UPPER RESPIRATORY TRACT

INFECTIONS
 It includes
• Rhinitis
• Sinusitis
• Pharyngitis
• Laryngitis
• Tonsillitis
 DEFINITION:

• Rhinitis is inflammation and swelling of

the mucous membrane of the nose,
characterized by a runny nose and
stuffiness and usually caused by
the common cold or a seasonal allergy.
 TYPES
• Rhinitis is classified as:
1. Allergic rhinitis : Allergic rhinitis is caused by a reaction
of the body’s immune system to an environmental
trigger. The most common environmental triggers
include dust, molds, pollens, grasses, trees, and animals.
Both seasonal allergies and year-round allergies can
cause allergic rhinitis.
2. Non- allergic rhinitis: It may be caused by a variety of
factors, including environmental factors such as changes
in temperature or humidity, odors, or foods; infection;
age; ; drugs (cocaine) or prescribed medications; or the
presence of a foreign body
 CAUSES

• Environmental or occupational irritant

such as dust, perfumes, chemical etc.
• Weather changes
• Infection most commonly viral
infection.
• Food and beverages
• Certain medication
• Hormonal changes
 PATHO-PHYSIOLOGY
Due to allergen, infection or other reason

Immediate and delayed release of number of

mediators (eg. Histamine)

Increase mucus secretion

Nasal congestion and pressure

Rhinitis
 SIGN AND SYMPTOMS

• Itchy nose, mouth, eyes, throat, skin, or

any area
• stuffiness,
• Rhinorrhea (Runny nose)
• Sneezing
• Tearing eyes
• Fatigue
• Headache
• Coughing
 Investigations and Diagnosis

• History and physical examination

• X- ray study
• Blood test
• Allergic skin test
 Management
• Antihistamine: such as Chlorpheramine
• Nasal corticosteroid: for inflammation of nasal
mucosa
• Nasal decongestant: nasal spray to reduce
swelling of nasal mucosa.
• Oral decongestant.
 Nursing management
• Advice patient to avoid allergen.
• The nurse give instructions to patient about
use of medication.
• Nurse advice patient to avoid transmission of
infection.
• Advice patient to avoid over use of nasal
decongestant.
 DEFINITION:

• Sinusitis is inflammation of the

sinuses, most commonly caused
by a viral or bacterial infection or
by an allergy.
 Types
1. Acute sinusitis
• Sinusitis is defined as acute if it is totally resolved
in less than 30 days In people who have a normally
functioning immune system, acute sinusitis is
usually caused by a viral infection.
2. Chronic sinusitis
• Sinusitis is defined as chronic if it has been
ongoing for more than 90 days. Doctors do not
understand exactly what causes chronic sinusitis,
but it involves factors that cause chronic
inflammation
 CAUSES:
• Viral infection
• Bacterial infection
• Fungal infection
• Allergic rhinitis
• Nasal polyps or tumours
• Deviated nasal septum
Nasal polyp
PATO-PHYSIOLOGY
Due to etiological factors

Inflammation and enema of sinus

Obstruction of sinus cavity

Sinusitis
 SIGN AND SYMPTOMS
Acute and chronic sinusitis cause similar symptoms,
including:
• Yellow or green pus discharged from the nose
• Fever
• Swelling or redness around your eyes
• Severe headache
• Pressure and pain in the face
• Congestion and blockage in the nose
• Tenderness (pain when touched) and swelling over the
affected sinus
• Reduced ability to smell (hyposmia)
 Diagnosis
• History and physical examination
• X ray
• Endoscopy
 Management
• Antibiotic therapy or anti viral medication
• Nasal decongestant
• Antihistamines
• Inhalation
 SURGICAL MANAGEMENT:
ANTRUM PUNCTURE:

