Which recommendations should the nurse give to treat epistaxis? Select all that apply.

Epistaxis, or a nosebleed, primarily originates from Kiesselbach’s plexus, a highly vascularized region on the anterior septum. Management focuses on mechanical hemostasis through direct pressure and positional maneuvers to prevent aspiration of blood or gastric irritation from swallowing, ensuring the maintenance of a patent airway during the event. Rationale: A. Applying firm, continuous pressure to the soft portion of the nose compresses the bleeding vessels against the septum. This mechanical compression facilitates the formation of a fibrin clot to stop the hemorrhage. It is a standard first-aid intervention that should be initiated immediately upon the onset of bleeding. B. Tilting the head back is contraindicated as it allows blood to flow down the posterior pharynx. This can lead to nausea or vomiting due to blood entering the stomach or, more seriously, cause aspiration into the lungs. Keeping the head upright or forward is essential for safety. C. Constant pressure must be maintained for at least 10 to 15 minutes to allow the coagulation cascade to stabilize a clot. Releasing pressure too early can disrupt the fragile seal and cause rebleeding from the damaged vessel. Patience is required to ensure effective and lasting local hemostasis. D. The head should be tilted forward to ensure that blood drains out of the nostrils rather than into the throat. This position minimizes the risk of choking and allows the nurse to monitor the volume of blood loss more accurately. It is the safest postural alignment for the patient. E. Pinching above the nostrils, specifically on the nasal bones, is ineffective because the bone cannot be compressed against the bleeding site. Pressure must be applied to the cartilaginous distal portion of the nose to effectively squeeze the septal vessels. Improper placement of the fingers will fail to stop the flow.