Module 4 Ophthalmic Conditions, Otologic Conditions, & Integumentary Conditions

Question 1

The nurse understands that a stye (hordeolum) is best described as

Answer 1

A tender, red, inflamed area on the edge of the eyelid. A stye forms when a tiny oil gland near the eyelashes becomes blocked and gets infected.

Question 2

Describe bacterial conjunctivitis and the recommendation for this type of conjunctivitis.

Answer 2

Bacterial conjunctivitis is the inflammation or infection of the transparent membrane that lines the eyelid and eyeball. It’s characterized by redness and a gritty sensation in the eye, along with itching. Often a discharge forms a yellow or yellow/green crust on the eyelashes during the night and the lashes may stick together in the morning upon waking. The most important recommendation is excellent hand hygiene practices. This type of conjunctivitis is treated with antibiotics typically.

Question 3

Describe viral conjunctivitis and the recommendations for this type of conjunctivitis.

Answer 3

Viral conjunctivitis causes is the inflammation of the eyeball which results in the sclera appearing red and the patient complaining of itchy, watery eyes. This form of conjunctivitis is very contagious and is often referred to as pink eye. The most important recommendation is excellent hand hygiene practices. Treatment includes artificial tears, cleaning your eyelids with a wet cloth, and applying cold or warm compresses several times daily. No one should share wash clothes in the home. Dispose of all eye make-up or contact lenses that have been worn.

Question 4

Describe allergic conjunctivitis and the recommendations for this type of conjunctivitis.

Answer 4

Allergic conjunctivitis is not contagious. The eyes will appear red, itchy, and watery. The patient will also have nasal congestion, sneezing, eyelid swelling, and often sensitivity to light. Both eyes are typically affected. The most important recommendation is excellent hand hygiene practices. Treatment includes antihistamines.

Question 5

Which of the following is an emergency condition?
A. Macular degeneration
B. Retinal detachment
C. Conjunctivitis
D. Strabismus

Answer 5

B. Retinal detachment is an emergency condition. Tissue at the back of the eye pulls away from a layer of blood vessels that provide necessary oxygen and nourishment. Symptoms include floaters, sudden flashes of light, blurred vision, and/or a curtain-like shadow over your visual field. Diplopia following retinal detachment usually responds to simple measures for treatment. Diplopia is double vision.

Question 6

What is the difference between benign paroxysmal positional vertigo and Meniere disease?

Answer 6

Benign paroxysmal positional vertigo (BPPV) is triggered by certain changes in head position, such as tipping the head up, down, or side to side. It results in a spinning sensation and dizziness. It’s rarely serious unless it increases the risk of falling. The episodes are typically brief (less than one minute) and resolve spontaneously. Meniere’s disease is a disease of unknown causes that affects the membranous labyrinth of the ear. Symptoms include fluctuating episodes of tinnitus, feelings of ear fullness, and violent rotary vertigo that often renders the person unable to sit or walk.

Question 7

Describe a bulla and know how to spell this term.

Answer 7

A bulla is a skin condition also called a blister. It is a well circumscribed collection of free fluid that is > 1 cm.

Question 8

Describe a macule and know how to spell this term.

Answer 8

A macule is a skin abnormality at is a circular, flat discoloration that is < 1 cm. The discolored area may appear brown, blue, red, or hypopigmented.

Question 9

Describe a nodule and know how to spell this term.

Answer 9

A nodule is a circular, elevated, solid lesion that is > than 1 cm.

Question 10

Describe a vesicle and know how to spell this term.

Answer 10

A vesicle is a circular collection of free fluid that is less than or equal to 1 cm.

Question 11

Describe a pustule and know how to spell this term.

Answer 11

A pustule is a vesicle containing pus which is composed of inflammatory cells and cellular debris, may be white, yellow, or pink or green tinged.

Question 12

A patient complains of an itchy, raised circular red rash with central clearing. The patient says his friend told him it was a ringworm infection. The patient asks how to “get rid” of this worm. What is the best response by the nurse?

Answer 12

This rash is called ringworm but no worm is involved. It is actually the result of a fungal skin infection and is medically known as a tinea infection. The physician can order antifungal medication to treat this infection.

Question 13

A 55-year-old patient with a past medical history of chickenpox at age seven states that they were exposed to a person with shingles. They express concern about “catching shingles.” What would be the nurse’s best response?

