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FNP I HEENT Flashcards

0
Q

How is NPH diagnosed?

A

With CT or MRI

The only real way to tell is to slowly drain CSF & c if Sx’s gradually improve

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1
Q

Normal Pressure Hydrocephalus

A

Affects >60

Gradual (insidious onset)

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2
Q

What symptom triad is associated with NPH?

A

Magnetic Gait
Dementia
Urinary incontinence
(Wet, Wobbly, Wacky)

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3
Q

Bacterial Conjunctivitis

When does it occur?

A

Purulent discharge
Normal vision
Gritty/ Crusted lids

Occurs in the fall/winter

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4
Q

Treatment for Bacterial Conjunctivitis

A

Oral and topical abx
(erythromycin or azithromycin ung; gentamicin or Tobramycin gtts)
Sulfcetamid (>2yrs)
Flurooquinolone gtts (>1yr)

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5
Q

Treatment for Viral Conjunctivitis

A

Warm Compresses
Artificial Tears QID
NSAIDS

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6
Q

Viral Conjunctivitis

When does it occur?

A 
Watery discharge
Normal Vision
Itchy, burning, tearing
Eyes R really red
Pre-auricular Lymph node Palpable

Occurs after URI

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8
Q

Allergic Conjunctivitis

When does it occur?

A

Stringy Mucoid discharge
Normal Vision
Itching/ burning

Occurs in fall/spring

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8
Q

Treatment for Allergic Conjunctivitis

A

Oral/Topical antihistamines
(topical vasoconstrictors)
Cool compresses

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9
Q

Giant Papillary

What causes this?

A

Watery Discharge
Blurry Vision
Itchy/ gritty
Drooping eyelid

Characterized by bumps under the eyelids

Contact wear or contact solution

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10
Q

Treatment for Giant Papillary

A

D/C contacts

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11
Q

Bacterial conjunctivitis of the new born is ____

A

Ophthalmia neonatorum

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12
Q

Ophthalmia neonatorum is usually caused by

A

Gonorrhea or Chlamydia

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13
Q

How is ophthalmic neonatorum treated?

A

By erythromycin; given @ birth

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14
Q

C. Trachomatis (chlamydia) in adults…

A

You need to Cx it

Treat sexual partners as well

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15
Q

Herpes Zoster Eye Infections treatment

A

Start antiviral if early dx is made
Cool compresses

Refer to Ophthalmologist Immediately

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16
Q

Signs & Symptoms of Herpes Zoster Opthalmicus

A 
Pain
Tearing
Photophobia
Mucoid discharge
Moderate conjunctival hyperemia
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18
Q

Signs & Symptoms of Corneal Abrasions

A 
Pain
Tearing
Photophobia
Foreign Body Sensation (FOS)
Conjunctival Hyperemia
Decreased vision
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18
Q

What should the clinician do to inspect the eye for foreign objects or scratches related to corneal abrasion?

A

stain the eye with fluorescein dye and use cobalt blue filter light or slit lamp

May use tetracaine for evaluation but not for Rx for treatment

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19
Q

Treatment for Corneal Abrasion

A

Abx gtts or ung (ointments) for 5 days
w/ follow up daily until symptoms resolve
Tetanus
Eye rest

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20
Q

Patient education with corneal abrasion

A

Avoid wearing contacts until eye has healed

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21
Q

Hordeolum

A

Stye
swelling of the edge
erythamotus tender lump with in the eye

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22
Q

Subjunctival Hemorrhage

A

Caused by trauma and excessive straining such as with coughing
Sudden onset of painless red eye
Will resolve on its on within 2-4 weeks (does not require treatment – observe patient)

