UPPER AIRWAY

INFECTIONS
BY
STELLA APPIAH (MRS.), PhD, RN, FWACN, FGCNM
DEPARTMENT OF NURSING, VVU, OYIBI
INTRODUCTIONS
 These are conditions that are common and
affect most people occasionally
 Some of the conditions are acute with

symptoms that last for a long time or recur.

 Patients who suffer from these conditions

normally do not require hospitalization

 It is very important for nurses to recognize

these conditions since they are more likely

to encounter them in their day to day
activities.
LESSON OBJECTIVES
By the end of the lesson, students should be
able to
 Describe the common upper respiratory

conditions
 Describe nursing management of patients

with upper respiratory disorders using the

nursing process
 Differentiate one condition from the other

based on cause, incidence, clinical

manifestation, management and significance
of preventive health care.
RHINITIS
 Rhinitis is a group of disorders characterized
by inflammations and irritations of the
mucous membranes of the nose.
 It may be classified as nonallergic and

allergic
 Rhinitis may be acute or chronic
CAUSES
Nonallergic rhinitis may be caused by a variety of
factors. Including the following
 Environmental factors such as changes in

temperature or humidity
 Odors

 Foods

 Infections

 Age

 Systemic disease

 Drugs

 Foreign body
CAUSES CONT’D
 Rhinitis also may be a manifestation of
allergy, in which case it is referred to as
allergic rhinitis.
PATHOPHYSIOLOGY
 The pathophysiologic process in rhinitis
happens this way, the mucous membrane
lining the nasal passages become inflamed,
congested, and edematous
 The swollen nasal conchae block the sinus

opening and mucous is discharged from the

nostrils.
CLINICAL MANIFESTATIONS
 The signs and symptoms include Rhinorrhea
(excessive nasal drainage, runny nose)
 Nasal congestion
 Nasal discharge (purulent if it is bacterial

rhinitis)
 Nasal itchiness
 Sneezing
 Headaches may occur
MEDICAL MANAGEMENT
 The management depend on the cause which may
be identified during history taking and physical
examination
 If the cause is due to virus, then medications are
given to relieve the symptoms
 If bacterial, then antibiotics are prescribed.
 Medication therapy for allergic and nonallergic
rhinitis focuses on the symptoms.
 Antihistamines are administered for sneezing,
itching and Rhinorrhea
 Oral decongestants are given nasal congestion. In
addition, intranasal corticosteroids may be used.
NURSING MANAGEMENT
Using the nursing process the nurse does the
following
 Assessment: History taking and Physical

examination
 Nursing Diagnosis: Come out with both

actual and potential diagnosis

 Planning of care: What are your outcomes

and priority of care?

CONT’D
Implementation: Patient Teaching (self care)
 Instruct a patient with allergic rhinitis to

avoid or reduce exposure to the allergens

and irritants such as dust, spray, fumes,
odors, powders, tobacco etc. The patient is
instructed about the importance of
controlling the environment at home and
work place.
CONT’D
Saline application or spray may be useful in
the nasal lining. Instruct the patient on the
proper use of medication s that have been
prescribed. The patient is taught to blow the
nose before applying medications.
 Patient is taught to prevent reinfection in

cases of infectious rhinitis.

CONT’D
 Client is instructed to take in more fluids
and fruits
 Instruct to observe good hand hygiene to

prevent reinfection.
 Evaluation: Has objectives been met? If not,

do reassessment.
VIRAL RHINITIS
 The term “common cold” is used when referring
to upper respiratory tract infection that is self-
limited and caused by virus.
 The condition is characterized by nasal
congestion, rhinorrhea, sneezing, sore throat and
general malaise.
 Specifically the term “cold” refer to an afebrile,
infectious, acute inflammation of the mucous
membranes of the nasal cavity.
 Colds are highly contagious because viruses are
shed for about 2 days before the symptoms
appear.
CAUSES
Six viruses are said to be responsible for
causing the condition. These are:
 Rhinovirus
 Para influenza virus
 Corona virus
 Respiratory syncytial virus
 Influenza virus
 Adenovirus
CONT’D
 Viral rhinitis can occur at any time during
the year but become very common during
the dry seasons.
 The immunity after recovery is variable and

