discuss the incidence and prevalence of epistaxis, pathophysiology from an advanced practice perspective, physical assessment and examination, evidence-based treatment plan and patient education, as well as follow up and evaluation to assess the efficacy and outcomes of the evidence-based treatment plan for management of an episodic, acute, and chronic case involving the pathology(s)

It is common for people to experience nosebleeds or epistaxis. Epistaxis is more common in some populations than others. According to Kucik and colleagues (2005), up to 60 percent of the population may experience epistaxis at some point in their lives. Up to 85% older people report at least one epistaxis episode (Kucik, 2005). According to Gifford (2018), up to 6% in the population could suffer from chronic epistaxis.

Advanced practice in Pathophysiology

There are many blood vessels in the nose, making it vulnerable to bleeding and injury. Most nose bleeding occurs in the Kiesselbachplexus, which is found on the anterior nasal septum. The posterior nasal cavity can also be a source of bleeding, but this is more serious and needs immediate medical attention. Local and systemic causes can both be involved in epistaxis.

Local factors can include injury, infection and irritation due to environmental factors, such as pollution and dry air. Hypertension, coagulation problems, anticoagulants, or medications that alter platelet function are all systemic factors. In cases of chronic or repeated bleeding, it is crucial to check for any underlying conditions which may be contributing to the epistaxis.

Examining the physical condition

To determine the severity and cause of epistaxis, a comprehensive physical exam is required. A thorough examination of the nasal cavities and vital signs (such as heart rate and blood pressure) should be part of a physical exam. You can use a nasal scope to see the septum of your nose and determine any bleeding or irritation.

It may be necessary in severe cases to do a posterior nose examination to determine the cause of bleeding. Referral to a specialist or otolaryngologist may be necessary. It may be necessary to perform laboratory tests such as a complete blood count or coagulation study, along with electrolyte measurements, to determine underlying conditions which may cause epistaxis.

Patients education on evidence-based treatments and treatment plans

Treatment of epistaxis is dependent on its severity and the underlying causes of bleeding. For mild-to-moderate bleeding, conservative treatment options such as topical vasoconstrictors or nasal packing are often the first choice. If the bleeding is severe, like in cases of posterior bleeding, embolization or cauterization might be required to stop it.

Patients should be educated on the importance of maintaining proper nasal hygiene. This includes avoiding excessive nose picking and blowing, using humidifiers to moisturize the air and avoiding irritating substances such as smoke. If a patient has underlying conditions like hypertension or bleeding disorders, they should be advised on the importance to manage these conditions.

Evaluation and follow-up

Epistaxis management is not complete without evaluation and monitoring. Monitoring patients for any recurrences of bleeding or adverse treatment effects, like infection or nasal irritation is important. If you have chronic or recurrent blood loss, it may be necessary for further assessment and management to determine and treat underlying medical conditions.

Epistaxis, as a condition of common occurrence, requires a careful assessment and treatment. In order to create an effective treatment, you must first assess the causes of bleeding. For milder to moderate bleeding, conservative measures like direct pressure or topical vasoconstrictors can be effective. More severe cases might require embolization or cauterization. To prevent bleeding from recurring and to promote good nasal hygiene, it is vital that patients are educated. Follow