1. Psychological nursing
Warmly receive patients and give psychological comfort, calmly assist doctors in physical examination and hemostasis. Patients with epistaxis often bleed too much, which leads to mental stress, lethargy, fatigue, insomnia and poor health. Nurses should comfort patients, make them calm, reduce psychological fear and stress, and maintain a good mental state. If necessary, give them sedatives, such as phenobarbital sodium, and let them stay in bed.
2. Bleeding care
Observe the bleeding situation of the patient, and if there is bleeding, instruct the patient to vomit in the curved disk to accurately estimate the amount of bleeding. Don't swallow the blood, so as not to stimulate the gastric mucosa, cause nausea and vomiting, and aggravate nosebleeds.
A small amount of bleeding can be stopped simply, such as cold compress on forehead and back neck, to promote vasoconstriction and reduce bleeding. Pinch both nasal alars with your fingers 10 ~ 15 minutes; Or a cotton piece soak with 1% ephedrine is stuffed into that nasal cavity to temporarily stop bleede. If the patient has a large amount of bleeding and has symptoms of hemorrhagic shock, such as pallor, cold sweat, rapid pulse and decreased blood pressure, he should quickly establish a venous channel, give hemostatic drugs and rehydration, and immediately notify the doctor for emergency treatment.
3. Environment and posture
Keep the ward quiet and tidy, the bed unit clean and comfortable, and reduce bad stimulation. Ask the patient to stay in bed. Patients generally take a sitting or semi-lying position, and those suspected of shock should take a concave lying position.
4. Nasal care
After nasal packing, instruct patients to avoid coughing and sneezing, and prevent the packing gauze from loosening or coming out; People who fill the back nostril should not pull the gauze ball exposed outside the nasal cavity at will to prevent the gauze ball from falling off and causing suffocation. After nasal packing, the gauze strips can be withdrawn gradually after 48 hours (after nasal packing, the gauze strips can be withdrawn after 72 hours). Patients should be instructed to drip paraffin oil into their noses three times a day to avoid bleeding again when taking out gauze strips. After the gauze strip is taken out, use 1% ephedrine nasal drops, 2 ~ 3 drops each time, three times a day, and the course of treatment shall not exceed one week. 1% ephedrine is prohibited for patients with hypertension, organic heart disease and hyperthyroidism. If it is a patient with nasal congestion, pay attention to observe the ear symptoms.
5. Diet care
Patients with nosebleeds are often weak, so they should be given a high-calorie, light and digestible semi-liquid diet and encouraged to eat, so as to increase nutrition, avoid spicy, irritating and overheated food, prevent bleeding and avoid alcohol and tobacco. Instruct patients to eat more fruits and fresh vegetables to keep their stools unobstructed. Constipation patients should take soapy water enema and give laxatives when necessary to prevent nosebleeds caused by forced defecation. Patients with epistaxis caused by hypertension should be instructed to eat a low-salt and low-fat diet. A small amount of nosebleed can be given a warm and semi-liquid diet or a soft food with less residue, low cellulose and easy digestion. Massive bleeding should be supplemented by fasting and drinking, intravenous rehydration and blood transfusion.
6. Oral care
Because the nasal cavity is stuffed, when breathing with the mouth open, the oral mucosa can't humidify and heat the inhaled air, or the blood in the oral cavity is not removed in time, which can easily cause dry mouth and bad breath. If there is oozing blood in the mouth, spit it out gently at any time and clean the mouth. Rinse your mouth with Dobby's solution 3 ~ 4 times a day to keep your mouth clean and prevent infection. And you can cover your mouth with wet gauze, and your lips are chapped and coated with paraffin oil to increase drinking water.