ObjectiveBy the end of this lecture the student should able to

1.Discuss the Pathophysiology Pharyngitis

2. Discuss the Therapeutic Interventions of upper respiratory infection .

3 . Discuss the Nursing care plan for the Patient with an Upper Respiratory Infection

Pharyngitis

Pathophysiology

Inflammation of the pharynx, is usually

related to bacterial or viral infection.

It may also occur as a result of trauma to the tissues.

Etiology

The most common bacterial infection is caused by beta-hemolytic streptococci, commonly referred to as strep throat.

If strep throat is not treated with antibiotics, it can lead to rheumatic fever, glomerulonephritis, or other serious complications

Signs and Symptoms

The most common symptom of pharyngitis is:-

a sore throat.

Some patients may also experience dysphagia (difficulty swallowing).

The throat appears red and swollen.

exudate (drainage or pus) may be present.

Exudate usually signifies bacterial infection and may be accompanied by :-

Fever.

Chills.

headache.

and generalized malaise.

Diagnostic Tests

a throat culture and sensitivity test

to identify the causative organism

and determine which antibiotic will be effective

Therapeutic Interventions

If the pharyngitis is bacterial, antibiotics are ordered.

Acetaminophen or throat lozenges may be used to relieve discomfort.

Saltwater gargles help reduce swelling.

Increased fluids (if not contraindicated) and rest are encouraged.

Laryngitis

Pathophysiology

Laryngitis is an inflammation of the mucous membrane lining the larynx (voice box).

Etiology

irritation from smoking.

alcohol.

chemical exposure .

a viral.

fungal.

bacterial infection.

If often follows an upper respiratory infection.

Signs and Symptoms

The most common symptom is:-

hoarseness.

Cough.

Dysphagia.

fever may also be present

Diagnostic Tests

A physician may use a laryngeal mirror to view the larynx.

If hoarseness persists for more than 2 weeks, a laryngoscopy may be done to rule out cancer of the larynx.

Therapeutic Interventions

Treatment includes :-Rest. fluids. humidified air. and aspirin or acetaminophen. Antibiotics are used if bacterial infection is present. Encourage the patient to avoid speaking to rest the voice.

Obtain a “magic slate” (from the speech therapy department) or paper and pen to help the patient communicate.

Throat lozenges may help increase comfort. Help the patient to identify and avoid causative factors.

Nursing care plan for the Patient with an Upper Respiratory Infection

Nursing Diagnosis: Acute pain related to infectious process

Expected Outcomes Patient will be comfortable .

Interventions

1.Assess for cause of discomfort: malaise, muscle aches, fever.

2. Offer acetaminophen or other analgesic/antipyretics as ordered.

3. Offer throat lozenges and saltwater gargles as ordered for irritated throat.

• Encourage rest

Nursing Diagnosis: alter body temperature more than body requirement related to infectious process

Expected Outcomes :patient with normal body Temperature

Interventions

1. Monitor temperature every 4 hours.

2. If patient begins chilling, recheck temperature when

chilling subsides.

3.Monitor for signs of dehydration: dry skin and mucous

membranes, thirst, weakness, hypotension.

Encourage oral fluids if not contraindicated.

Administer antipyretic such as acetaminophen if fever is higher than (39C) or for discomfort.

Nursing Diagnosis: Risk for infection: transmission to others related to presence of infectious disease

Expected Outcomes Risk for infection of others is reduced, as evidenced by the following:

(1) Patient states measures to prevent transmission.

(2) (2) Patient takes precautions against spread

Interventions

1.Assess patient’s understanding of infection transmission.

2. Based on patient’s previous knowledge, teach patient and all caregivers the importance of good hand washing after contact with patient or patient’s belongings, covering nose and mouth when coughing or sneezing, and not sharing eating or drinking utensils.