ENT Disorders Notes

Fancy term for a nosebleed.
Causes:
- High blood pressure
- Drugs
- Overuse of nasal spray
Something causes ruptures of capillary membranes in the nose.
Assessment:
- Bleeding from the nose (obvious)
- Blood can go down the throat, so check the back of the throat to ensure the patient doesn't aspirate on it.
- Be cautious as blood clots can obstruct the airway.
Interventions:
- Pack the nose with cotton.
- Epinephrine to promote vasoconstriction.
- Position patient sitting up, leaning forward.
- Pinch the nose to apply pressure.
- Apply ice compresses or have the patient suck on ice for vasoconstriction.
Nursing Monitoring:
- Airway
- Vital signs (blood pressure)
- Monitor for hypovolemic shock.
Patient Education After Correction:
- Avoid blowing the nose forcefully.
- Avoid nasal trauma.
- Moisturize the nose; use humidifiers.
- Patients on nasal cannula O2 are prone to nosebleeds due to dry air; consider humidification.

Deviation means it's not in the midline.
The airway becomes obstructed (partially or completely).
Causes:
- Trauma
- Nasal polyps
- Sinus inflammation
- Congenital issues (born with it)
Signs and Symptoms:
- Deviated septum appearance.
- Difficulty breathing; noisy breathing.
- Postnasal drip.
- Potentially higher respiratory rate.
Medical Interventions:
- Nasioseptoplasty (surgery)
- Polypectomy (if polyps are the cause)
- Antihistamines (for postnasal drip).
Nursing Care Post-Septoplasty:
- Monitor airway.
- Watch for signs of infection.
- Observe for hemorrhage.
- Educate patient not to blow their nose. Don't strain or cough due to the risk of bleeding out. Caution during bowel movements.

Airway obstruction during sleep.
Risk Factors:
- Obesity
- Older age (males over 60)
- Enlarged tonsils
- Nasal conditions (allergies, polyps)
- Thicker neck
Apnea: cessation of breathing.
Brief respiratory standstill during sleep.
Signs and Symptoms:
- Snoring (loud)
- Gasping/choking sounds
- Tiredness during the day, lethargy
- Headache
- Sore throat (from mouth breathing)
Diagnosis: Sleep study (in lab or at home).
Treatment: CPAP (Continuous Positive Airway Pressure).
- CPAP delivers continuous airway pressure to keep the lungs expanded.
Nursing Management:
- Ensure patient wears CPAP.
- Educate on proper use and maintenance (seal water, cleaning) to prevent mold growth.
Lifestyle Changes:
- Weight loss.

Obstruction of the upper airway.
Causes:
- Food
- Seizures (tongue falling back)
- Unconscious person/tongue obstruction
Signs and Symptoms:
- Cyanosis (turning blue)
- Grasping at the neck
- Inability to talk
- Agitation, fear, confusion
- Apnea
Interventions:
- Remove obstruction (if possible)
- Heimlich maneuver (abdominal thrusts)
- Emergency tracheostomy or artificial airway.
Nursing Priority: Open the airway.

Risk Factors:
- Smoking
- Heavy GERD (Gastroesophageal Reflux Disease)
- Age over 60
- Family history
- Vocal abuse (singers)
- Chronic laryngitis
Signs and Symptoms:
- Persistent, progressive hoarseness
- Radiating pain to the ear
- Dysphagia (difficulty swallowing)
- Lump in the throat feeling
- Later signs: Bloody sputum
Diagnosis: Biopsy.
Treatment:
- Radiation and/or chemotherapy
- Possible tracheostomy
- Laryngectomy (removal of the voice box).
Nursing Care:
- Manage eating difficulties.
- Suction at bedside (due to risk of aspiration).
- Address communication needs, especially with a trach.
- Involve speech therapy and rehab.

Signs and Symptoms:
- Sore throat
- Loss of appetite
- Aches, fatigue
Diagnosis:
- Based on symptoms.
- Sputum culture or throat culture to rule out bacterial infection.
Treatment:
- Treat the symptoms.
- Over-the-counter decongestants and medications.
Nursing Management:
- Encourage fluids.
- Warm compresses for congestion.
- Neti pots/nasal irrigation.
Patient Education:
- Handwashing
- Stay home for 48 hours to prevent spreading the virus.