2-34
2-34. CARE FOLLOWING SURGERY OF THE NOSE
a. Surgery of or through the nose may be required to correct the results of trauma to the nose and related structures; to correct deformities that interfere with breathing, such as a deviated septum, hypertrophy of the turbinates, or polyps; and to relieve the effects of sinusitis. Surgery of the nose may also be done for cosmetic reasons.
b. Epistaxis is usually the most serious complication of surgery of the nose. If bleeding occurs postoperatively, attempt to control the bleeding with compression of the nostrils and utilization of cold compresses. If nasal packing is in place, bloody sputum or bloody vomit may be considered signs of nasal
bleeding. The nursing personnel must be alert for excessive or continuous bleeding, restlessness, breathing irregularities, cyanosis, and tachycardia. If these signs and symptoms are noted, the professional nurse must be notified immediately. If the physician must be called, make ready a head mirror, light, nasal speculum, packing forceps, and packing material.
c. Quite often, the patient's nose will be packed at the termination of the surgery. This may cause an intense fear of suffocation. The patient must be reassured that mouth breathing will supply sufficient air. Continued mouth breathing will cause dryness of the lips and mouth. Ointment such as petrolatum should be applied to the patient's lips and fluids given as tolerated to moisten the mouth. The patient may have the urge to blow his nose to relieve the sense of fullness caused by the packing. Instruct the patient not to blow his nose, as this may cause bleeding and would be ineffective in relieving the sense of fullness.
