Epistaxis/"Nosebleeds" - ATI: Nursing Care of Children

client education

For recurrences, remind the child to sit up and slightly forward so blood does not flow down the throat and cause coughing. Inform the family that bleeding usually stops within 10 min. Instruct the child and family to seek medical care if bleeding lasts longer than 30 min, and that repeated episodes require further evaluation for bleeding disorders.

Nursing Care

Maintain a calm demeanor with the child and family. Have the child sit up with the head tilted slightly forward to prevent aspiration of blood. Apply pressure to the lower nose with the thumb and forefinger for at least 10 min. If needed, pack cotton or tissue into the side of the nose that is bleeding. Encourage the child to breathe through her mouth while her nose is bleeding. Apply ice across the bridge of the nose if bleeding continues.

physical assessment findings

active bleeding from the nose, restlessness, agitation

expected history

bleeding gums or blood in body fluids or stool; trauma, illness, allergies, or placing foreign bodies in the nose

complication of epistaxis

hemorrhage

Factors that Precipitate Nosebleeds

low humidity, allergic rhinitis, upper respiratory infection, blunt injury, or a foreign body in the nose

Increases Bleeding

medications that affect clotting factors

diseases that cause epistaxis

von Willebrand disease, hemophilia, idiopathic thrombocytopenia purpura, leukemia