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NURS 629 Peds Exam 2
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NURS 629 Peds Exam 2
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NURS 629 Peds Exam 2Strabismus - ANS-Misalignment of the eyes. Lazy eye or cross-eyed.
Results in loss of depth perception and double vision.
Assessment techniques to detect strabismus - ANS-Red light reflex
Cover-uncover test
Deviation of the weak eye outward - ANS-Exotropia
Deviation of the weak eye inward - ANS-Esotropia
Visual axis of one eye is higher than the fellow fixating eye - ANS-
Hordeolum - ANS-Sty; an acute infection of a sebaceous gland of the eyelid
Obstruction of the sebaceous glands or eyelid.
Staphylococcal aureus is the most common causative organism.
What might a patient with a hordeolum complain of - ANS-Swollen, red, painful lesion
on the lid margin
Itchiness of the eyelid
Pimple or abscess in either lid
External - next to eyelash
Internal - under eyelid
Painful swelling
Typically develops suddenly
Treatment for a hordeolum - ANS-Warm compresses-20 minutes qid
Antimicrobial ointment or drops
Good eye hygiene and hand washing
Chalzion - ANS-Chronic inflammation of the eyelid.
,Blocked meibomian gland - may result from internal hordeolum.
Often not painful but sensation of pressure.
Develop over weeks to months.
Clinical finding of chalzion - ANS-Mild erythema and edema of the eyelid that resolves
and results in a painless, non-pigmented mass
Itchiness of the eyelid
Pimple or abscess in either lid
External - next to eyelash
Treatment of chalzion - ANS-Erythromycin drops or ointment if hordeolum is present
Cellulitis develops - treat with erythromycin or cephalexin
Most important vital sign for a patient with an eye complaint - ANS-Visual acuity
Peritonsillar abscess (PTA) - ANS-Collection of pus or fluid around the tonsil
Symptoms of PTA - ANS-Increased fever
Anorexia
Drooling
Dyspnea
Restless & irritable
Muffled voice
Stridor
Respiratory distress
Physical exam findings of PTA - ANS-Fiery red asymmetric swelling of one tonsil
Uvula is often displaced and often forward
Large, tender lymphadenopathy
Management of PTA - ANS-Aspiration of the abscess may be performed for accurate
diagnosis and treatment.
, CT scan of the head and neck
Monitor airway at all times
ENT consult is essential
Usual Management
- IV antibiotics
- Inpatient management
At what age should hearing testing start? - ANS-4
If a child's hearing test results are anything greater than -10 to +15, what is the 1st thing
a provider should do? - ANS-Check the ear with an otoscope for an obstruction with
cerumen or a foreign body
Risk factors for otitis media - ANS-Boys
1st born
Winter months
Bottle fed babies
Preemies
Daycare children
Children of smokers
Acute otitis media epidemiology - ANS-75% of cases are viral
Pathogens are most likely S. pneumoniae, H. influenzae, M. catarrhalis
H. influenzae - must treat with Augmentin (conjunctivitis + AOM) must treat with a
topical antibiotic for the eye
Symptoms of otitis media - ANS-Fever
Pain
Discharge from the ear
Tugging or batting at the ear - can be a teething or a comfort thing
Irritability, crying, lethargy
Decreased appetitie - chewing & swallowing can increase pressure in the inner ear
Decreased sleep
Recent URI
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