Causes of epistaxis are all except?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Medical & Surgical Nursing

Medium

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2021

Explanation

Allergic rhinitis is considered the correct answer because it is an indirect cause of epistaxis.
The condition causes inflammation and itching, which leads to nose rubbing, blowing, or picking, and this secondary trauma is what typically causes the bleeding.
Unlike the other options, allergic rhinitis itself does not directly cause blood vessels to rupture spontaneously in most cases.

Option A: Nose picking (digital trauma) is a very common and direct cause of epistaxis, as it involves physically damaging the blood vessels in the nasal septum.
Option B: A foreign body in the nose is a direct cause of epistaxis due to local trauma, inflammation, and mucosal erosion.
Option D: Thrombocytopenia is a direct systemic cause of epistaxis. The low platelet count impairs the body's ability to form clots, leading to spontaneous bleeding.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Epistaxis as background academic context rather than a clinical decision trigger.
Nurses must be able to provide immediate first aid for epistaxis: have the patient sit up, lean forward, and pinch the soft part of the nose for 10-15 minutes. Leaning forward prevents blood from being swallowed or aspirated.
Patient education is key for prevention. For recurrent epistaxis, nurses should advise on avoiding nose picking, using a humidifier in dry environments, and applying a saline-based lubricant to the nostrils.
A nurse should assess for underlying causes, especially in cases of severe or recurrent epistaxis. This includes asking about medications (like aspirin or anticoagulants) and symptoms of bleeding disorders (e.g., easy bruising).

How to Approach the Question

First, identify the negative framing of the question indicated by the word 'except'. This means you are looking for the option that does not fit with the others.
The question asks for causes of epistaxis. Your task is to evaluate each option's relationship to nosebleeds.
Analyze each option: 'Nose picking' is direct trauma. 'Foreign body' is direct trauma/inflammation. 'Thrombocytopenia' is a direct systemic cause (impaired clotting).
Evaluate 'Allergic rhinitis'. While it is associated with epistaxis, consider the mechanism. The bleeding is often secondary to nose blowing or rubbing caused by the allergy symptoms.
Compare the mechanisms. Three options are direct causes of bleeding (trauma or clotting failure). One option is an indirect cause (inflammation leading to trauma).
Conclude that the most indirect cause, Allergic rhinitis, is the 'exception' in this context.

Concept Tested & Keywords

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