Académique Documents
Professionnel Documents
Culture Documents
Ê
Ô
£mpaired drainage
j Meningitis ,
j Brain abscess,
j ischemic infarction, and
j Osteomyelitis.
?
j Severe orbital cellulitis,
j Subperiosteal abscess, and
j Cavernous sinus thrombosis.
M al Maag
;
The goals of treatment of acute sinusitis are to;
- treat the infection,
- shrink the nasal mucosa, and
- relieve pain.
ð meications
A ^ntibiotics (orally) for two weeks. Longer if needed to
prevent relapse
e.g.- amoxicillin, 1st line
- cothrimoxazole (Bactrim) as
- cephalosporins, 2nd line
- amoxicillin clavulanate (^ugmentin) as
-ciprofloxacin
Ú ^ntibiotics £ in hospital if no response to oral treatmë
Ú decongestant agents
- oral e.g. pseudoephedrine
- Topical e.g. oxymetazoline (^frin) up to 72 hours.
Ú a mucolytic agent e.g. Guaifenesin.
j subperiosteal abscess,
j cavernous sinus thrombosis,
j meningitis,
j encephalitis, an
j ischemic infarction
M al Maag
;
j Medical management of chronic sinusitis is almost the same as for
acute sinusitis. The course of treatment may be 3 to 4 weeks.
jRurgery
Dndoscopic sinus surgery
A ntral irrigation
° Saline solution instilled via 16-gauge needle.
° Patient seated with head forward & mouth open to allow drainage
of purulent irrigating solution.
A alwell-Luc proceure
° £f endoscopic surgery unsuccessful.
° Creates an opening between maxillary sinus & lateral nasal wall.
A xternal sphenoethmoiectomy
j Êost-op Nursing are
A Gauze packing 24-48 hours post-op.
A ?pper lip & teeth numbness for several months.
A £mpaired chewing on affected side.
A Liquids only first 24 hours post-op.
° Followed by soft diet
A ^void for 2 weeks after removal of packing
° Dentures
° alsalva maneuver
G ral iursg ar ;
AGenerally no packing required
AFrequent nasal cleaning & irrigation
°Sterile normal saline
ATeach
°Open mouth sneezing
°^void blowing nose
°^void lifting or straining
j increasing fluid intake, and applying local heat (hot wet
packs).
j Remi-Fowler·s position
A Relieves pain.
"#!
j ^cute pharyngitis is an inflammation or infection in the throat,
usually causing symptoms of a sore throat.
Caus a Êa
slg
j Most cases of acute pharyngitis are caused by viral infection.
j When group beta-hemolytic streptococcus, the most
common bacterial organism, causes acute pharyngitis, the
condition is known as strep throat
j The body responds by triggering an inflammatory response in
the pharynx.
j This results in pain, fever, vasodilation, edema, and tissue
damage, manifested by redness and swelling in the tonsillar
pillars, uvula, and soft palate. ^ creamy exudate may be present
in the tonsillar pillars.
Clal Ma sas;
j a fiery-re pharyngeal membrane an tonsils,
j streptolysin titers,
j and throat cultures.
j Nasal swabs and blood cultures may also be
necessary to identify the organism.
M al Maag
;
º Supportive measures for iral pharyngitis.
º ^ntimicrobial agents (penicillin) for Bacterial
pharyngitis at least 10 days.
º ^nalgesic agent e.g. aspirin or acetaminophen
(Tylenol) can be taken at 3- to 6-hour intervals.
º ^ liquid or soft diet.
º ^ntitussive medication e.g. codeine,
dextromethorphan (Robitussin DM), or
hydrocodone bitartrate (Hycodan).
iursg Maag
;
- Bed rest.
- Proper tissue disposal.
- Warm saline gargles or irrigations with a temperature of
105°F to 110°F (40.6°C to 43.3°C)
- ^n ice collar.
- Teach about the complication.
C
las;
Ñ sinusitis,
Ñ otitis meia,
Ñ peritonsillar abscess,
Ñ mastoiitis, an
Ñ cervical aenitis
j £n rare cases the infection may lead to bacteremia,
pneumonia, meningitis, rheumatic fever, or
nephritis.
ë Ô! "#!
£t is a persistent inflammation of the pharynx.
£t is common in adults who work or live in usty
surrounings, use their voice to excess, suffer from
chronic cough, an habitually use alcohol an tobacco
hree types of chronic pharyngitis are recognizedO
ypertrophicO-general thickening and congestion of the
pharyngeal mucous membrane
trophicO probably a late stage of the first type (the
membrane is thin, whitish, glistening, and at times
wrinkled)
hronic granular (´clergyman·s sore throatµ):
characterized by numerous swollen lymph follicles on the
pharyngeal wall.
Clal Ma sas;
-a constant sense of irritation or fullness in the throat,
- mucus that collects in the throat and can be expelled by coughing, and
- difficulty swallowing.
M al Maag
;
j is based on
-relieving symptoms,
- avoiing exposure to irritants, an
- correcting any upper respiratory, pulmonary, or cariac conition
that might be responsible for a chronic cough
j Nasal sprays or medications containing ephedrine sulfate (Kondon·s
Nasal) or phenylephrine hydrochloride (Neo-Synephrine).
j ^ntihistamine decongestant medications, such as Drixoral or
Dimetapp, is taken orally every 4 to 6 hours.
j ^ntiinflammatory and analgesic agent like ^spirin or acetaminophen
iursg Maag
;
j avoid contact with others until the fever subsides.
j ^lcohol, tobacco, second-hand smoke, and
exposure to cold are avoided.
j The patient may minimize exposure to pollutants
by wearing a disposable facemask.
j drink plenty of fluids.
j Gargling with warm saline solutions