Epistaxis, or nosebleed, is caused by the rupture of tiny blood vessels in the nasal cavity. It commonly originates in the anterior portion of the nose. Potential causes include trauma, infections, medications, and underlying medical conditions. Clinical features may include nasal bleeding along with fever, headache, and dizziness. Management depends on severity but generally involves compression of the nose to stop bleeding along with medications to constrict blood vessels. Nursing care focuses on comfort, activity tolerance, temperature monitoring, education, and preventing complications.

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

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