Exam 2 Review-finished. GRADED A
1) Child with allergic rhinitis
○ patho: exposure to sensitizing agent, body initiates inflammatory response releasing
histamines and leukotriene. Blood vessels of nasal mucosa vasodilate causing increase
permeability to affected area
○ causes swelling and nasal congestion
○ exhibit a triad of signs:
i) the allergic shiner-a darkening of the lower eyelid because of suborbital
edema)
ii) the allergic crease-a transverse line above the
tip and below the bridge of the nose
iii) the allergic salute (frequent wiping of the nose with the palm of the hand)
Other signs commonly present are a nasal quality to the voice, constant
coughing from a postnasal drip, chapped lips, and a dry mouth from mouth
breathing.
○ Can be infectious or non-infectious: Infectious = common cold. Non = allergic (seasonal)
and nonallergic (pregnancy, inhaled drugs, humidity)
2) Anti-histamine that doesn’t cause drowsiness
○ Allegra (can be in the form of nasal spray or saline spray)
○ (1st gen = benedryl, 2nd gen = allegra – no drowsiness, fatigue, or dry mouth)
Side effects: anticholinergic effects (dry mouth, constipation), GI
discomfort (N/V, constipation), Acute toxicity (flushed face, high fever,
tachycardia, dry mouth, urinary retention, pupil dilation), excitation,
hallucinations, incoordination, and seizures
*SEDATION EFFECT*
○ -Use with caution with clients with asthma, urinary retention,
open-angle glaucoma, hypertension, and BPH
○ -can cause respiratory depression
○ -Do not give to clients with cardiac dysrhythmias, hepatic disease,
and MAOI therapies
,Exam 2 Review-finished. GRADED A
3) Teaching for client w/allergic rhinitis
○ keep windows closed*
○ run air conditioning*
○ remove carpeting to reduce pollen and humidity. *
○ remove pets if possible, If unable to remove pet, keep it out of the bedroom*
○ do not use feather pillows, and put pillows in
zippered, dust proof encasings, Replace feather or
down-filled covers and pillows with synthetic
items*
○ wash linen in hot water*
○ POLLENS
i) • Avoid freshly cut grass; do not mow the lawn. • Keep windows and doors closed
during allergy season. • Shower after outdoor activities to remove pollen from
clothing and skin.
○ MOLDS
, Exam 2 Review-finished. GRADED A
i) • Clean damp areas frequently, at least once a week, with a chlorine bleach
solution. • Ventilate areas well (bathrooms, kitchens, and basements).
• Consider a dehumidifier if living in a humid climate.
○ PETS
i) • Reduce cat allergen by bathing the cat every two weeks
○ IRRITANTS
i) • Avoid cigarette smoke, perfumes, aerosol sprays, strong cleaning products
4) Tonsillectomy: know what to expect after and
what is abnormal post op
Diagnostics:
○ Throat culture for group A strep. & bacterial infection
○ CT if infection present to see if it spread to neck region
○ Pre-op CBC to assess for anemia/infections
Tonsillectomy Education:
○ Report= signs of hemorrhage, fever, excessive vomiting of bright red blood, unrelieved
pain, excessive coughing or swallowing (means a child can be swallowing blood)-
abnormal
○ pt will have pain, difficulty swallowing, and
difficulty talking
○ Drink minimum 8 glasses of water a day
○ Soft foods for first few days
○ Avoid smoking & heavy lifting
○ No gargling – can irritate surgical site
○ Sore throat is expected for approximately 1 week postop
○ Provide pain control with analgesics and ice collar postop
○ Offer clear, chilled fluids or ice pops to relieve pain and reduce inflammation when
awake and alert
○ avoid red-colored liquids because emesis of these fluids could be mistaken for blood
5) Pneumonia risk factors
○ from slide: most at risk for pneumonia os sickle cell
pt with a cough!
