 Define septoplasty and related terms.
 Understand patient’s history and diagnosis.
 Review the anatomy of nose.
 Discuss the disease condition.
 Describe related nursing interventions.

 Identify the health education given to the patient.

Deviated- to turn aside from a regular course

Cartilage- a tough elastic connective tissue

Nasal septum- partition between two nasal cavities

Incision- the act of cutting

By: Shuroq Safori

. Septoplasty .a surgical procedure to correct the shape of the deviated septum of the nose.  It is done to correct defects or deformities of the septum.  It is performed to correct obstructions related to the nasal septum.

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 -Nasal airway obstruction . chronic nasal infection.Can lead to mouth breathing. or obstructive sleep apnea.  Nasal septal deformity  Headaches caused by septal spurs  Chronic and uncontrolled nosebleeds  Chronic sinusitis associated with a deviated septum  Tumor excision .

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 The goal of septoplasty is to improve breathing through the nose and also to prevent sinus infections.  An incision is made in the lining of the septum to reach the cartilage. splints or nasal packs to prevent bleeding. .  The procedure usually involves an excision of a portion of the cartilage and bone.  The septum may then be stabilized with small plastic tubes.

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It secretes mucus fluid that usually drains into the nose .  Nasal Septum ..a partition dividing between 2 nasal cavities Sinuses.

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by: Sherly Reji .

Scheduled for Septoplasty on 11th August 2009 at 0900H under DR.On 10th August 2009 at 1400H. Hossam. . a 26 y/o female Saudi patient admitted from ENT out patient department with known case of Deviated Septum.

soft. DVT form. ambulatory. general history and physical assessment filled by admitting physician . non-tender. As per protocol. + bowel sounds Admission and surgical consent signed by father. lax.Normal heart sound Abdomen .L. on room air Heart .O. oriented. .C.Alert.

Patient complained of nasal obstruction since there was no improvement with medical treatment. so advised for surgical treatment .

Fall Risk assessment form completed. O2 saturation Weight Height 117/70mmHg 80bpm 20breaths/min 37degrees centigrade 98% on room air 103kg 165cm .Routine admission procedure done. Baseline V/S checked: BP Pulse Rate Respiration Temp.

6 sec PTT 34.0 g/dL 37.12.18.7.6.1 sec 32.37.0 % 140.6 g/dL 39. All within normal range.6.6 sec Blood chemistry was done also.0 12. .440 K/dL 4.51.CBC : Hgb Hct Plt RBC NORMAL VALUE 13.9 % 232 K/dL 4.73 M/uL Coagulation profile: PT 11.0.0.30 M/uL 10.8 sec INR 1.20.

 Anesthesia evaluation done at 2100h. with preanesthesia checklist completed. On 10th August 2009 Evening shift:  Consent for surgery checked and confirmed.  Routine evening care done. .

Re-assured. NPO re-iterated. .  IV fluid D5 Water 500ml hooked and regulated at 100ml/hr rate at 0600H. Patient was instructed Nothing Per Orem after 12 midnight as ordered.  IV cannula G22 inserted on Rt Metacarpal vein at 0530H.

. On 11th August 2009 Day shift:  Injection Zantac 50mg IV and Premosan 10 mg IV given at 0830h.  NPO maintained.

 Patient reassured and to Operating room on call for septoplasty. done and completed. . Pre-op V/S checked and recorded.  Pre-operative checklist as per protocol checked.

 Patient was propped in reclined position.  Dressing was assessed for further bleeding. .  V/S checked as per protocol.  Patient was instructed not to blow in the nose.

 Kept rested with siderails up in comfortable position. Sips of water served and when tolerated.  Pain assessed and analgesic given as prescribed. . normal diet served.

 Dressing was changed and noted for further bleeding.  Tolerated normal diet. . Nasal pack was removed by ENT surgeon on 12th August 2009 at 0800H.  Discharged at 1400H with discharge and home meds instructions given.

