Epistaxis Nursing Diagnosis

[LadyQT]

i'm working on a presentation for pediatrics on nosebleeding. i need nursing diagnosis that this type of patient may present with. i came up with:

distrubed body image

risk for aspiration

any other suggestions? all would help greatly!

[Daytonite, BSN, RN]

In determining any nursing diagnoses you ALWAYS look at the symptoms the patient would have. For epistaxis the symptoms include:

• bleeding from the nostril(s)

If the bleeding is excessive and has gone on for a while then you will see signs and symptoms of significant blood loss:

• dizziness
  
• light-headedness
  
• confusion
  
• fainting

Complications include nausea and airway obstruction.

Your nursing diagnoses are then based upon symptoms. Since bleeding is a loss of body fluids the most likely diagnosis to use would be Risk for Deficient Fluid Volume. Also, since you are talking about a child and bringing a child into a healthcare situation for care, they are going to be scared, so Fear is also another nursing diagnosis to consider. Others might be Risk for Ineffective Breathing Pattern or Ineffective Airway Clearance. I think a child is too young to have a Disturbed Body Image. Risk for Aspiration might be possible, but from everything I've read, not likely.

You will find information on the signs and symptoms as well as common causes for nosebleeds on these websites along with some good interventions to include in your presentation:

• http://www.emedicinehealth.com/nosebleeds/article_em.htm
  
• http://www.fpnotebook.com/ENT137.htm
  
• http://www.nlm.nih.gov/medlineplus/ency/article/003106.htm
  
• http://familydoctor.org/online/famdocen/home/healthy/firstaid/basics/132.printerview.html
  
• http://kidshealth.org/kid/watch/er/nosebleeds.html