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RELIANCE INSTITUTE OF
NURSING
TOPIC :- EPISTAXIS
Om verma Msc lecturer
reliance institute of nursing
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
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
 EPISTAXIS REFERS TO NOSE BLEED OR
HEMORRHAGE FROM THE NOSE . IT
COMMONLY ORGINATE IN THE
ANTERIOR PORTION OF THE NASAL
CAVITY.
LIPPINCOTT
ANATOMY AND
PHYSIOLOGY
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
 PULMONARY COPD
 CCF
 HYPERTENSION
 MALIGNANCY
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
CLINICAL FEATURES
 NASAL BLEEDING
 FEVER
 HEADACHE
 BODYACHE
 GIDDINESS
 MALAISE
 NAUSEA
 VOMITING
DIAGNOSTIC EVALUATION
CT SCAN
X-RAY
BLOOD TEST
BLOOD CULTURE
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
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
 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
 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
NURSING
MANAGMENTS
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
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
COMPLICATION
 CEREBRAL HAEMORRHAGE
 ASPIRATION
 SHOCK
 SEPTICEMIA
 PNEUMONIA
 CORONARY THROMBOSIS
 INTESTINE INFARTION
 RHINITIS
 MAXILLARY &FRONTAL SINUSITIS
 OTITIS MEDIA
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
Epistaxis
Epistaxis

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Epistaxis

  • 1. RELIANCE INSTITUTE OF NURSING TOPIC :- EPISTAXIS Om verma Msc lecturer reliance institute of nursing
  • 2. 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
  • 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
  • 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