Sinusitis, Laryngitis,

and pharyngitis

Prepared by;
John Micahel Orias SN UM
 Objectives:
 Within 30 mins. Of my discussion, my co-student nurse
will be able to:
 To discuss what is sinusitis and its types and according
to its location
 To know what are the primary causes of sinusitis
 To discuss what is the pathophysiology sinusitis
 Know the difference between laryngitis and pharyngitis
 To discuss what are the pathophysiology of laryngitis
and pharyngitis
 And to discuss its primary causes
 To know what are the medical management and its
prevention
 Sinusitis

What are sinuses?

 The sinuses are cavities, or air-filled pockets,
near the nasal passage. Like the nasal
passage, the sinuses are lined with mucous
membranes. There are four different types of
sinuses
 four different types of sinuses:

 ethmoid sinus - located inside the face, around the

area of the bridge of the nose. This sinus is present
at birth, and continues to grow.
 maxillary sinus - located inside the face, around the
area of the cheeks. This sinus is also present at birth,
and continues to grow.
 frontal sinus - located inside the face, in the area of
the forehead. This sinus does not develop until
around 7 years of age.
 sphenoid sinus - located deep in the face, behind
the nose. This sinus does not develop until
adolescence
What is sinusitis?

Sinusitis is an infection of the sinuses

near the nose. These infections
usually occur after a cold or after
an allergic inflammation.
There are four types of sinusitis:

 acute - symptoms of this type of infection last less

than four weeks and get better with the appropriate
treatment.
 subacute - this type of infection does not get better
with treatment initially, and symptoms last four to
eight weeks.
 chronic - this type of infection happens with repeated
acute infections or with previous infections that were
inadequately treated. These symptoms last eight
weeks or longer.
 recurrent - three or more episodes of acute sinusitis a
year
 Acute sinusitis
Pathophysiology

 An infection of the paranasal sinuses.

 Because there is unresolved viral or bacterial
infection, or exacerbation of allergic rhinitis it
frequently develop.
 Nasal congestion, caused by inflammation,
edema and transudation of fluids, leads to
obstruction of the sinus cavities
Signs and symptoms
 Facial pain  Dental pain
 Pressure in the affected  Cough
sinus area  Decreased sense of
 Nasal obstruction smell
 Fatigue  Sore throat
 Purulent  Eyelid edema
 Nasal discharge  Facial congestion of
 Fever fullness
 Headache
 Ear pain or fullness
How is sinusitis diagnosed?
 sinus x-rays
 computed tomography (Also called CT
or CAT scan.)
 cultures from the sinuses
Treatment for sinusitis:
 antibiotics (antibiotics are usually given for at
least 14 days)
 Amoxicillin
 Antihistamines
 acetaminophen (for pain or discomfort)
 a decongestant (i.e., pseudoephedrine
[Sudafed®]) and/or mucus thinner (i.e.,
guaifenesin [Robitussin®])
 cool humidifier in your child's room
 nasal spray to reduce inflammation
surgery
 Surgery should be considered only if other
treatments have failed.
 endoscopic sinus surgery
Complication

 Meningitis
 Brain abscess
 Ischemic infarction
 osteomyelitis
Chronic sinusitis

 An inflammation of the sinuses that persists

for more than 3 weeks in an adult and 2
weeks in a children.
 It is estimated that 32 million people a year
develop chronic sinusitis
Pathopysiology

 Narrowing or obstruction in the ostia of the

frontal, maxillary and anterior ethmoid
sinuses. preventing adequate drainage to the
nasal passage.
 The combined is known as the osteomeatal
complex.
 The blockage that persists for greater than 3
weeks because infection, allergy, or structural
abnormalities.
Signs and symptoms
 Impaired mucociliary clearnce and ventilation
 Cough
 chronic hoarseness
 Chronic headaches in the periorbital area
 Fatigue, nasal stuffiness, decrease smell and
taste
 Usually in the morning
prevention
 Perform hand hygiene often
 Use disposable tissues
 Avoid crowds during the flu season
 Avoid individuals with colds or respiratory infection
 Obtain influenza vaccination, if recommended
 Practice good health habits
 Eat nutritious foods
 Get plenty of sleep and rest
 Avoid or reduce stress if possible
 Exercise appropriately
 Avoid smoking or second-hand smoke and
excessive intake of alcohol
 Increase humidity of the house
 Practice adequate hygiene
 Avoid allergens are associated with upper
respiratory infections
 Reduced irritants (dust, chemical, tabacco
smoke) when possible
 Limit exposure to animals and house pets
 Laryngitis
 An inflammation of the larynx, often occurs as
a result of voice abuse or exposure to dust,
chemicals, smoke, and other pollutant.
 It may also caused by isolated infection
involving only the vocal cords
Causes:
 Temperature changes
 Dietary deficiencies
 Malnutrition
 Immunosuppressed state
 Acute laryngitis:
 Viral infection such as those cause a cold
 Vocal strain, caused by yelling or over using
of voice
 Bacterial infections
 Chronic Laryngitis:
 Inhaled irritants, such as chemicals fumes,
allergens and smoking
 Acid reflux, also called gastro esophageal
reflux disease GERD
 Chronic sinusitis
 Excessive alcohol abuse
 Habitual overuse of your voice
 Smoking
 Clinical manifestation:
 Tickling sensation and rawness of your throat
 Sore throat
 Dry throat
 Dry cough
 Acute: Hoarseness and aphonia
 Chronic: Severe cough
 Medical Management:
 Resting of voice
 Avoiding or smoking cessation
 Inhaling cool steam or an aerosol
 Avoiding second-hand smoking
 Topical corticosteroids (vanceril)
 Nursing management:
 Instruct the patient to rest the voice
 Maintain well humidified environment
 If secretion is present: expectorant
 Increase oral fluid intake up to 3L/day
Medication