By: Sindhu Philip .

gastric ulcer including that associated with non.steroidal antiinflammatory agents . GI disturbances and HTN . altered liver function tests. Zantac 50 mg IV stat . dizziness. drowsiness.operative ulcer -Diarrhea and other gastrointestinal disturbances. vertigo.Duodenal ulcer. dyspeptic manifestation due to a digestive mobility disorder Extrapyramidal reactions. dizziness. rash Inj Primperan 10mg IV stat Nausea and vomiting.DRUG NAME DOSE & ROUTE INDICATION ADVERSE REACTION Inj. headache. headache. depression.post.

skin rash. diarrhea. headache.To relive pain in postoperative cases .inflammatory and analgesic effects.Nausea.Upper respiratory tract infection . abdominal pain and paresthesia Tab Sapofen 400mg BD per orem Anti. . dyspepsia.. .POST-OP MEDICINE DRUG NAME DOSE & ROUTE INDICATION ADVERSE REACTION Tab Klacid 500mg BD per orem Treatment of infections: -Lower respiratory tract infection . nervousness. vomiting. tinnitus. headache.Gastrointestinal disturbances.

headache. tinnitus.To relive pain in postoperative cases . . skin rash.Gastrointestinal disturbances.inflammatory and analgesic effects. . nervousness.POST-OP MEDICINE DRUG NAME Tab Sapofen DOSE & ROUTE 400mg BD per orem INDICATION ADVERSE REACTION Anti.

by: Ednaly Santiago .

O.NURSING DIAGNOSIS Fear and anxiety r/t upcoming invasive procedure ASSESSMENT S .Patient verbalized she feels better and calm.Encouraged patient to verbalize feelings and reassured. facial expression GOAL Patient will be able to control and reduce the level of fear and anxiety pre and post operatively INTERVENTION RATIONALE EVALUATION -Clear and -To lessen concise patient’s explanation was fear given regarding procedure . -Patient verbalized that she understoo d the procedure.uneasy feeling. .“ Ana fi kouf sister”as verbalized by patient. . .

POST-OP: Alteration in comfort.“ Ahlam sister” as claimed by patient.Post-op V/S monitored according to protocol.Analgesic administered as prescribed. pain r/t post septoplas ty S.slght swelling noted over patient’s nose . . O.NURSING DIAGNOSIS ASSESSMENT GOAL INTERVENTION To promote comfort by minimizing pain. . RATIONALE EVALUATION To monitor level of pain and lessen pain Patient verbalized relief and minimal tolerable pain.

“ Fi dam etla” .NURSING DIAGNOSIS ASSESSMENT GOAL Potential for bleeding r/t postop procedure S.To minimize and prevent further bleeding on the operated site O. No further bleeding or swelling noted.Dressing checked every now and then for further bleeding. RATIONALE EVALUATION Head elevation reduces further bleeding and swelling . . . Bleeding and swelling minimized.nasal dressing was minimally soaked with blood INTERVENTION -Patient’s head was kept elevated and rested in reclined position.

By: Shuroq Safori .

 Septoplasty can occasionally lead to a few minor complications like:  Bleeding  Infection  Septal perforation  Nasal deformity  Adhesions  Numbness of upper front teeth .

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 Not to hit or move any part of the nose.  To expect a crusting in the nose for not more than 6 weeks while the incision is healing. Sneeze with the mouth open. . Patient was instructed and taught:  To expect blood stained/ pinkish discharge for a few days  That she will be breathing through mouth until swelling is gone.  Not to hold back a sneeze.

 She can eat and drink normally although soft diet are best.   Avoid smoky.  To avoid all moderate and heavy physical activity. to consult doctor. dusty and dry atmospheres. If develops a temperature and increasing nasal / facial pain a few days after the operation. .  Improvement in nasal breathing may take a few weeks. including sport for ten days after the operation and avoid bending.