Nokea
The nurse is creating a plan of care for a patient diagnosed with acute laryngitis. What intervention should be included in the patients plan of care?
- A. Place warm cloths on the patients throat, as needed.
- B. Have the patient inhale warm steam three times daily.
- C. Encourage the patient to limit speech whenever possible.
- D. Limit the patients fluid intake to 1.5 L/day.
Correct Answer: C
Rationale: Management of acute laryngitis includes resting the voice, avoiding irritants (including smoking), resting, and inhaling cool steam or an aerosol. Fluid intake should be increased. Warm cloths on the throat will not help relieve the symptoms of acute laryngitis.
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The ED nurse is assessing a young gymnast who fell from a balance beam. The gymnast presents with a clear fluid leaking from her nose. What should the ED nurse suspect?
- A. Fracture of the cribriform plate
- B. Rupture of an ethmoid sinus
- C. Abrasion of the soft tissue
- D. Fracture of the nasal septum
Correct Answer: A
Rationale: Clear fluid from either nostril suggests a fracture of the cribriform plate with leakage of cerebrospinal fluid. The symptoms are not indicative of an abrasion of the soft tissue or rupture of a sinus. Clear fluid leakage from the nose would not be indicative of a fracture of the nasal septum.
The nurse is providing patient teaching to a patient diagnosed with acute rhinosinusitis. For what possible complication should the nurse teach the patient to seek immediate follow-up?
- A. Periorbital edema
- B. Headache unrelieved by OTC medications
- C. Clear drainage from nose
- D. Blood-tinged mucus when blowing the nose
Correct Answer: A
Rationale: Patient teaching is an important aspect of nursing care for the patient with acute rhinosinusitis. The nurse instructs the patient about symptoms of complications that require immediate follow-up. Referral to a physician is indicated if periorbital edema and severe pain on palpation occur. Clear drainage and blood-tinged mucus do not require follow-up if the patient has acute rhinosinusitis. A persistent headache does not necessarily warrant immediate follow-up.
A patient states that her family has had several colds during this winter and spring despite their commitment to handwashing. The high communicability of the common cold is attributable to what factor?
- A. Cold viruses are increasingly resistant to common antibiotics.
- B. The virus is shed for 2 days prior to the emergence of symptoms.
- C. A genetic predisposition to viral rhinitis has recently been identified.
- D. Overuse of OTC cold remedies creates a rebound susceptibility to future colds.
Correct Answer: B
Rationale: Colds are highly contagious because virus is shed for about 2 days before the symptoms appear and during the first part of the symptomatic phase. Antibiotic resistance is not relevant to viral illnesses and OTC medications do not have a rebound effect. Genetic factors do not exist.
The nurse is caring for a patient who needs education on his medication therapy for allergic rhinitis. The patient is to take cromolyn (Nasalcrom) daily. In providing education for this patient, how should the nurse describe the action of the medication?
- A. It inhibits the release of histamine and other chemicals.
- B. It inhibits the action of proton pumps.
- C. It inhibits the action of the sodium-potassium pump in the nasal epithelium.
- D. It causes bronchodilation and relaxes smooth muscle in the bronchi.
Correct Answer: A
Rationale: Cromolyn (Nasalcrom) inhibits the release of histamine and other chemicals. It is prescribed to treat allergic rhinitis. Beta-adrenergic agents lead to bronchodilation and stimulate beta-3-adrenergic receptors in the smooth muscle of the bronchi and bronchioles. It does not affect proton pump action or the sodium-potassium pump in the nasal cells.
The nurse is creating a care plan for a patient who is status post-total laryngectomy. Much of the plan consists of a long-term postoperative communication plan for alaryngeal communication. What form of alaryngeal communication will likely be chosen?
- A. Esophageal speech
- B. Electric larynx
- C. Tracheoesophageal puncture
- D. American sign language (ASL)
Correct Answer: C
Rationale: Tracheoesophageal puncture is simple and has few complications. It is associated with high phonation success, good phonation quality, and steady long-term results. As a result, it is preferred over esophageal speech, and electric larynx or ASL.