HEENT Flashcards
Tension Headache
- most common
- band like pain
- dull, non-pulsating
- typically bi lateral
- up to 7 days
Migraine
- throbbing, pulsating
- unilateral - temple area
- sudden
- N/V
- sensitive to light/sound
- up to 3 days
- 10% experience an aura (flashes of light, blind spot)
Cluster
- constant, sharp pain
- unilateral (near eyes)
- sudden
- up to 3 months
- tearing, red eye, runny nose
Conjunctivitis - Viral
- pink/red eye
- watery discharge
- low fever
- 1 to 3 weeks
Conjunctivitis - Bacterial
- pink/red eye
- green/yellow discharge
- crusted eye lids
- 2 weeks
Allergic conjuntivitis
- pink/red eyes
- clear, watery discharge
- burning/itching
Dry Eye
- Redness
- burning, stinging
Blepharitis
- lump on/near eye lid
- painful, swollen, pus-filled
- may lead to sty formation
Otitis media
- inflammation of inner ear
- common in children <3
- crying, pulling at ears, discharge
- fever
Otitis externa (swimmer’s ear)
- inflammation of skin lining outer ear canal
- pain, discharge, itching, burning
- fever
Cerumen Impaction
- build up of ear wax, blocking ear canal
- earache
- fullness of ear, tinnitus, partial hearing loss, itching
Water Clogged Ears
- ear fullness
- gradual hearing loss
- itching
Sinusitis (head cold) - Viral
- HA
- congestion
- low fever
- nasal discharge
- halitosis
- lasts up to 10 days
Sinusitis (head cold) - Bacterial
-worsening congestion
-facial pain
-thick yellow-green nasal discharge
fever
-halitosis
Allergic Rhinitis
- inflammation of nasal mucous membrane
- clear rhinorrhea
- sneezing
- congestion
- watery eyes
- itchy EENT
Cold Sores
- blisters on lips, chin, cheeks, nostrils
- red, painful blisters, oozing/yellow crusting of blister, itching
Canker Sores
- small round sores inside of mouth
- red edge with white center
- painful
Gingivitis
-inflammation of gums
Oral candidiasis (thrush)
- fungal infection of mouth
- cottage cheese appearance
- creamy white lesion
- loss of taste
Head Questions
i. What sx are you experiencing?
ii. Describe your head pain. What does the pain feel like?
iii. Have you had this type of pain before? How often do you experience it?
iv. When did your pain/sx begin (gradual vs sudden)
v. Where is the pain located? (unilateral vs bilateral)
vi. What makes your pain worse?
vii. What makes the pain better? What have you tried to alleviate the pain?
Eye Questions
i. What sx are you experiencing?
ii. If discharge is present, please describe the discharge
iii. Have these sx occurred before? Have you been in contact with anyone
with similar sx?
iv. When did the sx start?
v. Are you experiencing these sx in one or both eyes?
vi. What makes the sx worse?
vii. What makes the sx better? What have you tried to treat the sx?
Ear Questions
i. What sx are you experiencing?
ii. If pain is present, what does if feel like? If discharge is present, describe
the discharge.
iii. Have you experienced this before and how often does it occur? Have
you recently injured your ear?
iv. When did the sx start?
v. Are you experiencing these sx in one or both ears? Are other body parts
affected?
vi. What makes the sx worse?
vii. What makes the sx better? What have you tried to treat the sx?
Nose Questions
i. What sx are you experiencing?
ii. If nasal discharge is present, please describe it.
iii. Have you experienced these sx before? What allergies do you have
(meds, pollen, pets)?
iv. When the sx start?
v. Are you experiencing these sx in one or both nostrils?
vi. What makes the sx worse?
vii. What makes the sx better? What have you tried to treat the sx?
Throat Questions
i. What sx are you experiencing?
ii. If lesions/sores are present, please describe them
iii. Have you experienced these sx before? Have you injured your mouth
lately?
iv. When did the sx start?
v. Where in your mouth are you experiencing sx?
vi. What makes the sx worse?
vii. What makes the sx better? What have you tried to treat the sx?
Head Treatment
Refer if:
- Migraine or Cluster HA
- HA associated with significant HTN
- Headache lasting more than 10 days
- More than 3 headaches a week
- Head Trauma
- Resistant to self-care
If self-treat:
- Suggest ibuprofen to relieve pain and to avoid triggers
Eye Treatment
Refer if:
- Sx of infection
- Conditions resistant to self-care for 3 days
- Exposure to chemicals
- Trauma
- S&S of vision loss
- Glaucoma
If self-treat:
- Pharm options:
a. Viral conjunctivitis: Artificial tears, decongestants
b. Allergic Conjunctivitis: Ocular antihistamines
c. Dry eyes: Artificial tears
d. Blepharitis/sty: Warm compress - Non-pharm:
a. Wash hands
b. Wear glasses
Ear Treatment
Refer if:
- Hearing loss, pain, drainage, tinnitus
- Sx of infection
- Otitis media, otitis externa
- Foreign object in ear
If self-treat:
- Cerumen Impaction – debrox
- Water clogged ears – isopropyl alcohol
iii. If otitis media, refer, but if patient wants something in the interim: - Local heat
- Analgesic for pain
iv. If otitis externa, refer, but if patient wants something in the interim: - Warm water or saline
- Antiseptic drops
Nose Treatment
Refer if:
- Severe HA not relieved after OTC products
- Systemic infection sx
- Sx >10 days
- Cold that worsens after 7 days
- Changes in vision
- Sx resistant to self-care
If self-treat:
- Pharm options:
a. Sinusitis
i. Oral or topical decongestants
ii. AVOID antihistamines
b. Allergic rhinitis
i. Oral or topical antihistamines
ii. Decongestants - Non-pharm options:
a. Allergen avoidance
b. Neti-pot
c. Saline nasal spray
Throat Treatment
Refer if:
- Lesions w/ significant pain/large area
- Gingivitis
- Thrush
- Sx >2 weeks
- Recurrence of cold sores
- Resistant to self-care
- Immunocompromised patients
If self-treat: 1. Pharm options a. Cold sores (self-limiting) i. Topical antivirals (ie Abreva – be careful to note how long sore has been present) ii. Benzocaine if sore has been present for a while b. Canker sores (self-limiting) i. Benzocaine for pain 2. Non-pharm a. Avoid hot foods/beverages, spicy foods, citrus b. Good oral hygiene c. Ice or warm compress
