Patient states that they are having trouble breathing on one side of their nose. As the nurse completing a head and neck assessment, what is one possible diagnosis that you will assess for?

A) Epistaxis: Epistaxis, or a nosebleed, typically presents with the sudden onset of blood coming from one or both nostrils. Although a nosebleed can cause discomfort and a sense of obstruction, it does not typically present as difficulty breathing through one side of the nose. Epistaxis is more related to trauma, dry air, or nasal irritation rather than a structural issue causing airflow restriction.

B) Perforated septum: A perforated septum refers to a hole or tear in the nasal septum, the cartilage and bone that separates the two nasal passages. It may cause symptoms such as a whistling sound when breathing or increased susceptibility to infections, but difficulty breathing on one side of the nose alone isn't the most common symptom. A perforated septum is often associated with chronic drug use or injury, but it doesn't usually present with unilateral breathing difficulty unless it's very severe.

C) Deviated septum: A deviated septum occurs when the thin wall of bone and cartilage that divides the nasal cavity is displaced to one side. This condition is one of the most common causes of breathing difficulty on one side of the nose. The deviation can obstruct airflow, leading to symptoms like difficulty breathing through one nostril, congestion, or sinus infections. This diagnosis is most likely based on the patient's complaint.

D) Ankyloglossia: Ankyloglossia, also known as tongue-tie, refers to a condition where the frenulum (the membrane under the tongue) is abnormally short, restricting the tongue's movement. While it can cause feeding difficulties in infants or speech issues, it has no connection to nasal airflow or breathing problems. This diagnosis is unrelated to the symptoms described.

A) Diabetic retinopathy: Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina. It can lead to vision problems, including blurry vision, floaters, and in advanced stages, vision loss. However, the central vision loss specifically described in the question is more characteristic of macular degeneration, as diabetic retinopathy typically causes peripheral vision loss rather than affecting the center of the visual field.

B) Detached retina: A detached retina occurs when the retina pulls away from its normal position, which can lead to sudden vision changes such as the appearance of floaters, flashes of light, and a shadow or curtain over the vision. While it can result in significant visual impairment, it does not typically cause a black spot in the center of vision. The loss of vision in a detached retina tends to occur in peripheral vision first, not centrally.

C) Macular degeneration: Macular degeneration, specifically age-related macular degeneration (AMD), is the most likely cause of the central vision loss described. It affects the macula, the part of the retina responsible for central vision. As the disease progresses, patients may notice a dark or empty spot in the center of their visual field, which matches the complaint of a "black large spot" in the center of their vision.

D) Glaucoma: Glaucoma is a group of eye diseases that typically cause increased intraocular pressure, leading to damage to the optic nerve and peripheral vision loss. It is more commonly associated with peripheral vision loss, and the central vision is generally preserved until the disease progresses to advanced stages. Therefore, central vision loss is not typically a characteristic symptom of glaucoma.