Nurse Lucy is planning to give preoperative teaching to a client who will be undergoing rhinoplasty. Which of the following should be included?
A. Results of the surgery will be immediately noticeable postoperatively
B. Normal saline nose drops will need to be administered preoperatively
C. After surgery, nasal packing will be in place 8 to 10 days
D. Aspirin-containing medications should not be taken 14 days before surgery
Correct Answer: D. Aspirin-containing medications should not be taken 14 days before surgery
Aspirin-containing medications should not be taken 14 days before surgery to decrease the risk of bleeding. Impaired coagulation may cause postoperative complications. Patients should be asked about a history of excessive bruising or bleeding, consumption of drugs, supplements, or vitamins that alter coagulation cascade or history of thrombotic events in the past. Any drug, vitamins, or supplement that impairs coagulation might have to be suspended preoperatively.
Option A: Results would not be seen immediately, as swelling on the postoperative part will be prominent after surgery. Preoperative photos have to be taken for previous analysis and planning and for medico-legal purposes. Frontal, both profiles, and a basal view are the minimum requirements. They should be taken using a dark background with good lighting settings.
Option B: There is no indication for normal saline nose drops after surgery. Closed rhinoplasty can be performed either with general anesthesia or local anesthesia and sedation, both with similar results in experienced hands.The patient is placed in the supine position, with a slight reverse Trendelenburg, to minimize bleeding.
Option C: Internal dressings or nasal packings remain in place for 1 to 7 days after the surgery. After mucosal incisions are closed with resorbable sutures, Silastic splints are placed and sutured to each side of the septum in order to provide septal support and enhance mucosal healing. Several strips of paper tape are distributed over the dorsum and a cast over it, which is removed 7 days postoperatively.