Conjunctivitis

Question 1

Pathophysiology of Allergic Conjunctivitis

Answer 1

Contact with allergen results in an allergic response (overreaction of the immune response). The mast cell and histamine mediators are the activated, resulting in inflammation

Question 2

Pathophysiology of Bacteria Conjunctivitis

Answer 2

When bacteria comes in contact with the bulbar or palpebral conjunctiva, they are recognized as foreign antigens and an antigen-antibody immune reaction occurs, resulting in inflammation

Question 3

Pathophysiology of Viral Conjunctivitis

Answer 3

When viruses comes in contact with the bulbar or palpebral conjunctiva, they are recognized as foreign antigens and an antigen-antibody immune reaction occurs, resulting in inflammation

Question 4

Risk Factors for Allergic Conjunctivitis

Answer 4

(1) Family History
(2) History of asthma
(3) Allergic rhinitis
(4) Atopic Dermatitis

Question 5

Risk Factors for Bacterial and Viral Conjunctivitis

Answer 5

(1) Age younger than 2 weeks
(2) Day Care
(3) Preschool or School attendance
(4) Viral Upper Respiratory Infections
(5) Pharyngitis
(6) Otitis Media

Question 6

Sign/Symptoms of Allergic Conjunctivitis

Answer 6

(1) Inflamed Conjunctivae
(2) Watery or Stringy Discharge
(3) Itching
(4) Eyelid Edema

Question 7

Signs/Symptoms of Bacterial Conjunctivitis

Answer 7

(1) Inflamed Conjunctivae
(2) Purulent, mucoid
(3) Mild Pain
(4) Occasional Eyelid Edema

Question 8

Signs/Symptoms of Viral Conjunctivitis

Answer 8

(1) Inflamed Conjunctivae
(2) Watery, mucoid
(3) Lymphadenopathy, photophobia, tearing
(4) Eyelid Edema

Question 9

Interventions for Allergic Conjunctivitis

Answer 9

(1) Eye drops with antihistamine or mast stabilizer drops
(2) Encourage not to rub/touch eyes
(3) Rinse child’s eyelids periodically with a clean washcloth and cool water
(4) When the child comes in from outdoors, wash the child’s face and hands
(5) Shower and shampoo before bedtime
(6) Avoid allergens that trigger allergic response

Question 10

Interventions for Bacterial Conjunctivitis

Answer 10

(1) Antibiotic drops or ointment
(2) Warm compress
(3) Encourage not rub/touch eyes
(4) Do not share towels or washcloths
(5) Handwashing
(6) May return to school when mucopurulent drainage is no longer present (usually 24-48 hours of treatment with a topical antibiotic)

Question 11

Interventions for Viral Conjunctivitis

Answer 11

(1) Warm compress
(2) Symptom Relief: antiherpetic agent if caused by herpes
(3) Handwashing
(4) May return to school when symptoms lessen

Question 12

Nursing Assessment:

Answer 12

(1) Health History:
> Sign/Symptoms reported may include:
> Redness
> Edema
> Tearing
> Discharge
> Eye pain
> Itching of the eye
> Determine onset of symptoms and their progression and response to treatments used at home
> Assess risk factors

(2) Physical Examination
> Observe for eyelid swelling
> Inspect the conjunctiva for redness
> Note quantity, color and consistency of discharge

(3) Nursing Management:
> Alleviating Symptoms:
(1) Teach parents how to apply eye drops or ointment
(2) Warm compresses
(3) Encourage the child to avoid perennial allergens

> Preventing Infectious Spread
(1) Teach appropriate handwashing
(2) Discourage sharing towels and washcloths
(3) Bacterial- return to school 24-48 hours after treatment)
(4) Viral- return to school when symptom lessen