Case Scenario

Deviated Nasal Septum

Mr.Rakesh ,35yrs Male came with complaints of chronic nasal congestion, particularly on the
left side. He reports difficulty breathing through his left nostril, especially when lying down at
night. He also mentions frequent sinus infections over the past year, which have been
bothersome and affecting his work productivity.
History of Present Illness:
Rakesh describes the onset of his symptoms as gradual over the past few years. He reports
occasional episodes of nasal congestion and sinus pressure, which he initially attributed to
seasonal allergies. However, he noticed worsening symptoms over time, particularly on the left
side. He denies any recent trauma to the face or nose.
He is hailing from Chittoor, Belongs to nuclear family, lives with his two daughter ( Kumari 10
years & Raj kumar 8 years )
He is the head of the family, earns amount of Rs.120000 / annum. he is residing in own house
with facilities like safe drinking water, electricity and sufficient ventilation. Essential services
such as hospital, school and market are within 1km radius.
He is a non vegetarian, taking three meals per day. He takes bath daily. His bowel pattern is
normal and she passes urine 3 times a day. He sleeps for 6 hours during night and sleeps for 2
hrs during daytime. He is not having habit of smoking and beetle leaf chewing.
Past medical History:
No significant past medical history
On Examination
 General Appearance: Alert and oriented, no acute distress
 Vital signs are stable
 General: Alert and oriented, in no acute distress
 Nasal Examination: Deviation of the nasal septum to the left side, obstructing the left
nasal passage. Mucosal congestion noted bilaterally, more pronounced on the left side.
No evidence of nasal polyps or masses.
 ENT: Occasional nosebleeds, especially during periods of increased congestion
 Sleep: Reports snoring and occasional waking up feeling unrested

Management
  Tab .cefixime 200mg oral bd (It is a cephalosporin antibiotics, It works by killing
bacteria or preventing their growth)
 Tab.SP 10 mg oral BD (NSAID- To reduce pain and inflammation)
 Nasivion nasal drops - 0.05% 3 drops TID (To treat nasal congestion (blocked nose)
caused by the common cold or flu, hay fever and other allergies)
 Nasal corticosteroid spray- fluticasone - 93 mcg 2 drops BD (To reduce nasal
inflammation and congestion)
 Referred to an otolaryngologist (ENT specialist) for further evaluation and consideration
of surgical correction of the deviated septum (septoplasty) if conservative measures are
ineffective

Formulate Nursing diagnosis for Deviated Nasal Septum

Answer Key

1. Impaired Nasal Breathing related to Deviated Nasal Septum as evidenced by difficulty

breathing ,nasal congestion
2. Ineffective Airway Clearance related to Nasal Congestion as evidenced by increased nasal
secretions
3. Chronic Pain related to Facial Pressure and Headaches associated with nasal congestion and
sinus symptoms as evidenced by discomfort
4. Anxiety related to Nasal Symptoms and Impact on Daily Functioning as evidenced by worry
and frustation
4. Risk for Impaired Tissue Integrity related to Nasal Congestion and nose bleed
5. Risk for Impaired Sleep Pattern related to Nasal Obstruction and Snoring
6. Risk for Impaired Communication related to Nasal Congestion and Voice Changes