depend on many factors including the

person’s natural host resistance and the
specific virus that cause it.
CILINICAL
MANIFESTATIONS
 The sign and symptoms of viral rhinitis are
nasal congestion, runny nose, sneezing,
nasal discharge, nasal itchiness, tearing
watery eyes, scratchy or sore throat,
general malaise, low grade fever, chills and
often headaches and muscle aches.
 As the illness progress, cough may appear.

In some people herpes simplex or cold sores

may appear.
 The symptoms last from one to two weeks.
CONT’D
 If there is significant fever then the disease
is progressing to be other upper respiratory
disorder.
MEDICAL MANAGEMENT
 There is no specific treatment for common
cold or influenza.
 Management is symptomatic and consist of
providing adequate fluid intake, encouraging
rest, increasing intake of vitamin C and
preventing chills
 Expectorants are needed
 Warm salt water gargle can be of help
 Anti-inflammatory agents such as Aspirin or
Brufen can relieve the aches and pains and
fever in adults.
CONT’D
 Antihistamines are used to relieve sneezing,
rhinorrhea, and nasal congestion.
 Topical or nasal decongestants can help to

relieve the nasal congestion but must be

used with caution
 Some lozenges may help at the initial

stages.
NURSING MANAGEMENT
PATIENT TEACHING:
 Teach patient how to break the chain of

infection because during sneezing large

volume of particles are suspended in the air.
 Hand washing remains the most potent

means of preventing reinfection.

 Use disposable tissue, avoid crowds

 Eat a nutritious diet, reduce stress during this

period, exercise appropriately, practice

adequate oral hygiene, avoid allergens,
provide warmth
ACUTE SINUSITIS
 This is inflammations of the sinuses
 Sinusitis affect about 14% of the population

and accounts for high cost of care.

 There are some individuals who are more

prone to sinusitis due to their kind of work

example continuous exposure to hazards
such as paint, sawdust, and other
chemicals.
 Sinusitis may be acute or chronic
PATHOPHYSIOLOGY
 Acute sinusitis is an inflammation of the
paranasal sinuses.
 It frequently develops as a results of an upper
respiratory infection such as unresolved viral or
bacterial infections or an exacerbation of allergic
rhinitis.
 Nasal congestion caused by inflammation,
edema and transudation of fluid, leads to
obstruction of the sinus cavities. This provides an
excellent medium for the growth of bacterial.
 Bacterial organisms accounts for about 60% of
the cases of acute sinusitis.
CAUSES
 Streptococcus pneumoniae
 Haemophilus influenza
 Moraxella catarrhalis
 Dental infections also have been associated

with acute sinusitis

CLINICAL MANIFESTATION
 The symptoms of acute sinusitis may
include the following:
 Facial pain or pressure over the affected

sinus area
 Nasal obstruction
 Fatigue
 Purulent nasal discharge
 Fever
CONT’D
 Headaches
 Ear pain and fullness
 Dental pain
 Cough
 Decreased sense of smell
CONT’D
 Sore throat
 Eyelid edema
 Facial congestion or fullness
 It may be difficult to differentiate acute

sinusitis from other upper respiratory

conditions or allergic rhinitis
ASSESSMENT AND DIAGNOSTIC
FINDINGS
 A careful history and physical examination are
performed. The head and neck, particularly the nose,
ear, teeth, sinuses, pharynx and chest are examined.
They may be tender to palpate over the sinus area.
 The sinuses are percussed using index finger,
tapping lightly to determine if the patient
experiences pain.
 Sinus x-rays may be performed to detect sinus
opacity, mucous thickening, bone destruction and
air- filled levels.
 CT Scan of the sinuses is the most effective
diagnostic tool. It is also used to rule out other local
or systemic disorders such as tumor, fistula
COMPLICATION
 Acute sinusitis, if left untreated may lead to
severe and occasionally life-threatening
complications such as meningitis, brain
abscess, Ischemic infarction, and
osteomylitis
 Other complications which are uncommon

