Alterations In Head, Ears, Eyes, Nose, And Throat Flashcards
By age 2 to 3 vision is what?
20/50
By age 6 to 7 vision is usually what?
20/20
How are eustachian tubes and tympanic membranes different in children than adults?
Eustachian tubes are shorter, wider, and more horizontal. Tim panic membrane’s are closer to the surface.
What is conjunctivitis and what are the common symptoms?
Conjunctivitis is inflammation of the conjunctiva a signs and symptoms are redness, swelling, white or yellow discharge
What is conjunctivitis caused by?
Viruses, bacteria, allergies, trauma, and other irritants
What is ophthalmia neonatorum and what is it caused by?
Conjunctivitis in infants under 30 days old usually acquired by mom frequently caused by chlamydia and gonorrhea. May also be caused by prophylactic I treatment and develops within 24 to 48 hours after installation of the medication
What causes bacterial conjunctivitis, and what are the symptoms?
H. Influenzae, strep pneumoniae, moraxella catarrhalis, E. Coli. Symptoms are Adema of the eyelid, read conjunctiva, enlarged preauricular glands, Mucopurulent exit date, itching or burning, mild photophobia, and feeling of scratching under the lid
What is the most common cause of viral conjunctivitis?
Adenovirus is the most common cause, spreads from respiratory infection in her hand to eye Manor.
What is another cause of viral conjunctivitis?
Herpes virus infections. Prompt and vigorous treatment with IV acyclovir and topical eyedrops to prevent eye injury or blindness
What are symptoms of allergic conjunctivitis?
Intense itching, red eyes with watery discharge, conjunctivae which is cobblestone appearance, and puffy swollen eyes
What are treatments for bacterial conjunctivitis?
Antibiotic drops or ointment: floor quinolone (levofloxacin, ciloxan, ocuflox), ceftriaxone - goon occult conjunctivitis. Erythromycin- chlamydia
What are treatments for a viral conjunctivitis?
Comfort measures only, clean with one clean cloth, avoid bright lights when reading.
What are treatments for allergic conjunctivitis?
Topical antihistamine, decongestants with systemic antihistamines
What is usual neonatal eyesight?
20/100 or 20/400. Site is best at 8 inches away and color vision is not yet fully developed
If a child was diagnosed with bacterial conjunctivitis, how long before they can return back to school after they have been on antibiotics?
24 hours
What is Periorbital cellulitis, and what is the most common cause?
Infection of the eyelid and surrounding tissue usually buy a bacterial infection
What are common symptoms of Periorbital cellulitis
Swollen, tender, red or purple eyelids. Restricted, painful movements of area around eye, fever
For Periorbital cellulitis how long does it take for antibiotics to work?
Approximately 48 to 72 hours
What are errors in refraction?
Variations in the shape of the eyeball causing like to file somewhere else besides the retina.
What is hyperopia?
Hyperopia is one light focus is behind the retina and produces an inability to focus on nearby objects which means the patient is farsighted
If hyperopia is not treated it can cause what?
Amblyopia
What is myopia?
When light focuses in front of the retina, it produces the inability to see far off objects which means the patient is nearsighted it most commonly develops at about eight years old
What are signs and symptoms of myopia?
Headaches and squinting
What is astigmatism?
When the light is refracted differently caused by the curvature of the cornea or lens not uniformly spherical causing blurred images
What are signs and symptoms of astigmatism?
Child holding page is very close to face
What is Strabismus?
The abnormal turning of the In or out, symmetric vision is not possible. This may lead to amblyopia
What is treatment for Strabismus?
Treatment is best if started before two years to prevent amblyopia. Occlusion therapy, lenses for glasses, surgery of rectus muscles, eyedrops, prisms, eye exercises
What is amblyopia?
Reduced vision of the eye, one eye will have poor vision and it may result in strabismus
What is the treatment for amblyopia?
Compensatory lenses, occlusion therapy, 2 to 6 hours daily. Occasional eye exercises, atropine 1% one drop a day in the unaffected eye, best if treated by 5 to 6 years of age
What are cataracts?
Where all or part of the lens is opaque. It can be either congenital or acquired, and affect one or both eyes. It is seen in one out of every 250 newborns
What are signs and symptoms of cataracts?
Distorted red reflex, symptoms of vision loss, white pupils
What is treatment for cataracts?
Specific treatment depends on whether one or both eyes are affected, extent of cloudy, and presence of other eye problems. Surgical removal of the lines and corrective lenses contact lenses they implant lens. Surgery before two months of age yield best results
What is the technical visual acuity for legal blindness?
20/200 or worse
Who are at risk for legal blindness?
Premature infants, children his mothers were infected prenatally with rubella, toxoplasmosis, and other viruses. Certain congenital and hereditary condition, 90% of children with fetal alcohol syndrome have I abnormalities
What is retinopathy of prematurity?
A potentially blinding condition found in premature babies. Abnormal blood vessel development in the retina which can lead to retinal detachment if left untreated
Retinopathy of prematurity is linked to what?
High oxygen therapy
What is the treatment for a foreign object in the eye?
Remove the object if you can see it, irrigate the eye, place a patch over the eye, transport to emergency department
What is the treatment for chemical burns of the eye?
