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Ear, Eyes, Nose
Med Surg
| Question | Answer |
|---|---|
| What is conjunctivitis | infection of the conjunctiva (outer most layer of the eye), typically contagious |
| What is conjunctivitis commonly known as | pink eye |
| Types of conjunctivitis | viral, bacterial, allergic |
| S/S of viral conjunctivitis | watery discharge, irritation, red eye, infection usually begins, with one eye, but may spread easily to the other eye |
| S/S of bacterial conjunctivitis | stringy discharge that may cause the lids to stick together, especially after sleeping, swelling of the conjunctiva, redness, tearing, irritation and/or a gritty feeling, usually affects only one eye, but may spread easily to the fellow eye |
| S/S of allergic conjunctivitis | usually affects both eyes, itching, tearing, swollen eyelids |
| How to avoid spreading conjunctivitis | disinfect surfaces such as doorknobs/counters with diluted bleach solution, don't swim, avoid touch face, wash hands frequently, don't share towels/washcloths, avoid shaking hands |
| What is epistaxis | hemorrhage from the nose |
| What causes epistaxis | rupture of tiny, distended vessels in the mucous membrane of any area of the nose |
| Epistaxis risk factors | local infections (vestibulitis, rhinitis, sinusitis), systemic infections (scarlet fever, malaria), drying of nasal mucous membranes, nasal inhalation of illict drugs, trauma, arteriosclerosis, hypertension, tumor, thrombocytopenia, use of aspirin, |
| Epistaxis med management | pinch nose 5-10 mins, sit/stand up with head bent forward, ice compression (causes vasoconstriction), hypertensive pt. take their meds to control B/P |
| Epistaxis NRSG inter | monitor vital signs, assess pt. airway and breathing |
| Nose fractures | affect the ascending process of the maxilla and the septum |
| Nose fracture complications | hematoma, infection, abscess, avascular or septic necrosis |
| Nose fracture S/S | pain, external and internal bleeding into pharynx, swelling of soft tissues, nasal obstruction, deformity, asymmetric appearance |
| Nose fracture med mngmt | timing is important, further delay in treatment may result in significant bone healing. Treatment should be done within firth 3 hrs |
| Nose fracture NRSG mngmt | apply ice and encourage pt to heep head elevated. Instruct to apply ice for 20 mins 4 times a day to decrease swelling. Mouth rinse to mositen mucous membrane and reduce odor/taste of dried blood in oropharynx/nasopharynx. Pt. avoid sports activities 6wks |
| What is cataract | an opacity or cloudiness of the lens, protein clump, discoloration of the lens |
| Cataracts etiology | age, trauma, genetic defects (congenital), smoking, diabetics, excessive exposure to sunlight, steroid use, diuretic use, certain major tranquilizers, lipid metabolism disorders, down syndrome, |
| Cataracts S/S | cloudy/blurred vision, sensitivity to glare, reduce visual acutiy, diplopia (double vision), photosensitivity, hazy/fuzzy vision, difficulty driving at night, frequent prescription of eyeglass/contact change, myopic shift, astigmatism |
| Types of cataract surgery | intracapsular cataract extraction (ICCE), extracapsular cataract extraction (ECCE), phacoemulsification, lens replacement |
| Intracapsular cataract extraction (ICCE) | removes entire lens; rarely done today |
| Extracapsular cataract extraction (ECCE) | maintains the posterior capsule of the lens, reducing potential postoperative complications |
| Phacoemulsification | an ECCE that uses an ultrasonic device to suction the lens out through a tube; incision is smaller than with standard ECCE |
| Lens replacement | after removal of the lens by ICCE or ECCE, the surgeon inserts an intraocular lens implant (IOL), when eliminates the need for aphakic lenses; pt may still require glasses |
| Cataract NRSG mngmt | instruct pt to call dr. asap if vision changes, continuous flashing lights appear, redness, swelling, or pain increase, type and amount of drainage increase, pain not relief by acetaminophen, instruct pt no bending, stooping or lifting, use eye shild |
| What is glaucoma | ocular conditions, damage to the optic nerve is related to increased intraocular pressure caused by congestion of the aqueous humor |
| Glaucoma pathophysiology | aqueous outflow is blocked, pressure builds up in the eye, increased IOP causes irreversible mechanical and/or ischemic damage |
| Glaucoma risk factors | over 60 yrs., diabetes mellitus, hypertension, heredity (african americans), Hx of eye disease, heroin/marijuana use, exposure to cold, hypothyroidism, eye trauma, prolonged used of topical/systemic corticosteroids, stree, sedentary lifestyle |
| Glaucoma risk factors | thin cornea, cardiovascular disease, migraine syndromes, nearsightedness (myopia) |
| Types of glaucoma | open angle and angle closure (pupillary block) glaucoma |
| Open angle glaucoma | bilateral, but one eye more severly affected than the other, anterior chamber angle is open and appears normal; types: primary open angle, normal tension, ocular hypertension |
| primary open angle | optic nerve damage, visual field defects, IOP >21mmHg. Usually no symptoms but may have ocular pain, headache, and halos |
| Normal tension | IOP <21mmHg. Optic nerve damage, visual field defects |
| Ocular hypertension | elevated IOP, possible ocular pain or headache |
| Angle closure (pupillary block) glaucoma | obstruction in aqueous humor outflow due to the complete or partial closure of he angle from the forward shift of the peripheral iris to the trabecula. Results in increased IOP |
| Acute angle closure glaucoma | rapidly progressive visual impairment, periocular pain, conjunctival hyperemia, and congestion. Pain may assoicate with nausea, vomiting, bradycardia and profuse sweating. Pupil vertically oval, fixed in a semidialted position |
| Subacute angle closure glaucoma | blurring of vision, halos around lights, temporal headaches, ocular pain, pupil may be semidilated |
| chronic angle closure glaucoma | significant visual field loss, IOP may be normal or elevated, ocular pain and headache |
| Glaucoma S/S | "silent theif of sight", blurred vision, halos around lights, difficulty focusing, difficulty adjusting eyes in low lighting, loss of pheripheral vision, aching, or discomfort around eyes. Pt unaware they have disease until experienced visual changes/loss |
| Glaucoma dignostics | tonometry to measure the IOP, ophthalmoscopy to inspect the optic nerve, gonioscopy to examine the filtration angle of the anterior chamber, perimetry to assess the visual fields |
Created by:
syrosaneli
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