are severe orbital cellilitis, subperiostal

abscess
MEDICAL MANAGEMENT
 The goal of management is to treat the infections
and shrink the nasal mucosa and relieve the pain.
 Careful use of antibiotics to ensure effective
treatment. Examples are Amoxicillin,
Erythromycin
 Cephalosporin such as cefuroxime
 Newer antibiotics on the market can also help in
the management
 Use of oral and topical decongestant agents may
decrease mucosal swelling of nasal polyps
thereby improving drainage of the sinuses.
CONT’D
 Antihistamines may be used if an allergic
components is suspected.
 If symptoms persist for 7-10 days the

sinuses may need to be irrigated and

hospitalization may be required.
NURSING MANAGEMENT
TEACHING PATEINTS SELF-CARE
 Instruct the patient about the method of

draining the sinuses by inhalation of steam

 Increase fluid intake
 Apply local heat over the sinus area
 The nurse should advise the patient about

the importance of following the treatment

regimen
 The nurse educates the patient about the

signs and symptoms of the condition

CHRONIC SINUSITIS
 This is inflammation of the sinuses that
persists for more than 3 weeks in an adult
and 2 weeks in a child.
 It is estimated that 32 million people

worldwide develop chronic sinusitis yearly

PATHOPHYSIOLOGY
 Narrowing or obstruction in the Ostia of the
frontal, maxillary, and anterior ethmoidal
sinuses causes chronic sinusitis preventing
adequate drainage into the nasal passages.
 Blockage that persist for greater than 3 weeks
in an adult may occur because of infection,
allergy, or structural abnormalities.
 This result in stagnate secretion of an ideal
medium for infection. The organisms that
cause acute sinusitis are the same
complicated in this situation.
CLINICAL MANIFESTATION
This include:
 Impaired mucocilliary clearance and

ventilation
 Cough
 Chronic hoarseness
 Chronic headaches in the per orbital area
 Facial pain

These symptom are more pronounced when

patient awakes in the morning
CONT’D
 Fatigue
 Nasal stuffiness
 Some patients experience decrease sense

of smell
ASSESSMENT AND DIAGNOSTIC
FINDINGS
 A careful history and physical examination
are performed. The head and neck,
particularly the nose, ear, teeth, sinuses,
pharynx and chest are examined. They may
be tender to palpate over the sinus area.
 CT Scan
 Magnetic Resonance Imaging
 Nasal endoscopy
COMPLICATIONS
 Severe orbital cellulitis
 subperiostal abscess
 Meningitis
 Encephalitis
 Ischemic infarction
MEDICAL MANAGEMENT
 Is almost like acute sinusitis
 Use of antibiotics like Amoxicillin,

Augmentin, or Ampicillin
 Decongestant agents
 Antihistamines
 Saline spray
SURGICAL MANAGEMENT
 When standard medical therapy fail,
surgery, usually endoscopic which may be
to correct the structural deformities that
obstruct the Ostia (opening) is done
 Excising and cauterizing nasal polyps
 Correcting a nasal septum
 Incising and draining the sinuses
 Removing tumors
 Antimicrobial agents are administered

before and after surgery.

SINUPLASTY
ASSIGNMENT
 Discuss the nurses responsibility before and
after surgical management of chronic
sinusitis.
 Discuss Epistaxis as an upper respiratory

tract disorder.
PHARYNGITIS
 Pharyngitis is the inflammation of the
pharynx
 It can be acute or chronic
ACUTE PHARYNGITIS
 Acute pharyngitis or infection in the throat,
usually causing symptoms of a sore.
CAUSES:
 Most acute cases of pharyngitis are caused

by viral infection. The condition can also be

caused by A beta-hemolytic streptococcus
in this case the condition is referred to as
Strep throat.
PATHOPHYSIOLOGY

