SINUSITIS

A. Definition
Sinusitis is an inflammation or infection of the sinuses, the air-filled
chambers in the skull that are located around the nose. Symptoms of sinusitis
include thick nasal discharge, facial pain or pressure, fever, and reduced sense
of smell. Depending on how long these symptoms last, sinusitis is classified as
acute, subacute, chronic, or recurrent. Viruses are the most common cause of
acute sinusitis, but bacteria are responsible for most of the serious cases.

B. Etiology
Acute sinusitis can be caused by viral, bacterial, or fungal infections.
Allergans and environmental irritants are other possible causes. In most cases,
acute sinusitis is caused by an upper respiratory tract viral infection, such as
the common cold, and usually resolves on its own.
Chronic sinusitis refers to long-term swelling and inflammation of the
sinuses. Chronic sinusitis can result from recurring episodes of acute sinusitis
or it can be caused by other health conditions like asthma and allergic rhinitis,
immune disorders, or structural abnormalities in the nose like deviated septum
or nasal polyps.

C. Clinical Manifestation

Sinus symptoms are very common during a cold or the flu, but in most
cases they are due to the effects of the infecting virus and resolve when the
infection does. General symptoms of acute sinusitis (both viral and bacterial)
include:
1.
2.
3.
4.
5.
6.
7.

Nasal congestion or discharge

Headache
Facial pain or pressure
Cough or scratchy throat
Fever
Diminished or absent sense of smell
Other symptoms may include ear pain or pressure, dental pain, bad breath,
fatigue

D. Complications
Bacterial sinusitis is nearly always harmless (although uncomfortable
and sometimes even very painful). If an episode becomes severe, antibiotics

E. Treatment
The primary objectives for treatment of sinusitis are reduction of
swelling, eradication of infection, draining of the sinuses, and ensuring that
the sinuses remain open. Fewer than half of patients reporting symptoms of
sinusitis need aggressive treatment. Home remedies can be very useful.
Bacterial sinusitis, which is treated with antibiotics, accounts for only
2 - 10% of acute rhinosinusitis cases. Most cases of sinusitis are caused by
viruses, which do not respond to antibiotics. Acute viral sinusitis generally
clears up on its own within 7 - 10 days.

It is important to reserve antibiotics for illnesses caused by bacteria.

The intense and widespread use of antibiotics has led to a serious global
problem of antibiotic-resistant bacteria.

F. Pathway

Influenza

Infection

Dental caries

Sinusitis
Airways

Nervous system
Sinus stimulation

Psikological
Lack of knowledge

Accumulation of secretions sinus maxila

Pain
Ineffective airways

Anxiety

G. Focus Intervention
1. Pain related to inflammation of the nose
Goal : Pain is reduced or lost
Interventions:
a. Assess client's level of pain
R :/ Knowing the client's level of pain in determining further action
b. Explain the causes and effects of pain on the client and family
R :/ With the causes and consequences of pain the client is expected to
participate in treatment to reduce pain
c. Teach relaxation techniques and distractions
R :/ The client knows the distraction and relaxation techniques can be
practiced so as if in pain
d. Observation of vital signs and client complaints
R :/ Knowing the general state and development of the client's
condition.

2. Anxiety related to lack of client knowledge about diseases and medical

procedures (sinus irrigation / operation)
Goal: Anxiety is reduced / lost
Interventions:
a. Assess client's level of anxiety
R :/ Determining the next action
b. Show empathy (it comes with a touch client)
R :/ Facilitate client's receipt of the information provided

c. Give an explanation to clients about the illness slowly, quietly and use
of clear sentences, short easy to understand
R :/ Increase client understanding about the disease and therapies for
the disease so that the client more cooperative

3. Ineffective Airway Clearance related to the obstruction (nasal secret

buildup) secondary to inflammation of the sinuses
Goal: Effective airway, after a secret (seous, purulent) issued
Interventions:
a. Assess the existing build-secret
R :/ Knowing the severity and subsequent action
b. Observation of vital signs
R :/ Knowing the client's development prior to surgery
c. Collaboration with the medical team for cleaning discharge
R :/ cooperation to eliminate the buildup of secret / problem

BIBLIOGRAPHY

Mansjoer Arief, dkk, Kapita Selekta Kedokteran, edisi 2, Media Ausculapius,

FKUI 2001

Doenges, 2000, Rencana Asuhan Keperawatan, EGC, Jakarta

SINUSITIS

H. Definition
Sinusitis is an inflammation or infection of the sinuses, the air-filled
chambers in the skull that are located around the nose. Symptoms of sinusitis
include thick nasal discharge, facial pain or pressure, fever, and reduced sense
of smell. Depending on how long these symptoms last, sinusitis is classified as
acute, subacute, chronic, or recurrent. Viruses are the most common cause of
acute sinusitis, but bacteria are responsible for most of the serious cases.

