Define septoplasty and related terms.

Understand patients 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.

-Nasal airway obstruction

- Can lead to mouth breathing, chronic nasal

infection, 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

The goal of septoplasty is to improve breathing

through the nose and also to prevent sinus
infections.

The procedure usually involves an excision of a

portion of the cartilage and bone.

An incision is made in the lining of the septum to

reach the cartilage.

The septum may then be stabilized with small

plastic tubes, splints or nasal packs to prevent
bleeding.

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

by: Sherly Reji

On 10th August 2009 at 1400H, a 26 y/o

female Saudi patient admitted from ENT
out patient department with known case
of Deviated Septum.
Scheduled for Septoplasty on 11th August
2009 at 0900H under DR. Hossam.

L.O.C.

- Alert, oriented, ambulatory, on room air

Heart

- Normal heart sound

Abdomen - soft, lax, non-tender, + bowel sounds

Admission and surgical consent signed by father. As
per protocol, DVT form, general history and physical
assessment filled by admitting physician

Patient complained of nasal obstruction

since there was no improvement with

medical treatment, so advised for surgical

treatment

Routine admission procedure done. Fall Risk

assessment form completed. Baseline V/S
checked:
BP
Pulse Rate
Respiration
Temp.
O2 saturation
Weight
Height

117/70mmHg
80bpm
20breaths/min
37degrees centigrade
98% on room air
103kg
165cm

CBC :
Hgb
Hct
Plt
RBC

NORMAL VALUE
13.6 g/dL
39.9 %
232 K/dL
4.73 M/uL

Coagulation profile:
PT
11.6 sec
PTT
34.8 sec
INR
1.0

12.0- 18.0 g/dL

37.0- 51.0 %
140- 440 K/dL
4.20- 6.30 M/uL
10.7- 12.1 sec
32.6- 37.6 sec

Blood chemistry was done also. All within normal

range.

On 10th August 2009 Evening shift:

Consent for surgery checked and confirmed.

Routine evening care done.

Anesthesia evaluation done at 2100h, with preanesthesia checklist completed.

Patient was instructed Nothing Per Orem after 12

midnight as ordered. Re-assured.

IV cannula G22 inserted on Rt Metacarpal vein at

0530H. NPO re-iterated.

IV fluid D5 Water 500ml hooked and regulated at

100ml/hr rate at 0600H.

On 11th August 2009 Day shift:

Injection Zantac 50mg IV and Premosan 10 mg

IV given at 0830h.

NPO maintained.

Pre-op V/S checked and recorded.

Pre-operative checklist as per protocol checked,

done and completed.

Patient reassured and to Operating room on call

for septoplasty.

Patient was propped in reclined position.

V/S checked as per protocol.

Patient was instructed not to blow in the nose.

Dressing was assessed for further bleeding.

Sips of water served and when tolerated, normal

diet served.

Pain assessed and analgesic given as prescribed.

Kept rested with siderails up in comfortable

position.

Nasal pack was removed by ENT surgeon on 12th

August 2009 at 0800H.

Dressing was changed and noted for further

bleeding.

Tolerated normal diet.

Discharged at 1400H with discharge and home

meds instructions given.

By: Sindhu Philip

DRUG
NAME

DOSE &
ROUTE

INDICATION

ADVERSE
REACTION

Inj. Zantac

50 mg IV stat

- Duodenal ulcer,
gastric ulcer including
that associated with
non- steroidal antiinflammatory agents
- post- operative ulcer

-Diarrhea and
other gastrointestinal
disturbances,
altered liver
function tests,
headache,
dizziness, rash

Inj Primperan

10mg IV stat

Nausea and vomiting,

dyspeptic manifestation
due to a digestive
mobility disorder

Extrapyramidal
reactions,
drowsiness,
vertigo, dizziness,
headache,
depression, GI
disturbances and
HTN

POST-OP MEDICINE
DRUG
NAME

DOSE &
ROUTE

INDICATION

ADVERSE
REACTION

Tab Klacid

500mg BD per
orem

Treatment of infections:
-Lower respiratory tract
infection
- Upper respiratory
tract infection

- Nausea,
headache,,
dyspepsia,
diarrhea,
vomiting,
abdominal pain
and paresthesia

Tab Sapofen

400mg BD per
orem

Anti- inflammatory and

analgesic effects.
- To relive pain in postoperative cases

- Gastrointestinal
disturbances,
skin rash,
nervousness,
headache,
tinnitus.

POST-OP MEDICINE
DRUG
NAME
Tab Sapofen

DOSE &
ROUTE
400mg BD per
orem

INDICATION

ADVERSE
REACTION

Anti- inflammatory and

analgesic effects.
- To relive pain in postoperative cases

- Gastrointestinal
disturbances,
skin rash,
nervousness,
headache,
tinnitus.

by: Ednaly Santiago

NURSING
DIAGNOSIS

Fear and
anxiety
r/t
upcoming
invasive
procedure

ASSESSMENT

S - Ana fi
kouf
sisteras
verbalized
by patient.
O- uneasy
feeling,
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
patients
explanation was fear
given regarding
procedure .

-Patient
verbalized
that she
understoo
d the
procedure.

- Encouraged
patient to
verbalize
feelings and
reassured.

- Patient
verbalized
she feels
better and
calm.

NURSING
DIAGNOSIS

ASSESSMENT

GOAL

INTERVENTION

To promote
comfort by
minimizing
pain.

- Post-op V/S
monitored
according to
protocol.
- Analgesic
administered as
prescribed.

RATIONALE

EVALUATION

To
monitor
level of
pain and
lessen
pain

Patient
verbalized
relief and
minimal
tolerable
pain.

POST-OP:
Alteration
in
comfort;
pain r/t
post
septoplas
ty

S- Ahlam
sister as
claimed by
patient.
O- slght
swelling
noted over
patients
nose

NURSING
DIAGNOSIS

ASSESSMENT

GOAL

Potential
for
bleeding
r/t postop
procedure

S- Fi dam
etla

- To
minimize
and
prevent
further
bleeding on
the
operated
site

O- nasal
dressing
was
minimally
soaked
with blood

INTERVENTION

-Patients head
was kept
elevated and
rested in
reclined
position.
- Dressing
checked every
now and then
for further
bleeding.

RATIONALE

EVALUATION

Head
elevation
reduces
further
bleeding
and
swelling .

No further
bleeding or
swelling
noted.
Bleeding
and
swelling
minimized.

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

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 hit or move any part of the nose.

Not to hold back a sneeze. Sneeze with the mouth

open.

To expect a crusting in the nose for not more than 6

weeks while the incision is healing.

She can eat and drink normally although soft diet

are best.

To avoid all moderate and heavy physical activity,

including sport for ten days after the operation and
avoid bending.

Avoid smoky, dusty and dry atmospheres.

If develops a temperature and increasing nasal /

facial pain a few days after the operation, to consult

doctor.

Improvement in nasal breathing may take a few

weeks.