NUR 621 (Adult_Gero Acute) MOD #12, part 2 (HEENT part 2, pain) Questions with CORRECT
Answers (Grade A+)
Question 1:
epistaxis is most common in
Answer:
young and elderly
Question 2:
are anterior or posterior nosebleeds more common?
Answer:
anterior (bleeding single nare)
Question 3:
which nosebleed is harder to treat
Answer:
posterior nosebleed (bilateral nare bleeding)
Question 4:
initial treatment for epistaxis
Answer:
-maintain airway
-direct compression
-pledges (mini gauze)
with a vasoconstrictor with analgesia
Question 5:
how do you hold compression for epistaxis?
Answer:
lean forward, compress both nares just below the bone for 5+ minutes
Question 6:
,labs and diagnostics for epistaxis
Answer:
CBC, CMP, type and screen, INR
-CT angiography for possible embolization if bleeding doesn't stop
Question 7:
anterior bleeding tx:
-residual
-uncontrolled
-last step
Answer:
residual bleeding - topical vasoconstrictors and anesthetics uncontrolled-nasal packing with
vasoconstrictor, lubricant, anesthetic, and ABX last step if packing fails call ENT, need cautery
Question 8:
common topical vasoconstrictor drug used for epistaxis
Answer:
oxymetazoline (Afrin)
Question 9:
when using nasal packing, add
Answer:
lubrication and a topical antibiotic to prevent toxic shock syndrome (packing stays in for 24 hours)
Question 10:
with bilateral nare bleeding, hematemesis, of failed anterior measures, think
Answer:
posterior epistaxis
Question 11:
treatment posterior epistaxis
Answer:
, posterior balloon tampon (foley), posterior packing
-need sedation and to be
admitted
Question 12:
What med increases risk for epistaxis?
Answer:
ASA
Question 13:
Patient presents to ED with bilateral nare nosebleed and hematemesis? What is the diagnosis and
intervention?
Answer:
posterior epistaxis
-posterior packing and
balloon tampon, admit the patient
Question 14:
Again, what is INITIAL treatment for any patient with an active nosebleed?
Answer:
lean forward, apply direct compression to both nares for 5+ minutes
Question 15:
inflammatory condition of nasal mucosa
Answer:
rhinitis (can be allergic or non allergic)
Question 16:
what causes the symptoms of rhinitis?
Answer:
vasodilation, increased permeability, leukocyte adherence
Answers (Grade A+)
Question 1:
epistaxis is most common in
Answer:
young and elderly
Question 2:
are anterior or posterior nosebleeds more common?
Answer:
anterior (bleeding single nare)
Question 3:
which nosebleed is harder to treat
Answer:
posterior nosebleed (bilateral nare bleeding)
Question 4:
initial treatment for epistaxis
Answer:
-maintain airway
-direct compression
-pledges (mini gauze)
with a vasoconstrictor with analgesia
Question 5:
how do you hold compression for epistaxis?
Answer:
lean forward, compress both nares just below the bone for 5+ minutes
Question 6:
,labs and diagnostics for epistaxis
Answer:
CBC, CMP, type and screen, INR
-CT angiography for possible embolization if bleeding doesn't stop
Question 7:
anterior bleeding tx:
-residual
-uncontrolled
-last step
Answer:
residual bleeding - topical vasoconstrictors and anesthetics uncontrolled-nasal packing with
vasoconstrictor, lubricant, anesthetic, and ABX last step if packing fails call ENT, need cautery
Question 8:
common topical vasoconstrictor drug used for epistaxis
Answer:
oxymetazoline (Afrin)
Question 9:
when using nasal packing, add
Answer:
lubrication and a topical antibiotic to prevent toxic shock syndrome (packing stays in for 24 hours)
Question 10:
with bilateral nare bleeding, hematemesis, of failed anterior measures, think
Answer:
posterior epistaxis
Question 11:
treatment posterior epistaxis
Answer:
, posterior balloon tampon (foley), posterior packing
-need sedation and to be
admitted
Question 12:
What med increases risk for epistaxis?
Answer:
ASA
Question 13:
Patient presents to ED with bilateral nare nosebleed and hematemesis? What is the diagnosis and
intervention?
Answer:
posterior epistaxis
-posterior packing and
balloon tampon, admit the patient
Question 14:
Again, what is INITIAL treatment for any patient with an active nosebleed?
Answer:
lean forward, apply direct compression to both nares for 5+ minutes
Question 15:
inflammatory condition of nasal mucosa
Answer:
rhinitis (can be allergic or non allergic)
Question 16:
what causes the symptoms of rhinitis?
Answer:
vasodilation, increased permeability, leukocyte adherence
