HEENT

Question 1

Pediatric differences

Answer 1

• 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

Question 2

Conjunctivitis

Answer 2

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

Question 3

Periorbital Cellulitis

Answer 3

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

Question 4

Hyperopia

Answer 4

far sighted (cant see up close)

Question 5

Myopia

Answer 5

near sighted (can see far away)

Question 6

Astigmatism

Answer 6

eye isnt completely round= blurry vision

Question 7

Strabismus

Answer 7

crosseyed ( muscle around eye are weak)

Question 8

Amblyopia

Answer 8

eye is weak/lazy = decreased vision from the eye (acuity)

Question 9

cataracts

Answer 9

white coloring in the eye

Question 10

Glaucoma

Answer 10

cloudy / blurry vision due to increased pressure

Question 11

Retinoblastoma

Answer 11

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

Question 12

Retinopathy of prematurity (ROP)

Answer 12

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

Question 13

vision impairment

Answer 13

• 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

Question 14

Otitis Media

Answer 14

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

Question 15

How to instill ear drops 3 years old and under .

Answer 15

pull outer ear down and back

Question 16

How to instill ear drops 3 years old and older

Answer 16

pull outer ear up and back

Question 17

Hearing impairments

Answer 17

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

Question 18

Ear injuries

Answer 18

Lacerations, cellulitis, foreign bodies, membrane rupture

Nursing: no q tips, clear fluid out of ear after injury could be a basil skull fx

Question 19

Epistaxis (nosebleed)

Answer 19

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

Question 20

Nasopgharyngitis

Answer 20

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

Question 21

Sinusitis

Answer 21

Cause: infected after URI

S/Sx: HA, facial pain, fever, cough, postnasal drip, mouth breathing

Tx: antibiotics if bacterial

Question 22

Pharyngitis (inflammation of the pharynx or back of throat)

Answer 22

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

Question 23

Tonsilitis

Answer 23

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

Question 24

Mucositis

Answer 24

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

Question 25

Injuries

Answer 25

Mouth is very vascular, tiny cut bleeds alot
Choking risk
Tooth break, complete loss