NURS 5335 family 2 Study Guide EENT Family Nursing II
Modules 1&2 ,Questions with Complete Solutions
Non-Ulcerative: A/W seborrhea; seen commonly with trisomy 21; affects those with psoriasis,
seborrhea, eczema, allergies and lice. Chemical and environmental irritants contribute
Ulcerative:Involves the lash follicle & the Meibomian glands of the eyelid.May be pustules at the base
of the hair follicle that crust & bleed.Lashes break easy.
Blepharitis
Blepharitis treatment
TX: Warm compress; daily lid scrubs; erythromycin, quinolone or bacitracin ophthalmic ointment for
anterior blepharitis.
Consider oral ABX for resistance (Doxycycline or Tetracycline)
Disinfect contacts
Lid massages
hordeolum age group?
More common in children and adolescents
hordeolum s/s?
Localized tenderness, erythema, edema of eyelids; internal lesions pointing to external or internal eyelid
surface; external lesions pointing to eyelid margin
Pain
Ocular rosacea
Contact dermatitis,
Atopic Kerato-conjunctivitis,
Herpes simplex infection,
Preseptal cellulitis,
Acute dacryocystitis,
differentials of hordeolum
differentials of hordeolum
blepharitis
Sebaceous carcinoma,
Basal cell carcinoma,
Squamous cell carcinoma,
Dry eye syndrome,
Conjunctivitis,
,blepharitis
Ocular burning, eyelid margins red w/ scaling or crusting
Pain
Itching, tearing, chalazia, recurrent styes, photophobia, small ulceration at eyelid margin, broken or
absent eyelashes
hordeolum
(stye) red, painful pustule that is a localized infection of hair follicle at eyelid margin. The most common
associated organism is Staphylococcus aureus
TX: Warm compress; lid scrubs for recurrent lesions
Hordeolum tx
chalazion
a nodule or cyst, usually on the upper eyelid, caused by an obstruction in a sebaceous gland A
granulomatous infection of a Meibomian gland
Nontender chronic lesions; bump
Chalazion is More common in adults and S?S
TX: Warm compress; daily lid scrubs; lid message; intralesional steroid injection
Chalazion
Conjunctivitis
Refer to ophthalmology for
viral herpetic conjunctivitis w/RED FLAGS
Inflammation of the conjunctiva covering the front of the eye from a causative agent (bacteria, virus,
allergen)
Conjunctivitis
Conjunctivitis
Allergic conjunctivitis is seen more in Spring and Summer.
Bacterial is seen more in pediatric population.
Conjunctivitis
ALLERGIC: Pruritus; conjunctival hyperemia, chemosis; a watery or stringy discharge
BACTERIAL: Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash mattering; edema;
hyperemia; preauricular adenopathy only w/ hyperacute disorder
, VIRAL: Acute onset often A/W systemic illness; photophobia or foreign body sensation; preauricular
adenopathy; hyperemia; chemosis; watery discharge; classic dendritic corneal lesion present w/ herpes
simplex; periocular lesions present w/ herpes zoster opthalmicus
ALLERGIC: Conjunctivitis
Pruritus; conjunctival hyperemia, chemosis; watery or stringy discharge
Topical antihistamine/oral antihistamine or topical vasoconstrictor decongestant antihistamine (OTC)
drops: o Naphazoline hydrochloride 0.025% (Naphcon-A) o Naphazoline- antazoline 0.3% (Vasocon-A) o
Levocabastine hydrochloride 0.05% (Livostin) o Emedastine 0.05% (Emadine) mast cell stabilizers: o
Olopatadine 0.1% (Palatal) o Azelastine 0.05% (Optivar) 1st line = prevention; avoid whatever allergen
is triggering conjunctivitis
BACTERIAL:Conjunctivitis
Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash mattering; edema; hyperemia;
preauricular adenopathy only w/ hyperacute disorder
Caused by staph, strep, h flu, and m catarrhalis, Pseudomonas (contact lens wearers), gonorrhea
****Staph aureus (more common in adults)
Eye drops or ointment:
o Polytrim/trimethoprim/polymyxin o Erythromycin o Tobramycin o Gentamicin o Sodium sulfacetamide
o Ciprofloxacin o Fluoroquinolones-(**1st line for contact users) o Ointment over drops for children
VIRAL:conjunctivitis
the second eye usually infected after 24-48 hrs
itchy eyes.
Tearing.
Redness.
Discharge.
Sandy, gritty
Light sensitivity (when corneal involvement is present)
TX: Antihistamine/decongestant drops o Trifluridine (herpes conjunctivitis)
enlarged or tender preauricular node; initially unilateral, then bilateral caused from adenoviruses,
coxsackie virus, varicella, herpes, and herpes zoster § fluorescein stain= dendrites-----****Referral to
opthamologist
Red flags in conjunctivitis:
Diminished visual acuity, photophobia, severe foreign body sensation preventing pt from keeping eye
open, corneal opacity, fixed pupil, or severe HA with nausea
corneal abrasion
Modules 1&2 ,Questions with Complete Solutions
Non-Ulcerative: A/W seborrhea; seen commonly with trisomy 21; affects those with psoriasis,
seborrhea, eczema, allergies and lice. Chemical and environmental irritants contribute
Ulcerative:Involves the lash follicle & the Meibomian glands of the eyelid.May be pustules at the base
of the hair follicle that crust & bleed.Lashes break easy.
