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Peds > EENT (2) > Flashcards

EENT (2) Flashcards

1
Q

What is the visual acuity of neonates?

A

20/100 - 20/400

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2
Q

What is decreased in neonatal vision?

A

Accommodation and color

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3
Q

what is different about the cornea in infants and young children?

A

The Cornea occupies larger portion of the orbit

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4
Q

What is the visual acuity of 2 to 3 year olds?

A

20/50

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5
Q

What is the visual acuity of 6-7 y.o.s

A

20/20

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6
Q

what is important to know about the eustachian tubes in pediatrics?

A

They are shorter, wider, and more horizontal which allow for passage of their during sucking or yawning, allow for otitis media or ear infection

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7
Q

bybwhat age do children get their first tooth

A

6 mo

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8
Q

By what age do children have a full set of teeth?

A

2 y.o.

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9
Q

What is inflammation of the conjunctiva?

A

infectious conjunctivitis (pinkeye)

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10
Q

what are symptoms of infectious conjunctivitis?

A

Reddit swollen conjunctiva with clear, weight, or yellow discharge

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11
Q

what can cause infectious conjunctivitis?

A

Bacteria, viruses, allergy, trauma, other

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12
Q

what is the term for conjunctivitis in infants under 30 days old

A

ophthalmia neonatorum

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13
Q

How do infants get ophthalmia neonatorum

A

vaginal delivery from mother

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14
Q

what is the term for the allergic response to the prophylactic eye prescription

A

Chemical conjunctivitis

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15
Q

How long after administration of prophylactic eye prescription does chemical conjunctive it is happen?

A

24-48 hr

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16
Q

What ages does bacterial conjunctivitis affect?

A

all

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17
Q

What are symptoms of bacterial conjunctivitis?

A

eyelid edema, red conjunctive, enlarged lymph glands, Mucopurulent drainage, itching and burning

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18
Q

what organisms cause bacterial conjunctivitis?

A

StapH aureus, h. influenzae, strep pneumoniae, Moraxella catarrhalis

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19
Q

What ages does viral conjunctivitis happen in?

A

older children

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20
Q

What is the most common cause of viral conjunctivitis and how?

A

adenoviruses, rub and itch eyes

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21
Q

What is used when viral conjunctivitis is from herpes?

A

acyclovir IV and topical drops

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22
Q

What are symptoms of allergic conjunctivitis?

A
  • intense itching
  • red eyes with watery discharge
  • conjunctivae- cobblestone appearance
  • puffy, swollen eyes
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23
Q

Your nursing assignment for the day includes an infant with A URI. Doing your assessment you notice that the child has water discharge coming from both eyes. The conjunctiva is slightly redddend and edematous.

What do you think is the cause of this conjunctivitis?

A

Viral, URI and water drainage

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24
Q

how is the cause of conjunctivitis usually determined?

A

Getting a history, looking at signs and symptoms, culture of drainage

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25
Q

How long does treatment of bacterial conjunctivitis last?

A

5-7 days

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26
Q

What is used for the treatment of bacterial conjunctivitis?

A

Antibiotic drops or ointment, erythromycin

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27
Q

what is used to treat viral conjunctivitis?

A

comfort measures

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28
Q

What are comfort measures that can be used for viral conjunctivitis?

A

Warm or cool wet compresses, affording lights and reading

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29
Q

what is used for the treatment of allergic conjunctivitis?

A

Systemic or topical histamines; decongestants with systemic antihistamines

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30
Q

how long are decongestants with systemic antihistamines used for treatment of allergic conjunctivitis?

A

short!

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31
Q

What can be used to prevent reactions of allergic conjunctivitis?

A

mast cell stabilizaers

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32
Q

Is conjunctivitis contagious?

A

yes

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33
Q

How long are antibiotics needed for conjunctivitis at least?

A

24h (no school)

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34
Q

What other eye condition can mimic conjunctivitis?

A

Clogged tear duct

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35
Q

What is infection of the eyelid and surrounding tissues?

A

periorbital cellulitis

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36
Q

What causes periorbital cellulitis?

A

bacteria

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37
Q

What are symptoms of periorbital cellulitis?

A
  • Swollen, tender, red or purple eyelids
  • restricted, painful movement of area around eye
  • fever
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38
Q

how quickly does periorbital cellulitis need to be treated?

