Nursing Management of Epistaxis

Epistaxis (Nosebleed)

• Can be caused by a variety of factors including:
  • Foreign bodies
  • Dry air
  • Nasal spray misuse
  • Alcohol misuse
  • Street drug use
  • Anatomical malformation
  • Allergic rhinitis
  • Tumors
• Can be prolonged by medications like aspirin or anticoagulants
• Two types:
  • Anterior bleed (most common):
    • Usually self-treated and stops spontaneously.
  • Posterior bleed (closer to throat):
    • Difficult to determine blood loss
    • May require medical attention

Nursing and Interprofessional Management of Epistaxis

• Simple first aid measures:
  • Keep the patient quiet
  • Sit upright, leaning forward, or recline with head and shoulders elevated
  • Direct nasal compression (10-15 minutes)
  • Apply ice compresses to the forehead and suck on ice
  • Seek medical assistance if bleeding persists
• Medical treatment:
  • Vasoconstrictive agents
  • Cauterization
  • Packing (posterior packing requires hospitalization)

Allergic Rhinitis

• Inflammation of the nasal mucosa due to a specific allergen
• Two types:
  • Seasonal rhinitis:
    • Occurs in spring and fall due to pollen allergies
    • Lasts for weeks during peak pollen season
  • Perennial rhinitis:
    • Intermittent or constant
    • Triggered by environmental factors like pet dander, dust mites, molds, or cockroaches

Clinical Manifestations of Allergic Rhinitis

• Nasal congestion
• Sneezing
• Watery, itchy eyes and nose
• Altered sense of smell
• Thin, watery nasal discharge
• Pale, boggy, and swollen nasal turbinates
• Long-term exposure:
  • Headache
  • Congestion
  • Pressure
  • Postnasal drip
  • Nasal polyps
  • Cough
  • Hoarseness
  • Snoring
  • Recurrent need to clear the throat

Nursing and Interprofessional Management of Allergic Rhinitis

• Identifying and avoiding triggers
• Medications:
  • Nasal sprays
  • Leukotriene receptor antagonists
  • Antihistamines
  • Decongestants
• Immunotherapy:
  • Controlled exposure to allergens through frequent injections
  • Goal: decrease sensitivity

Epistaxis (Nosebleed)

• Causes:

  • Foreign bodies
  • Dry air
  • Nasal spray misuse
  • Alcohol misuse
  • Street drug use
  • Anatomical malformation
  • Allergic rhinitis
  • Tumors
  • Conditions that prolong bleeding time or alter platelet count
    • Aspirin or anticoagulants

• Types:

  • Anterior bleed: Most common, self-treatable, usually stops spontaneously
  • Posterior bleed: Closer to throat, difficult to assess blood loss, may require medical treatment

• Nursing and Interprofessional Management:

  • Simple first aid:
    • Keep patient quiet
    • Sit upright, leaning forward, or recline with head and shoulders elevated
    • Apply direct nasal compression for 10-15 minutes
    • Ice compresses on the forehead and sucking on ice
  • Medical treatment:
    • Vasoconstrictive agents
    • Cauterization
    • Packing (posterior packing requires hospitalization)

Allergic Rhinitis

• Definition: Inflammation of the nasal mucosa due to a specific allergen

• Types:

  • Seasonal rhinitis: Occurs in spring and fall due to pollens (trees, flowers, grasses), lasts for several weeks during high pollen counts.
  • Perennial rhinitis: Present intermittently or constantly, triggered by environmental factors like pet dander, dust mites, molds, or cockroaches.

• Clinical Manifestations:

  • Nasal congestion
  • Sneezing
  • Watery, itchy eyes and nose
  • Altered sense of smell
  • Thin, watery nasal discharge
  • Pale, boggy, and swollen nasal turbinates

• Chronic exposure to allergens:

  • Headache
  • Congestion
  • Pressure
  • Postnasal drip
  • Nasal polyps
  • Cough
  • Hoarseness
  • Snoring
  • Recurrent need to clear the throat

• Nursing and Interprofessional Management:

  • Identifying and avoiding triggers
  • Medications:
    • Nasal sprays
    • Leukotriene receptor antagonists
    • Antihistamines
    • Decongestants
  • Immunotherapy: Controlled exposure to allergens in small amounts through frequent injections, aiming to decrease sensitivity.

Explore the causes, types, and management strategies for nosebleeds (epistaxis) in this quiz. It covers both simple first aid measures and medical treatments, providing essential knowledge for nursing and interprofessional care. Test your understanding of this common condition and its management.