces a yellow "halo."

How is a simple displaced nasal fracture treated?

A simple closed reduction is performed within the first 24 hours using local or general anesthesia.

What is rhinoplasty?

Surgical repair of a fractured nose or reconstruction to improve function or appearance.

What is nasoseptoplasty/SMR?

Surgery to straighten a deviated septum by removing or reshaping the deviated cartilage and bone.

What is the priority action with facial trauma?

Assess the airway.

What should be assessed after the airway is established in facial trauma?

Bleeding, obvious fractures, soft-tissue edema, facial asymmetry, pain, and CSF leakage from the ears or nose.

Why are vision and eye movements assessed after facial trauma?

Orbital and maxillary fractures can entrap eye nerves and muscles.

What is Battle sign?

Extensive bruising behind the ears that is often associated with skull fracture and brain trauma.

What diagnostic imaging may be obtained for facial trauma?

Cranial CT, facial series, and cervical spine x-rays.

What are manifestations of facial trauma that may indicate airway/gas-exchange problems?

Stridor, dyspnea, anxiety/restlessness, hypoxia, hypercarbia, decreased SpO₂, and cyanosis.

When is a tracheotomy used?

For a patient who cannot be easily intubated with an endotracheal tube.

What is a cricothyroidotomy?

An emergency airway procedure through the cricothyroid membrane between the thyroid and cricoid cartilages.

When is a cricothyroidotomy used?

When it is the only way to secure an airway.

Why are fractured jaws placed in fixed occlusion?

To allow the teeth to heal in proper alignment.

How long may fixed jaw occlusion remain in place?

6-10 weeks.

What can cause jawbone infection after a fracture?

Treatment delay, tooth infection, or poor oral care.

How are extensive jaw fractures treated?

They may require open reduction with internal fixation (ORIF) using compression or reconstruction plates and screws.

What may be required if facial wounds are present with jaw fractures?

Debridement.

What type of cancer are head and neck cancers usually?

Squamous cell carcinomas.

What are the two initial lesion types associated with head and neck cancer?

Leukoplakia = white, patchy lesions; erythroplakia = red, velvety patches.

Where does head and neck cancer usually spread first?

Local lymph nodes, muscle, and bone.

Where can head and neck cancer spread later?

Distant sites, usually the lungs or liver.

What are warning signs of head and neck cancer?

Pain; mouth/throat/neck lump; difficulty swallowing; mouth/tongue color changes; nonhealing sore >2 weeks; oral bleeding; numbness; denture-fit changes; burning with citrus/hot liquids; unilateral ear pain; hoarseness/voice changes; recurrent sore throat; SOB; anorexia and weight loss.

What is the priority concern with head and neck cancer?

Airway obstruction; airway assessment is a priority.

How can gas exchange be supported in head and neck cancer?

Position changes, oxygen as ordered, hydration, and humidification.

What psychosocial problems can occur with head and neck cancer?

Anxiety and decreased self-esteem, especially because surgery can cause drastic changes and inability to talk.

What treatments may be used for head and neck cancer?

Radiation, chemotherapy, surgery, or combinations of these.

What chemotherapy drugs are commonly included in head and neck cancer regimens?

Cisplatin or another platinum-based drug combined with 5-FU.

What causes epistaxis?

Trauma to nasal mucosa, hypertension, blood dyscrasias, inflammation, tumor, decreased humidity, nose blowing, nose picking, chronic cocaine use, and NG suctioning.

Where does epistaxis most often occur in older adults?

The posterior portion of the nose.

Why is posterior epistaxis especially concerning?

It may be more severe and harder to control and creates a greater risk for airway compromise.

How can posterior epistaxis be treated?

Posterior packing, epistaxis catheters, gel tampons, cauterization, vessel ligation, or embolization.

What can happen if posterior nasal packing becomes dislodged?

Airway obstruction and reduced gas exchange.

What happens after a partial versus total laryngectomy?

A partial laryngectomy requires a temporary tracheostomy; a total laryngectomy creates a permanent laryngectomy stoma.

