LESSON PLAN

ON

DEVIATED NASAL SEPTUM

Prepared By:

Mrs. Aryalekshmi B

Tutor

Karuna College Of Nursing

NAME OF THE TEACHER : MRS. ARYALEKSHMI. B

SUBJECT : SURGICAL NURSING

UNIT : IIIV

TOPIC : MANAGEMENT OF PATIENT WITH D.N.S

DATE : 03.04.2019

TIME :

DURATION : 1HOUR

PLACE : 2ND YEAR B.Sc NURSING CLASS ROOM

METHOD OF TEACHING : LECTURE CUM DISCUSSION

GROUP :2ND YEAR B.SC NURSING STUDENTS

TEACHING AIDS : POWERPOINT PRESENTION AND CHALKBOARD

PREVIOUS KNOWLEDGE OF THE : KNOWLEDGE REGARDING SIGNS AND SYMPTOMS OF DNS STUDYED IN 1 ST YEAR BSC (N)
GENERAL OBJECTIVES: On completion of the class students acquire knowledge regarding the management of Patient with DNS which help them
to identify and give care accordingly in the clinical setup

SPECIFIC OBJECTIVES:

Students will be able to,

 enumerate the anatomy of nasalseptum

 tell the causes of DNS

 explain the common sites of DNS

 describe effects of DNS

 listdown clinical features of DNS

 describe treatment of DNS

Specific Objective Time Content Teacher Activity Learner A.V Aids Evaluation
 Activity

5 mints Introduction:

A deviated septum occurs when the thin wall

(nasal septum) between your nasal passages is
displaced to one side. In many people, the nasal
septum is displaced — or deviated — making one
nasal passage smaller.

Students will be 5 mints Aetiology Enumerates the Listening and Power point What are the
able to explain the cause of DNS taking notes Causes of
anatomy of nasal 1. Trauma DNS
septum 2. Developmental errors

3. Racial factors

4. Hereditary factors

Time Contents A.V Aids Evaluation

Specific Teacher Activity Student
Objectives Activity

Students will be 15mints Trauma Explains the cause. Listening and Power point What is the
able to tell the taking notes cause for DNS
cause. • A lateral blow on the nose may
cause displacement of septal
cartilage from the vomerine groove
and maxillary crest

• A crushing blow from the front may

cause buckling , twisting ,fractures
and crushing of nasal septum

• Trauma during delivery

Developmental Errors

• Nasal septum is formed by the

tectoseptal process which descends
to meet the two halves of developing
palate in the midline

• During primary and secondary

dentition further developments
takes place in palate

• Unequal growth between palate and

base of skull may cause buckling of
nasal septum

• In mouth breathers-high arched

palate and DNS
 • In cleft palate,cleft lip,dental
abnormalities

3. RACIAL FACTORS

Caucasians are more affected than negroes

4. HEREDITARY FACTORS

Members of same family may have

deviated

Septum

Contents Teacher Activity Student Activity A.V Aids Evaluation

Specific Objectives Time

Explain the sites if 5 min Sites of DNS List down the sites Listening and Power point What are the
DNS of DNS taking notes sites of DNS
• Cartilagenous/bony/both presentations

• Anterior/posterior

• High/low

Effects of DNS

• Compensatory hypertrophy of
turbinates of opposite side

• External deformity

• Impairment of drainage to sinus

• Secondary atrophic rhinits

Power point
Explain clinical Clinical Features List down the Listening and What are the
features 5 min clinical features of taking notes presentations clinical
1 . NASAL OBSTRUCTION DNS features
• Sites

• Vestibular

• At the nasal valve

• Attic
 • Turbinal

• Choanal

• Bilateral/unilateral obstruction

• HEADACHE

• SINUSITIS

• EPISTAXIS

• ANOSMIA

• EXTERNAL DEFORMITY

• MIDDLE EAR INFECTION

Cottles test

• Used in nasal obstruction due to

abnormality of nasal valve

• In this test ,cheek is drawn laterally

while patient breathes quietly.If the
nasal airway improves on test
side,the test is positive and indicates
abnormality of vestibular
component of nasal valve

Treatment
Explain about the 25 min Explaining the Listening and Power point What are the
treatment of DNS • Minor degrees of septal deviation treatment for
 require no treatment treatment measures taking notes presentations DNS

• If produces mechanical nasal

obstruction or other symptoms, an
operation is indicated

1.SUBMUCOUS RESECTION
OPERATION

• Generally done in adults under

local anaesthesia

• Elevating the mucoperichondrial

and mucoperiosteal flaps on either
side of the septal framework by a
single incision made on one side of
the septum

• Removing the deflected parts of

bony and cartilaginous septum

• Repositioning the flaps

2.SEPTOPLASTY

• Conservative surgery

• Only most deviated parts are

removed

• Rest of the septal framework is

corrected and repositioned by
plastic means.
• Mucoperichondrial or
mucoperiosteal flap is generally
raised only in one side of the septum
retaining the attachment and blood
supply of the other