CH. 18: Management of Patients with Upper Respiratory Tract

The nurse is providing client teaching to a young parent who has brought their 3-month-old infant to the clinic for a well-baby checkup. Which recommendation will the nurse make to the client to prevent the transmission of organisms to the infant during the cold season?

• Wash hands frequently.

• Gargle with warm salt water regularly.

• Dress self and infant warmly.

• Take preventative antibiotics as prescribed.

A client visiting the clinic is diagnosed with acute sinusitis. To promote sinus drainage, the nurse should instruct the client to perform which action?

• Apply a cold pack to the affected area.

• Apply heat to the forehead.

• Perform postural drainage.

• Increase fluid intake.

The nurse is creating a plan of care for a client diagnosed with acute laryngitis. Which intervention should be included in the client's plan of care?

• Place warm washcloths on the client's throat, as needed.

• Have the client inhale warm steam three times daily.

• Encourage the client to limit speech whenever possible.

• Limit the client's fluid intake to 1.5 L/day.

A client is being treated in the emergency department for epistaxis. Pressure has been applied to the client's midline septum for 10 minutes, but the bleeding continues. The nurse should anticipate using which treatment to control the bleeding?

• Irrigation with a hypertonic solution

• Nasopharyngeal suction

• Normal saline application

• Silver nitrate application

The nurse is planning the care of a client who is scheduled for a laryngectomy. The nurse should assign the highest priority to which postoperative nursing diagnosis?

• Anxiety related to diagnosis of cancer

• Altered nutrition related to swallowing difficulties

• Ineffective airway clearance related to airway alterations

• Impaired verbal communication related to removal of the larynx

The home care nurse is assessing the home environment of a client who will be discharged from the hospital shortly after a laryngectomy. The nurse should encourage the client to use which appliance during recovery at home?

• A room humidifier

• An air conditioner

• A water purifier

• A radiant heater

The nurse is caring for a client whose recent unexplained weight loss and history of smoking have prompted diagnostic testing. Which symptom is most closely associated with the early stages of laryngeal cancer?

• Hoarseness

• Dyspnea

• Dysphagia

• Frequent nosebleeds

The nurse is caring for a client who needs education on medication therapy for allergic rhinitis. The client is to take cromolyn daily. In providing education for this client, how should the nurse describe the action of the medication?

• It inhibits the release of histamine and other chemicals.

• It inhibits the action of proton pumps.

• It inhibits the action of the sodium-potassium pump in the nasal epithelium.

• It causes bronchodilation and relaxes smooth muscle in the bronchi.

The nurse is caring for a client who presents with a severe nosebleed. The site of bleeding appears to be the anterior portion of the nasal septum. The nurse instructs the client to tilt the head forward, and the nurse applies pressure to the nose, but the client's nose continues to bleed. Which intervention should the nurse next implement?

• Apply ice to the bridge of the nose.

• Lay the client down.

• Arrange for transfer to the local emergency department.

• Insert a cotton tampon in the affected nare.

The emergency department (ED) nurse is assessing a young gymnast who fell from a balance beam. The gymnast presents with a clear fluid leaking from the nose. Which condition should the ED nurse suspect?

• Fracture of the cribriform plate

• Rupture of an ethmoid sinus

• Abrasion of the soft tissue

• Fracture of the nasal septum