MADAM MURNIWATI ENT NUR 3354

FAIRUZ

BT JANI ALEESZAH BT ABDULLAH SITI AISHAHANIS BT SAID RAHMAT KAMARULZAMAN B SIDEK NOR HALIJAH BT AWANG ATHIFATUL HASANAH MOHD NASIB

Locations for nasal foreign bodies to lodge

anterior to the middle turbinate or below the inferior turbinate. Unilateral foreign bodies affect the right side about twice as often compared to the left. (due to a right-handed individuals to insert objects in their right naris.)

 Nasal

foreign bodies (NFBs) can occur frequently in the pediatric setting and adults, especially those with mental retardation or psychiatric illness. Children's interests to lodging foreign bodies in their nasal cavities.

 Nasal

foreign bodies - cause damage to the nasal cavity and surrounding structures. They can produce local inflammation may result pressure necrosis - can cause mucosal ulceration and erosion into blood vessels producing epistaxis. The swelling - obstruction to sinus drainage and lead to a secondary sinusitis difficulty breathing Button batteries, magnets, and living foreign bodies can be destructive

 Difficulty

breathing through the affected nostril Feeling of something in the nose Foul-smelling Bloody nasal discharge Irritability, particularly in infants Irritation or pain in the nose

Inorganic materials
plastic

or metal common from beads and small parts from toys. These materials are often asymptomatic and may be discovered incidentally.

Organic foreign bodies

food,

rubber, wood, and sponge be more irritating to the nasal mucosa and may produce earlier symptoms.

 Medical

history Physical examination. A special lighted instrument - to look inside the nostrils

 Difficulty

the nose Goal to improve the patient breathing pattern Interventions

Assess

breathing r/t foreign body in

patient level of breathing for nursing care plan. Advice patient to breathing through mouth to avoid object in further. Place patient in fowlers position to easy breathing. Avoid blowing nose too hard or repeatedly to prevent any injury. Evaluation

 Self

uncomfortability r/t Foulsmelling Goal - to increase patient comfortable with self Interventions
Assess

patient nose conditions like swelling for nursing care plan. Strictly patient about important of hygiene and handwashing before and after touch nose to prevent infection. Advice patient to not rub the nose. Perform good environment to prevent infections. Advice patient to wear mask to avoid any uncomfortable to others Evaluation Patient will comfort and confident with

Bloody nasal discharge r/t pressure of materials inside Goal decrease the amount of blood in nasal discharge Interventions

Assess amount and color of blood for nursing plan. Perform cold compress to stop the blood Advice patient to not rub the nose Advice patient to not wipe the discharge by using unclean towel. Advice patient to not try remove object that cannot see or not easy to grasp. Evaluations Decrease pressure given will decrease the amount of blood that contain in nasal discharge

 Inflammation

of nasal mucus

membranes. Release of histamine and others substances can cause vasodilation and edema occur as reactions to allergens (pollen,dust,mold or some food) May be caused by viral (viral rhinitis)or bacterial infection

Rhinitis divided into allergic and non-allergic rhinitis. Allergic rhinitis Non-allergic rhinitis, which can be subdivided into :
Infectious Drug-induced Gustatory Hormonal Occupational Vasomotor Non-allergic rhinitis with eosinophilia syndrome (NARES)

 Nasal

congestion Localized itching Sneezing Nasal discharge Fever or malaise

 Chronic

rhinitis - inflammation or an infection.

Diseases

such as tuberculosis, rhinoscleroma rhinosporidiosis,leishmaniasis, blastomycosis, histoplasmosis, and leprosy

Allergic

Rhinitis - caused by a reaction of the body's immune system to an environmental trigger.

Include

dust, molds, pollens, grasses, trees, and animals.

Acute

Viral Rhinitis: Acute viral rhinitis (the common cold) can be caused by a variety of viruses.

Skin test.

To find out whether symptoms might be caused by a certain allergen.

Blood test.

A blood test to measure immune system's response to common allergens by measuring the amount of certain antibodies in bloodstreem.

Nasal endoscopy.

This test to examine at the inside of nasal passages. This is done with a thin, fiber-optic viewing instrument called an endoscope.