 The body responds by triggering an inflammatory

response in the pharynx. This results in pain,
fever, vasodilation, edema and tissue damage.
This is manifested by redness and swelling in the
tonsillar pillars, uvula, and soft palate. A creamy
exudates may be present in the tonsillar pillars.
 Uncomplicated viral infections usually subside
promptly within 3 to 10 days after the onset.
However, if caused by the group A beta-
streptococci then it is a more severe illness.
 If left untreated the complications can be severe
and life threatening.
CLINICAL MANIFESTATION
 The signs and symptoms include fiery-red
pharyngeal membrane and tonsils,
lymphoid follicles that are swollen and
flecked with white-purple exudate, and
enlarged and tender cervical lymph nodes
and no cough.
 Fever, malaise and sore throat may also be

present.
COMPLICATIONS
 Sinusitis
 Otitis media
 Peritonsillar abscess
 Mastoiditis
 Cervical adenitis
 In rare cases the infection may lead to

bacteremia, pneumonia, meningitis,

rheumatic fever or nephritis.
ASSESSMENT AND DIAGNOSTIC
FINDINGS
 Screening should be done to isolate
streptococci with Enzyme immunoassay
 Throat culture should be done to determine

the causative organism.

 Nasal swabs
 Blood culture to identify the organism
MEDICAL MANAGEMENT
 If the cause is isolated to be viral, then
supportive measures will be given since
antibiotics cannot help.
 Bacterial pharyngitis can be managed with
variety of antibiotics. Some of these are
Penicillin which is the treatment of choice.
 If the client reacts to penicillin then other
antibiotics can be used for between 7-10
days.
 Sore throat can also be relieved by analgesic
medications e.g. Aspirin Paracetamol
CONT’D
 Antitussive medications in the form of
Codeine can also be for the persistent
cough.

 Liquid or soft diet is provided during the

acute stage depending on the patient’s
level of appetite and the degree of
discomfort upon swallowing. The patient is
encouraged to drink bit by bit.
 If swallowing is very difficult intravenous

fluids can be administered.

NURSING MANAGEMENT
 Instruct the patient to stay in bed during
febrile stage to rest frequently
 Tissues should be used ones
 Used tissues should be disposed properly to
prevent spread of infection
 Warm saline gargle or irrigation is done
depending on the severity of the condition.
The temperature of the solution should be
high.
 Instruct client to care for the mouth properly
 Instruct the patient to comply with treatment.
CHRONIC PHARYNGITIS
 This is a persistent inflammation of the
pharynx.
 It is very common in adults who work or live

in dusty surroundings, use their voices too

excessively, suffer chronic cough and use
tobacco and alcohol
TYPES
There are three types of chronic pharyngitis that
are recognized. These are
 Hypertrophic: which is characterized by general

thickening and congestion of the pharyngeal

mucous membrane.
 Atrophic: it is the late stage of the previous

phase. There is thin, whitish, glistening, and at

times wrinkled membrane.
 Chronic granular: This is sometimes referred to

as “Clergyman’s sore throat”. It is characterized

by numerous swollen lymph follicles on the
pharyngeal wall.
CLINICAL MANIFESTATIONS
 There is constant sense of irritation or
fullness in the throat
 Mucous collection in the throat which can

be expelled by cough
 Difficulty in swallowing
MEDICAL MANAGEMENT
 This is based on relieving symptoms and
avoiding exposure to irritants. There should be
correction of any condition of the upper
respiratory tract that cause persistent
coughing.
 Nasal spray containing Ephedrine can be used
to relieve the nasal congestion
 If there is allergy antihistamine can be used
 Paracetamol or Aspirin can be used due to their
analgesic and anti inflammatory properties.
 Lozenges can also be used.
NURSING MANAGEMENT
 Instruct the patient to avoid contact with
others until condition subside
 Instruct patient to avoid alcohol, tobacco,

reduce exposure to pollutants,

 Encourage patient to drink a lot of water
 Gargling with warm saline water can help

reduce the throat discomfort.

LARYNGITIS
 This is an inflammation of the larynx.