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23
Q

Treatment of hordeolum

A

Eye hygiene
Warm Moist Compresses QID
Topical ung

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24
What is seborrhea?
inflammatory skin condition that causes flaky, white to yellowish scales
25
Blepharitis
Lid crusting and seborrhea
27
Treatment for Blepharitis
``` Eye hygiene Abx ung (erythromycin) @HS ``` tx for blepharitis of the scalp - anti-dandruff shampoos
28
Chalazion
Mid eyelid swelling and erythema
29
Treatment for Chalazion
Warm compresses (up to 6 weeks) Abx-steroid ung Excision
30
Lid Cellulitis
Can be related to recent URI, trauma to lid or lid infection Characterized with painful lid edema
31
Plan for lid cellulitis
Refer to ophthalmologist CT scan to RO orbital cellulitis Red Flag
32
Orbital Cellulitis Symptoms
Lid edema H/A Fever
33
Plan for orbital cellulitis
Send to ER for IV abx to prevent vision loss Ophthalmology consult ASAP Restrict EOM
34
Dacryocytitis
Erythema Tearing Swelling over lacrimal sac
35
Treatment for Dacryocytitis
Eye Hygiene Warm moist compresses Topical opthalmic ung
36
Uveitis
Inflammation of the uveal tract
37
What are the two types of uveitis
1. Anterior (effects the iris aka Iritis) | 2. Posterior (effects choroids, retinitis)
38
Iritis
Aka Anterior Uveitis | Uveitis inflammation of the iris or anterior chamber of the eye
39
What is anterior uveitis associated with
``` Juvenile Rheumatoid Arthritis TB Herpes simplex Trauma Kawasaki disease ```
40
S/S of anterior uveitis (Iritis)
``` Decreased vision Pain Photophobia Pupil size decrease b/c iris crown the puli Cilliary Flush (no discharge or tearing) Refer immediately to ophthalmologist ```
41
Treatment for Iritis
Topical NSAIDs/ Corticosteroids
42
What is the leading cars of blindness in African Americans?
Glaucoma
43
2 types of glaucoma are
1. Primary open angle (slow) | 2. Primary angle closure (emergent) Intraocular pressure >22 mm Hg = glaucoma
44
Primary Open Angle Glaucoma
Most common Slow process with central vision affected late Usually bilateral Increase interocular pressure
45
Symptoms of Primary Open Angle Glaucoma
``` blurred vision nausea headache halos around bright lights Increase cup-disc ratio difference between eyes ```
46
Treatment for Primary Open Angle Glaucoma
Refer
47
Symptoms Primary Angle Closure Glaucoma
``` Sudden eye pain Brow aching Corneal edema Decrease vision Sensation of seeing halos around light Photophobia Sudden loss of vision ```
48
Treatment for Primary Angle Closure Glaucoma
Referral: EMERGENT Iridortomy laser hole in iris relieve pressure & damage Beta blocker eye gtts Timoptic decreases aqueous humor production by ciliary body Alpha agonists Alphagan dcrease aqueus prod. and increase ductal outflow Marajuana decreases IOP
49
PE for Glaucoma
Visual acuity, visual fields ophthalmic exam, IOP if equipped
50
Macular Degeneration Dry
Develops slowly causing loss of central vision | No Tx. Affects both eyes, one before other
51
Risk Factors for Macular Degeneration
Fhx, smoker (past or present), light skin light eyes, excessive sun exposure, obesity, female, dietary deficiencies in zeaxanthin and Lutein
52
Wet Age Related Macular Degeneration (AMD)
new blood vessel growth behind retina causes bleeding and scarring 10% can be Tx’d with laser
53
S/S of Macular Degeneration
Decrease in macula function: blurriness, dark cloud, difficult to read, straight line distorted Peripheral Vision okay.
54
Retinal Detachment S/S
SS increase floaters Curtain like over field of vision SS Depends where tear
55
Treatment for Retinal Detachment
Surgery
56
DM Retinopathy
develops from blood vessels that supply the retina and is the leading cause of blindness in adults age 20-64.Affects90% of Diabetics who have had DM >15 yrs.
57
What causes Proliferative DM?
Proliferative DM retinopathy most severe and threatening to sight. Caused by a lack of O2 to retina stimulates abnormal blood vessel growth which tightens and pulls on retina which detaches from inner wall. No pain, severe sight loss or blindness
58
Tx fro Proliferative DM
Laser surgery to reduce blood vessel growth, vitrectomy to remove blood in vitreous replace with saline
59
Cataract
Cloudy lens to the degree vision is disturbed
60
Causes of cataracts
``` Smoking Sun exposure Poor diet DM Steroids ```
61
S/S of cataracts
Gradual loss of vision: cloudy foggy vision | Light glare a problem reduces visual acuity: night driving
62
Cataract treatment
Surgery | Refer for evaluation
63
Further evaluation of visual acuity is necessary when
Adults & children ,>5yr: with visual acuity of 20/30 or worse > 5y 20/50 Infants failing gross visual acuity (follow object or social response) All who demonstrate more than one line difference between eyes
64
Myopia
light focuses in front of retina ; sees near objects best (nearsightedness)
65
Hyperopia
ight focuses behind the retina; sees far objects best (farsightedness)
66
Presbyopia
lens less resilient; poor near vision (aging)
67
Astigmatism
cornea or lens curvature causing unequal light refraction
68
Anisometropia
different refractive error in each eye
69
Amblyopia
Marked decrease in visual acuity in one eye due to interrutpion of normal visual development Blinkin excessively, frowns, behavior closing or covering one eye Refer
70
Strabismus
one eye not working with the other
71
Pseudostrbismus
Cross eyed | Genetic
72
Eso
inwards
73
Exo
outwards
74
Tropia
constant turned eye
75
Phoria
Both eyes are straight until coveredmisalignment of Visual axis revealed by the disassociation of the eyes
76
Advice for healthy eye aging
Avoid cigarette smoke Regular eye exams Healthy eating Wear UV protection outdoors

FNP I (4 decks)

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