Epistaxis

OM VERMA
ASSISTANT PROFESSOR
MEDICAL - SURGICAL NURSING
GRACIOUS COLLEGE OF NURSING ABHANPUR

1. RELIANCE INSTITUTE OF NURSING TOPIC :- EPISTAXIS Om verma Msc lecturer reliance institute of nursing

2. INTRODUCTION A HEAMORRHAGE FROM THE NOSE,REFFERED TO AS EPISTAXIS, IS CAUSED BY A RUPTURE OF TINY, DISTENDED VESSELS IN THE MUCOUS MEMBERANE OF ANY AREA OF NOSE.REARLY DOES EPAISTAXIS ORIGINATE IN THE DENSELY VASCULAR TISSUE OVER THE TURBINA

3. DEFINITION HEMORRHAGE FROM THE NOSE DUE TO RUPTURE OF TINY DISTENDED VESSELS IN THE MUCOUS MEMBERANE OF ANY AREA OF THE NOSE . BRUNNER AND SUDDARTH BLEEDING FROM THE KIESSELBACH AREA OF THE NOSE JAYPEES NURSES DICTIONARY

4. EPISTAXIS REFERS TO NOSE BLEED OR HEMORRHAGE FROM THE NOSE . IT COMMONLY ORGINATE IN THE ANTERIOR PORTION OF THE NASAL CAVITY. LIPPINCOTT

5. ANATOMY AND PHYSIOLOGY

6. ETIOLOGY CONGENITAL TRAUMA INFECTION INHALATION OF ILLICIT DRUGS VIRAL COMMON COLD BACTERIAL RHINITS AND SINUSITIS NASL TUMORS LOW HUMIDITY FOREIGN BODY IN NOSE DNS NEPRITIS

7. PULMONARY COPD CCF HYPERTENSION MALIGNANCY

8. PATHOPHYSIOLOGY DUE TO EXTERNAL TRAUMA, FOREIN BODIES, BLARRING OF NOSE,PICKING OF NOSE ALLERGIC RHINITIS OR SINUSITIS RESULT IN STRAIN OF EMOTIONAL EXCITEMENT OR PHYSICAL EXERCISE MAY BE ENOUGH TO START NOSE BLEEDING A CIRCULATORY RENAL OR EMOTIONAL CONDITIONS THAT PRODUCES ELEVATED BP MAY COUSE NASAL HEMORRHAGE IT LEADS TO RHEUMATIC FEVER A BLOOD DYSCRASIA OR AN INFECTION

9. CLINICAL FEATURES NASAL BLEEDING FEVER HEADACHE BODYACHE GIDDINESS MALAISE NAUSEA VOMITING DIAGNOSTIC EVALUATION CT SCAN X-RAY BLOOD TEST BLOOD CULTURE

10. MANAGEMENT A) DEPENDS ON THE SEVERITY & SOURCE OF BLEEDING IN THE NASAL CAVITY 1 ) PATIENT IS PLACED IN AN UPRIGHT POSTURE 2) PATIENT IS INSTRUCTED TO COMPRESS THE SOFT PART OF THE NOSE WITH INDEX FINGER & THUMP FOR 5-10 MINUTES 3) A COTTON PLEDGED SOAKED WITH A VASOCONSTRICTING AGENT 4) BLOOD VESSEL MAY BE CAUTERIZED 5) IF BLEEDING CONTINUES ,PACKING MAY BE LAYERED IN TO NASAL CAVITY OR BALLON TEMPONADE MAY BE REQUIRED 6) SURGICAL LIGATION OF THE VESSELS MAY BE REQUIRED

11. MEDICAL MANAGEMENT DRUG : INJ. ODANOSTERON DOSE/ROUTE : 8 MG/I V ACTION : BLOCKS THE SEROTONIN RECEPTOR SIDE EFFECT - HEADACHE DIZZINESS FATIQUE CONTIPATION , DIARRHEOA, ABDOMINAL PAIN

12. DRUG –TAB. BRUFEN DOSE - 200 mg ACTION – INHIBIT PROSTAGLADIN SYNTHESIS & ACT AS ANALGESIC SIDE EFFECT – CNS – HEADACHE , DIZZINESS , PSYHIC DISTURBANCE CVS – ARRYTHIMIA , EDEMA GI – BLEEDING , VOMITING , HEPATITIS DERM -RASHES

13. DRUG – PARACETAMOL DOSE – 500MG ACTION – INHIBIT SYNTHESIS OF PROSTAGLADIN THAT MAY SERVE A AS MEDIATOR OF PAIN &FEVERPRIMARILY TO CNS SIDEEFFECT GI – HEPATIC FAILURE &HEPATOTOXITY DERM – RASHES &URTICARIA

14. NURSING MANAGMENTS

15. NURSING DIAGNOSIS ALTERNATION IN COMFORT RELATED TO DISEASE CONDITION MANIFESTED BY BLEEDING ACTIVITY INTOLERANCE RELATED TO FATIQUE , LETHARGY &MALAISE ALTERATION IN BODY TEMPERATURE RELATED TO DISEASE CONDITION MANIFESTED BY FEVER KNOWLEDGE DEFICIT RELATED TO DISEASE CONDITION

16. DIET MANAGEMENT NORMAL VALUE CALORIE -2700kcal CHO -340 gm PROTEIN- 70 to 80 gm FAT -50 to 60 gm IN PATIENT CALORIE 2600 kcal CHO – 250 gm PROTEIN -78gm FAT – 56gm

17. COMPLICATION CEREBRAL HAEMORRHAGE ASPIRATION SHOCK SEPTICEMIA PNEUMONIA CORONARY THROMBOSIS INTESTINE INFARTION RHINITIS MAXILLARY &FRONTAL SINUSITIS OTITIS MEDIA

18. HEALTH EDUCATION WHEN THE NOSE STARTS BLEEDING SIT UP &LEAN FORWARD TO PREVENT FROM PASSING INTO THROAT WHICH MAY CAUSE CHOKING. PINCH THE NOSE FIRMLY TOGETHER BETWEEN THE THUMB &INDEX FINGER JUST BELOW THE NASAL BONE & HOLD IT FOR 10 MINUTES. MOISTEN THE COTTON BALL OR PAD WITH

19. THANK YOU

20. CONCLUSION