Definition, causes and Management of nasal polyps (Medical and Surgical intervention)

1. NASAL POLYPS

3. Broad objective
• By the end of this presentation fellow student nurses must acquire
knowledge, skills and attitude in management of patient with nasal
polyps

4. SPECIFIC OBJECTIVES
By the end of this presentation fellow student nurses should be able to;
• Define nasal polyps
• Explain the risk factors of nasal polyps
• List the signs and symptoms of nasal polyps
• Explain the diagnostic measures of nasal polyps
• Explain the medical management of nasal polyps
• Explain the nursing management of nasal polyps
• List complications of nasal polyps
• Explain the preventive measures of nasal polyps

5. NASAL POLYPS
• Are soft painless, non cancerous growth on the lining of nasal
passages or sinuses.They are typically benign but can cause a variety
of symptoms.

7. RISK FACTORS
• Allergic fungal sinusitis; is due to an allergy to airborne fungi
• Cystic fibrosis; a genetic disorder that result in the production and
secretion of abnormally thick sticky fluids ,including thick mucus from
nasal and sinus membrane
• Drug sensitivity; drug cause some people to be more likely to develop
nasal polyps i.e. ASA
• Asthma; a disease that causes overall airway inflammation and
constriction
• Other risk factor; recurring infection, certain immune disorder

8. SIGNS AND SYMPTOMS
• Snoring
• Postnasal drip
• Decreased or absent smell
• Loss of taste
• Facial pain or headache
• Pain in upper teeth
• Itching around eyes
• Headache

9. SIGNS AND SYMPTOMS
• Nose bleeding
• Difficulties in breathing

10. INVESTIGATIONS AND TESTS
1 Nasal endoscopy
- to examine the seriousness of growths in the nose.
2 Imaging studies[CT&MRI]
-helps to point size and location of the polyps in deeper areas.
3 Allergy test
- to determine if allergies are contributing to chronic inflammation.
4 Test for cystic fibrosis
-to determine if child has inherited condition affecting glands that
produce mucus tears sweat saliva and digestive juice.

12. MEDICAL MANAGEMENT
• Nasal spray to reduce inflammation eg dristan
• Nasal corticosteroids eg beclomethasone
• Oral and injectable corticosteroids e.g. prednisolone 2mg/kg
• Surgery
• Endoscopic surgery to remove the growth

13. NURSING MANAGEMENT
• Pre op care;
1. explain procedure to patient and guardians to allay anxiety
2. make patient sign consent form
3. obtain vital signs; temp bp respiration rate pulse rate
4. check FBC
5. Administer prophylactic antibiotic ceftriaxone 50-80mg/kg
6. Insert iv line N/S or R/L
7. Anaesthetist to review patient if fit for procedure

14. NURSING MANAGEMENT CONT...
• Post op care
1. check bleeding
2. check vital signs
3. administer prescribed drugs,
4. follow other post operative orders

15. NURSING DIAGNOSIS
• ineffective airway clearance ,related to nasal passage obstructions
secondary to nasal polyps
Goal
• Patient will have a patent airway within 2 hours of nursing
interventions
Intervention
• position the patient in supine to allow adequate air entry

16. NURSING DIAGNOSIS
• Altered comfort pain [headache] related to irritation of nerve endings as
evidenced by patient verbalization
Goal;
• Patient should verbalize reduced pain after 30 minutes of nursing
intervention
Interventions
• Provide diversion therapy i.e playing with the child, provide toys to reduce
child concentration to pain
• Administer paracetamol 15mg/kg 8 hourly to decrease the production of
prostaglandin in the CNS

17. COMPLICATIONS
• Obstructive sleep apnea
• Asthma flare ups
• Spread of the infection to the eye socket
• Meningitis
• Acquired nasal deformity
• Chronic sinusitis
• encephalitis

18. Prevention
• Practice good hygiene
• Avoid irritants
• Clean and humidify your home and the surrounding
• Use nasal rinse
• Manage allergies and asthma

19. Reference
• Kazembe, P.N. et al (2015) A Pediatric Handbook For Malawi.
Montfort Press, Limbe.
• www.medscape.com
• www.disease dictionary.com
• www.google.com/scholar

20. Group members
• Boniface kutelera
• Mervis
• Wisdom
• Gift
• Verena