CAUSES
 This often occur as a result of voice abuse,

exposure to dust, chemicals, smoke and

other pollutants or as part of an upper
respiratory tract infection.
 Infection of the vocal cord
 The cause of infection is always a virus.

Bacterial invasion is a secondary cause.

CONT’D
 The condition is associated with allergic
rhinitis or pharyngitis.
 The onset of the infection may be

associated with exposure to sudden

temperature changes, dietary deficiency,
malnutrition and an immunosuppressed
state. Laryngitis is easily transmitted to
others.
CLINICAL MANIFESTATIONS
 Acute laryngitis is characterized by
Hoarseness of the voice or Aphonia
 Severe cough
 Chronic laryngitis is marked by persistent

hoarseness of the voice

MEDICAL MANAGEMENT
 Testing of the voice
 Avoiding smoking
 Inhalation of steam or aerosol
 Appropriate antibiotics can be administered
 Resting the voice if the condition is chronic
 The condition normally resolves with conservative
treatment but if it is in an elderly or some one with
pneumonia then more attention should be paid to
the management.
 Topical corticosteroids inhalation may be used.
 Expectorant agents are given if laryngeal secretions
are present
NURSING MANAGEMENT
 Instruct the patient to rest the voice
 Tell patient to maintain a well humidified

environment
 Encourage copious fluid intake if patient can

tolerate.
TONSILLITIS AND
ADENOIDITIS
 Tonsillitis is the inflammation of the tonsils.
 The tonsils frequently serve as a site of

acute infection.
 Chronic tonsillitis is less common and may

be mistaken for other disorders.

 The common cause of tonsillitis is group A

beta-streptoccoci infection
 Adenoiditis always accompany tonsillitis
 It is common in children and adolescents.
CLINICAL MANIFESTATIONS
 Sore throat
 Chills
 Fever
 Malaise
 Snoring
 Difficulty in swallowing
 Enlarged adenoids may cause mouth

breathing earache, draining ear, frequent

colds, foul-smell breath, voice impairment
and noisy respiration
CONT’D
 Enlarged adenoids fill the space behind the
posterior nares making it difficult for air to
travel from the nose to the throat resulting
in nasal obstruction
 Infection can extend to middle ear by way

of the auditory tube and may result tin

acute Otitis media, which can lead to
spontaneous rapture of the eardrum
 The condition can extend to other parts of

the of the mastoid cells causing mastioditis.

ASSESSMENT AND DIAGNOSTIC
FINDINGS
 Thorough physical examination is done
 Careful history is taken
 Tonsillar site is cultured to determine the

presence of bacterial infection

MEDICAL MANAGEMENT
 Oral penicillin is the drug of choice.
 Tonsillectomy is the removal of the tonsils
when medical management fail.
 Enlargement of the tonsil is rarely an
indication for its removal
 Most children have naturally enlarged tonsils
but they shrink with age.
 Adenoidectomy can also be performed and is
only indicated if the patient has had bouts of
tonsillitis or hypertrophy of the tonsils or the
adenoids that can cause obstruction
CONT’D
 Appropriate antimicrobial agents are
prescribed for those going for the operation
and it is taken for 7 days. Examples of such
drugs are, Penicillin Amoxicillin,
NURSING MANAGEMENT
POST-OPERATIVE CARE
 Continuous nursing observation is required in the

immediate post operative and recovery periods

because of the significant risk of hemorrhage.
 Put client in a prone position with the head turn

to one side in the immediate periods of the post

operative care because this is the most
comfortable of all the positions
 Do not remove the oral airway until the patient’s

gag and swallowing reflexes have returned

CONT’D
 Apply an ice pack to the neck and provide
sputum mug for client for expectoration of
blood and mucus.
 Observe the expectorants of the blood