What is removed during a supraglottic partial laryngectomy?

Hyoid bone, false cords, and epiglottis; remaining voice may be normal or hoarse.

What is removed during a hemilaryngectomy/vertical laryngectomy?

One true cord, one false cord, and half of the thyroid cartilage; remaining voice is hoarse.

What is removed during a total laryngectomy?

The entire larynx, hyoid bone, strap muscles, and one or two tracheal rings; there is no natural voice afterward.

What are major complications after laryngectomy?

Airway obstruction, hemorrhage, wound breakdown, and tumor recurrence.

What are the first priorities after head and neck surgery?

Maintain the airway and ensure gas exchange.

Why is a tracheostomy collar used after laryngectomy?

It provides oxygen and humidity to help move mucus secretions.

What is expected about secretions immediately after laryngectomy?

Secretions may remain blood-tinged for 1-2 days; increased bleeding should be reported.

How is a total laryngectomy stoma cared for?

Inspect the stoma and clean the suture line with sterile saline or prescribed solution to prevent crusting and airway obstruction.

What should a healthy laryngectomy stoma look like?

Bright pink, shiny, and free of crusts.

What is a tissue flap after head and neck surgery?

Skin, subcutaneous tissue, and sometimes muscle taken from another body area for reconstruction.

How is wound breakdown after laryngectomy managed?

Packing and local care as prescribed to keep the wound clean and promote healthy granulation tissue.

How is pain commonly managed immediately after laryngectomy?

IV morphine through a PCA pump is often used for the first 1-2 days; liquid opioids may later be given through a feeding tube.

Why may an NG, gastrostomy, or jejunostomy tube be placed during laryngectomy?

For nutritional support while the head and neck heal; it may remain 7-10 days and is removed when the patient can swallow safely.

Can aspiration occur after a total laryngectomy?

No. The airway is completely separated from the esophagus.

How should communication be addressed after laryngectomy?

Work with the patient, family, and SLP to develop an acceptable communication method.

What is asthma?

A chronic disease with intermittent reversible airflow obstruction caused by inflammation and airway hyperresponsiveness with bronchoconstriction.

What can trigger asthma?

Inflammation, chemicals, allergic reactions, smoke, dust, mold, weather changes, aspirin/NSAIDs, GERD, stress, and hormonal changes.

Why can aspirin and NSAIDs trigger asthma?

They increase production of leukotrienes.

What asthma symptoms are assessed for control?

Daytime wheezing/dyspnea/coughing >2 times weekly, nighttime symptoms, rescue-drug use >2 times weekly, and activity limitation.

What is controlled asthma?

None of the listed symptoms are present.

What is partly controlled asthma?

1-2 of the listed symptoms are present.

What is uncontrolled asthma?

3-4 of the listed symptoms are present.

What are the goals of asthma therapy?

Control/prevent episodes, improve airflow and gas exchange, and relieve symptoms.

What is the asthma action plan?

A plan involving drug therapy and lifestyle management to help the patient understand and manage asthma.

What is control therapy for asthma?

Preventive therapy used every day regardless of symptoms to change airway responsiveness and prevent attacks.

What are reliever drugs for asthma?

Rescue drugs used to stop an attack after it has started.

What is oxygen used for in respiratory disease?

To correct hypoxemia; the document lists a goal of maintaining SpO₂ >93%.

What are SABA examples?

Albuterol and levalbuterol.

What do SABA drugs do?

Relax bronchial smooth muscle, relieve acute symptoms/bronchospasm, prevent exercise-induced asthma, and treat impending attacks.

What are common SABA side effects?

Tremor, anxiety, tachycardia, palpitations, dysrhythmias, hypertension, hypokalemia, throat irritation, bronchospasm, and refractory asthma.

What should patients know about albuterol/levalbuterol?

Carry it at all times; monitor heart rate; when using other inhaled medications, use albuterol/levalbuterol at least 5 minutes before the other inhaled medication.

What are anticholinergic respiratory drugs?

Ipratropium and tiotropium.