• IT IS DONE to irrigate sinus cavity through

normal saline
 Nursing management
• Pain management
• Airway maintanance
 LIFE STYLE AND HOME REMEDIES
• Get plenty of rest
• Drink plenty of fluids
• Steam sinus cavities
• Apply warm compresses to face
• Sleep with your head elevated
• Pharyngitis is inflammation of the pharynx,
which is in the back of the throat. It’s most
often referred to simply as “sore throat.”
• Pharyngitis can also cause scratchiness in the
throat and difficulty swallowing.
• It usually occurs when bacteria or virus from
rhinitis or sinusitis involve throat.
 TYPES
1. Acute or chronic pharyngitis: acute
pharyngitis last less then week and casued
by viral infection while chronic
pharyngitis last longer.
2. Bacterial or viral pharyngitis: bacterial
pharyngitis is caused by bacterial
infection while viral pharyngitis is caused
by viral infection
 Conti…
• Other types of pharyngitis:
1. Nonexudative pharyngitis: Nonexudative
pharyngitis is an inflammation of the back of
the throat (pharynx) that is not accompanied by
the accumulation of thick mucous material or
pus in or on the throat tissues
2. Exudative pharyngitis: This may cause
significant lymph-node swelling with marked
redness and swelling of the throat.
3. Ulcerative pharyngitis: it is a condition found in
association with the ulcer in throat.
 CAUSES:
1. Viral infections
• Viral illnesses that cause a sore throat include:
• Common cold
• Flu (influenza)
• Mono (mononucleosis)
• Measles
• Chickenpox
• Croup — a common childhood illness
characterized by a harsh, barking cough
• Whooping cough (pertussis)
 Causes Cont…

2. Bacterial infections
• A number of bacterial infections can cause a
sore throat. The most common is
Streptococcus pyogenes (group A
streptococcus) which causes strep throat.
 Cause Cont..
Other causes
• Allergies.
• Dryness.
• Irritants.
• HIV infection.
 Risk Factors

• Cold and flu seasons

• Having close contact with someone who
has a sore throat or cold
• Smoking or exposure to second hand
smoke
• Frequent sinus infections
• Allergies
PATHO-PHYSIOLOGY
Due to etiological factors

Bacterial or viral infection of throat

Antibody production by body

Antigen and antibody reaction

Inflammation of pharynx

Pharyngitis
 Signs and Symptoms
• Sore throat
• Sneezing
• Cough
• A low fever (less than 102 °F)
• Earache
• Sore throat with flu
• Fatigue
• Swollen lymph node
• Difficulty in speaking and swallowing
• Breathing difficulty
 DIAGNOSTIC FINDINGS
Tests that may be done include:
• History and physical examination
• Blood culture or throat culture
• Complete blood count (CBC)
• Neck x-ray
 MEDICAL MANAGEMENT
• Antibiotics therapy like
erythromycin Amoxicillin
• Corticosteroids like dexamethsone
• Analgesics like acetaminophen and
NSAIDS
 NURSING MANAGEMENT
• ADVICE PATIENT:
• Rest..
• Drink Plenty of fluids.
• Try comforting foods and beverage. Warm liquids —
broth, caffeine-free tea or warm water with honey
• Gargle with saltwater.
• Humidify the air.
• Avoid irritants. Keep your home free from cigarette
smoke and cleaning products that can irritate the
throat.
• Avoid infecting others
 Definition
• Laryngitis is an inflammation of your voice box
(larynx) from overuse, irritation or infection.
• It mostly occurs due to infection but some
times caused by irritation or over use.
• It can be acute or chronic, although in most
cases the condition is temporary and has no
serious consequences.
 Types
1. Acute laryngitis: most cases of laryngitis are
temporary and short term and it is resolved
when cause is treated.
2. Chronic laryngitis: Chronic laryngitis is often
caused by lifestyle factors, such as ongoing
exposure to irritants
 Causes
• Bacterial infection
• Viral infection
• Inhaled irritant such as chemical, allergen or
smoke.
• Pharyngitis
• Excessive use of vocal cord
PATHO-PHYSIOLOGY
Due to etiological factors

