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NRSG 206: OB > [Exam 4] Chapter 39 – Alteration in Sensory Perception/Disorder of the Eyes or Ears > Flashcards

[Exam 4] Chapter 39 – Alteration in Sensory Perception/Disorder of the Eyes or Ears Flashcards

1
Q

Variations in Anatomy - Eyes: When is iris color determined?

A

By 6-12 months of age. They are born with blue eyes.

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2
Q

Variations in Anatomy- Eyes: Infant sees best at what distance?

A

8-10 inches

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3
Q

Variations in Anatomy- Eyes: When is 20/20 vision obtained?

A

By 6-7 years

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4
Q

Variations in Anatomy - eyes: When does binocular vision develop?

A

By 4 months of age

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5
Q

Variations in Anatomy -Ears: Main difference here between adult and child?

A

Eustachian tube is straight in a child, but slants as they grow older.

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6
Q

Common Medical Tx, Health Hx: Past medical history may be significant for what?

A

Prematurity, genetic defect, eye or ear deformity or deafness.

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7
Q

Common Medical Tx, Health Hx: When asking parents about history, ask then about onset and progression and presence of what?

A

Fever, nasal congestion, eye/ear pain, eye rubbing, ear pulling and headache.

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8
Q

Common Medical Tx, Health Hx, Inspection: Note what about the eyes?

A

Whether child uses eyeglasses, corrective lenses, or hearing aid. Observe eyes for positioning and variations in eyelids.

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9
Q

Common Medical Tx, Health Hx, Inspection: What to know about sclera in newborns?

A

They will appear bluish in newborns, but become white within the first few weeks of life.

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10
Q

Common Medical Tx, Health Hx, Inspection: Ears will be checked for what?

A

Size/Shape, Position, and Presence of skin tags, dimples.

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11
Q

Common Medical Tx, Health Hx, Palpation: Ears should be palpated for what?

A

Tenderness over tragus or pinna.

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12
Q

Common Medical Tx, Health Hx, Palpation: What does Typanometry do?

A

Probe in ear canal measures movement of eardrum

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13
Q

Acute Otitis Media (AOM): What is this?

A

Common illness in children, resulting from infection (bacterial or viral) of fluid in the middle ear.

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14
Q

Acute Otitis Media (AOM): Why are children more prone to get this?

A

Due to short length and horizontal positioning of the Eustachian tube, and limited respones to antigens

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15
Q

Acute Otitis Media (AOM): Biggest risk factors for this?

A

Eustachian tube dysfunction and susceptibility to recurrent upper respiratory infections

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16
Q

Acute Otitis Media (AOM) - Patho: What frequently precedes this?

A

Upper respiratory infection. They travel upward invading the middle ear space.

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17
Q

Acute Otitis Media (AOM) - Patho: What occurs acutely once invasion begins?

A

Fever and pain. Increased pressure behind membrane may cause proliferation resulting in decreased pain and yield drainage.

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18
Q

Acute Otitis Media (AOM) - Patho: What happens once infection clears?

A

Fluid remains in the middle ear space behind the tympanic membrane after several months.

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19
Q

Acute Otitis Media (AOM) - Patho: Most common complications from this?

A

Hearing loss, expressive speech delay, typanosclerosis, tympanic membrane perforation, and chronic suppurative otitis media.

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20
Q

Acute Otitis Media (AOM) - therapeutic mx: Viral treatment?

A

They usually resolve spontaneously

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21
Q

Acute Otitis Media (AOM) - therapeutic mx: Bacterial treatment?

A

Require treatment with an antibiotic.

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22
Q

Acute Otitis Media (AOM) - therapeutic mx: How can this be determined?

A

Culture of middle ear. Also can check fluid obtained via tympanostomy in children with AOM.

23
Q

Acute Otitis Media (AOM) - therapeutic mx: Why does antibiotic resistance develop?

A

Due to overuse of antibiotics.

24
Q

Acute Otitis Media (AOM) - therapeutic mx: Certain diagnosis of this is based on what?

A

Signs of fluid in middle ear, with moderate to severe bulging of tympanic membrane with complaint of ear pain.

Along with sign and symptoms of inflammation in middle ear.

25
Q

Acute Otitis Media (AOM) - therapeutic mx: Current recommendation by AAP for treatment?

A

Allow for a period ob observation. Allows for natural resolution.

26
Q

Acute Otitis Media (AOM) - therapeutic mx: When would observation be recommended and not antibiotics?

A

When there are not severe signs or symptoms

27
Q

Acute Otitis Media (AOM) - Health Hx: Common sign and symptoms include?

A

Fever, complaint of otalgia (ear pain), fussiness, tugging on er, and fluid draining from ear.

28
Q

Acute Otitis Media (AOM) - Health Hx: Risk factors for this?

A

Young age, day care attendance, previous hx, and antecedent or concurrent URI.

29
Q

Acute Otitis Media (AOM) - Physical Exam/Diagnostic Testing: On otoscopic examination, how will tympanic membrane appear?

A

Dull or opaque appearance and is bulging and/or red. Greenish pus may be visible.