Answer 13

The nurse should advise that the shingles virus is not contagious for people diagnosed with chickenpox in the past. Shingles will give an unvaccinated person or a person who has not contracted chickenpox previously chickenpox. Shingles will not cause another person to develop shingles. A person will present with shingles only if they have had chickenpox in the past because the virus must be inside their body to develop shingles.

Question 14

A patient presents with a rash composed of vesicles on the left shoulder area. The rash does not cross the dermatome and is described as having a burning pain with tenderness to touch. The nurse should anticipate the client will need treatment for what diagnosis?

Answer 14

Shingles (Herpes Zoster) would be the expected diagnosis for a rash that consists of vesicles on a single dermatome that is painful and tender to touch.

Question 15

Compare and contact dermatitis vs. atopic dermatitis.

Answer 15

Contact dermatitis can be from an allergen source or from an irritant source. The irritant source is often contracted from chemical exposure that is irritating to the skin. Contact dermatitis will have symptoms of pruritus (itchy skin), rash, hives, fluid-filled blisters, and/or oozing blisters that leave crusts. Think of when you have contracted poison oak in the past. Atopic dermatitis is also known as eczema. This is an inflammatory skin disorder typically characterized by erythema, edema, vesicles, and weeping in the acute stages. Once eczema enters the chronic stage lichenification (hardening and thickening of the skin) occurs.

Question 16

A patient has been utilizing a topical steroid cream for atopic dermatitis (eczema) treatment with successful resolution of symptoms. The patient would like to stay on this medication long-term to prevent the return of symptoms. What would be the best response by the nurse?

Answer 16

The nurse should advise against long-term topical steroid cream usage in the treatment of atopic dermatitis because long-term usage is associated with thinning of the skin, permanent stretch marks (striae), bruising, discoloration, or thin spidery blood vessels (telangiectasia).

Question 17

A patient has been diagnosed with a first-degree burn (superficial partial-thickness). What would the nurse anticipate finding upon assessment of this patient’s burns?

Answer 17

The nurse should anticipate finding a burn that only involves the outer layers of the epidermis. The burn will appear red, painful, dry to the touch, and may have mild edema present. Hint: Think of a sunburn.

Question 18

A patient has been diagnosed with a second-degree partial thickness burn. What would the nurse anticipate finding upon assessment of this patient’s burns?

Answer 18

The nurse should anticipate that the epidermis and varying areas of the dermis will be involved. The burn will appear red and moist with blistering noted. The patient will complain of extensive pain.

Question 19

A patient has been diagnosed with a second-degree full-thickness burn. What would the nurse anticipate finding upon assessment of this patient’s burns?

Answer 19

The nurse should anticipate that the epidermis and dermis are involved. The burn will appear edematous, mottled pink/red with tissue paper-like blisters. There may be waxy white areas present. These burns are typically very painful but may have some areas without sensation.

Question 20

A patient has been diagnosed with a third-degree full-thickness burn. What would the nurse anticipate finding upon assessment of this patient’s burns?

Answer 20

The nurse should anticipate that the client will have involvement of the epidermis, dermis, subcutaneous, and potentially muscle and bone. The burn area will appear very edematous and have areas of waxy white, yellow, deep brown, black, tan, or red areas. There is no sensation in this burn tissue because all the nerve endings are no longer present.

Question 21

A nurse is discussing the admission of a burn patient to the ICU with a new graduate registered nurse. The nurse understands that the new graduate can correctly estimate TBSA of a burn injury when they state:

Answer 21

TBSA means total body surface area of a burn injury and is important in accurately providing fluid resuscitation and deciding on hospitalization of a client. The total body surface area burned can be calculated using the Rule of Nines or the Palmer Method.

Question 22

A client presents with a circumferential burn to the right upper extremity. The nurse has been monitoring the patient for compartment syndrome. The nurse cannot palpate a radial pulse upon reassessment and anticipates that the client requires what emergency treatment?

Answer 22

Fasciotomy and or escharotomy to allow blood flow to return to the hand.

Question 23

When teaching a group of clients about skin cancer, the nurse understands that education should cover these benign tumors on the skin that predispose an individual to cancer?

Answer 23

Nevi (moles)

Question 24

The nurse knows that a group of nursing students adequately understands the signs of skin cancer when they state:

Answer 24

The signs of skin cancer can be remembered by listing A, B, C, D, E, which each stand for an abnormality. A is for asymmetry, B is for border abnormality (uneven), C is for color variation, D is for large diameter (greater than a pencil eraser), and E is for evolving characteristics. Evolving characteristics indicated are when the mole has changed size, color, shape, or begins to bleed or scab.