Question

The nurse is preparing to discharge a client who has been treated for epistaxis. The client should be told to avoid: A. Using saline nasal sprays B. Gently blowing his nose C. Using a household humidifier D. Taking anti-inflammatories

Short answer

Answer: B. Gently blowing his nose

Step-by-step solution

Understanding epistaxis and its causes

Epistaxis, commonly known as nosebleed, occurs when blood flows from the nostrils due to irritation or damage to the nasal blood vessels. Some common causes of epistaxis include trauma, nasal dryness, or use of blood-thinning medications.

Analyze option A - Using saline nasal sprays

Saline nasal sprays are recommended to alleviate nasal congestion and alleviate breathing difficulties. It can help keep the nasal passages moist and prevent irritation that may cause further bleeding. Therefore, this option is not harmful and the client should not be told to avoid it.

Analyze option B - Gently blowing his nose

Gently blowing the nose can apply pressure to the delicate blood vessels and may lead to dislodging of the blood clot that has formed to stop the bleeding. This may result in rebleeding or worsening the existing epistaxis. Therefore, this option is potentially harmful, and the client should be told to avoid it.

Analyze option C - Using a household humidifier

Using a household humidifier helps in maintaining optimal humidity levels, which can prevent nasal dryness and irritation. This helps in reducing the risk of nosebleeds. Therefore, this option is not harmful, and the client should not be told to avoid it.

Analyze option D - Taking anti-inflammatories

Anti-inflammatory medications, such as NSAIDs (nonsteroidal anti-inflammatory drugs), can increase bleeding risk by impairing the blood clotting process. This may exacerbate epistaxis or delay the recovery process. Therefore, this option may be harmful, and the client should be told to avoid it.

Determine the correct option

Among the available options, the client should avoid option B (gently blowing his nose) and option D (taking anti-inflammatories). Since the question asks for one option, B. Gently blowing his nose is the most direct action that the client should avoid in the context of epistaxis. Therefore, the correct answer is B. Gently blowing his nose.

Key concepts

Discharge Education for Patients with Epistaxis

Educating patients upon discharge is a critical component of care, particularly for those who have recently been treated for epistaxis, or nosebleeds. It is essential to provide clear instructions to prevent recurrence and ensure proper healing.

Patients should be advised to keep their nasal passages moist, which can be achieved through the use of saline nasal sprays and maintaining a humid environment at home. It is crucial to educate on the importance of avoiding actions that might disturb the delicate nasal tissues, such as vigorously blowing their nose or picking at the nasal mucosa.

Moreover, patients should be made aware of the risks associated with taking blood-thinning medications, including certain over-the-counter anti-inflammatories, as these can exacerbate bleeding. Informing patients about the signs of a recurrent nosebleed and when to seek medical attention is also paramount.

Lastly, ensuring the patient understands all these instructions, possibly by providing written guidelines or reviewing them verbally, can reinforce the information and lead to better outcomes.

Nosebleed Prevention

Preventing nosebleeds is often possible with simple measures that protect and maintain the integrity of the nasal blood vessels.

• Applying a thin layer of a water-based lubricant or using saline nasal sprays can help keep the nasal passages moist, especially in dry environments.
• Using a humidifier at home can also add necessary moisture to the air to prevent the nasal passages from drying out.
• Avoiding harsh nose blowing and refraining from inserting objects into the nose is crucial as these can damage the sensitive blood vessels.
• Managing high blood pressure and avoiding medications that might thin the blood, unless prescribed by a doctor, can also reduce the risk of a nosebleed.

By advocating for these preventative actions during patient education, healthcare providers can play a significant role in reducing the frequency and severity of nosebleeds for their patients.

Nursing Care After Epistaxis Treatment

After a patient has received treatment for a nosebleed, nursing care is essential to ensure proper recovery and minimize the risk of recurrence.

Post-treatment care includes continuous monitoring of vital signs to detect any signs of shock or blood loss. It's also important to keep the head elevated to decrease nasal blood pressure and instruct the patient to avoid any strenuous activity that might elevate their blood pressure, leading to rebleeding.

The nursing team should also educate the patient on the proper technique for applying pressure to the nostrils in the event of another nosebleed and monitor for any adverse reactions to medications or treatments given during their care.

Completing proper documentation of the patient's response to treatment, including any teaching provided and the patient's understanding, is key to ensuring a high-quality continuation of care.