NOSE & SINUSES ASSESSMENT

• the upper third of the nose is bone; the remainder is cartilage
• If the client reports difficulty or abnormality in smell, the nurse may test the client’s olfactory sense
• Lightly palpate the external nose to determine any areas of tenderness, masses, and displacements of bone and cartilage.
• Inspect the external nose for any deviations in shape, size, or color and flaring or discharge from the nares.
• Determine patency of both nasal cavities. Ask the client to close the mouth, exert pressure on one naris, and breathe through the opposite naris.
• Facing the client, insert the tip of the speculum about 1 cm (0.4 in.). Care must be taken to avoid pressure on the sensitive nasal septum.
• Ethmoid and maxillary sinuses are present at birth; frontal sinuses begin to develop by 1 to 2 years of age
• Infants and young children have fewer sinus problems than older children and adolescents.
• sphenoid sinuses develop later in childhood
• Ethmoid sinuses continue to develop until age 12.
• Cough and runny nose are the most common signs of sinusitis in preadolescent children.
• Adolescents may have headaches, facial tenderness, and swelling, similar to the signs seen in adults.
• The sense of smell markedly diminishes because of a decrease in the number of olfactory nerve fibers and atrophy of the remaining fibers.
• Nosebleeds may result from hypertensive disease or other arterial vessel changes.
• ABNORMALITIES OF THE NOSE

  NASALPOLYP

  PERFORATED SEPTUM