○ Acute or chronic infection of one or both lungs caused by bacteria or virus, upper
respiratory infection
1) Child with allergic rhinitis
○ patho: exposure to sensitizing agent, body initiates inflammatory response releasing
histamines and leukotriene. Blood vessels of nasal mucosa vasodilate causing increase
permeability to affected area
○ causes swelling and nasal congestion
○ exhibit a triad of signs:
i) the allergic shiner-a darkening of the lower eyelid because of suborbital
edema)
ii) the allergic crease-a transverse line above the
tip and below the bridge of the nose
iii) the allergic salute (frequent wiping of the nose with the palm of the hand)
Other signs commonly present are a nasal quality to the voice, constant
coughing from a postnasal drip, chapped lips, and a dry mouth from mouth
breathing.
○ Can be infectious or non-infectious: Infectious = common cold. Non = allergic (seasonal)
and nonallergic (pregnancy, inhaled drugs, humidity)
2) Anti-histamine that doesn’t cause drowsiness
○ Allegra (can be in the form of nasal spray or saline spray)
○ (1st gen = benedryl, 2nd gen = allegra – no drowsiness, fatigue, or dry mouth)
Side effects: anticholinergic effects (dry mouth, constipation), GI
discomfort (N/V, constipation), Acute toxicity (flushed face, high fever,
tachycardia, dry mouth, urinary retention, pupil dilation), excitation,
hallucinations, incoordination, and seizures
*SEDATION EFFECT*
○ -Use with caution with clients with asthma, urinary retention,
open-angle glaucoma, hypertension, and BPH
○ -can cause respiratory depression
○ -Do not give to clients with cardiac dysrhythmias, hepatic disease,
and MAOI therapies
,Exam 2 Review-finished. GRADED A
3) Teaching for client w/allergic rhinitis
○ keep windows closed*
○ run air conditioning*
○ remove carpeting to reduce pollen and humidity. *
○ remove pets if possible, If unable to remove pet, keep it out of the bedroom*
○ do not use feather pillows, and put pillows in
zippered, dust proof encasings, Replace feather or
down-filled covers and pillows with synthetic
items*
○ wash linen in hot water*
○ POLLENS
i) • Avoid freshly cut grass; do not mow the lawn. • Keep windows and doors closed
during allergy season. • Shower after outdoor activities to remove pollen from
clothing and skin.
○ MOLDS
, Exam 2 Review-finished. GRADED A
i) • Clean damp areas frequently, at least once a week, with a chlorine bleach
solution. • Ventilate areas well (bathrooms, kitchens, and basements).
• Consider a dehumidifier if living in a humid climate.
○ PETS
i) • Reduce cat allergen by bathing the cat every two weeks
○ IRRITANTS
i) • Avoid cigarette smoke, perfumes, aerosol sprays, strong cleaning products
4) Tonsillectomy: know what to expect after and
what is abnormal post op
Diagnostics:
○ Throat culture for group A strep. & bacterial infection
○ CT if infection present to see if it spread to neck region
○ Pre-op CBC to assess for anemia/infections
Tonsillectomy Education:
○ Report= signs of hemorrhage, fever, excessive vomiting of bright red blood, unrelieved
pain, excessive coughing or swallowing (means a child can be swallowing blood)-
abnormal
○ pt will have pain, difficulty swallowing, and
difficulty talking
○ Drink minimum 8 glasses of water a day
○ Soft foods for first few days
○ Avoid smoking & heavy lifting
○ No gargling – can irritate surgical site
○ Sore throat is expected for approximately 1 week postop
○ Provide pain control with analgesics and ice collar postop
○ Offer clear, chilled fluids or ice pops to relieve pain and reduce inflammation when
awake and alert
○ avoid red-colored liquids because emesis of these fluids could be mistaken for blood
5) Pneumonia risk factors
○ from slide: most at risk for pneumonia os sickle cell
pt with a cough!
○ Acute or chronic infection of one or both lungs caused by bacteria or virus, upper
respiratory infection
