Advanced Nursing NSG 6001 Exam |94
Questions and Answers
Chalazion - -A chronic sterile, lipogranulomatous inflammation lesion of the
mibomian gland.
- What causes a Chalazion - -meibomian glands secrete the oil layer of the
tear film in the eye. NOT AN INFECTION. More common in adults.
- What are the risk factors of a Chalazion - -Chronic Blepharitis, Seborrhea,
Viral infection, rosacea
- Clinical presentation of Chalazion - -Chronic swelling at the inner eye lid.
(NOT ON THE LASH LINE)
Swollen, palpable nodule in lid margin of the eye.
NONTENDER.
Discomfort or irritation due to swelling, feeling of foreign body in the eye,
swelling of the eyelid.
- Treatment of Chalazion - -Small lesions may not need any treatment.
Usually absorbs spontaneously in 2-8 weeks
Drains through the inner surface of the eyelid
May need intralesion steroid injection
Warm compress 3-5 times per day
Gentle massage of eyelid (do not try and pop it)
Abx not indicated unless lesion is associated with Blepharitis
Optho referral if develops cellulitis or does not respond to treatment.
- Patient education for Chalazion - -- Patient can wear contact lenses. They
should be cleaned with disinfectant. Disposable lenses do not need to be
discarded any sooner than schedule.
- Discard eye makeup.
- Good hand hygiene
- Hordeolum - -"STYE"
An acute INFECTION of a glands in the eyelid, may be associated with
blepharitis.
- On the lash line
- Causes of Hordeolum - -staph aureus is the most common associated
organism, can progress to cellulitis or abcess
- more common in children
- Clinical presentation of Hordeolum - -Gradual enlarging localized nodule
, - in 2-4 days will start draining
-painful, tender
-lid erythema, warmth, tearing
- Treatment of hordeolum - -- warm compresses for 5-10 min TID
- bactricacin or erythromcyin eye ointment
- Eyelid scrub (same as blepharitis)
- Good hand hygiene
- Monitor for Cellulitis- systemic antibiotics, optho referral
- Otitis Externa - -A cellulitis of the EXTERNAL AUDITORY CANAL that may
extend into the auricle
- Risk factors for Otitis Externa - -Removal of protective cerumen, vigorous
cleaning of external canal, maceration of skin from accumulation of moisture
infection. (Staph, pseudomonas)
- Clinical presentation of Otitis Externa - -Pain of affected ear and auricle,
fullness in ear, itching, drainage from ear, hearing loss, fever
- Physical exam of Otits Externa - -Pain and tenderness on palpitation of
trigs or manipulation of auricle, ear canal is red and or swollen, canal is filled
with debris and sloughed tissue.
Diagnostics: Culture of drainage if possible
- Treatment of Otitis Externa - -- NSAID for pain
- topical anesthetics and corticosteroids for severe pain/swelling
- Topical Abs ( Cortisporin otic suspension, Ciprodex)
- Insert wick into affected ear if needed to ensure medication. gets in.
- systemic therapy if extends beyond the canal
- Otitis Media - -Inflammation and or infection of the middle ear
- inflammation and edema of ET and or adenoids
- narrowing of Eustachian tube, decreased drainage of fluid from the middle
ear.
- accumulation of fluid in middle ear ( otitis media with effusion)
- Causes of Otitis Media - -Bacterial or viruses (often refluxes from
nasopharynx into ear) occurs with or follows URI, allergic rhinitis, exposure to
smoke in young children, ET is short and more horizontal, bottle feeding,
attending daycare, GERD, pacifier use, craniofacial abnormalities
- Most common organisms: Strep Pneumo, H.Flu, Moraxella Catarrhalis
- most frequent childhood infectious disease
Questions and Answers
Chalazion - -A chronic sterile, lipogranulomatous inflammation lesion of the
mibomian gland.
- What causes a Chalazion - -meibomian glands secrete the oil layer of the
tear film in the eye. NOT AN INFECTION. More common in adults.
- What are the risk factors of a Chalazion - -Chronic Blepharitis, Seborrhea,
Viral infection, rosacea
- Clinical presentation of Chalazion - -Chronic swelling at the inner eye lid.
(NOT ON THE LASH LINE)
Swollen, palpable nodule in lid margin of the eye.
NONTENDER.
Discomfort or irritation due to swelling, feeling of foreign body in the eye,
swelling of the eyelid.
- Treatment of Chalazion - -Small lesions may not need any treatment.
Usually absorbs spontaneously in 2-8 weeks
Drains through the inner surface of the eyelid
May need intralesion steroid injection
Warm compress 3-5 times per day
Gentle massage of eyelid (do not try and pop it)
Abx not indicated unless lesion is associated with Blepharitis
Optho referral if develops cellulitis or does not respond to treatment.
- Patient education for Chalazion - -- Patient can wear contact lenses. They
should be cleaned with disinfectant. Disposable lenses do not need to be
discarded any sooner than schedule.
- Discard eye makeup.
- Good hand hygiene
- Hordeolum - -"STYE"
An acute INFECTION of a glands in the eyelid, may be associated with
blepharitis.
- On the lash line
- Causes of Hordeolum - -staph aureus is the most common associated
organism, can progress to cellulitis or abcess
- more common in children
- Clinical presentation of Hordeolum - -Gradual enlarging localized nodule
, - in 2-4 days will start draining
-painful, tender
-lid erythema, warmth, tearing
- Treatment of hordeolum - -- warm compresses for 5-10 min TID
- bactricacin or erythromcyin eye ointment
- Eyelid scrub (same as blepharitis)
- Good hand hygiene
- Monitor for Cellulitis- systemic antibiotics, optho referral
- Otitis Externa - -A cellulitis of the EXTERNAL AUDITORY CANAL that may
extend into the auricle
- Risk factors for Otitis Externa - -Removal of protective cerumen, vigorous
cleaning of external canal, maceration of skin from accumulation of moisture
infection. (Staph, pseudomonas)
- Clinical presentation of Otitis Externa - -Pain of affected ear and auricle,
fullness in ear, itching, drainage from ear, hearing loss, fever
- Physical exam of Otits Externa - -Pain and tenderness on palpitation of
trigs or manipulation of auricle, ear canal is red and or swollen, canal is filled
with debris and sloughed tissue.
Diagnostics: Culture of drainage if possible
- Treatment of Otitis Externa - -- NSAID for pain
- topical anesthetics and corticosteroids for severe pain/swelling
- Topical Abs ( Cortisporin otic suspension, Ciprodex)
- Insert wick into affected ear if needed to ensure medication. gets in.
- systemic therapy if extends beyond the canal
- Otitis Media - -Inflammation and or infection of the middle ear
- inflammation and edema of ET and or adenoids
- narrowing of Eustachian tube, decreased drainage of fluid from the middle
ear.
- accumulation of fluid in middle ear ( otitis media with effusion)
- Causes of Otitis Media - -Bacterial or viruses (often refluxes from
nasopharynx into ear) occurs with or follows URI, allergic rhinitis, exposure to
smoke in young children, ET is short and more horizontal, bottle feeding,
attending daycare, GERD, pacifier use, craniofacial abnormalities
- Most common organisms: Strep Pneumo, H.Flu, Moraxella Catarrhalis
- most frequent childhood infectious disease