Computerized tomography (CT) scan.

This procedure is a computerized X-ray technique that produces images of sinuses.

Acute pain r/t disease process goal- to decrease patient level of pain and increase the ability of sleep Interventions
Assess for cause of discomfort,muscles aches,fever for nursing care plan Encourage patient to rest Administer acetaminophen or other analgesics or antipyretics as doctor order Administer throat lozenges or salt-water gargles as ordered by doctors. Evaluation Patient level of pain decrease and can sleep well

Hyperthermia r/t infections Goal to decrease the patient temperature and no sign and symptoms of dehydration. Interventions

Monitor temperature daily every 4hours if patient having fever Monitor for sign of dehydration such as dry skin,mucus membrane,thirst and weakness. Advice patient to increase the amount of fluid to treat dehydration. Administer acetaminophen or other analgesics or antipyretics as doctor order Evaluations Fever controlled in safe levels and patient well hydrated.

Risk for infection r/t poor hygiene Goal to reduce risk of infections Interventions

Assess patient understanding of infections. Advice patient to do handwashing before and after touch the nose Advice patient to do hygiene care for reduce infections Advice patient to covering mouth and nose when sneezing and coughing Use clean towel to cover the mouth. Perform good environment Evaluations Risk for infections decrese by evidence patient follow the nursing interventions well

deviated septum occurs when the thin wall (nasal septum) inside nose is displaced to one side. The septum separates the right and left nasal cavities. The nasal septum is displaced, making one nasal passage smaller. If become severe,can block one side of nose and reduce airflow.

Obstruction of one or both nostrils - difficult to breathe through the nostril. When having a cold (upper respiratory tract infection) or allergies that cause nasal passages to swell and narrow. Nasal congestion - Postnasal drip occurs when mucus is blocked from flowing out of nose, causing it to drip into and linger in the back of throat. Nosebleeds - The surface of nasal septum become dry, increasing risk of nosebleeds. Frequent or recurring sinus infections - result from blocked mucus and are often marked by facial pain and headaches. Noisy breathing during sleep - This is more

condition present at birth.

septum occurs during fetal development and is apparent at birth.

Deviated

Injury
Can

to the nose

causes the nasal septum to be knocked out of position. In infants - injury may occur during the labor process. In children and adults
accidents

septum from tripping on a step to colliding with another person on the sidewalk

may lead to a nose injury and deviated

 Physical

examination

nosebleeds

or nasal and ask about had any trauma to patient nose.

Use

bright light and an instrument (nasal speculum) to spread open nostrils that examine by doctor - to diagnose deviated septum and determine the seriousness of condition. Refer to an ear, nose and throat specialist (otolaryngologist).

Risk for infections r/t blocked mucus Goal to decrease the risk of infections Interventions

Assess patient conditions for nursing care plan Strictly patient about handwashing before and after touch the nose Advice patient about the hygiene care to prevent from infections. Advice patient to rest in bed because block mucus can cause headache.

Evaluation Risk for infections have decrease.

 Sleep

disturbance r/t obstruction of airway(breathing) Goal increase patient ability and comfort while sleep at night Interventions
Assess

patient patern of sleep like having snorr and complain of patient for nursing care plan Maintain patient in Fowlers position as much as possibles. Encourage patient to breathing through mouth.

Evaluation Patient feel comfort when sleeping

Nosebleeds r/t dryness of nasal septum Goal to decrease the amount of bleeding Interventions Assess patient amount of bleeding and color of blood and any absent of swelling or bruising for nursing care plan. Apply ice compress to reduces swelling Maintain patient in Fowlers position Advice patient to avoid anything that can increase pressure and bleeding such as sneezing or coughing. Promote good environment.

Evaluation Amount of bleeding decrease caused by nursing interventions

 http://www.healthopedia.com/foreign-body-

in-nose http://www.mayoclinic.com Walsh.Crumbie,2007,Clinical Nursing and Related Science(7th Edition), Philadelphia, Elsevier Williams.Hopper,2003,Understanding Medical Surgical Nursing (3rd Edition), Philadelphia, I Group Press CO.Ltd http://www.merckmanuals.com http://www.wrongdiagnosis.com/r/rhinitis