which will be bright red if the patient brings

them from the throat. It may however look
brown if it has gone through the digestive
tract.
CONT’D
 Observe for hemorrhage which is a common
complication of tonsillectomy. If the patient
vomits large amount of dark blood or bright-
red blood at frequent intervals or if the
pulse rate and temperature readings rise,
and if the patient becomes restless, notify
the surgeon immediately.
CONT’D
 Examine the surgical site for bleeding
 If bleeding is severe the patient may be taken to
the theatre for resuturing or ligation by the
surgeon.
 When patient comes back to the ward
continuous monitoring is important to ensure
that the patient is in good condition.
 If there is no bleeding, water and ice chips may
be given to client as soon as possible. The
patient is refrain from too much talking and
coughing because these activities can produce
pain and discomfort in the throat.
CONT’D
PATIENT TEACHING
 Tonsillectomy/adenoidectomy do not require long

hospitalization.
 This will therefore require some form of

education on the part of the patient and relatives

so that at home they can recognize the signs and
symptoms that denote danger.
 Patient is told to report any bleeding to the

facility
 Mouth wash and warm saline solutions are useful

to manage halitosis that occur after the surgery

CONT’D
 It is important to explain to the patient that
bleeding, sore throat stiff neck, and
vomiting are common things that are likely
to occur within the first 24 hours.
 Liquid, followed by semi-liquid diets are

served for several day till patient is able to

swallow very well. Patient should avoid
spicy, acidic, or rough foods. Milk and milk
products may be restricted because they
may make removal of mucous very difficult.
CONT’D
 Patient should be told that halitosis and
some ear pains may be present for the first
few days.
 Instruct the patient to avoid rigorous tooth

brushing or gargling which can cause

bleeding
PERITONSILLAR ABSCESS
 This is the collection of purulent exudates
between the tonsillar capsule and the
surrounding tissues including the soft
palate.
 It is believed to develop after an acute

tonsillitis which progress to a local cellulitis

and abscess.
CLINICAL MANIFESTATION
 Fever
 Pain
 Raspy voice
 Odynophagia (severe sensation of burning,
squeezing pain while swallowing)
 Dysphagia
 Otalgia and Drooling
 Swelling of the soft palate upon examination
which often occlude almost half of the mouth
opening into the pharynx
 There is tonsillar hypertrophy and dehydration
ASSESSMENT AND DIAGNOSTIC
FINDINGS
 Aspiration of the purulent material by
needle aspiration is required to make
appropriate diagnosis through culture and
Gram’s stain.
 A CT scan is done if it is not possible to do

aspiration
MEDICAL MANAGEMENT
 Antibiotics are usually prescribed and can resolve
the abscess without incision

SURGICAL MANAGEMENT:
 If treatment delay the abscess is evacuated by

spraying with anesthetic agents and several needle

aspirations done to decompress the abscess.
 The abscess may also be incised and drained which

is best done when patient is in a sitting up position

 If these measures fail as in about 30% of patients,

tonsillectomy will be done.

NURSING MANAGEMENT
 Saline mouth wash and gargles are best
 Instruct client to gargle at the rate of 1 to 2

hours intervals for 24 hours

 Serve liquids that are easily tolerated
 Topical agents are encouraged.
NURSING PROCESS OF PATEINTS
WITH UPPER AIR WAY INFECTION
ASSESSMENT:
 Health history to find out the signs and

symptoms of any upper respiratory

infection. Determine the when the
symptoms started so that you can have an
idea about the onset and how long the
symptoms have persisted, what precipitated
the unset, what relieves the and aggravates
the symptoms. Determine any history of
allergy or the existent of any concomitant
illness.
CONT’D
 Inspection the nose, throat, tonsils, pharynx
to reveal abnormalities of the upper
respiratory tract such as swelling, bleeding,
polyps, mucosa for redness, exudates
 Palpate the sinuses for tenderness and the

trachea to determine the midline position in

the neck and also to determine masses or
deformities. Palpate the lymph nodes for
enlargement and tenderness.
NURSING DIAGNOSIS
 Based on the findings from the assessment,
the patients major nursing diagnosis may
include the following:
 Ineffective airway clearance related to

excessive mucus production secondary to

retained secretions and inflammation
 Acute pain related to upper air way irritation

secondary to infection
 Alteration in comfort related to pain in the

throat due to infection .

