Exam 4 Flashcards
Blepharitis is
Characterized by
Management
Inflammation of eyelid edges
- Itchy, red, burning eyes & seborrhea of eyelids with greasy scales
- warm & moist compresses, avoid rubbing eyes
Hordeolum is
Management
A stye
- warm compresses 4x a day & antibacterial ointment (can blur vision)
Chalazion is
Characterized by
Treatment
Inflammation of sebaceous gland in eyelid (protrudes inside eyelid)
- eye fatigue, light sensitivity, excessive tears
- warm compresses 15min 4x a day, followed by ophthalmic ointment
Conjunctivitis is
Presentation
Parent teaching
Infection or inflammation caused by bacteria, viruses or trauma
- hyperemia, burning, mucropurulent discharge
- prevent cross contamination, warm compresses, ophthalmic ointment & antibiotic eye drops
Glaucoma
Open angle
Closed angle
Patient education
- asymptomatic, increased IOP, loss of peripheral vision, tunnel vision, difficult adapting to dark, halo vision, mild headaches
- severe acute ocular pain, sudden decrease in vision, pupils dilated, nausea/vomiting, significant increased IOP, halo vision, red conjunctiva
- elevate HOB, protect eye with patch, administer eye meds
Cataract is
Manifestations
Classifications
Post-op care
Clouding or opacity of lens leading to loss of vision
- gradual painless blurring, decreased vision, night glare, cloudy white opacity
- congenital, senile, traumatic, secondary
- antibiotics, discharge within 1 hour, mild itching normal pain indicates complication, assess for bleeding
Management of ear wax impaction
irrigate canal with mixture of water & hydrogen peroxide
External otitis is
Treatment
Otitis media
Non-surgical management
Post-op surgical care
Irritating or infective agents come into contact with external ear causing pain
- reduce inflammation, edema & pain with heat, bedrest, analgesics, antibio
Throbbing pain in affected ear, fever, drainage, bulging eardrum
- quiet env, bedrest w limited head movement, heat & cold, systemic antibiotics, analgesics, antihistamines
- keep external ear canal free of substances, keep head dry for days
Ménière’s disease due to
Disease process
Management
Education
Overproduction & poor absorption of endolymph
- tinnitus, one-sided sensorineural hearing loss, vertigo
- slow head movement, salt & fluid restriction, smoking cessation, mild diuretics, nicotinic acid, antihistamines, gentamicin & steroids
- hearing in affected ear is sacrificed
Conductive hearing loss
Sensorineural hearing loss
Non-surgical treatment
Surgical
Results from any physical obstruction of sound wave transmission
- results from a defect in cochlea, 8th cranial nerve or the brain
- stand in front of patient, reduce background noise, speak slow & clear, use body language, assistive devices
- tympanoplasty, stapedectomy (hearing doesn’t improve till 6 weeks)
Common complications of fractures
Management
Compartment syndrome, crush syndrome, hemorrhage, fat embolism, venous thromboembolism, infection, malunion, avascular necrosis
- manage acute pain, increasing mobility, preventing & monitoring neurovascular compromise, prevent infection
6 P’s
Management of skeletal traction
Assist with application
maintain traction,
maintain positioning/mobility hazards
prevent skin breakdown
assess supportive devices
pin care
monitor neurovascular status
Post spinal surgery
Traction weight
Traction to cervical spine through crutch field tongs into skull
Possible rotorest bed or halo brace
Prevent complications of immobility
Skeletal traction 15-30 lbs (pins
Buck traction 5-10lbs (no pins)
Sprain
Strain
Manifestations
RICE
injury to ligaments
Injury to muscle tendon
Pain, edema, loss of fxn
Rest, Ice, compress, elevate
Colles vs smith fracture
Due to
Interventions for distal radial fracture
- a common distal radius fracture
- colles (outward) smith (inward)
- due to a fall with hand outstretched landing on heel of hand
- removing jewelry
Preforming neurovascular assess
Immobilizing wrist
Elevating extremity
Applying ice
Managing pain
ACL drawer test
ACL Lachman test
Rotator cuff apley scratch test
Drop arm test
Empty can test
- 90 degrees pull tibia forward from knee
- 30 degrees pull tibia upward while holding femur
- reach behind back
- patient Lowers arm, if it immediately drops & lower than 90
- raise arms & turn thumbs down, downward force is applied
Carpal tunnel syndrome is due to
Tinel’s sign
Phalens test
Treatments
Pressure on the median nerve causing numbness, pressure & pain
- tapping in wrist causing outward tingling radiation
- back of hands together causing radiation of pain down fingers
- steroids, splinting, NSAIDs, surgical decompression
Rheumatoid arthritis is
Risk factors
Signs
Lab diagnostics
Medications
Systemic Inflammatory autoimmune disease degeneration of joint
- more frequent in women
- morning joint stiffness, fatigue, erythema & warmth to affected joint
- RA factor, osteopenia on X-ray
- DMARDs, corticosteroids, enbrel, remicade, celecoxib
Osteoarthritis is
Signs
Treatment
Loss of joint space typically affecting weight bearing joints
- pain worsens with movement, joint swelling, limited ROM, heberdens nodes, bouchards nodes
- heat & cold application, exercise (bike, water based), PT (assistive devices)
Patient education after hip replacement
Abduction splint
Do not cross legs across midline
Do not sit in low chairs or cross legs
Avoid flexing hips past 90, use grippers to reach
Use elevated toilet
Sleep with pillow between legs
Swan-neck
Heberdens nodes
Boutonnière
Ulnar deviation
Distal interphalangeal dip
Swelling of distal interphalangeal
Proximal interphalangeal
Metacarpophlangeal joint deviates finger to slant position
HIV disease process
Diagnosis of AIDS CD4
HIV virus attacks & enters T cells to make copies
T cells burst spreading HIV to other cells
CD4+ T cell count begins to fall & viral load rises
Immune system weakens
Everyone with AIDS has HIV, Not everyone with HIV has AIDS
- CD4 count less than 200
HIV disease prevention
Post exposure prophylaxis
Avoid sharing needles & practice safe sex
Antiretroviral therapy should be initiated in anyone living with HIV
Use of daily PrEP
- anyone who may have been exposed, must begin within 72hrs, consists of 2-3 ART meds,
Side effects include nausea
PrEP is
Criteria
Patient education
Pre exposure prophylaxis
- used for high risk populations, homosexual men, heterosexually active men & women, injecting drug users
- PrEP is covered by insurance
