Management of Patients With Upper Respiratory Tract Disorders

1. Mary Par, 44 years of age, is a female patient who presents to the emergency
department with epistaxis. She has a bath towel saturated with bright red blood and
small clots. She is breathing through her mouth as she has her head tilted forward and
has direct pressure applied to the soft outer portion of the nose against the midline
septum using her thumb and index finger. She applied direct pressure for over 15
minutes and her nose will not stop bleeding.

a. What nursing management is needed for the patient?

b. What measures may be used to treat the epistaxis?

c. Once the bleeding is controlled and the underlying cause is identified, if able and
treated, what instructions should the nurse provide the patient?

2. Donald Bark, a 55-year-old patient, is diagnosed with laryngeal cancer and is

scheduled for a total laryngectomy. He is in the outpatient department to receive
patient education and preadmission testing for the surgery scheduled next week. The
patient is a high school math teacher. He plans on retiring from the teaching career in 5
years. He has already undergone radiation therapy. His voice is deep, raspy, and weak.
He has a long history of alcoholism and drinks two six-packs of beer every weekend. He
recently quit smoking cigarettes and has a two pack per day history for 35 years. The
patient’s life partner recently died. He lives by himself in a one-story home.

a. Using the nursing process as a framework, discuss the care the patient will need?