What do anticholinergics do?

Relax bronchial smooth muscle, relieve bronchospasm, and prevent attacks.

What are common anticholinergic side effects?

Dry mouth, bitter taste, bronchoconstriction, and palpitations; tachycardia occurs less often than with beta₂ agonists.

What teaching is important for anticholinergics?

Shake the MDI, increase daily fluids for dry mouth, and report blurred vision, eye pain, headache, nausea, palpitations, tremors, or inability to sleep.

What do inhaled corticosteroids such as fluticasone and beclomethasone do?

Reverse airway inflammation and open the airways.

What are important corticosteroid inhaler teaching points?

Use daily even without symptoms, expect maximum effectiveness after 48-72 hours, practice mouth care, check for oral lesions/drainage, and rinse the mouth after use.

Why are inhaled corticosteroids not rescue medications?

They have a slow onset and do not relieve acute symptoms.

What does prednisone do for asthma?

Reduces airway inflammation and helps open the airways.

What are important prednisone side effects?

Systemic immunosuppression, increased infection risk, hyperglycemia, GI ulceration, bruising, and petechiae.

What should patients taking prednisone avoid/do?

Avoid people with upper respiratory infections, avoid activities that could cause injury, take with food, and never stop suddenly.

What is a LABA?

A long-acting beta₂ agonist that relaxes bronchiolar smooth muscle, has slow onset and long duration, and prevents attacks rather than treating acute attacks; example: salmeterol.

What do leukotriene modifiers do?

Block inflammatory mediators and prevent asthma attacks triggered by inflammation or allergens; example: montelukast.

How should an MDI be used?

Shake for 5 seconds between inhalations, inhale through the mouth, keep tongue under the mouthpiece, inhale slowly/deeply while pressing the canister, hold breath 5-10 seconds, then exhale.

When can a spacer be used with an MDI?

When the patient has difficulty timing the spray with inhalation.

What is emphysema?

A destructive problem of lung elastic tissue that reduces recoil, causes hyperinflation, dyspnea, increased respiratory rate, and reduced gas-exchange area from loss of alveolar tissue.

What is chronic bronchitis?

Inflammation of the bronchi/bronchioles with increased mucus and a chronic productive cough for at least 3 months of the year for 2 consecutive years.

What is a key difference between emphysema and chronic bronchitis?

Emphysema primarily involves destructive loss of alveolar tissue; chronic bronchitis affects the airways and involves mucus and inflammation.

What happens to ABGs as COPD worsens?

Hypoxemia and hypercapnia develop, causing chronic respiratory acidosis; metabolic alkalosis occurs as renal compensation through bicarbonate retention.

What does advanced emphysema look like on chest x-ray?

Hyperinflation, widely spaced ribs, and a flattened diaphragm.

What may happen to H&H/RBCs in COPD?

They may increase to compensate for oxygen needs.

What should be assessed in a COPD history?

Family history, smoking/pack-years, occupational/environmental exposure, cough, sputum, activity tolerance, nutrition/fluid intake, and sleep position/orthopnea.

What are common COPD assessment findings?

Thin appearance, muscle loss, slow/stooped movement, tripod positioning, rapid/shallow breathing, accessory muscle use, wheezing, decreased breath sounds, barrel chest, cyanosis, delayed capillary refill, clubbing, and dyspnea.

What does a respiratory rate of 40-50/min indicate in COPD?

An emergency.

What does a silent chest indicate?

Serious obstruction or pneumothorax.

What can occur with severe COPD involving the heart?

Ankle/foot edema may occur with right-sided heart failure.

What are COPD treatments?

Breathing techniques, effective coughing/positioning, oxygen therapy, smoking cessation, hydration, pulmonary rehabilitation, dietitian support, small frequent high-calorie/high-protein meals, energy conservation, assistance with ADLs, and vaccinations.

What surgical treatments are listed for COPD?

Lung transplantation and lung volume reduction surgery (LVRS).

What does LVRS do?

Removes hyperinflated lung tissue that traps stagnant air to improve gas exchange.