HEENT Flashcards
Pediatric differences
- Visual acuity improves as the child grows
- Eustachian tube is shorter, wider, horizontal (more prone to ear infections)
- Primarily nose breathers until 6 months old
- Tonsils and adenoids are larger
- Sucking muscles for eating and speech development
- Teeth emerges around 6 months old
Conjunctivitis
Patho: inflammation of the conjunctivia ( the white part of the eye)
Causes: ophthalmia neonatorum ( chlamydia and gonorrhea), virus, bacteria, allergies, foreign body
Nursing considerations: when giving eye drop you oull the lower eye lid down and put med in that pocket and have child look up. educate about transmission: wash hands, dont share was cloths and towels
Periorbital Cellulitis
Patho: bacterial infection of the eyelid/ surrounding tissue
S/Sx: edema, tenderness, pain, fever
Tx: IV antibiotics, warm compress
Nursing: can lead to bacterial meningitis ( will perform CT to r/o abscess
Hyperopia
far sighted (cant see up close)
Myopia
near sighted (can see far away)
Astigmatism
eye isnt completely round= blurry vision
Strabismus
crosseyed ( muscle around eye are weak)
Amblyopia
eye is weak/lazy = decreased vision from the eye (acuity)
cataracts
white coloring in the eye
Glaucoma
cloudy / blurry vision due to increased pressure
Retinoblastoma
Patho: tumor is the eye (cancer)
S/Sx: “white glow” in the iris, absent red reflex in the iris, strabismus, red, painful, blindness (late sign)
Tx: surgery to remove tumor
Retinopathy of prematurity (ROP)
Patho: oxygen use damages the vasculature of retina
- PREMATURE INFANTS AT HIGH RISK
Tx: laster surgery
Nursing: can lead to retinal detachment, frequent eye exams needed
vision impairment
- complete or partial
Infant S/Sx: unable to follow object, no eye contact
Children s/sx: rub eyes, blink, squint, hold objects close
- screenings
Nursing when in hospital: verbally explain surroundings, give tour
Otitis Media
Patho: middle ear inflammation vs. infection
Causes: eustachian tube dysfunction, URI, Effusion (fluid)
S/Sx: acute otitis media - pain, pulling at ears, V/D, fever, reddened tympanic membrane (pain is worse at night)
Tx: antibiotics, tylenol or ibuprofen, surgery (myringotomy w/ tympanostomy, tubes)
Nursing: hearing loss concerns, no water in ears, no swimming in the lake
How to instill ear drops 3 years old and under .
pull outer ear down and back
How to instill ear drops 3 years old and older
pull outer ear up and back
Hearing impairments
Screenings: at 24 hours old
Infants S/Sx: doesnt startle or turn head, absence of babbling by 7 months
Children S/Sx: unintelligible speech, poor school performance, asking to repeat not meeting language milestones
Tx: lip reading and sign language, hearing aids, cochlear implants, interpreter and communication devices
Nursing: promote socialization
Ear injuries
Lacerations, cellulitis, foreign bodies, membrane rupture
Nursing: no q tips, clear fluid out of ear after injury could be a basil skull fx
Epistaxis (nosebleed)
ANTERIOR : bleeding from one side
- cause: irritation, allergens
- nursing: sit upright, tilt head forward, compress nares below nasal bone for 15 minutes, nasal packing
POSTERIOR: bleeding from one/both sides
-S/Sx: down throat= swallowing, bledding disorder, injury
- Nursing: nasal packing
Nasopgharyngitis
Patho: inflammation of the nose and throat
++ most common childhood illness++
Causes: rhinovirus, RSV, coronavirus
S/SX: red nasal mucosa, clear nasal drainage, enlarged sire tonsils
Tx: saline drops with suction, humidifier, encourage fluid intake
Nursing: frequent hand washing
Sinusitis
Cause: infected after URI
S/Sx: HA, facial pain, fever, cough, postnasal drip, mouth breathing
Tx: antibiotics if bacterial
Pharyngitis (inflammation of the pharynx or back of throat)
Cause: viral or bacterial (strep throat)
S/Sx: sore throat, reddened, exudate, lymphadenopathy, fever
Dx: throat swab culture
Tx: acetaminophen, ibuprofen, humidifier, salt water gargles
Tonsilitis
Cause: viral or bacterial
Tx: antibiotics, surgery
S/Sx: red throat, difficult swallowing, talking
Nursing: Tonsillectomy
- preop= lose teeth
- Postop care= pain control, no red or purple popsicles/drink, no citrus
- watch for frequent swallowing = bleeding
Mucositis
Cause: chemotherapy (drug attacks rapidly dividing cells)
S/sx: painful ulcers, and swelling
Tx: oral care, mouthwash
Nursing: diet concerns- no citrus, cold drinks are ok
