Understanding the NCLEX: A Guide.

By Peter Jumba
Image
  Understanding the NCLEX: A Guide. Understanding the NCLEX: A Guide. The NCLEX (National Council Licensure Examination) is the high-stakes exam used to determine if a candidate is prepared for entry-level nursing practice. It is developed by the National Council of State Boards of Nursing (NCSBN). There are two versions: NCLEX-RN: For those seeking licensure as a Registered Nurse. NCLEX-PN: For those seeking licensure as a Practical or Vocational Nurse. 1. The Computerized Adaptive Testing (CAT) Format The NCLEX does not function like a traditional paper exam. It uses CAT technology, which means the test adjusts its difficulty based on your performance: Correct Answers: The computer gives you a slightly more difficult question. Incorrect Answers: The computer gives you a slightly easier question. The Goal: The computer wants to determine with 95% certainty that your ability level is above the "passing standard." 2. Next Generation NCLEX (NGN) As of April 2023, the exam shi...
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Epistaxis: Causes, Signs And Symptoms, Risk Factors, Prevention, Treatment Options.

By Peter Jumba

 Epistaxis: Causes, Signs And Symptoms, Risk Factors, Prevention, Treatment Options.



Epistaxis is the medical term for a nosebleed, which occurs when a blood vessel in the nose ruptures. Most nosebleeds are not serious and can be managed with home treatment. They are common in children and older adults. 


Types of epistaxis:

There are two main types of nosebleeds, categorized by where the bleeding originates: 

  • Anterior epistaxis: This is the most common type, making up about 90% of cases. It occurs in the front of the nose from a network of small, fragile blood vessels known as the Kiesselbach's plexus.


  • Posterior epistaxis: Less common but potentially more serious, this type originates deep inside the nose from larger blood vessels. It can cause heavy bleeding that drains down the back of the throat and may require medical attention. 


Common causes:

Nosebleeds can be caused by local, systemic, environmental, and medication-related factors. 

Local and environmental causes:

  • Dry air: This is the most common cause, especially in dry climates or heated indoor spaces, where low humidity dries and cracks the nasal membranes.


  • Trauma: Includes nose-picking, forceful nose-blowing, or a direct injury to the nose or face.


  • Infections: Colds, sinusitis, or allergies can cause irritation and inflammation of the nasal lining.


  • Nasal abnormalities: A deviated septum or nasal polyps can disrupt airflow and dry out the nasal membranes.


  • Foreign objects: Especially in young children.


  • Irritating chemicals: Exposure to chemical fumes can irritate the nasal passages. 


Systemic and medication-related causes:

  • Blood-thinning medications: Drugs like aspirin, NSAIDs (ibuprofen), and warfarin can interfere with blood clotting and increase the risk of nosebleeds.


  • High blood pressure: While not a direct cause, hypertension is associated with nosebleeds and can make them more difficult to control.


  • Bleeding disorders: Conditions such as hemophilia and von Willebrand disease can cause recurrent nosebleeds.


  • Alcohol use: Heavy alcohol consumption can interfere with blood clotting.


  • Tumors: Rarely, benign or malignant tumors in the nasal cavity can cause nosebleeds. 

First aid treatment:

Most nosebleeds can be stopped at home with a few simple steps: 

  • Stay calm: Anxiety can increase blood pressure and worsen bleeding.


  • Sit up straight and lean forward: This prevents blood from flowing down the back of your throat, which can cause gagging or vomiting.


  • Pinch your nose: Using your thumb and index finger, firmly pinch the soft, fleshy part of your nose just below the bony bridge.


  • Hold for 10–15 minutes: Apply constant pressure without releasing. Breathe through your mouth during this time.


  • Use a cold compress: Apply a cloth-wrapped ice pack to the bridge of your nose to help constrict the blood vessels.


  • Avoid irritation: After the bleeding stops, do not blow your nose, pick at the clot, or engage in strenuous activity for several hours. 


When to see a doctor:

You should seek medical attention if: 

  • The bleeding does not stop after 20 minutes of continuous pressure.


  • The blood loss is rapid or very heavy.


  • The nosebleed follows a head or facial injury.


  • You feel faint, weak, or dizzy.


  • You experience frequent nosebleeds. 


Medical treatments

If home treatment is ineffective, a healthcare provider may use one of the following methods: 

  • Cauterization: A chemical (like silver nitrate) or a heat source is used to seal the bleeding blood vessel.


  • Nasal packing: Absorbent gauze or a special balloon is inserted into the nasal cavity to apply pressure to the bleeding vessel.


  • Adjusting medication: Your doctor may need to change the dosage of blood-thinning medication.


  • Surgery: In rare cases of severe or persistent bleeding, surgery may be necessary to ligate (tie off) the problematic blood vessels. 



This is for informational purposes only. For medical advice or a diagnosis, consult a professional. 


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