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What are the most common causes of a deviated septum?
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Trauma to the nose or a congenital disproportion
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________ fractures account for 40% of of bone injuries in facial traumas.
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Nasal
What is the most common type of nasal fracture?
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Bilateral
_______ nasal fractures typically produce little or no disfigurement.
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Unilateral
________ nasal fractures give the nose a flattened look.
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Bilateral
Powerful frontal blows to the face cause ________ fractures which may also involved subsequent damage to adjacent facial structures like the eyes or teeth.
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Complex
What is the most common presenting sign of a nasal fracture?
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Epistaxis
A man comes to the ER after a rigorous fight with his brother. His nose is bleeding and he suspects it is broken. Once he's cleaned up, you notice a clear fluid leaking from his nose. You are concerned that it is Cerebrospinal Fluid (CSF), so you do a test bedside. The test looks for the presence of __________. If it is present, the fluid is CSF.
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Glucose
How long could a patient have to wait to have a broken nose repaired?
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5-10 days to allow time for significant edema to resolve
What are the goals of nursing management related to a nose fracture?
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Maintain the airway, reduce edema, prevent complications and provide emotional support.
What is the best way to maintain the airway in someone with a broken nose?
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Keep them upright.
What is the best way to reduce swelling for a patient with a broken nose?
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Apply ice to the face and nose (which also reduced bleeding).
________ is a surgical reconstruction of the nose that is performed on an outpatient basis to reshape the nose for cosmetic reasons or to improve airway function when trauma or developmental deformities result in nasal obstruction.
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Rhinoplasty
Assessment of a patient's __________ prior to rhinoplasty is a critical component of preparation for the surgery.
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Expectations. Expected results should be explained truthfully to avoid disappointment
The presence of a septal hematoma, whether from trauma or surgery, increases the risk of _________.
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Infection
Prior to nasal surgeries, clients should be instructed not to take NSAIDS or aspirin for _______ before the procedure to reduce the risk of bleeding.
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Two weeks
T/F A patient has undergone a rhinoplasty and has developed ecchymosis and edema. These findings need to be reported to the physician.
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False, these are common after a nasal surgery
Which are groups are most likely to experience nosebleeds (epistaxis)?
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Children under 10 and adults over 50
T/F Hypertension increases the risk of epistaxis.
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False, but it does make bleeding (if it occurs) more difficult to control
Children and young adults tend to develop anterior or posterior nosebleeds.
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Anterior
Older adults typically have anterior or posterior nasal bleeding (epistaxis)?
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Posterior
Which type of nosebleed, anterior or posterior, may require medical treatment?
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Posterior (Anterior typically resolves spontaneously)
What measures should a nurse take initially to control a nosebleed?
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-Keep the patient quiet -Place them in a sitting position, or high Fowler's if they can't sit upright -Pinch the entire lower portion of the nose for 10-15 minutes -Insert a small gauze pad into the bleeding nostril and hold in place if pinching doesn'
A nurse is assisting a patient who has nosebleed. She knows that she needs to pinch the lower portion of the nose for ________ minutes as a first measure.
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10-15 minutes
What vasoconstrictive agents are typically used on a nasal tampon to stop epistaxis?
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Cocaine or oxymetazoline
A patient has had anterior packing of his nostril because of a resistant nosebleed. You know that he needs to return in ______ hours to have it removed.
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48-72 hours
You have an elderly patient that is experiencing a posterior nosebleed. Posterior packing is required. The doctor admits the patient to the hospital. You know this is because...
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Nasal packing may alter respiratory status, especially in elderly patients. Hypoventilation/hypoxemia may result in cardiac dysrhythmias or respiratory arrest.
Where, specifically, is a posterior packing for a nosebleed placed?
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Behind the soft palate in the posterior nasopharynx
Nasal packing predisposes a patient to a bacterial infection from __________, which is normally present in the nasal cavity.
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Staph aureus


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