A

quick!

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39
Q

Why does periorbital cellulitis require hospitalization?

A

IV antibiotics

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40
Q

What are visual disorders caused by?

A

Errors of Refraction

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41
Q

what type of visual disorder is where light falls behind the retina?

A

hyperopia

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42
Q

What kind of visual disorder is when light falls in front of the retina?

A

myopia

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43
Q

What is abnormal turning of the eye in or out that may lead to amblyopia?

A

strabismus

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44
Q

What can be used to help strabismus?

A

Occlusion therapy, patching the good eye in order to use the weak eye

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45
Q

what visual disorder is where one eye is poorer than the other, may result instrubitemis, genetic, lazy eye

A

amblyopia

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46
Q

what med can be used for treatment of amblyopis

A

atropine 1%

47
Q

How do people get cataracts?

A

Congenital or acquired

48
Q

What is the clouding of the lens?

A

cataracts

49
Q

What are signs and symptoms of cataracts?

A

Distorted red reflex, symptoms of vision loss

50
Q

What is the treatment of cataracts?

A

surgery

51
Q

what is when immature blood vessels in the retina constrict and necrose

A

retinopathy of prematurity

52
Q

what 3 things is retinopathy of prematurity associated with?

A
  • oxygen therapy
  • resp distress
  • assisted ventilation
53
Q

what age, sex, and race is retinopathy of prematurity most common in

A
  • boys born before 28 weeks, weight less than 1600 gms
  • whites
  • alaskan natives
54
Q

how is retinopathy of prematurity diagnosed?

A

ophthalmic exam

55
Q

treatemnt of retinopathy of prematuroty

A

laser therapy

56
Q

what is the most common cause of blindness in the US?

A

Retinopathy of prematurity

57
Q

what ages and sex are eye injuries most common in

A

boys age 11-14

58
Q

treatment for black eye

A

ice both eyes 1-2 days, then warm compresses

59
Q

treatment for foreign objects in the eye

A
  • remove if seen
  • irrigate
  • patch
  • transport to ED
60
Q

treatment for chemical burns of the eye

A
  • irrigate 15-30 mins
  • transport to ED
61
Q

treatment for penetrating and perforating eye injury

A
  • call emergency transport, NO CAR
  • never try to remove object
62
Q

what is included in an ear assessment

A
  • placement
  • pinna
  • external auditory canal
  • hearing
63
Q

what is low-set ears associated with?

A

congenital renal disorders

64
Q

what is inflammation of the middle ear, sometimes associated with infection

A

otitis media

65
Q

what bacteria causes otitis media

A

streptococcus pneumoniae

66
Q

what demographics is otitis media usually higher in?

A

boys, children in daycare, children with allergies, children exposed to tobacco smoke

67
Q

.s/sx of otitis media

A

acute pain, rep tympanic membrane, ear effusion

68
Q

how is otitis media diagnosed

A

history and pneumatic otoscopy

69
Q

how long is otitis media treated with antibiotics in children under 2 years old

A

10 days

70
Q

how long is otitis media treated with antibiotics in children 2-5 y.o.

A

7-10 days

71
Q

how long is otitis media treated with antibiotics in children 6 + y.o.

A

5-7 days

72
Q

what is the first line therapy for otitis media

A

amoxicillin

73
Q

0what 2 things can be done for recurring otitis media

A
  • myringotomy (equilizes pressure between external canal and middle ear)
  • tympanostomy tubes
74
Q

how much of everyday convo does a person with mild hearing loss lose?

A

50%

75
Q

what are some consequences of having a hearing imapirment for children?

A
  • speech delay
  • imapired learning
  • poor congitivie learning
76
Q

what reflex is absent or diminished when a child has hearing loss

A

startle reflex

77
Q

describe babbling in child with hearing loss

A

little or none

78
Q

what is speech like in toddlers with hearing loss?

A

unintelligible (90% should be)

78
Q

what can hearing loss be confused for?

A

developmentally delayed

79
Q

manifestations of hearing loss in school age children

A
  • asks for repeated isntruction
  • answer questions inappropriately
  • poor school performance
  • speech probs
  • sits close to TV
  • pefers to play alone
80
Q

what kind injuries occur to the external ear (pinna)?

