الجمعة، 22 يونيو 2018

28-Epistaxis

About
Nose Bleed.
Assess
Duration and frequency of nosebleeds, trauma, nasal dryness, history of allergies.
Complications
Hypoxemia- monitor pulse oximetry, administer oxygen, encourage mouth breathing.
Hemorrhage- monitor vital signs, seek emergent physician intervention.
Respiratory distress- monitor respiratory status; monitor for patent airway; monitor pulse oximetry.
Diagnosis
  • Knowledge deficit related to care of frequent nosebleeds, prevention
  • Fear related to appearance of large amounts of blood

Goals
  • Client will have no active nasal bleeding.
  • Client will state three interventions to prevent reoccurrence of nasal bleeding.
  • Client will state criteria for when to seek additional medical assistance.

Interventions
  • Position the  client upright, apply pressure laterally to the nose and hold for 5 minutes.
  • Monitor for aspiration of blood contents.
  • Apply ice or cool compresses to area.
  • Teach client to avoid blowing nose for at least the day to prevent re-opening clots.
  • Insert nasal packing loosely if above strategies do not stop bleeding.
  • If bleeding continues, seek emergent medical attention, may require surgical intervention, posterior nasal packing, or pressure catheters inserted by a physician.
  • If surgical intervention, monitor patient frequently, hydrate with plenty of fluids, encourage mouth breathing, monitor for gag reflexes, assess pulse ox for signs of hypoxemia.
  • Administer analgesics as ordered.
  • Monitor for signs/ symptoms of complications.

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