Irrigate for 15 to 30 minutes transport to emergency department
What is the treatment for a penetrating or perforating injury to the eye?
Call the emergency transport, do not take out a car! Never try to remove the object
What is the treatment for a blackeye?
Apply ice to both eyes for 1 to 2 days, then warm compresses
What is otitis media?
Inflammation of middle ear sometimes accompanied by an affection one of the most common childhood illnesses
What commonly proceeds otitis media?
Upper respiratory infection. Mucous membranes of eustachian tube is edematous , airflow is blocked, air in middle ear is reabsorbed into bloodstream, fluid is that hold into the former airspace which sets up for rapid growth of pathogens leading to infection
What are the most common organisms for otitis media?
Strep pneumoniae, hamophilus influenzae, moraxella catarrhalis
What are signs and symptoms of otitis media?
Pulling or rubbing it here is a sign of pain. Irritability and acting out our sides of related hearing impairments. Diarrhea vomiting fever. Sleep disturbances with crying because of increased pressure when prone or supine.
What is the treatment for otitis media?
Treat with antibiotics for 10 to 14 days. Amoxicillin which is the first line therapy. Treat pain, local anesthetic Tylenol or ibuprofen. Breast-feeding is protected against otitis media
What are complications related to otitis media?
Hearing deficit fluid remains present or occurs frequently. Delayed speech or speech problems due to alterations and hearing
What is treatment for recurrent OM?
Myringotomy which is a surgical incision of the tympanic membrane. Tamponostomy tubes which are pressure equalizing and drain the fluid from the middle ear.
Infants are at risk for hearing impairments if they have a positive tiger for TORCH. what is TORCH?
Toxoplasmosis, rubella, cytomegalovirus, syphilis, herpes
What infants are at risk for hearing loss?
Infants with the family history, cranial facial abnormalities, low birth weight less than 1500 g, bilirubin of over 16 mg/dL, aminoglycoside meds for over five days, low Apgar score’s one or five minutes, bacterial meningitis, ventilator use for more than five days, and other symptoms
What is conductive hearing loss and how would you get it?
From impacted cerumen, swimmers here, trauma, foreign body, when the tympanic membrane doesn’t fully vibrate.
What is sensorineural hearing loss?
When hairstyles in the cochlea or auditory nerve are damaged
Sensorineural hearing loss can be congenital, genetic, and acquired. List examples of each.
Congenital can be from maternal rubella, genetic can be from Tay-Sachs disease, acquired can be from all the toxic drugs, bacterial meningitis, or loud noise
What is epistaxis and what age range is most common in?
Nosebleeds, most common in school age children
What is Kiesselbach’s plexus?
Anterior Nanners often the source of nosebleeds because of plentiful veins
What are causes of nosebleeds? I had
Irritation from nose picking, foreign bodies, and low humidity. Other causes are forceful coughing, allergies, infections resulting in congestion of nasal mucosa
Bleeding from posterior septum:
More serious and life-threatening which may require hospitalization and indicate systemic disease or injury
What is treatment for a posterior septum nose bleed?
Kids maybe take into the emergency department especially if parents are unable to stop the bleeding. Squeeze near is just below the nasal bone, have child sit upright with head forward, take pulse and blood pressure, examine nasal mucosal. Have a child blow out clots, determine if one or both or both nares are affected
If the posterior septum nose bleed does not stop what should you do next?
Place patent medicated with Neo-synephrine, epinephrine, Robin, lidocaine in affected nare. Possible cauterization, absorbent packing maybe used if continued bleeding.
After severe nosebleed has stopped what should the patient avoid for the next 3 to 4 days?
Bending over, stooping, hot drinks, hot baths or showers, strenuous exercise
What is nasopharyngitis?
Upper respiratory infection, or common cold. Causes inflammation and infection of nose and throat. This is the most common illness of infancy and childhood
What are he most common viruses causing nasopharyngitis?
Rhinovirus and coronavirus
What is the most common bacteria causing nasopharyngitis?
Group A streptococcus
What are the manifestations of viral pharyngitis?
Nasal congestion, mild sore throat, conjunctivitis, hoarseness, mild pharyngeal redness, minimal tonsillar exudate, fever under 38.3, mild tender nodes
What are manifestations of strep throat?
Abrupt onset, painful swallowing, tonsillar exudate, painful cervical nodes, anorexia, nausea, vomiting, abdominal pain, headache, malaise, fever over 38.3, petechial modeling of the soft palate
If the patient has symptoms of pharyngitis what do you do?
Get a rapid stress test, if it is positive treat with penicillin, oral or injection, administer pain meds, cool nonacidic fluids. Soft foods, ice chips or frozen juice pops
What is tonsillitis?
Infection or inflammation of the Palitine tonsils. Can be viral or bacterial
What are symptoms of tonsillitis?
Frequent throat infections, difficulty swallowing and breathing, persistent redness, enlargement of cervical nodes
What is treatment for tonsillitis
The goal is to relieve discomfort for the child, symptomatic treatment, antibiotics, occasional surgery
What is appropriate pain management for tonsillitis post surgery?
Rinse mouth with lidocaine then swallow. No ibuprofen!
