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NURS 5335 family 2 Study Guide EENT Family Nursing II Modules 1&2 with complete solution
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NURS 5335 family 2 Study Guide EENT Family Nursing II Modules 1&2 with complete solution
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NURS 5335 family 2 Study Guide EENT Family Nursing II Modules 1&2 with complete solutionNon-Ulcerative: A/W seborrhea; seen commonly with trisomy 21; affects those with psoriasis, seborrhea, eczema, allergies and lice. Chemical and environmental irritants contribute
Ulcerative:Involves the lash follicle & the Meibomian glands of the eyelid.May be pustules at the base of the hair follicle that crust & bleed.Lashes break easy. Answer - Blepharitis
Blepharitis treatment Answer - TX: Warm compress; daily lid scrubs; erythromycin, quinolone or bacitracin ophthalmic ointment for anterior blepharitis. Consider oral ABX for resistance (Doxycycline or Tetracycline)
Disinfect contacts
Lid massages
hordeolum age group? Answer - More common in children and adolescents
hordeolum s/s? Answer - Localized tenderness, erythema, edema of eyelids; internal lesions pointing to external or internal eyelid surface; external lesions pointing to eyelid margin
Pain
Ocular rosacea
Contact dermatitis,
Atopic Kerato-conjunctivitis,
Herpes simplex infection,
Preseptal cellulitis,
Acute dacryocystitis, Answer - differentials of hordeolum
differentials of hordeolum Answer - blepharitis
Sebaceous carcinoma,
Basal cell carcinoma,
Squamous cell carcinoma,
Dry eye syndrome,
Conjunctivitis,
blepharitis Answer - Ocular burning, eyelid margins red w/ scaling or crusting Pain
Itching, tearing, chalazia, recurrent styes, photophobia, small ulceration at eyelid margin, broken or absent eyelashes
hordeolum Answer - (stye) red, painful pustule that is a localized infection of hair follicle
at eyelid margin. The most common associated organism is Staphylococcus aureus
TX: Warm compress; lid scrubs for recurrent lesions Answer - Hordeolum tx
chalazion Answer - a nodule or cyst, usually on the upper eyelid, caused by an obstruction in a sebaceous gland A granulomatous infection of a Meibomian gland
Nontender chronic lesions; bump Answer - Chalazion is More common in adults and S?
S
TX: Warm compress; daily lid scrubs; lid message; intralesional steroid injection Answer - Chalazion
Conjunctivitis Answer - Refer to ophthalmology for viral herpetic conjunctivitis w/RED FLAGS
Inflammation of the conjunctiva covering the front of the eye from a causative agent (bacteria, virus, allergen) Answer - Conjunctivitis
Conjunctivitis Answer - Allergic conjunctivitis is seen more in Spring and Summer.
Bacterial is seen more in pediatric population.
Conjunctivitis Answer - ALLERGIC: Pruritus; conjunctival hyperemia, chemosis; a watery or stringy discharge
BACTERIAL: Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash mattering; edema; hyperemia; preauricular adenopathy only w/ hyperacute disorder
VIRAL: Acute onset often A/W systemic illness; photophobia or foreign body sensation; preauricular adenopathy; hyperemia; chemosis; watery discharge; classic dendritic corneal lesion present w/ herpes simplex; periocular lesions present w/ herpes zoster opthalmicus
ALLERGIC: Conjunctivitis Answer - Pruritus; conjunctival hyperemia, chemosis; watery or stringy discharge
Topical antihistamine/oral antihistamine or topical vasoconstrictor decongestant antihistamine (OTC) drops: o Naphazoline hydrochloride 0.025% (Naphcon-A) o Naphazoline- antazoline 0.3% (Vasocon-A) o Levocabastine hydrochloride 0.05% (Livostin) o Emedastine 0.05% (Emadine) mast cell stabilizers: o Olopatadine 0.1% (Palatal) o Azelastine 0.05% (Optivar) 1st line = prevention; avoid whatever allergen is triggering conjunctivitis
BACTERIAL:Conjunctivitis Answer - Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash mattering; edema; hyperemia; preauricular adenopathy only w/ hyperacute disorder
Caused by staph, strep, h flu, and m catarrhalis, Pseudomonas (contact lens wearers), gonorrhea ****Staph aureus (more common in adults)
Eye drops or ointment:
o Polytrim/trimethoprim/polymyxin o Erythromycin o Tobramycin o Gentamicin o Sodium
sulfacetamide o Ciprofloxacin o Fluoroquinolones-(**1st line for contact users) o Ointment over drops for children
VIRAL:conjunctivitis Answer - the second eye usually infected after 24-48 hrs
itchy eyes.
Tearing.
Redness.
Discharge.
Sandy, gritty
Light sensitivity (when corneal involvement is present)
TX: Antihistamine/decongestant drops o Trifluridine (herpes conjunctivitis)
enlarged or tender preauricular node; initially unilateral, then bilateral caused from adenoviruses, coxsackie virus, varicella, herpes, and herpes zoster § fluorescein stain= dendrites-----****Referral to opthamologist
Red flags in conjunctivitis: Answer - Diminished visual acuity, photophobia, severe foreign body sensation preventing pt from keeping eye open, corneal opacity, fixed pupil, or severe HA with nausea
corneal abrasion Answer - Partial or complete defect in the epithelial layer of cells after traumatic event or overexposure to sunlight
Corneal Abrasion
Fluorescein stain, C&S for Answer - Overexposure to sunlight, sports, failure to wear eye protection
Urgent referral to ophthalmology for erosions and emergent for ulcers
corneal abrasion tx Answer - Pain, redness, tearing, photophobia, foreign body sensation
Abx ointment or drops for 5-7 days -Traumatic/foreign body/recurrent abrasions= erythromycin ointment OR sulfacetamide o Contact lens abrasion= ofloxacin, cipro OR tobramycin drops/ointment
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