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Summary Nursing (NR602)
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Summary on NR602 Pediatric study
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lOMoARcPSD|8178116Post - NR602 Final exam study guide
Primary Care Of The Childbearing (Chamberlain University)
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NR602: Pediatric Study Topics
Pediatric Study Topics
Eye Disorders- 616- 646
Strabismus- a defect in In ocular alignment, or the position of the eyes in relation to each
other; It is commonly called lazy eye. And strabismus, the visual axes are not parallel because
the muscles of the eyes are not coordinated; When one eye is directed straight ahead, the
other deviates.
Retinoblastoma is an intraocular tumor that develops in the retina. Although it is rare, this
malignant retinal tumor is the most common tumor in childhood (some 4% of cancers in
children younger than 15 years of age)
Clinical findings
strabismus is the most common finding
there is a decreased visual acuity uni- or bilateral white pupil (leukocoria),
described often as an intermittent “glow, glint, gleam, or glare” by parents, is
usually seen in low light settings or noted in photographs taken with a flash i.e.
(cat's eye reflex)
other symptoms include an abnormal red reflex, nystagmus, glaucoma, orbital
Cellulitis and photophobia, hyphema, hypopyon (plus an anterior Chamber of
eye); Signs of global rupture or also possible
Bulbar or palpebral conjunctival injection is a common presentation, which can be unilateral or
bilateral.
differential diagnosis should include allergy, conjunctivitis, infection, foreign body, chemical
exposure, or systemic inflammatory disease, irritation of the conjunctiva or cornea, and
congenital glaucoma.
Watery discharge can occur with allergies, nasolacrimal obstruction, foreign bodies, viral
infection, and iritis.
Purulent or mucoid discharge can be noted with chronic dacrocystitis or nasolacrimal
obstruction.
Advanced allergic conjunctivitis can have some mucoid production.
To differentiate, microscopic investigation of discharge may lead to other clues.
Photophobia is a symptom common of trauma and in infants with glaucoma or retinal disease.
Other non-eye related causes of photophobia include migraines and meningitis.
A white pupil, or leukocoria is a serious finding and demands immediate referral to the
pediatric ophthalmologist.
Causes of leukocoria include retinal detachment, cataract, retinal dysplasia, retinopathy of
prematurity, and in newborns retinoblastoma.
All newborns should have a fundoscopic examination within 24 hours of birth and yearly on
physical examinations.
Conjunctivitis chart
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Chalazion vs Stye
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CHALAZIONS – Benign, chronic lipogranulomatous inflammation of the eyelid
Causes – blockage of the meibomian cyst
Risk – hordeolum or any condition which may impede flow through the meibomian
gland. Also mite species that reside in lash follicles
Assessment – PAINLESS, NOT INVOLVING LASHES
Lid edema, or palpable mass
Red or grey mass on the inner aspect of lid margin
Prevention – good eye hygiene
Treatment – warm, moist compresses 3x per day
Antibiotics not indicated because chalazion is granulomatous condition,
if secondarily infected consider SULFACETAMIDE, ERYTHROMYCIN
Follow up – 2-4 weeks, if still present after 6 weeks follow up with ophthalmologist
Blepharitis-
BLEPHARITIS – Inflamation/infection of the lid margins (chronic problem)
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