Blepharitis
Blepharitis treatment
TX: Warm compress; daily lid scrubs; erythromycin, quinolone or bacitracin ophthalmic ointment for
anterior blepharitis.
Consider oral ABX for resistance (Doxycycline or Tetracycline)
Disinfect contacts
Lid massages
hordeolum age group?
More common in children and adolescents
hordeolum s/s?
Localized tenderness, erythema, edema of eyelids; internal lesions pointing to external or internal eyelid
surface; external lesions pointing to eyelid margin
Pain
Ocular rosacea
Contact dermatitis,
Atopic Kerato-conjunctivitis,
Herpes simplex infection,
Preseptal cellulitis,
Acute dacryocystitis,
differentials of hordeolum
differentials of hordeolum
blepharitis
Sebaceous carcinoma,
Basal cell carcinoma,
Squamous cell carcinoma,
Dry eye syndrome,
Conjunctivitis,
,blepharitis
Ocular burning, eyelid margins red w/ scaling or crusting
Pain
Itching, tearing, chalazia, recurrent styes, photophobia, small ulceration at eyelid margin, broken or
absent eyelashes
hordeolum
(stye) red, painful pustule that is a localized infection of hair follicle at eyelid margin. The most common
associated organism is Staphylococcus aureus
TX: Warm compress; lid scrubs for recurrent lesions
Hordeolum tx
chalazion
a nodule or cyst, usually on the upper eyelid, caused by an obstruction in a sebaceous gland A
granulomatous infection of a Meibomian gland
Nontender chronic lesions; bump
Chalazion is More common in adults and S?S
TX: Warm compress; daily lid scrubs; lid message; intralesional steroid injection
Chalazion
Conjunctivitis
Refer to ophthalmology for
viral herpetic conjunctivitis w/RED FLAGS
Inflammation of the conjunctiva covering the front of the eye from a causative agent (bacteria, virus,
allergen)
Conjunctivitis
Conjunctivitis
Allergic conjunctivitis is seen more in Spring and Summer.
Bacterial is seen more in pediatric population.
Conjunctivitis
ALLERGIC: Pruritus; conjunctival hyperemia, chemosis; a watery or stringy discharge
BACTERIAL: Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash mattering; edema;
hyperemia; preauricular adenopathy only w/ hyperacute disorder
, VIRAL: Acute onset often A/W systemic illness; photophobia or foreign body sensation; preauricular
adenopathy; hyperemia; chemosis; watery discharge; classic dendritic corneal lesion present w/ herpes
simplex; periocular lesions present w/ herpes zoster opthalmicus
ALLERGIC: Conjunctivitis
Pruritus; conjunctival hyperemia, chemosis; watery or stringy discharge
Topical antihistamine/oral antihistamine or topical vasoconstrictor decongestant antihistamine (OTC)
drops: o Naphazoline hydrochloride 0.025% (Naphcon-A) o Naphazoline- antazoline 0.3% (Vasocon-A) o
Levocabastine hydrochloride 0.05% (Livostin) o Emedastine 0.05% (Emadine) mast cell stabilizers: o
Olopatadine 0.1% (Palatal) o Azelastine 0.05% (Optivar) 1st line = prevention; avoid whatever allergen
is triggering conjunctivitis
BACTERIAL:Conjunctivitis
Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash mattering; edema; hyperemia;
preauricular adenopathy only w/ hyperacute disorder
Caused by staph, strep, h flu, and m catarrhalis, Pseudomonas (contact lens wearers), gonorrhea
****Staph aureus (more common in adults)
Eye drops or ointment:
o Polytrim/trimethoprim/polymyxin o Erythromycin o Tobramycin o Gentamicin o Sodium sulfacetamide
o Ciprofloxacin o Fluoroquinolones-(**1st line for contact users) o Ointment over drops for children
VIRAL:conjunctivitis
the second eye usually infected after 24-48 hrs
itchy eyes.
Tearing.
Redness.
Discharge.
Sandy, gritty
Light sensitivity (when corneal involvement is present)
TX: Antihistamine/decongestant drops o Trifluridine (herpes conjunctivitis)
enlarged or tender preauricular node; initially unilateral, then bilateral caused from adenoviruses,
coxsackie virus, varicella, herpes, and herpes zoster § fluorescein stain= dendrites-----****Referral to
opthamologist
Red flags in conjunctivitis:
Diminished visual acuity, photophobia, severe foreign body sensation preventing pt from keeping eye
open, corneal opacity, fixed pupil, or severe HA with nausea
corneal abrasion
