1. Nasal polyp OPTHALMOLOGY & OTORINOLARYNGOLOGY NURSING DNC 206

2. Objective In the end of this presentation, students will able to… Understand the Definition of Nasal Polyp Know the Statistic / incidence of Nasal Polyp List the Etiology/Risk factors Nasal Polyp Know the Clinical manifestations of Nasal Polyp Know the Complications of Nasal Polyp Know the Diagnostic tests of Nasal Polyp Know the Prevention of Nasal Polyp Explain the Nursing management of Nasal Polyp Know the Medical management of Nasal Polyp Know the Nursing care plan for Nasal Polyp Know the Prognosis of Nasal Polyp Explain the Health Education for Nasal Polyp Summary

4. definition Nasal polyp… Non – cancerous growth (benign) Develop on the lining of the passages at sinuses Growth : -small growth(may cause no problem) -big growth(cause many complications) Come in many sizes and shapes. (1998-2010 Mayo Foundation for Medical Education and Research (MFMER), 20th February,2009)

6. Common in adult. Rare in children. 4 times are common in men than women. 1 and 20 out of every 1000 people will develop Nasal Polyp. (www.mayoclinic.com/health/nasal -polyps/ds00498) incidence

7. pathophysiology Triggering factors Viral infections, bacterial infections, allergies, fungus, chronic inflammation, asthma, chronic sinus infections, hayfever, sinusitis. Proliferation of fibroblasts And myoblasts Allows fluid to build up in the cells of nose and sinuses. Over time, as gravity pulls on these fluid- filled cells. Nasal polyp developed.

8. Etiology

9. Sinusitis Viral and bacterial infection

10. Allergic rhinitis (hayfever) Chronic inflammation

11. Allergic fungal sinusitis Asthma Allergies

12. Risk factors

13. Aspirin sensitivity Asthma Cystic fibrosis Allergic fungal sinusitis

14. Churg –Strauss Syndrome Age- common in adult Family history

15. Clinical manifestations Runny nose Mouth breathing Z zzz Snoring Shape of face may change

16. Persistent stuffiness and facial discomfort Decreased/ no sense of smell and taste Nasal obstruction

17. Complications Obstructive sleep apnea

18. Altered facial structure Bleeding

19. DIAGNOSTIC TESTs

20. CT Scan of Nasal cavity Physical examination

21. Nasal endoscopic Test for cystic fibrosis

22. preventions Clean and humidify your home and surrounding Use nasal rinse or nasal lavage Practice good hygiene Manage allergies and asthma Avoid irritants

23. Medical/ surgical management

24. NASAL CORTICOSTEROID Fluticasone (Flonase.Veramyst) Budesonide (Rhinocort) Flunisolide (Nasarel) Prednisone (either alone or with nasal spray)

26. nursing management

27. Pre operative care of patient undergo Polypectomy. Physical examination. Taking vital signs as baseline data. Inform or explain to patient and family members about the procedure. Ensure the consent form is signed.

28. Make sure case note, blood result, and CT Scan film are ready. Ask patient to change his/ her clothes to OT gown. Shaving if necessary (moustache). Tell patient to stop taking medicine that can lead to severe bleeding. E.g aspirin.

29. Ask patient to fasting 6-8 hours before procedure. Ensure that patient has already past motion and urine.

30. Post operative care.. Monitor patient’s vital signs properly. Observe any complications such as bleeding and infections. Administer analgesic drugs as prescribed by doctor. Inform doctors if any abnormalities detect. Examples : inflammation

31. Assess patient’s conditions ~ take patient’s level of pain. (pain scale)

32. prognosis Removing the polyps makes easier to breath through nose. Nasal polyps can return Treatment and surgery does not always improve lost sense of smell.

33. nursing Care plan

38. Health education Advise patient to compliant with medication given and not to take herbs that are not recommended by doctor. Follow up review ~ condition of the nasal cavity after surgery done. ~detect any infection or inflammation.

39. Avoid any irritants that can develop back the nasal polyps such as dust, infection, etc. Advice patient not to injured to the surgery area such as.. ~digging ~blowing

40. Summary Nasal polyp is not a disease. It caused by many triggering such as viral and bacterial infections, allergies, and fungus. Nasal polyps are commonly developed in adult. The common causes of nasal polyp are aspirin sensitivity, asthma, cystic fibrosis, and allergic fungal infection.

41. Nasal polyps can manifest complications such as chronic sinus infection, bleeding, altered facial structures and others. Nasal polyps can return after surgery.

42. REFERENCES Bachert C, Van Cauwenbergep.Nasal Polyps and Sinusitis. In: Adkinsaon NF, Yunginger JW, Busseww,et,eds. Middleton’s Allergy, Principles and Practice, 6thed Philadelphia, Morby; 2003:1421-1436 Lewis, Heitkemper, Dirksen, O’Brian, Bucher. Medical-surgical Nursing. Assessment and management of clinical problems. Page 541.International edition. Mayo Clinic Staff, 1998-2010 Mayo Foundation for Medical Education & Research(MFMER) (www.mayoclinic.com /health/nasal-polyps/ds00498) Pl Dhingra , Disease of ear,nose and throat. Fourth edition 2007. Elsevier, A division of Reed Elsevier India private limited . Seth Schwartz, MD, MPH, Otolaryngologist, Bachert C, Gevaert P, Van CauwenbergeP.Nasal polyps and rhinosinusitis. In:Adkinson NF Jr.,Bochner BS ,Busse WW, Holgate ST,Lemaske RF Jr.,eds.Middleton’sAllergy:Principles and Practice.7thedition.Philadelphia,Pa;Mosby Elsevier;2008:chap 56