Maryville University Nurs 621 - HEENT
Exam 1questions With Correct Detailed
Answers.
What are conditions that require immediate referral? - ANSWER- -severe or sudden
vision loss.
-sudden or intense eye pain.
-corneal ulceration.
-trauma.
-foreign body
-herpetic infection of the eye
What type of pain does conjunctivitis, stye and dry eyes have? - ANSWER- Irritation,
grittiness or scratchiness.
What type of pain will the patient experience if the cornea is the issue? - ANSWER- -
photophobia (can be severe)
-difficulty keeping eye open.
What 2 things can we ask the patient to help us distinguish between viral, allergic and
bacterial? (in terms of eye complaints) - ANSWER- -Ask about timing of the discharge.
-Ask about the characteristic of the eye discharge.
-Also ask about history of any URI symptoms
What are the basics in terms of physical exam for someone with an eye complaint? -
ANSWER- -making sure the globe is intact.
-red reflex
-pupils are reactive to light.
-EOM
-Visual acuity.
What is Blepharitis? - ANSWER- -Inflammation involving the structures of the lid margin.
-The most common ocular disease.
What is the presentation of Blepharitis? - ANSWER- -redness
-scaling
-crusting of the lid margins and eye lashes.
-pt reports burning, itching, feeling like something is in the eye.
How do you manage Blepharitis? - ANSWER- -Warm compresses 5-10 mins BID.
-scrub lash with diluted baby shampoo BID.
What is a Hordeolum (stye)? - ANSWER- -an erythematous tender lump within the eye
lid.
-involves infection or inflammation of a hair follicle of the eye lashes along the lid
margin.
- caused by blocked meibomian glad or infection of sebaceous glands of the eyelash.
What is the onset for a Hordeolum? - ANSWER- Acute
Presentation of hordeolum? - ANSWER- -Sudden onset
-painful swelling
-pimple/abscess in either upper or lower lid.
-tender lump.
What is a Chalazion? - ANSWER- -A hordeolum that doesn't resolve and eventually
forms granulation tissue.
-A blocked Meibomian gland.
-Pea-sized nodule within the eyelid, typically top eyelid.
What are the symptoms of a Chalazion? - ANSWER- -slow developing.
-no pain.
-hard mass/nodule within the eye lid (upper eyelid usually)
Is a Chalazion an infection? - ANSWER- No
What do you do if the Chalazion is persistent? - ANSWER- Refer to ophthalmology for
further evaluation.
What is bacterial conjunctivitis?
Is it contagious? - ANSWER- Inflammation and infection of the conjunctiva which is
caused by bacteria.
Yes, highly contagious - direct contact with secretions or contaminated surfaces.
What is the symptomatic presentation of bacterial conjunctivitis? - ANSWER- -redness
-purulent or mucopurulent discharge (thick and globular)
-unilateral at onset
-eyelids "glued" shut in the AM.
-eyelid edema.
What are major pathogens in acute bacterial conjunctivitis? - ANSWER- Gram Positive
Organisms
-Staphylococcus aureus (most common in adults)
-Streptococcus pneumoniae
What is the diagnostic clue of Chlamydial Conjuctivitis? - ANSWER- A CC that an eye
infection has persisted for >3 weeks despite treatment with topical antibiotics.
How is Chlamydia Conjunctivits trasmitted? - ANSWER- Autoinoculation from infected
genital secretions.
What are the S/S of chlamydial conjunctivitis? - ANSWER- -mucopurulent discharge.
-corneal infiltrates.
-palpable preauricular node is usually present.
Ear infection and rhinitis cold accompany it.
What is the treatment of chlamydial Conjunctivitis? - ANSWER- Doxycycline 100mg BID
x7 days
OR
Azithromyacin 1 gram PO in combination with topicals.
What is the presentation of Allergic Conjunctivitis? - ANSWER- -bilateral redness.
-watery discharge.
-May have stringy or rope-like discharge.
-itching (cardinal sign)
-crusty in the morning.
-history of allergy symptoms.
How do you treat allergic conjunctivitis? - ANSWER- -Cold compresses
-lubricants
-Topical antihistamines, decongestants, NSAIDS and mast cell stabilizers.
--Naphcon-A (Naphazoline + pheniramine) -- antihistamine/decongestant OTC 1gtt QID
PRN up to 8 days.
Olopatadine (Patanol) 0.1% or 0.2% solution 1 gtt BID
Ketorolac (Acular) NSAID 1gtt QID
-Systemic Antihistamines.
What is the presentation of Viral Conjunctivitis? - ANSWER- -gritty/burning feeling.
-morning crusting.
-watery to serous discharge during the day.
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