Chapter 17: Nursing Care of the Child With an Alteration in Sensory Perception/Disorder of the Eyes or Ears

The parents of a 4-year-old boy tell the nurse, "We're really worried that our child doesn't have 20/20 vision. It seems that he doesn't always see clearly at a distance." What is the best response by the nurse? "20/20 vision isn't usually achieved until the age of 6 or 7 years but I will let the physician know your concerns." While 20/20 vision isn't usually achieved until the age of 6 or 7 years, it is important to notify the physician in case there is another cause for the lack of vision clarity. Visual acuity can be assessed prior to the child's ability to read The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39° C (102.2° F). Which intervention would the nurse expect to implement? Administering antibiotics as soon as they're available Explanation: Because of the severity of the symptoms, the child will be treated with antibiotics immediately. This decision is based on the clinical practice guideline developed by the American Academy of Pediatrics and American Academy of Family Physicians. This clinical practice guideline helps to eliminate the need for obtaining middle ear fluid for culture. It is unreasonable to obtain a culture of middle ear fluid with every episode of acute otitis media to determine the specific cause. A 20-month-old's gait would most likely appear as swaying from side to side while moving forward. It is not until the toddler is around 3 years of age that he or she demonstrates walking in a heel-to-toe fashion with a steady gait. Antiviral medications would be used if the diagnosis of a viral cause was confirmed and the child was older than the age of 2 years. 00:05 01:23 The nurse is caring for a 10-year-old girl with acute periorbital cellulitis. Which nursing intervention (therapy) is primary for this disorder? Administering antibiotics IV as ordered Intravenous antibiotics will be the primary therapy for this child, followed by oral antibiotics. Warm compresses will be applied for 20 minutes every 2 to 4 hours. However, narcotic analgesics are not necessary to handle the pain associated with this disorder A 13-year-old reports she recently saw a television program showing surgery to correct vision problems. She states she hates wearing glasses and wants to have this procedure done. What is the best response by the nurse? "Although there are surgeries for vision, they are not normally recommended for someone your age." In most cases laser surgery for someone this young is not recommended. Explaining that other girls wear glasses does not answer the teen's original question. While contact lens may be something for consideration, this response does not address the teen's question. An infant is born with congenital glaucoma. She is scheduled for surgery to relieve this condition at age 2 days. Which preoperative order would you question for her? A preoperative injection of atropine Glaucoma means the exit for intraocular fluid is blocked. A drug that causes pupil dilation narrows the exit of fluid further and, thus, is contraindicated. The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan? Assess the child's ability to convey information. Children who are unable to hear during the first 36 months of life are unable to learn the language necessary for normal verbal communication; therefore, it will be important to assess the child's ability to convey information. Visual assessment is not indicated. Educating parents about botulinum injections is an intervention for strabismus. Vinegar and alcohol eardrops are a treatment for swimmer's ear The nurse is teaching a group of parents about eyes and eye concerns. The nurse tells these caregivers about a condition that occurs when unequal curvatures in the cornea bend the light rays in different directions and this causes images to be blurred. The condition the nurse is referring to is: Astigmatism Astigmatism is caused by unequal curvatures in the cornea that bend the light rays in different directions and produce a blurred image. Refraction is the way light rays bend as they pass through the lens to the retina. Myopia is nearsightedness; and hyperopia is farsightedness The school age child has been diagnosed with astigmatism. The parents state, "I never knew our child had trouble seeing at a distance." How should the nurse respond? "Astigmatism doesn't mean being farsighted, it's actually a curvature of the cornea that causes blurry vision." In astigmatism the cornea's curvature is uneven, which results in an irregular quality of vision because the light rays are refracted unevenly. Children with astigmatism often have blurry vision and difficulty seeing letters as a whole, so their ability to read is affected The school nurse is assessing a student complaining of left eye pain. Upon visual inspection, the nurse notes left conjunctivae redness and thick, colored discharge. The nurse understands that these signs and symptoms are consistent with which diagnosis? Bacterial conjunctivitis Bacterial, viral, and allergic conjunctivitis signs and symptoms include redness, edema, tearing, and eye pain. Bacterial conjunctivitis has colored, thick discharge, viral conjunctivitis has clear or white discharge, and allergic conjunctivitis results in watery discharge. Chalazion is a painless infection of the meibomian gland which may be visible as a small nodule on the lid margin. The conjunctivae remain clear with chalazion. A child diagnosed with acute otitis media has been given a prescription for benzocaine. The nurse is correct when she makes which statement? "Benzocaine drops should be placed in your ear to numb it and reduce pain." Benzocaine numbing eardrops can prescribed for acute otitis media to help with severe pain. Benzocaine is not an antibiotic and when prescribed for otitis media should be placed in the ear A nursing instructor is teaching about eye disorders in childhood. Which statement made by a student indicates a need for further instruction? "Cataracts are only present in adults." A cataract is a marked opacity of the lens and may be present at birth. The nurse is talking with the mother of a 4-year-old son who will soon be going to a prekindergarten program. The child has had the Snellen vision test done at home, and he was unable to distinguish the pictures at the distance that would indicate his vision is normal. The child's mother asks the nurse if he will need glasses. Which statement made by the nurse would be most appropriate regarding the child's vision? "Children's vision is not completely developed by this age. Your child might outgrow this nearsightedness." Visual acuity of children gradually increases from birth, when the visual acuity is usually between 20/100 and 20/400, until about 7 years of age, when most children have 20/20 vision. Hyperopia (farsightedness) is a refractive condition in which the person can see objects better at a distance than close up. Astigmatism is caused by unequal curvatures in the cornea that bend the light rays in different directions