Lab 1/17 Flashcards
Signs of cerumen impaction
Ear pruritis Ear discomfort Dizziness Recurrent otitis external Vertigo
What are potential complications of cerumen removal?
Bleeding
Mild dizziness
TM perf
What temp should the water be at for cerumen removal
Body temp
How long should a patient sit or lay down following cerumen removal
5-10 min
Contraindications to cerumen removal using curettage
High risk of bleeding Inability to cooperate Excess cough reflex Thrombocytopenia Otitis externa Suspected TM perf Otitis furnucle/ pustule Inability to visualize
When should you look in the ear when doing cerumen removal
Before and after removal
What is a big potential complication of FB removal of the nose
Aspiration
What should you do before and after when doing a procedure to the eyes
Visual acuity
C/I to irrigation for cerumen removal
Prior recent ruptured TM Hx of tympanostomy tubes acute otitis media acute, chronic or recurrent otitis externa DM Immunocomprimised Bloody discharge from ear (refer) recurrent vertigo recent ear pain failure after 5 attempts to remove significant amounts
What meds should you not prescribe fore patients to take home with an eye complaint
Anesthesia drops or topical steroids
Can only do removal of eye FB if it has been there for less than …..
24 hours
If a patient has ______ in their eye it may form rust rings
Iron
How should first attempt to removal an eye FB
Irrigation
Contraindications to treating epistaxis
Facial fracture (basilar)
Nasal packing for epistaxis needs to have what on it
Petroleum jelly on it
potential complications with irrigation technique for cerumen removal
Perforated tympanic membrane (1 in 1,000 incidence) Minor bleeding from the ear canal Ear canal laceration Otitis media External otitis Vertigo Tinnitus Hemotympanum Malignant external otitis (in diabetics)
potential complication with currettage technique for cerumen removal
Perforated tympanic membrane
Minor bleeding from the ear canal
Ear canal laceration
what should patients be instructed to immediately report after cerumen removal
pain tinnitus fever vertigo drainage of blood
contraindications to FB removal in ear or nose
uncooperative patient marked bleeding limited visualization distal location of displacement of FB trauma induced disorientation of normal anatomy previous ear surgery (risk of perf) known/ suspected cholesteatoma
potential complications of FB removal in ear or nose
Bleeding Abrasion Infection Perforation Aspiration Nausea or vomiting with removal of an object in the ear
if mucous membrane injury occurs w/ FB removal from nose what should you recommend?
Follow up visit in 1-2 days
saline irrigation TID for 2 week
potentially refer to ENT
If ear canal trauma or TM perf occurs what should you instruct the patient to do
three drops of abx drop in ear TID for 7 days
audiometry and tympanometry testing
indications for referral for removal of an object from the eye
intraocular presence of an object large corneal epithelial defect corneal infiltrate or white spot corneal opacity purulent discharge
what are some topical ophthalmic anesthetics?
tetracine
proparacaine
what are some topical abx ointments for the eyes
erythromycin
bacitracin
sulfacetamide
indications for FB removal from conjunctiva/ cornea
Small, conjunctival or corneal foreign bodies embedded < 24 hours
Contraindications for FB removal from conjunctiva/ corena
iron based FB deeply embededd >24 hours possible acid or alkali contamination rupture globe hyphema lens opacification irregularity of pupil signs/ symptoms of infection
potential complications of FB revmoal from conjunctiva/ cornea
Infection Perforation of the cornea Scarring Visual impairment Corneal ulceration
when is followup necessary for FB removal from conjunctiva or cornea
abraision is >3mm w/ decreasing vision
contact lens related abrasion
who are at greatest risk of epistaxis?
diagnosed HTN
blood thinners
potential complications of epistaxis
bleeding
toxic shock syndrome
patient education regarding epistaxis (after packing)
don’t remove packing yourself
don’t blow your nose
sneeze w/ mouth open
head elevated and dont’ bend forward for 2-3 days