Bacterial or viral infection of throat

Antibody production by body

Antigen and antibody reaction

Inflammation of larynx

Laryngitis
 Clinical manifestation
• Sore throat
• A low-grade fever
• Hoarseness
• Trouble speaking
• A dry cough
• A constant urge to clear your throat
• Swollen glands
 Diagnosis
• History and physical examination
• Laryngoscopy. Doctor can visually examine
your vocal cords in a procedure called
laryngoscopy, by using a light and a tiny mirror
to look into the back of your throat
• Biopsy. If doctor sees a suspicious area, he or
she may do a biopsy — taking a sample of
tissue for examination under a microscope.
 Management
• Antibiotics. In almost all cases of laryngitis, an
antibiotic won't do any good because the
cause is usually viral. But if you have a
bacterial infection, doctor may recommend an
antibiotic.
• Anti viral for viral infection
• Corticosteroids. Sometimes, corticosteroids
can help reduce vocal cord inflammation.
 Nursing management
• Breathe moist air. Use a humidifier to keep the air
throughout home or office moist. Inhale steam from a
bowl of hot water or a hot shower.
• Rest voice as much as possible. Avoid talking or singing
too loudly or for too long. If you need to speak before
large groups, try to use a microphone or megaphone.
• Drink plenty of fluids to prevent dehydration (avoid
alcohol and caffeine).
• Moisten throat. Try gargling with salt water or chewing a
piece of gum.
• Avoid whispering. This puts even more strain on your
voice than normal speech does.
• Lemon and honey mixure
TONSILLITIS:
 DEFINITION:

• Tonsillitis is an inflammation of the

tonsils most commonly caused by
viral or bacterial infection.
 TYPES OF TONSILLITIS
• Acute tonsillitis:
• Chronic tonsillitis:
 CAUSES:
• Inflammation of the tonsils may result from
bacterial or viral infections.
• Bacterias: Tonsillitis is often caused by Group
A streptococcal bacteria, resulting in strep
throat.
• Virus: Tonsillitis may be caused by viruses
such as the Epstein-Barr virus
PATHO-PHYSIOLOGY
Due to etiological factors

Bacterial or viral infection of throat

Antibody production by body

Antigen and antibody reaction

Inflammation of tonsil

Tonsillitis
 Signs and symptoms
• Red, swollen tonsils
• White or yellow coating or patches on the
tonsils
• Sore throat
• Difficult or painful swallowing
• Fever
• Enlarged, tender glands (lymph nodes) in the
neck
• Bad breath
• Stiff neck
• Headache
 ASSESSMENT AND
DIAGNOSTIC FINDINGS
• History and physical examination
• Throat swab culture
Rapid strep test
Throat swab culture
 MEDICAL MANAGEMENT
• NSAIDs: Anti-inflammatory, pain relief, and fever
tackling medicines such as ibuprofen, acetaminophen,
and aspirin
• Antibiotics. : If tonsillitis is caused by Group A Beta-
Hemolytic Streptococci, antibiotics like penicillin,
amoxicillin, erythromycin, or clindamycin
• Anti viral for viral infection
• Rest
• Hydration
 Surgical management
• Tonsillectomy: Tonsillectomy is
surgical procedures performed to
remove the tonsils.
 Nursing management
• Breathe moist air. Use a humidifier to keep the air
throughout home or office moist. Inhale steam from a
bowl of hot water or a hot shower.
• Rest voice as much as possible. Avoid talking or singing
too loudly or for too long. If you need to speak before
large groups, try to use a microphone or megaphone.
• Eat smooth food:
• Drink plenty of fluids to prevent dehydration (avoid
alcohol and caffeine).
• Moisten throat. Try gargling with salt water or chewing a
piece of gum.
• Avoid whispering. This puts even more strain on your
voice than normal speech does.
 Pre and post operative care:
• Special point for post of care:
• Give prone position.
• Apply ice collar.
• Observe for bleeding.
• Give liquid diet initially.
• Provide ice collar for vasoconstriction.
• Give analgesics for pain