Week 4: CH 19 ENT Flashcards
conjunctivitis
inflammation of the conjunctiva (clear membrane that lines the inside of the lid and sclera)
4 causes of conjunctivitis
- Chemical (splash injury/foreign body)
- Bacterial
- Viral
- Allergic
bacterial conjunctivitis
pus like drainage
viral conjunctivitis (most common)
watery drainage
allergic conjunctivitis
very itchy and usually both eyes
opthalmia neonatorum
conjunctivitis in a newborn usually acquired from the mother during vaginal birth and contact with infected vaginal secretions
common organisms that cause eye infections in newborns (from birth canal)
chlamydia, gonorrhea, or herpes
does opthalmia neonatorum require treatment?
YES (especially herpes), immediately to prevent injury or blindness
older infants with frequent discharge upon waking can also be…
plugged tear duct
treatment for bacterial conjunctivitis
- antibiotic
- isolate patient
treatment for viral conjunctivitis
- antivirals
treatment for allergic conjunctivitis
- antihistamines
- decongestants
- lubricant
biggest complications from conjunctivitis
periorbital cellulitis
periorbital cellulitis
bacterial infection of the eyelid and surrounding issues
cause of periorbital cellulitis
- conjunctivitis left untreated or respiratory infections
- caused by strep/staph typically
periorbital s/s
- swollen
- tender
- redness/purple
- fever
should you treat periorbital cellulitis rigtht away?
YES, if not infection may spread and cause bacterial meningitis
treatment of periorbital cellulitis
- IV antibiotics
- IV fluids
- Warm packs
- Takes 48-72 to get better
common causes of eye injuries
- BB guns
- fireworks
- sharp objects
- chemical burns
- sports
strabismus
condition where the eyes are misaligned
esotropia
cross eyed
exotropia
lazy eye
retinopathy prematurity
abnormal retinal blood vessel growth due to premature birth and oxygen therapy that causes retinal detachment
treatment of eye burns
irrigate the eye for 15-30 min and recommend family transport to ER immediately
treatment of eye penetration
never remove object until an ophthalmologist can
treatment for corneal abrasion
- fluorescein strip ( makes eye orange) to see the abrasion
- erythromycin eye drops
treatment for foreign body on conjunctiva
- avoid rubbing
- irrigate
- if not able to remove, come into ER
treatment for black eye
ice for the first 2 days then warm compress
otitis media (ear infection)
inflammation of the middle ear
how to diagnose otitis media
- ear pain
- bulging of the tympanic membrane
- fluid behind middle ear
common group with otitis media
- boys
- children in daycare
- children with allergies
- winter months
what is effective to prevent otitis media
breastfeeding
specific cause of otitis media
unknown but appears to be related to disfunction of the eustachian tubes
most cases of the start of otitis media
a viral upper respiratory infection blocks air from reaching the inner ear which causes the eustachian tubes to be inflamed
nursing education topics for treating otitis media
- use of antibiotics (full duration)
- pain control
- follow up care
- prevent second-hand smoke
- hold infants to feed (upright is better)
- limit use of pacifier (link to ear infection)
otitis externa (what is it and how is it treated)
- swimmers ear
- inflammation of the skin and soft tissue of the ear canal
- treated with antibiotic ear drops/steroid drops
epistaxis
- nose bleed
cause of epistaxis
- nose picking
- foreign body
- dry air
- allergic
- infection
- coughing
nursing care of epistaxis
- determine the flow of blood (anterior vs posterior)
- we want anterior bleed because posterior bleed is more vascular and patient can hemorrhage
treating epistaxis
- have the child sit upright and tilt the head forward
- squeeze the nasal bone for 10-15 minutes
- if bleeding persist you can stick a cotton ball in noise
- consider labs if bleeding is prolonged
tonsillitis
inflammation of palatine tonsils
main causes of tonsillitis
- 80% caused by virus
- 20% caused by bacteria which is often group A strep
tonsillitis s/s
- difficulty swallowing
- enlargement of cervical lymph nodes
- breathing difficulties
- assess for redness/swelling
treatment of tonsillitis
- cold fluids
- bacterial treated with oral penicillin for 10 days
- s/s resolve within 24 hours
- antibiotics for a full 24hrs make patient not contagious
when can tonsils get taken out?
- at least 7 episodes of tonsillitis in the past year
- at least 5 episodes per year for 2 years
- sleeping disturbed from tonsillar hypertrophy
what is normal post tonsillectomy?
- slight smell or white exudate
- low grade fever
what is concerning post tonsillectomy?
fever greater than 38.8 C
sinusitis
- viral or bacterial infection causing inflamed sinus passages
- causes facial pain, congestion, post nasal drip, and headache