30
Q

Acute Otitis Media (AOM) - Nursing Mx, Managing Pain: What has been proven to manage mild to moderate pain?

A

Analgesics such as acetaminophen and ibuprofen, and they may also reduce fever

31
Q

Acute Otitis Media (AOM) - Nursing Mx, Managing Pain: What instructions should be given to parents about heating/cooling packs?

A

Lie on the affected side with the heating pad or covered ice pack in place to that ear.

32
Q

Acute Otitis Media (AOM) - Nursing Mx, Managing Pain: What to know for eardrops?

A

Eardrops like benzocaine (auralgan) may be helping in event of acute, severe pain

33
Q

Acute Otitis Media (AOM) - Nursing Mx, Educating Family: If treatment selected is observation, what should be taught to parents?

A

The imporance of returning for evaluation if child not improving within 48-72 hours.

34
Q

Acute Otitis Media (AOM) - Nursing Mx, Educating Family: What must be taught to family once treatment begins?

A

To adhere to antibiotics. And that follow-up for resolution of AOM is necessary

35
Q

Acute Otitis Media (AOM) - Nursing Mx, Preventing AOM: Why should mothers be encouraged to breastfeed?

A

Because they have a lower incidence of AOm. Encouraged to feed for 6-12 months.

36
Q

Acute Otitis Media (AOM) - Nursing Mx, Preventing AOM: How to best prevent child from getting this?

A

Avoid those who have URI. Do not expose them to second-hand smoke.

37
Q

Acute Otitis Media (AOM) - Nursing Mx, Preventing AOM: What to know about Xylitol Syrup?

A

It’s a sucrose substitute, and may be protective. May cause diarrhea with excessive dosing.

38
Q

Otitis Media with Effusion (OME): What is this?

A

Presence of fluid within middle ear space, without signs of infection. May persist after AOM has resolved.

39
Q

Otitis Media with Effusion (OME):Risk factors for this?

A

Passivesmoking, absence of breastfeeding, frequent URI, allergy, and male sex.

40
Q

Otitis Media with Effusion (OME):Complications of this?

A

AOM, hearing loss, and deafness.

41
Q

Otitis Media with Effusion (OME), Health Hx: What symptoms may they show?

A

May be asymptomatic or experienc a popping sesnation or fullness behind ear

42
Q

Otitis Media with Effusion (OME), Physical Exam: Otoscopic exam would reveal what?

A

Dull, opaque tmpanic membrane that may be white, gray, or bluish.

If not opaque, fluid level or air bubble may be visualized.

43
Q

Otitis Media with Effusion (OME), Physical Exam: What can determine diagnosis of this?

A

Tympanometry. Mobility may be absent or diminished

44
Q

Otitis Media with Effusion (OME), Nursing Mx, Educating Family: What to teach parents about treating?

A

Usually resolves spontaneously, but children should be rechecked every 4 weeks.

45
Q

Otitis Media with Effusion (OME), Nursing Mx, Educating Family: What should parents not do?

A

Feed infants in supine position and avoid bottle propping

46
Q

Otitis Media with Effusion (OME), Nursing Mx, Monitoring for Hearing Loss: What is the main concern when OME persists?

A

Effect on hearing. This can depress language acquisition

47
Q

Otitis Media with Effusion (OME), Nursing Mx, Monitoring for Hearing Loss: What should happen for child with chronic OME?

A

They should be referred to a specialist for hearing eval.

48
Q

Otitis Media with Effusion (OME), Nursing Mx, Monitoring for Hearing Loss: How to communicate effectively with children with OME who have hearing loss?

A

Turn off music or television. Position within 3 ft when talking.

Face child when speaking.

Use visual cues

49
Q

Otitis Media with Effusion (OME), Providing PostOp Care for Child with Pressure-Equalizing Tubes: Standard treatment for persistent OME is?

A

Surgical insertion of pressure-equalizing (PE) tubes into the tympanic membrane

50
Q

Otitis Media with Effusion (OME), Providing PostOp Care for Child with Pressure-Equalizing Tubes: how long do tubes stay in place?

A

For seveeral months and fall out on their own.

51
Q

Otitis Media with Effusion (OME), Providing PostOp Care for Child with Pressure-Equalizing Tubes: What must parents do postop?

A

Administer ear drops if prescribed.

Also wear ear plugs when in bathtub or swimming.

52
Q

Otitis Media with Effusion (OME), Providing PostOp Care for Child with Pressure-Equalizing Tubes: What does placement of PE tubes allow for?

A

Adequate hearing, which encourages appropriate speech development.

53
Q

Otitis Media with Effusion (OME), Providing PostOp Care for Child with Pressure-Equalizing Tubes: What happens if middle ear becomes infected with PE tubes in place?

A

Tube allows infected fluid to drain from the ear.

54
Q

Which situation would cause the nurse to become concerned about possible hearing loss?

12-month old who babbles incessantly, making no sense
8-month old who says only “da”
3-month old who startles easily to sound
3-year old who drops the letter “s”
A

8-month old who says only “da”

NRSG 206: OB (42 decks)

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