STUDY - Technical - New Dacian's Medicine
Nasal
flaring (Classical / Allopathic Medicine)
Nasal flaring is
an abnormal dilation of the nostrils. Although it usually
occurs during inspiration, it may occasionally occur during
expiration or throughout the respiratory cycle. Nasal flaring
indicates respiratory dysfunction, ranging from mild
difficulty to potentially life-threatening respiratory
distress.
ALERT:
If you note nasal flaring:
- quickly evaluate the patient's respiratory status and check for airway obstruction
- institute emergency measures, as necessary.
If the patient's condition permits, perform a focused assessment.
If you note nasal flaring:
- quickly evaluate the patient's respiratory status and check for airway obstruction
- institute emergency measures, as necessary.
If the patient's condition permits, perform a focused assessment.
Recognizing
respiratory distress in infants
Because infants can't verbalize their symptoms, you'll need to teach parents how to recognize the signs of infant respiratory distress. Using these illustrations, show them how to evaluate nasal flaring. This sign, along with retractions and grunting on expiration, is graded to measure the severity of respiratory distress.
Grade 0
The infant breathes normally, with no nasal flaring.
Grade 1
The infant shows some signs of respiratory distress, including slightly flared nostrils and a slightly visible rib cage on inspiration. Instruct the parents to watch the infant closely and to begin measures to help him breathe more easily.
Grade 2
The infant has pronounced respiratory distress. His nostrils flare widely, his rib cage is quite visible on exhalation, and he grunts as he exhales. Tell the parents to call his physician immediately and to continue measures to make breathing easier.
HISTORY:
Ask the patient if he has a history of cardiac or pulmonary disorders such as asthma.
Ask the patient if he has allergies.
Ask the patient if he has experienced a recent illness (such as a respiratory infection) or trauma.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Because infants can't verbalize their symptoms, you'll need to teach parents how to recognize the signs of infant respiratory distress. Using these illustrations, show them how to evaluate nasal flaring. This sign, along with retractions and grunting on expiration, is graded to measure the severity of respiratory distress.
Grade 0
The infant breathes normally, with no nasal flaring.
Grade 1
The infant shows some signs of respiratory distress, including slightly flared nostrils and a slightly visible rib cage on inspiration. Instruct the parents to watch the infant closely and to begin measures to help him breathe more easily.
Grade 2
The infant has pronounced respiratory distress. His nostrils flare widely, his rib cage is quite visible on exhalation, and he grunts as he exhales. Tell the parents to call his physician immediately and to continue measures to make breathing easier.
HISTORY:
Ask the patient if he has a history of cardiac or pulmonary disorders such as asthma.
Ask the patient if he has allergies.
Ask the patient if he has experienced a recent illness (such as a respiratory infection) or trauma.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
PHYSICAL
ASSESSMENT:
Auscultate the patient's lungs for adventitious sounds.
Obtain a pulse oximetry reading.
Auscultate the patient's lungs for adventitious sounds.
Obtain a pulse oximetry reading.
SPECIAL
CONSIDERATIONS:
To help ease breathing, place the patient in a high Fowler's position. If he's at risk for aspirating secretions, place him in a modified Trendelenburg or side-lying position.
To help ease breathing, place the patient in a high Fowler's position. If he's at risk for aspirating secretions, place him in a modified Trendelenburg or side-lying position.
PEDIATRIC
POINTERS:
Nasal flaring is an important sign of respiratory distress in infants and very young children who can't verbalize their discomfort. Common causes include airway obstruction, hyaline membrane disease, croup, and acute epiglottiditis. (See Recognizing respiratory distress in infants.)
Nasal flaring is an important sign of respiratory distress in infants and very young children who can't verbalize their discomfort. Common causes include airway obstruction, hyaline membrane disease, croup, and acute epiglottiditis. (See Recognizing respiratory distress in infants.)
PATIENT
COUNSELING:
Instruct the patient and his family on what to expect from diagnostic testing, which may include chest X-rays, lung scan, pulmonary arteriography, sputum culture, complete blood count, arterial blood gas analysis, and electrocardiography.
Instruct the patient and his family on what to expect from diagnostic testing, which may include chest X-rays, lung scan, pulmonary arteriography, sputum culture, complete blood count, arterial blood gas analysis, and electrocardiography.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common symptoms,
Edition V, McGraw - Hill, 2002.