EENT and Sleep Disorders Q 40 - Gyan Darpan : Learning Portal
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Tuesday, 22 March 2022

EENT and Sleep Disorders Q 40

Professor McGonagall had undergone nasal surgery with posterior packing in place. Which assessment data would alert the nurse to the possibility of active bleeding?
     A. Appearance of anxiety.
     B. Discoloration around the eyes.
     C. Frequent swallowing.
     D. Black, tarry stool.

Correct Answer: C. Frequent swallowing

After nasal surgery, drainage trickling down the posterior pharynx (seen with a flashlight) accompanied by frequent swallowing, belching, or hematemesis indicate continued bleeding. If nasal packing is used, there may be some difficulty with swallowing. A sucking action will occur in the throat because packing doesn’t allow air to pass through the nose thereby creating a partial vacuum.

Option A: Anxiety is common because of the necessity to breathe through the mouth. When sneezing, the client must also keep the mouth open. Closing of the mouth may cause an increase in surgical site strain and potentially can cause the nasal sutures to move.
Option B: Discoloration around the eyes occurs with surgical trauma and is to be expected. This happens because the capillaries have burst and leaked under the skin. As fluids collect in the space around the eye, bruising, swelling, and puffiness result.
Option D: Tarry stools indicate previous, but not current bleeding. Black or tarry stools with a foul smell are a sign of a problem in the upper digestive tract. It most often indicates that there is bleeding in the stomach, small intestine, or right side of the colon. The term melena is used to describe this finding.

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