A complete nasal and sinus assessment addresses each of the following as indicated by the patient’s condition and orders, and compares each finding to baseline.
Nasal patency — airflow through each nostril and any obstruction or congestion.
Epistaxis — frequency, estimated volume, whether anterior or posterior, and the response to pressure, with the anticoagulation and blood-pressure context.
Nasal drainage — character (clear, purulent, bloody) and any post-nasal component.
Sinus symptoms — facial pain or pressure, tenderness over the sinuses, and their pattern.
The skin of the nares and the ears under a nasal-oxygen cannula — for pressure marks, erythema, or breakdown.
Smell — any change, given its effect on appetite and safety (cross-reference Taste/Swallowing).
The oxygen prescription and cannula fit where the patient is on oxygen (management in Respiratory and the COPD overlay).
The anticoagulation and antiplatelet regimen and the blood pressure where epistaxis is present.
Nasal mucosal condition — dryness or crusting that predisposes to bleeding, and humidification.
Any nasal trauma, foreign body, or device (such as a nasal tube) affecting the nose.
