Week 5 - ENT Flashcards
Visual Acuity in Neonates
20/400
What is the visual acuity in children
20/100
* improves as children age
Conjunctivitis
KNOW THIS!!!!!
Inflammation of the conjunctiva
- Types: chemical, bacterial, viral, fungal, allergic
Nursing Management
* Contact precautions
* Keep eye clean & dry
* Administer ophthalmic medication
Bacterial Conjunctivitis
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“Pink eye”
S/S: Purulent drainage; inflamed / red conjunctiva, swollen lids
Tx: antibiotics - erythromycin drops
Viral Conjunctivitis
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Cause (common): Adenovirus (respiratory infection)
S/S: edema of the eyelid, inflamed conjunctiva, & serous (watery) drainage
Tx: Antivirals & supportive care
Allergic Conjunctivitis
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Cause: allergies
S/S: the child complains of intense itching, watery to thick drainage, swollen eyelids
Tx: antihistamines, decongestants, lubricants
Opthalmia Neonatorum
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Conjunctivitis of the newborn (< 30 days old)
Cause: Acquired vaginally from birth infections (gonorrhea, chlamydia, HSV)
Eye Drop Administration
KNOW THIS!!!!!
- Adquate immobilization is needed to avoid injury
- The nurse’s hand can be stabilized by resting the wrist on the child’s head
- Explanations & therapeutic play can be used with children old enough to explain the process of administration
- Have the medication at room temperature
Periorbital Cellulitis
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Bacterial infection of the eyelids & tissue surrounding the eye
Causes: staphylococcus or streptococcus
S/S: swollen, tenderness, red/purple lids, painful movement, & fever
Tx: IV antibiotics, IV fluids, warm pack
Eye Injuries
Very common among school-aged boys
- Causes: BB guns, fireworks, sharp objects, burns, or sports injuries
Eye Burn
Irrigate the eye for 15-30 minutes & go to the ER
Eye Penetrating Objects
NEVER remove the object; should be removed by an opthamologist
Corneal Abrasion
- Flourisein strip to see the abrasion
Tx: erythromycin drops
Foreign Body on the Eye
- Avoid rubbing the eye
- Irrigate
- Go to the ER if foreign body can’t be removed
Black Eye
Ice; then apply warm compress after 2 days
Ears - Pediatric Differences
KNOW THIS!!!!!
- Eustachian Tube: shorter, wider, & more horizontal in infants than older children & adults
- Internal & Middle Ear: relatively large at birth; tympanic membrane easily injured
Otitis Media
KNOW THIS!!!!!
Inflammation of the middle ear
* common in boys, daycare, allergies, winter months
S/S: redness (over portions of the ear drum), bulging tympanic membrane, fluid w/ no movement or excessive movmement
Tx: antibiotics, tympanostomy, tube placmeent
Acute Otitis Media (AOM)
Otitis Externa
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“Swimmer’s Ear”; inflammation of the outer ear
Cause: can be caused by placing things in ears
Tx: antibiotic ear drops, steroid drops
Epistaxis
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Nosebleed
Cause: nose picking, dryness, foreign bodies, allergies, coughing, blunt trauma
Tx: head upright & tilted forward, squeeze nares below nasal bone for 10 minutes; cotton ball with epi, thrombin, or lidocaine (vasoconstrictors)
Tonsilitis & Pharyngitis
KNOW THIS!!!!!
Inflammation of the tonsils & pharynx
- 80% viral by group A beta strep
S/S: difficulty swallowing, enlarged lymph nodes, breathing difficulties
Tx: penicillin (10 day course), supportive care
Tonsilectomy
KNOW THIS!!!!!
Surgical removal of the tonsils
Only considered if:
* 7 episodes of tonsilitis within 1 year
* 5 episodes of tonsilitis per year within 2 years (10 episodes / 2 yr)
* 3 episodes per year for 3 years (9 episodes in 3 years)
Tonsilectomy Nursing Care
KNOW THIS!!!!!
- Promote fluids (popsicles, ice cream, slurpees)
- Ice for discomfort
- Pain relief
- Watch for bleeding / infection
- Normal for white / yellow exudate 7 days following
