N212 Pathophysiology Study Guide Exam 1 Patho physiology (Eastwick College)

Focus Points: Sinusitis ● Etiology - Sinusitis, often called rhinosinusitis, is an inflammation of the mucous membranes of one or more of the sinuses, usually the maxillary or frontal sinus. Swelling of the mucosa can block the drainage of secretions, which can cause a sinus infection. - Sinusitis often occurs after rhinitis and can be associated with a deviated nasal septum, nasal polyps, inhaled air pollutants or cocaine, facial trauma, dental infections, or loss of immune function. - The infection is often caused by a virus, Streptococcus pneumoniae, Haemophilus influenzae, diplococcus, and bacteroides. Medications Nasal decongestants, such as phenylephrine, are used to reduce swelling of the mucosa. Client education - Begin over-the-counter decongestant use at the first manifestation of sinusitis. - Manifestations of rebound nasal congestion can occur if decongestants are used for more than 3 to 4 days. - Broad-spectrum antibiotics, such as amoxicillin, are used on a limited basis for a confirmed causative bacterial pathogen. - Pain relief medications include NSAIDs, acetaminophen, and aspirin. Therapeutic Procedures - Deviated septum repair - Surgical excision of nasal polyps ● Viral vs bacterial treatments for sinusitis The most common sinus infection are viral and account for ~90% of cases. These viral pathogens are often caused by the common cold virus or influenza virus. Viral infections will typically resolve on their own and DO NOT need antibiotics. Voaded_by infections usually resolve with a few weeks w/o antibiotics. Nursing Interventions: Treat the symptoms with NSAID, Saline or corticosteroid nasal sprays, decongestants, oaded_by antihistamines. Surgery may be required if sinusitis becomes a chronic condition (greater than 3 months). Sinus infections can also be caused by bacterial pathogens, but less common (10% of cases). Usually occur due to unresolved viral infections. The bacteria comes from the nose and throat. Antibiotics may be need to the infection. Most common bacterial pathogen is Step Pneumoniae and Hemophilus Influenzae Oral antibiotics used to treat bacterial sinus infections: Amoxicillin, Doxycycline, Levofloxacin. Azithromycin “Z-pack” is overprescribed and not general not recommended due to antibiotic resistance. Sinusitis can also be caused by allergic “allergic sinusitis” and fungal infections although rare. Questions: 1. Q: A nurse is providing care to a client who reports facial pain, including dental pain in the upper teeth. Which of the following additional symptoms would lead the nurse to suspect sinusitis as the source of the pain? A:The client has nasal congestion that does not significantly improve with over-the-counter decongestants or antihistamines. Explanation: The client has nasal congestion that does not significantly improve with over-thecounter decongestants or antihistamines: Persistent nasal congestion despite the use of decongestants or antihistamines is a common symptom of sinusitis, indicating that the source of the problem may be inflammation or infection in the sinuses.