I. Etiology
Acute sinusitis can be caused by viral, bacterial, or fungal infections.
Allergans and environmental irritants are other possible causes. In most cases,
acute sinusitis is caused by an upper respiratory tract viral infection, such as
the common cold, and usually resolves on its own.
Chronic sinusitis refers to long-term swelling and inflammation of the
sinuses. Chronic sinusitis can result from recurring episodes of acute sinusitis
or it can be caused by other health conditions like asthma and allergic rhinitis,
immune disorders, or structural abnormalities in the nose like deviated septum
or nasal polyps.

J. Clinical Manifestation

Sinus symptoms are very common during a cold or the flu, but in most
cases they are due to the effects of the infecting virus and resolve when the
infection does. General symptoms of acute sinusitis (both viral and bacterial)
include:
8. Nasal congestion or discharge
9. Headache
10. Facial pain or pressure
11. Cough or scratchy throat
12. Fever
13. Diminished or absent sense of smell
14. Other symptoms may include ear pain or pressure, dental pain, bad breath,
fatigue
K. Complications
Bacterial sinusitis is nearly always harmless (although uncomfortable
and sometimes even very painful). If an episode becomes severe, antibiotics

L. Treatment
The primary objectives for treatment of sinusitis are reduction of
swelling, eradication of infection, draining of the sinuses, and ensuring that
the sinuses remain open. Fewer than half of patients reporting symptoms of
sinusitis need aggressive treatment. Home remedies can be very useful.
Bacterial sinusitis, which is treated with antibiotics, accounts for only
2 - 10% of acute rhinosinusitis cases. Most cases of sinusitis are caused by
viruses, which do not respond to antibiotics. Acute viral sinusitis generally
clears up on its own within 7 - 10 days.

It is important to reserve antibiotics for illnesses caused by bacteria.

The intense and widespread use of antibiotics has led to a serious global
problem of antibiotic-resistant bacteria.

M. Pathway

Influenza

Infection

Dental caries

Sinusitis
Airways

Nervous system
Sinus stimulation

Psikological
Lack of knowledge

Accumulation of secretions sinus maxila

Pain
Ineffective airways

Anxiety

N. Focus Intervention
4. Pain related to inflammation of the nose
Goal : Pain is reduced or lost
Interventions:
e. Assess client's level of pain
R :/ Knowing the client's level of pain in determining further action
f. Explain the causes and effects of pain on the client and family
R :/ With the causes and consequences of pain the client is expected to
participate in treatment to reduce pain
g. Teach relaxation techniques and distractions
R :/ The client knows the distraction and relaxation techniques can be
practiced so as if in pain
h. Observation of vital signs and client complaints
R :/ Knowing the general state and development of the client's
condition.

5. Anxiety related to lack of client knowledge about diseases and medical

procedures (sinus irrigation / operation)
Goal: Anxiety is reduced / lost
Interventions:
d. Assess client's level of anxiety
R :/ Determining the next action
e. Show empathy (it comes with a touch client)
R :/ Facilitate client's receipt of the information provided

f. Give an explanation to clients about the illness slowly, quietly and use
of clear sentences, short easy to understand
R :/ Increase client understanding about the disease and therapies for
the disease so that the client more cooperative

6. Ineffective Airway Clearance related to the obstruction (nasal secret

buildup) secondary to inflammation of the sinuses
Goal: Effective airway, after a secret (seous, purulent) issued
Interventions:
d. Assess the existing build-secret
R :/ Knowing the severity and subsequent action
e. Observation of vital signs
R :/ Knowing the client's development prior to surgery
f. Collaboration with the medical team for cleaning discharge
R :/ cooperation to eliminate the buildup of secret / problem

BIBLIOGRAPHY

Mansjoer Arief, dkk, Kapita Selekta Kedokteran, edisi 2, Media Ausculapius,

FKUI 2001

Doenges, 2000, Rencana Asuhan Keperawatan, EGC, Jakarta