laryngeal edema.ppt

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Obstruction of the upper airway:

Obstruction of the upper airway Acute & chronic laryngeal edema Monika ( clinical instructor) Army college of nursing

Acute laryngeal edema:

Acute laryngeal edema It is acute inflammation of the laryngeal mucosa due to infection, allergy or inhalation of irritant materials. It causes obstruction to air flow & dyspnea.

Cont……………..d:

Cont……………..d This condition is manifested by hoarseness & shortness of breathe. ,dyspnea progress rapidly. Endotracheal intubation may be very difficult due to edematous laryngeal wall. Emergency tracheostomy may be required. Subcutaneous epinephrine 1: 1000 is beneficial. i/v corticosteroids are also used.

Chronic laryngeal edema:

Chronic laryngeal edema Chronic laryngeal edema may occur when lymph drainage is obstructed. Obstruction is done with infection or tumor. If severe edema is significant ,an artificial airway may be required. It can be through tracheosotomy or an endotracheal tube .

Slide 5:

CHRONIC AIRWAY OBSTRUCTION NASAL POLYPS

INTRODUCTION :

INTRODUCTION (nasal mucosa ) or sinuses It may occur as solitary or multiple lesions. Nasal polyps are out pouching of mucous membrane lining the nose or para nasal sinuses. Nasal polyps are sac-like growths of inflamed tissue lining the nose

etiology:

etiology Nasal polyps typically start near the ethmoid sinuses and grow into the open areas. Large polyps can block the sinuses or nasal airway. People with the following conditions are more likely to also have nasal polyps: Chronic sinus infections Hay fever

Clinical manifestation:

Clinical manifestation People with nasal polyps often complain about having a cold that has lasted for months or years. Symptoms include: Mouth breathing Nasal obstruction Reduced or complete loss of sense of smell Runny nose Headaches or pain are NOT common unless there is also a sinus infection.

Exams and Tests :

Exams and Tests Inspection of nasal cavity reveals greyish grape-like mass in the nasal cavity. A Ct- Scan of the sinuses will show opaque (cloudy) spots where the polyps are.

Medical management:

Medical management Medications help relieve symptoms but rarely get rid of nasal polyps. Nasal steroid sprays may help in nasal blockage or runny nose, but symptoms return if treatment is stopped. Corticosteroid pills or liquid may also improve symptoms. Antibiotics should only be taken if there is a bacterial sinus infection. Some people may need surgery, such as functional endoscopic sinus surgery (FESS).

Cont………………….d:

Cont………………….d Attempts of medical management is made to reduce the size of the polyps.

Surgical management:

Surgical management In many clients ,surgery is needed to remove nasal polyps in order to restore to restore nasal breathing . Nasal polypectomy is usually performed with the use of a local anesthetic. The anesthetic eliminates discomfort while also producing vasoconstriction to minimize bleeding during the procedure.

Cont……………d:

Cont……………d The bleeding sites are cauterized & intranasal packing is inserted. The nasal packing is maintained for several hours to minimize the possibility of post operative bleeding. It is removed before discharge of the client. Because of the presence of nasal packing & edema ,client need to breathe through their mouth for the first 24 to 48 hours.

Cont………………….d:

Cont………………….d The use of humidification ,frequent mouth care & increasing oral fluids helps to minimize the dryness. Inspect the effectiveness of these measures. The client is placed in a semi fowlers to high fowlers position after surgery to minimize edema & to control bleeding. In addition ,continuous use of ice compress in the immediate post op period ,nasal bleeding should be minimal.

Cont……………d:

Cont……………d the client should be assessed for vital signs. Most client experience only minimal discomfort after nasal polypectomy. So mild analgesics may be given for post op discomfort. The use of aspirin should be avoided because of their anticoagulant effect. Instruct the client not to blow nose & to avoid sneeze. when there is stimulus to sneeze ,the client can sneeze by mouth.

Possible Complications :

Possible Complications Infection Nasal polyps may come back

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