NURS 5335 family 2 Study Guide EENT Family Nursing II Modules 1&2, Exam Solutions

NURS 5335 family 2 Study Guide EENT Family Nursing II Modules 1&2, Exam Solutions-Non-Ulcerative: A/W seborrhea; seen commonly with trisomy 21; affects those with psoriasis, seborrhea, eczema, allergies and lice. Chemica ...

NURS 5335 family 2 Study Guide EENT Family Nursing II Modules 1&2, Exam Solutions-Non-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. - Blepharitis Blepharitis treatment - 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? - More common in children and adolescents hordeolum s/s? - 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, - differentials of hordeolum differentials of hordeolum - blepharitis Sebaceous carcinoma, Basal cell carcinoma, Squamous cell carcinoma, Dry eye syndrome, Conjunctivitis, blepharitis - 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 - (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 - Hordeolum tx chalazion - 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 - Chalazion is More common in adults and S?S TX: Warm compress; daily lid scrubs; lid message; intralesional steroid injection - Chalazion Conjunctivitis - 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) - Conjunctivitis Conjunctivitis - Allergic conjunctivitis is seen more in Spring and Summer. Bacterial is seen more in pediatric population. Conjunctivitis - 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 - 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 - 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 - 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