CONT’D
 Impaired verbal communication related to
physiologic changes and upper air way irritation
secondary to infection or swelling
 Fluid volume deficit/deficient related to
increased fluid loss secondary to diaphoresis
associated with fever.
 Alteration in nutrition less than body
requirement related to difficulty in swallowing
secondary to sore throat.
 Deficient knowledge regarding prevention of
upper respiratory infection, treatment, surgical
procedure or post operative care.
PLANNING
 The major goal for the patient may include
maintenance of a patent airway, relief pain,
maintenance of effective means of
communication, adequate nutrition, normal
hydration, knowledge of how to prevent
upper air way infections and absence of
complications
NURSING INTERVENTIONS
MAINTAINING A PATENT AIRWAY
Nurses can implement several interventions to
maintain airway by losing the thick secretions or
keep them moist so that they can easily be
expectorated.
 Increase fluid intake to help thin the mucus
 Encourage steam inhalation
 Instruct the patient to assume the best position

that help drainage of the secretions as in sinusitis

 Serve prescribed medications that are for nasal or

throat congestion
CONT’D
PROMOTING COMFORT
 Encourage the patient to use topical

applications that will relieve the pains

 Hot packs to relieve discomfort
 Warm water gargle to relieve pains
 Encourage client to rest enough to relieve

general malaise
 Instruct patient to maintain general hygiene

to prevent spread of infection

 Encourage the use of ice packs if necessary.
CONT’D
PROMOTING COMMUNICATION
 Instruct patient to refrain from talking or

speaking as much as possible

 Encourage patient to communicate in

writing
 Encourage patient to use signs where

possible to promote communication

 Explain to significant others the need to

help the client to refrain from talking

CONT’D
ENCOURAGING FLIUD INTAKE
 Instruct client to take in more fluids whether

cold or hot.
 Encourage patient to take 2-3 liters of water

a day
 Serve warm beverages to client
 Encourage client to take in other drinks

he/she can tolerate

 Monitor fluid intake and out put
 Check the client for signs of dehydration
CONT’D
PROMOTING ADEQUATE NUTRITION
 Encourage client to clean the mouth
 Serve light or liquid diet according to the

patient’s tolerant level

 Serve foods free from spices
 Ensure that the environment is free from

bad odor
 Serve food in small quantities at a time
 Serve food whenever client demands it
 Serve food attractively
CONT’D
PROVIDING KNOWLEDGE ON PREVENTION
 Teaching patient self-care: Instruct patient to observe

good hand hygiene, adequate oral hygiene, use one

tissue at a time, dispose tissue appropriately after
use
 Avoid exposure to others who are at risk, avoid crowd

that have the potential to infect you, eat nutritious

diet, having good rest, avoid smoking and second
hand smoking, avoid intake of alcohol, avoid
exposure to irritants and allergies
 Teach client about the causes, signs and symptoms,

complications and relieving measure and the need to

comply with prescribed medications.
EVALUATION
 EXPECTED PATIENT OUTCOMES
 This may include:

1. Maintaining a patent airway by managing

secretions
 Report decreased congestion
 Assume best position to encourage drainage

2. Report feeling more comfortable

 Uses comfort measures such as ice packs,
gargles, hot packs, analgesics
 Demonstrate adequate oral hygiene
CONT’D
3. Demonstrate ability to communicate needs,
wants and level of comfort
4. Maintain adequate fluid intake
5. Maintain adequate nutritional intake
6. Identifies strategies to prevent upper airway
infections and allergies
 Demonstrate hand hygiene techniques

 Demonstrate adequate level of knowledge and

performs self-care adequately

 Becomes free of signs and symptoms of

infections
SUMMARY AND
CONCLUSIONS
 Upper respiratory condition are very common
and similar to each other. One needs to know
the causes, signs and symptoms,
complications in order to differentiate one
condition from the other.
 The nursing process is the best approach in
the nursing management of patients having
upper respiratory tract infections.
 The process needs to be practiced
continuously in order for one to be familial
with the use.