A
  • lacerations
  • infection
  • hematomas
  • cellulitis
81
Q

what kind if injuries occur to the ear canal?

A
  • foreign body
  • insects
82
Q

what is done if theres an insect in the ear

A

mineral oil to immobilize and flush

83
Q

what kind of injury happens to the tympanic membrane

A

ruptures

84
Q

what is the source of blleding in nosebleeds?

A

kiesselbach’s plexus (anterior nares, plentiful veins)

85
Q

what are the common causes of nosebleeds

A
  1. irritation from picking
  2. foreign bodies
  3. low humidity
86
Q

what vitals should be taken in nosebleed

A

BP pulse

87
Q

how should a child with nosebleed be positioned?

A

upright, head forward so they dont choke on blood or get nauseous from it

88
Q

where and how long should nose be squezzed with nosebleed?

A

just below nasal bone 10-15 mins

89
Q

what kind of infection id nasopharyngitis?

A

URI (common cold)

90
Q

causes of nasopharyngitis?

A
  • numerous viruses and bacteria
91
Q

which viruses and bacteria cause nasopharyngitis?

A

rhinovirus, coronavirus, group A streptococcus

92
Q

what are signs and symptoms of nasopharyngitis in infants less than 3 m.o.

A
  • lethargic
  • irritability
  • poorm feeding
  • fever
93
Q

what are signs and symptoms of nasopharyngitis in infants 3 m.o. and older

A
  • fever
  • vomit
  • diarrhea
  • sneezing
  • anorexia
  • irritable, restless
94
Q

what are signs and symptoms of nasopharyngitis in older children

A
  • dry, irritated nose/throat
  • chills, fever
  • aches, headache
  • post-nasal discharge
  • sneezing
  • nasal discharge
95
Q

characteristics of viral pharyngitis

A
  • gradual onset
  • cough, coryza, diarrhea
  • sore throat
  • low grade fever
96
Q

which kind of pharyngitis is most common?

A

viral (not strep)

97
Q

characteristics of bacterial pharyngitis (strep throat)

A
  • abrupt
  • moderate/high fever
  • headache
  • red pharynx
  • painful swallowing
  • painful cervical nodes
  • petechial mottling of soft pallate
  • caused by group a strep
98
Q

what bacteria causes bacterial pharyngitis

A

groupo a strep

99
Q

what is the treatment of pharyngitis?

A
  • pain relief (Acetaminophaen) (also used for fever)
  • cool, non-acidic, soft food, ice chips, gargle warm salt water
  • oral penicillin (erythromycin if allergic) (non contagious after 24h on antibiotic)
100
Q

symptoms of tonsillitis

A
  • frequent throat infections
  • difficulty swallowing and breathing
  • persistent redness
  • enlargement of cervical nodes
101
Q

how is tonsillitis treated?

A

symptomatically, recurrent episodes= removal

102
Q

what defines a tonsillitis episode?

A

having a sore throat AND one of the following…
* fever > 38.3
* cervical adenopathy
* tonsillar exudate
* + group b strep

103
Q

infection in what time frames qualifies for surgery (tonsillitis)

A
  • 7 episodes in 1 year
  • 5 episodes a year for 2 years
  • 3 episodes a year for 3 years
104
Q

post-op tonsillectomy meds

A

no antibiotics after removal, one dose of intraoperative IV dexamethasone for swelling

105
Q

when to call the doctor after a tonsillectomy

A

if there is bright red bleeding or temp > 38.8

106
Q

post-op tonsillectomy care

A
  • drink cool fluids or chew gum
  • acetaminophen as ordered
  • apply ice on childs neck
  • gargle with baking soda solution and salt in 8oz water
  • rinse mouth with viscous lidocaine, then swallow
107
Q

describe the three tooth injuries

A

fracture, partially knocked out, completely out

108
Q

what is luxation

A

partially knocked out tooth

109
Q

what is avulsion

A

completely knocked out tooth

110
Q

how should a tooth be handled?

A

by crown, not root

111
Q

what should you do if a tooth is fully knocked out?

A

place back in socket quickly!

112
Q

what kind of fluid should a knocked out tooth be transported in?

A

isotonic fluid, like cows milk

Peds (30 decks)

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