 Antibiotics

 Corticosteroids
Test and Diagnosis

 Laryngoscopy

 Biopsy
Nursing Diagnosis;
 Impaired verbal communication
 Hypertermia
 Impaired swallowing
 Imbalance nutrition less than
bodyrequirments
Acute Pharyngitis

- Is an infection or inflammation in the throat,

usually caused by a viral organism.
- Common in patient younger than 25 years old
Pathophysiology
 The inflammatory response results in the
throat, with pain, fever, vasodilatation,
edema, and tissue damage (redness and
swelling, in the tonsillar pillars, uvula, and soft
palate ).
 Pharyngitis caused by streptococcus is a
more severe illness because of dangerous
complications
 Signs and Symptoms

 Feiry red pharyngeal membrane and tonsils.

 Lymphoid follicles swollen and freckled with
white-purple exudate
 Cervical lymph nodes enlarged and tender
 Fever, malaise, and sore throat
 Hoarseness
Diagnostic Methods

 Rapid screening test for streptococcal

antigens
 optical immunoassay
 Steptolysin titers
 Throat cultures
 nasal swabbing and blood cultures
Medical Management

 Antibiotic agents- to treat pharyngitis caused

by bacteria.(Penicillin and Cephalosphorin)
 Analgesic and antitussive medications
 liquid or soft diet is recommended
 IV fluid is given if patient cannot swallow
 Nursing Management
 Encourage bed rest during febrile stage of
illness
 Implement secretion precautions to prevent
spread of infection
 Administer warm saline gargles or irrigations to
ease pain.
 Performed mouth care to prevent fissures of lips
and inflammation of the mouth
 Inform patient and family of symptoms to watch
for that may indicate development of
complications, including nephritis and rheumatic
fever.
 Chronic Pharyngitis
common in:
 Adults who work or live in dusty surrounding
 Use their voices to excess
 Chronic cough
 Habitually use alcohol and tobacco
Signs and Symptoms

 Constant sense of irritation or fullness in the

throat.
 Mucous that collects in the throat and is
expelled by coughing
 Difficulty swallowing
Medical Management

 Treatment is based on symptoms relief,

avoidance of exposure to irritants
 Nasal sprays- to relieve nasal congestion
 Aspirin or Acetaminophen- to control
inflammation and relieve discomfort
 Nursing Management
 Advise patient to avoid contact with others until
fever has subsided completely to prevent
infection from spreading
 Instruct patient to avoid alcohol, tobacco,
secondhand smoke, exposure to cold, and
environmental and occupational pollutant.
 Suggest to wear disposable mask for protection
 Encourage to increase OFI and encourage
gargling with warm salt water to relieve throat
discomfort
Nursing Diagnoses
 hyperthermia
 Impaired oral mucous membrane
 Impaired swallowing
Prognosis
A sore throat usually goes away quickly on its own. If you
have had a sore throat for more than a week, or you have
a fever, swollen lymph nodes, or a rash, you should call
your doctor right away. Fever, swollen lymph nodes, or a
rash may indicate strep throat or a complication such as
rheumatic fever
 Nursing process:
 Assessment
 With upper airway infection; sinusitis,
laryngitis, and pharyngitis
 A health assessment may reveal sign and
symptoms:
 Head ache
 Sore throat
 Pain around the eyes on either side of the
nose
 Difficulty of swallowing
 Cough
 Hoarseness
 Fever
 Stuffiness
 Generalized discomfort
 Fatigue

 Inspection may reveal:

 Swelling, redness, ulceration, lesion,
evidence of drainage, enlargement,
asymmetry of the nose as well as bleeding or
discharge
 Palpation
 Tenderness
 Inflammation
 Enlargement of the lympnodes
 Nursing Diagnosis:

 Ineffective airway clearance related to

excessive mucus production secondary to
retained secretion and inflammation
 Acute pain related to upper airway irritation
secondary to infection
 Impaired verbal communication related to
physiologic changes and upper airway
irritation secondary to infection or swelling
 Deficient fluid volume related to increase fluid
loss secondary to diaphoresis associated with
fever
 Deficient knowledge regarding prevention of
the upper respiratory infection treatment
regimen, surgical procedure, of post
operative
 Planning goals:

 Maintenance of a patent airway

 Relief of pain
 Maintenance of effective means of
communication
 Normal hydration
 Knowledge of how to prevent upper airway
infection
 Absence of complications
 Nursing intervention:

 Maintaining a patent airway

 Promoting comfort
 Promoting communication
 Encouraging fluid intake
 Health teaching
 Evaluation

 Maintains a patent airways by managing

secretions
 Reports of felling more comfortable
 Demonstrate ability to communicate needs
and wants, level of discomfort
 Maintains adequate fluid intake
 Identifies strategies of preventions
 Free from sig and symptoms
 thank you for
listening!!!! 