Chapter 3 – Respiratory System Show Inspection and palpation of the nose should be performed standing directly in front of the client while they are sitting upright on the examination table or a chair. It is important to don gloves as you may be in contact with bodily fluids such as nasal discharge. InspectionSteps to inspect the nose include:
Figure 3.8: Inspecting the nasal cavity and mucosa 4. Note findings:
Video 3.4: Inspecting the nasal cavity and mucosa PalpationSteps to palpate the nose and sinuses include:
None of the abnormal findings on their own are considered critical findings. However, you should call for assistance while monitoring breathing and vital signs and performing a focused assessment if the client is experiencing signs of respiratory distress associated with any malformations, trauma/injury to the nose, or nasal obstructions. It can be helpful to sit the client upright to assist with breathing. Deviated septum is quite common. Unless it affects a client’s breathing, typically no action is required. Other abnormal findings that require action are lesions and sinus pain. A focused assessment should be performed and findings reported to the physician/nurse practitioner. Depending on the cause, sinus pain may require treatment such as decongestants, antibiotics, or antihistamines. Cutaneous lesions on the nose should be closely examined. There are many causes of lesions such as herpes simplex virus or a melanoma. For example, the lesion in Figure 3.9 is a carcinoma. These lesions are not a critical finding, but they are life-threatening; they require prompt intervention because they are curable if diagnosed and treated early. Figure 3.9: Squamous cell carcinoma lesion (Image from the National Cancer Institute: https://visualsonline.cancer.gov/details.cfm?imageid=2165) Activity: Check Your UnderstandingWhen do you use an otoscope to assess the nasal cavity?Inspect inside of nose with otoscope with largest ear speculum. Tilt patient's head back slightly and insert speculum gently into vestibule of each nostril. Avoid contacting nasal septum as this is a sensitive area. Hold otoscope handle to one side to avoid patient's chin and improve mobility.
How do you assess a patient's nose for patency?Steps to palpate the nose and sinuses include:. With your thumb, gently palpate one sinus at a time. Use a circular motion to palpate. ... . Palpate the nose for airflow/patency. ... . Gently palpate the external nose if trauma/injury or lesions are present. ... . Note the findings:. What are the projections in the nasal cavity that increase the surface area are called Group of answer choices?Bony projections, called turbinates, protrude into each breathing passage; they help to increase the surface area of the inside of the nose. There are three turbinates on each side of the nose (the inferior, middle, and superior turbinates).
Which sinuses can you assess through examination?Only the frontal and maxillary sinuses are accessible for clinical exam. Physical assessment of the paranasal sinuses, along with the patient's signs and symptoms, can help you to identify certain conditions such as acute sinusitis involving the frontal or maxillary sinuses.
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