Unit 1 Nasal and laryngeal obstruction PRESENTED BY

Unit 1 Nasal and laryngeal obstruction PRESENTED BY: REVIEWED BY: Ms. Pavithra K Mr. Jobin Lecturer, MSN dept Asst. Professor, MSN dept

LEARNING OBJECTIVES At the end of the class students will be able to • define nasal obstruction • Enlist the causes of nasal obstruction • list down the clinical features of nasal obstruction • enumerate the management of nasal obstruction • define Laryngeal obstruction • enumerate the management of Laryngeal obstruction

Nasal obstruction

Definition • Nasal obstruction refers to some blockage of the nose or nasal cavity and can be caused by swelling of the nasal tissue or an anatomical blockage which results in a narrowing of the nasal cavity and the feeling of the passages being congested.

causes Temporary causes : • Chronic sinusitis • Allergic rhinitis • Environmental irritants, such as smoke or dust • Cold or flu • Foreign body

Anatomical factors • Deviated nasal septum • Enlarged turbinates • Nasal polyps • Enlarged adenoids • Nasal tumors (benign or cancerous)

Signs and symptoms • • • Nasal congestion Rhinorrhoea stuffiness Difficulty in breathing Trouble sleeping Absent sense of smell

Management • Nose irrigation • Use of humidifier using inhaler which Moistens the air and keeps the nasal passages open. • Stuffy nose -Blow the nose remove secretions. • Drinking plenty of water: Liquid helps to keep mucous flowing.

• Do not smoke: Outside irritants can worsen congestion. • Sleep on side or propped up with pillows: Laying on back can encourage mucous build-up. • Topical nasal steroids- betamethasone • Oral antihistamines- diphenhydramine • Antibiotics

Surgical management • • Radiofrequency turbinate ablation Septoplasty FESS Turbinate Reduction

LARYNGEAL OBSTRUCTION

Definition • Airway obstruction • Laryngeal obstruction is a blockage in any part of the airway

Etiology • Inflammatory : – Acute laryngitis – Abscess • Traumatic : – Foreign bodies – Trauma to the larynx by external injuries, endoscopy and intubation – Inhalation of irritant fumes – Neoplastic

Clinical manifestations • • • Airway obstruction laryngospasm Irritation Cough Expectoration of blood or mucus

Management Medical management : • administering subcutaneous epinephrine • corticosteroid • applying ice pack to the neck • Symptomatic treatment – Bronchodialotors – Oxygen therapy

Foriegn body - The Heimlich maneuver • person standing behind the person who is choking, • wrapping their arms around the choking person’s waist. • Make a fist and place it in the xiphoid • press into the person’s abdomen with five quick thrusts.

Nursing Diagnosis • Ineffective airway clearance related to respiratory secretions • Ineffective Breathing Pattern related to hypoxia as evidence by shortness of breath

EVALUATION • • • What is nasal obstruction. What are the causes of nasal obstruction. Enlist the clinical features of nasal obstruction. Explain the management of laryngeal obstruction

REFERENCE • Smeltzer – Brunner & Suddharth Textbook of Medical Surgical Nursing, Wolters kluwer publishers, 12 th edition 2009. • Black – Medical Surgical Nursing, Elsevier publishers, 8 th edition 2009. • Nettina – Lippincott manual of Nursing Practice, Wolters kluwer publishers, 7 th edition 2014. • Lewis – Medical Surgical Nursing, Elsevier publishers, 10 th edition, 2017