Nursing Diagnosis of Nasal surgery
A. Pre operative Nursing Diagnosis
Actual Nursing Diagnosis
a)
Fear related to perceived threat of the surgical procedure as evidenced by facial
tension, sympathetic activation(BP; 140/100 mm of Hg, PR: 88 beats/min)
Potential Nursing Diagnosis
b) Risk for fluid volume deficit related to restriction to oral intake for surgery
B. Post operative Nursing Diagnosis
Actual Nursing Diagnosis
a) Ineffective breathing pattern related to nasal packing as evidenced by respiration
rate 24 breaths/min , oxygen saturation 88% in room air.
b) Impaired physical comfort related to presence of nasal pack as evidenced by
patient’s verbalization.
c) Disturbed body image related to application of nasal pack as evidenced by sad
facial expression.
d) Hyperthermia related to inflammatory process as evidenced by temperature 100
degree Fahrenheit, Pulse : 88b/m.
e) Deficient knowledge related to post operative care and considerations as
evidenced by patient frequently asking about what can be done and what cannot
be done.
Potential Nursing Diagnosis
f)
Risk for dry mouth related to mouth breathing.
g) Risk for aspiration related to bleeding, inability to blow nose.
h) Risk for infection related to alteration in nasal mucosal membrane and
application of nasal pack.