LATEST FINAL EXAM TOPICS - MEDSURG.?✅✅

NASAL FRACTURE - CX: airway obstruction, epistaxis, CSF leak, septal hematoma, deformity ● manifestations: pain, crepitus, swelling, bleeding, hematoma, difficulty breathing ○ raccoon eyes (ecchymosis around eyes) sugg ...

NASAL FRACTURE - CX: airway obstruction, epistaxis, CSF leak, septal hematoma, deformity ● manifestations: pain, crepitus, swelling, bleeding, hematoma, difficulty breathing ○ raccoon eyes (ecchymosis around eyes) suggests basilar skull fracture ○ clear, pink tinged or persistent draining suggests CSF leak ● management: sit upright, apply ice 10-20 min intervals, Acetaminophen/Tylenol, decongestants, humidifier, AVOID hot showers and alcohol for first 48 hrs, quit smoking EPISTAXIS/NOSEBLEED ● Causes: low humidity, blood coagulopathy, sinusitis, foreign bodies, drugs, tumors ● may be prolonged if using Aspirin, NSAIDs, warfarin, anticoagulants ● management: sit upright slightly leaning forward with head forward, squeeze nostrils 5-15 mins ○ pledget (nasal tampon), lidocaine (numbs), epinephrine (vasoconstriction), oxidized cellulose (surgical), gelatin foam (gelfoam), gelatin-thrombin combo 
(floseal), silver nitrate ○ nasal packing → risk for infection of Staph Aureus ○ Acetaminophen/Tylenol w/ Codeine for pain ○ sneeze w/ mouth open ○ avoid aspirin/NSAIDs ALLERGY MEDS ● pseudoephedrine/sudafed → tachycardia, increased BP = sympathetic stimulation ● Second gen antihistamines (--DINE and --ZINE) → less drowsy ● First gen antihistamines (--MINE) → sleepy VIRAL RHINITIS ● usually caused by rhinovirus and self-limiting ● can also be caused by coxsackievirus, adenovirus = more severe illness ● airborne droplets ● no antibiotics unless secondary bacterial infection (after first 3 days and worse sx: fever 103, tender/swollen glands, severe ear/face/body pain, green purulent nose drainage) INFLUENZA ​→ A&B significant in humans, A is most common and deadly - animals ● direct or indirect contact w/ infected animals ● droplet and inhalation ● Common complications: primary viral pneumonia, secondary bacterial pneumonia and ear/sinus infections - worse bc harder to manage ● Viral culture & sensitivity is gold standard for testing ● Vaccination is most effective prevention strategy → don’t give if allergic to eggs ○ TIV injection- for at risk pts: chronic med conditions, elderly, immunocompromised, pregnant○ Live attenuated: nasal spray & for healthy individuals ● Antiviral meds: zanamivir/relenza-inhaler, oseltamivir/tamiflu-oral, peramivir/rapivab-IV SINUSITIS​ - inflammation/swelling blocks openings in sinuses (viral, bacterial, fungal) ● rhinosinusitis = sinusitis + inflammation/infection of nasal mucosa ● Viral sinusitis - usually resolves W/O tx in less than 14 days → if sx worsen after 3-5 days or 10+days then might be secondary bacterial infection ● Bacterial sinusitis: Streptococcus pneumoniae, haemophilus Influenzae, Moraxella Catarrhalis ○ AMOXICILLIN ● Acute sinusitis findings: edematous mucosa, discolored purulent nasal drainage, enlarged turbinates, tenderness over sinuses, halitosis = bad breath, recurrent HA ACUTE PHARYNGITIS - inflammation of the tonsils, palate, and uvula (viral, bacterial, fungal) ● Viral pharyngitis - most common ○ tx: ibuprofen or acetaminophen for pain, increase fluids ● Bacterial pharyngitis (“strep throat” - Group A B-Hemolytic Streptococci ○ heart: rheumatic fever, rheumatic heart disease ○ kidneys: acute glomerulonephritis/renal failure ○ manifestations: Fever 100, Enlarged lymph nodes, Yellow pus/exudate patches on tonsils/pharynx, NO cough → if 2+ sx present then do C&S to determine cause ○ tx: PENICILLIN ● Fungal pharyngitis: candidiasis → prolonged antibiotic use or corticosteroid use ○ white, irregular patches on oropharynx ○ tx: NYSTATIN swish & swallow for pharynx ○ rinse mouth after using corticosteroids to decrease risk of fungal pharyngitis ● symptom relief: gargle w/ warm saltwater, drink warm/cold liquids, suck on popsicles, hard candies, or throat lozenges ● NO citrus juices HEAD AND NECK CANCER: squamous cell carcinoma most common → smoking, alcohol, viruses, chemicals ● CANCEROUS LYMPH NODES: Immovable, painless, hard