Epistaxis

Predisposing Factors Precipitating Factors

Gender (Postmenopausal women) Infections

Age (50-60 years old) Trauma
Arteriosclerosis Tumor
Hypertension
Nasal Inhalation of Illicit drugs
Thrombocytopenia
Redu-Osler-Weber syndrome

Infection Entry of foreign object Trauma to Nose

Rupture of tiny, distended vessels

in mucus membrane of nose

Profuse Bleeding

Epistaxis

Treatment Nursing Management

Apply Pressure Monitor Vital Signs

Cauterization Assist in control of bleeding
Cotton Tampon Provide tissue and basin for excess blood
Compressed Nasal Sponge Assure patient in a calm, efficient manner
Gauze with petroleum or Continually Assess Patient’s airway and breathing
antibiotic ointment Instruct patient about self-care

Legend
Disease
Risk Factors
Signs and Symptoms
Treatment
Nursing Management
Medications
Disease Process
Definition

Epistaxis, or haemorrhage from the nose is caused by the rupture of tiny, distended
vessels in the mucus membrane of any area of the nose. It usually occurs in the anterior septum
wherein three major blood vessels converge in the nasal cavity. The anterior ethmoidal artery,
the sphenopalatine artery and the internal maxillary branches.

Pathophysiology

The three most common causes of epistaxis is from local infections, blunt force trauma
or the forceful entry of foreign to the nose. This causes the rupture of tiny, distended vessels in
the mucus membrane leading to profuse bleeding in the nasal area.

Medical Management

Management varies according to its cause and location of the bleeding site. First, the
location must be determined with the use of a nasal speculum, penlight or headlight. Initial
treatment may include applying direct pressure; this is done by tilting the head forward and
pinching the soft outer portion of the nose against the midline septum for 5-10 minutes. A cotton
tampon may also be used. Another alternative may be packing the nose with gauze embedded
with a petrolatum jelly or antibiotic ointment. A compressed nasal sponge may also be used or it
can also be treated by cauterizing with silver nitrate.

Nursing Diagnoses

1. Ineffective Airway Clearance r/t Nasal Obstruction s/t Epistaxis

2. Risk for Deficient Fluid Volume r/t Profuse Bleeding s/t Epistaxis

Nursing Interventions

1. Monitor Vital Signs

2. Assist in control of bleeding
3. Provide tissue and basin for excess blood
4. Assure patient in a calm, efficient manner
5. Continually Assess Patient’s airway and breathing
6. Instruct patient about self-care