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Nasal polyp
OPTHALMOLOGY & OTORINOLARYNGOLOGY
NURSING DNC 206
1. Understand the Definition of Nasal Polyp 2. Know the Statistic / incidence of Nasal Polyp3. List the Etiology/Risk factors Nasal Polyp4. Know the Clinical manifestations of Nasal
Polyp 5. Know the Complications of Nasal Polyp 6. Know the Diagnostic tests of Nasal Polyp7. Know the Prevention of Nasal Polyp 8. Explain the Nursing management of Nasal
Polyp9. Know the Medical management of Nasal Polyp10. Know the Nursing care plan for Nasal Polyp11. Know the Prognosis of Nasal Polyp12. Explain the Health Education for Nasal Polyp 13. Summary
In the end of this presentation, students will able to…
Objective
Non – cancerous growth (benign)Develop on the lining of the passages
at sinusesGrowth :
-small growth(may cause no problem)-big growth(cause many complications)
Come in many sizes and shapes.
(1998-2010 Mayo Foundation for Medical Education and Research (MFMER), 20th February,2009)
definitionNasal polyp…
Common in adult.Rare in children.4 times are common in men
than women.1 and 20 out of every 1000
people will develop Nasal Polyp.
(www.mayoclinic.com/health/nasal -polyps/ds00498)
incidence
Triggering factors
Viral infections, bacterial infections, allergies, fungus, chronic inflammation, asthma,
chronic sinus infections, hayfever, sinusitis.
Allows fluid to build up in the cells of nose and sinuses.
Over time, as gravity pulls on these fluid- filled cells.
Nasal polyp developed.
Proliferation of fibroblastsAnd myoblasts
pathophysiology
Etiology
Sinusitis
Viral and bacterial infection
Allergic rhinitis(hayfever)
Chronic inflammation
Asthma Allergic fungal
sinusitis
Allergies
Risk factors
Cystic fibrosis
Aspirin sensitivity Asthma
Allergic fungal sinusitis
Churg –Strauss Syndrome
Age- common in adult
Family history
Z z z z
Runny nose Mouth breathing
Snoring Shape of face may change
Clinical manifestations
Persistent stuffiness and facial discomfort
Decreased/ no sense ofsmell and taste
Nasal obstruction
Complications Obstructive sleep apnea
Altered facial structure
Bleeding
DIAGNOSTIC TESTs
CT Scan of Nasal cavityPhysical examination
Nasal endoscopic Test for cystic fibrosis
Manage allergies
and asthma
Avoid irritants
Practice good
hygiene
Clean and humidify
your home and surroundi
ng
Use nasal rinse or nasal
lavage
preventions
Medical/ surgical
management
Fluticasone (Flonase.Veramyst) Budesonide (Rhinocort)
Flunisolide(Nasarel)
Prednisone (either alone or with nasal spray)
NASAL CORTICOSTEROID
•To reduce inflammati
on
NASAL SPRAY
SurgicalmanagementPOLYPECTOMY
Removed using a small mechanical suction device or a microdebrider.
ENDOSCOPIC SINUS SURGERY
• Procedure to remove the nasal polyp
Endoscopic Sinus surgery/ Polypectomy
of the Nasal Polyp
nursing
management
Pre operative care of patient undergo Polypectomy.
Physical examination.
Taking vital signs as baseline data.
Inform or explain to patient and family members about the procedure.
Ensure the consent form is signed.
Make sure case note, blood result, and CT Scan film are ready.
Ask patient to change his/ her clothes to OT gown.
Shaving if necessary (moustache).
Tell patient to stop taking medicine that can lead to severe bleeding. E.g aspirin.
Ask patient to fasting 6-8 hours before procedure.
Ensure that patient has already past motion and urine.
Post operative care..Monitor patient’s vital signs properly.
Observe any complications such as bleeding and infections.
Administer analgesic drugs as prescribed by doctor.
Inform doctors if any abnormalities detect. Examples : inflammation
Assess patient’s conditions ~ take patient’s level of pain.
(pain scale)
Removing the polyps makes easier to breath through nose.
Nasal polyps can return
Treatment and surgery does not always improve lost sense of smell.
prognosis
nursing
Care plan
NURSING DIAGNOSIS
GOALSNURSING INTERVENTION
EVALUATION
Low self-esteem due to altered facial structure
Patient will improved his self-esteem slowly.
-Suggest patient to wear a mask.
-Explain to the patient that the polyps will shrink after the inflammation treated and polyps will removed by surgical management.
Patient’s self-esteem slowly improved.
NURSING DIAGNOSIS GOALS
NURSING INTERVENTION EVALUATION
Anxiety due to growth of the polyps
Patient will verbalize less anxiety
-Administer an anti-inflammatory drugs to reduce the polyps as prescribed by doctor.
-Provide patient an information about nasal polyps.
-Let patient express his feeling regarding the disease.
Patient verbalized less anxiety
NURSING DIAGNOSIS GOALS
NURSING INTERVENTION EVALUATION
Risk for bleeding related to patient nose care.
Prevent from bleeding.
-advise patient not to digging his nose or blowing too hard because it will cause trauma/ bleeding.
Bleeding prevented.
Nursing Diagnosis
Goals Nursing intervention
Evaluation
Pain related to the surgery.
Patient will verbalize less pain
-administer patient an analgesic drug such as tramadol and voltaren according to doctor’s order.
- Assess patient’s pain with pain scale
Patient verbalized less pain.
Health education
Advise patient to compliant with medication given and not to take herbs that are not recommended by doctor.
Follow up review~ condition of the nasal cavity after
surgery done.~detect any infection or
inflammation.
Avoid any irritants that can develop back the nasal polyps such as dust, infection, etc.
Advice patient not to injured to the surgery area such as..
~digging~blowing
Summary Nasal polyp is not a disease.
It caused by many triggering such as viral and bacterial infections, allergies, and fungus.
Nasal polyps are commonly developed in adult.
The common causes of nasal polyp are aspirin sensitivity, asthma, cystic fibrosis, and allergic fungal infection.
Nasal polyps can manifest complications such as chronic sinus infection, bleeding, altered facial structures and others.
Nasal polyps can return after surgery.
REFERENCES Bachert C, Van Cauwenberge p.Nasal Polyps and Sinusitis. In:
Adkinsaon NF, Yunginger JW, Busse ww,et,eds. Middleton’s Allergy, Principles and Practice, 6th ed Philadelphia, Morby; 2003:1421-1436
Lewis, Heitkemper, Dirksen, O’Brian, Bucher. Medical-surgical Nursing. Assessment and management of clinical problems. Page 541.International edition.
Mayo Clinic Staff, 1998-2010 Mayo Foundation for Medical Education & Research(MFMER)
(www.mayoclinic.com /health/nasal-polyps/ds00498) Pl Dhingra , Disease of ear,nose and throat. Fourth edition 2007.
Elsevier, A division of Reed Elsevier India private limited . Seth Schwartz, MD, MPH, Otolaryngologist, Bachert C, Gevaert P,
Van Cauwenberge P.Nasal polyps and rhinosinusitis. In:Adkinson NF Jr.,Bochner BS ,Busse WW, Holgate ST,Lemaske RF Jr.,eds.Middleton’s Allergy:Principles and Practice.7th edition.Philadelphia,Pa;Mosby Elsevier;2008:chap 56
