EENT (2)

Question 1

What is the visual acuity of neonates?

Answer 1

20/100 - 20/400

Question 2

What is decreased in neonatal vision?

Answer 2

Accommodation and color

Question 3

what is different about the cornea in infants and young children?

Answer 3

The Cornea occupies larger portion of the orbit

Question 4

What is the visual acuity of 2 to 3 year olds?

Answer 4

20/50

Question 5

What is the visual acuity of 6-7 y.o.s

Answer 5

20/20

Question 6

what is important to know about the eustachian tubes in pediatrics?

Answer 6

They are shorter, wider, and more horizontal which allow for passage of their during sucking or yawning, allow for otitis media or ear infection

Question 7

bybwhat age do children get their first tooth

Answer 7

6 mo

Question 8

By what age do children have a full set of teeth?

Answer 8

2 y.o.

Question 9

What is inflammation of the conjunctiva?

Answer 9

infectious conjunctivitis (pinkeye)

Question 10

what are symptoms of infectious conjunctivitis?

Answer 10

Reddit swollen conjunctiva with clear, weight, or yellow discharge

Question 11

what can cause infectious conjunctivitis?

Answer 11

Bacteria, viruses, allergy, trauma, other

Question 12

what is the term for conjunctivitis in infants under 30 days old

Answer 12

ophthalmia neonatorum

Question 13

How do infants get ophthalmia neonatorum

Answer 13

vaginal delivery from mother

Question 14

what is the term for the allergic response to the prophylactic eye prescription

Answer 14

Chemical conjunctivitis

Question 15

How long after administration of prophylactic eye prescription does chemical conjunctive it is happen?

Answer 15

24-48 hr

Question 16

What ages does bacterial conjunctivitis affect?

Answer 16

all

Question 17

What are symptoms of bacterial conjunctivitis?

Answer 17

eyelid edema, red conjunctive, enlarged lymph glands, Mucopurulent drainage, itching and burning

Question 18

what organisms cause bacterial conjunctivitis?

Answer 18

StapH aureus, h. influenzae, strep pneumoniae, Moraxella catarrhalis

Question 19

What ages does viral conjunctivitis happen in?

Answer 19

older children

Question 20

What is the most common cause of viral conjunctivitis and how?

Answer 20

adenoviruses, rub and itch eyes

Question 21

What is used when viral conjunctivitis is from herpes?

Answer 21

acyclovir IV and topical drops

Question 22

What are symptoms of allergic conjunctivitis?

Answer 22

• intense itching
• red eyes with watery discharge
• conjunctivae- cobblestone appearance
• puffy, swollen eyes

Question 23

Your nursing assignment for the day includes an infant with A URI. Doing your assessment you notice that the child has water discharge coming from both eyes. The conjunctiva is slightly redddend and edematous.

What do you think is the cause of this conjunctivitis?

Answer 23

Viral, URI and water drainage

Question 24

how is the cause of conjunctivitis usually determined?

Answer 24

Getting a history, looking at signs and symptoms, culture of drainage

Question 25

How long does treatment of bacterial conjunctivitis last?

Answer 25

5-7 days

Question 26

What is used for the treatment of bacterial conjunctivitis?

Answer 26

Antibiotic drops or ointment, erythromycin

Question 27

what is used to treat viral conjunctivitis?

Answer 27

comfort measures

Question 28

What are comfort measures that can be used for viral conjunctivitis?

Answer 28

Warm or cool wet compresses, affording lights and reading

Question 29

what is used for the treatment of allergic conjunctivitis?

Answer 29

Systemic or topical histamines; decongestants with systemic antihistamines

Question 30

how long are decongestants with systemic antihistamines used for treatment of allergic conjunctivitis?

Answer 30

short!

Question 31

What can be used to prevent reactions of allergic conjunctivitis?

Answer 31

mast cell stabilizaers

Question 32

Is conjunctivitis contagious?

Answer 32

yes

Question 33

How long are antibiotics needed for conjunctivitis at least?

Answer 33

24h (no school)

Question 34

What other eye condition can mimic conjunctivitis?

Answer 34

Clogged tear duct

Question 35

What is infection of the eyelid and surrounding tissues?

Answer 35

periorbital cellulitis

Question 36

What causes periorbital cellulitis?

Answer 36

bacteria

Question 37

What are symptoms of periorbital cellulitis?

Answer 37

* Swollen, tender, red or purple eyelids * restricted, painful movement of area around eye * fever

Question 38

how quickly does periorbital cellulitis need to be treated?

Answer 38

quick!

Question 39

Why does periorbital cellulitis require hospitalization?

Answer 39

IV antibiotics

Question 40

What are visual disorders caused by?

Answer 40

Errors of Refraction

Question 41

what type of visual disorder is where light falls behind the retina?

Answer 41

hyperopia

Question 42

What kind of visual disorder is when light falls in front of the retina?

Answer 42

myopia

Question 43

What is abnormal turning of the eye in or out that may lead to amblyopia?

Answer 43

strabismus

Question 44

What can be used to help strabismus?

Answer 44

Occlusion therapy, patching the good eye in order to use the weak eye

Question 45

what visual disorder is where one eye is poorer than the other, may result instrubitemis, genetic, lazy eye

Answer 45

amblyopia

Question 46

what med can be used for treatment of amblyopis

Answer 46

atropine 1%

Question 47

How do people get cataracts?

Answer 47

Congenital or acquired

Question 48

What is the clouding of the lens?

Answer 48

cataracts

Question 49

What are signs and symptoms of cataracts?

Answer 49

Distorted red reflex, symptoms of vision loss

Question 50

What is the treatment of cataracts?

Answer 50

surgery

Question 51

what is when immature blood vessels in the retina constrict and necrose

Answer 51

retinopathy of prematurity

Question 52

what 3 things is retinopathy of prematurity associated with?

Answer 52

* oxygen therapy * resp distress * assisted ventilation

Question 53

what age, sex, and race is retinopathy of prematurity most common in

Answer 53

* boys born before 28 weeks, weight less than 1600 gms * whites * alaskan natives

Question 54

how is retinopathy of prematurity diagnosed?

Answer 54

ophthalmic exam

Question 55

treatemnt of retinopathy of prematuroty

Answer 55

laser therapy

Question 56

what is the most common cause of blindness in the US?

Answer 56

Retinopathy of prematurity

Question 57

what ages and sex are eye injuries most common in

Answer 57

boys age 11-14

Question 58

treatment for black eye

Answer 58

ice both eyes 1-2 days, then warm compresses

Question 59

treatment for foreign objects in the eye

Answer 59

* remove if seen * irrigate * patch * transport to ED

Question 60

treatment for chemical burns of the eye

Answer 60

* irrigate 15-30 mins * transport to ED

Question 61

treatment for penetrating and perforating eye injury

Answer 61

* call emergency transport, NO CAR * never try to remove object

Question 62

what is included in an ear assessment

Answer 62

* placement * pinna * external auditory canal * hearing

Question 63

what is low-set ears associated with?

Answer 63

congenital renal disorders

Question 64

what is inflammation of the middle ear, sometimes associated with infection

Answer 64

otitis media

Question 65

what bacteria causes otitis media

Answer 65

streptococcus pneumoniae

Question 66

what demographics is otitis media usually higher in?

Answer 66

boys, children in daycare, children with allergies, children exposed to tobacco smoke

Question 67

.s/sx of otitis media

Answer 67

acute pain, rep tympanic membrane, ear effusion

Question 68

how is otitis media diagnosed

Answer 68

history and pneumatic otoscopy

Question 69

how long is otitis media treated with antibiotics in children under 2 years old

Answer 69

10 days

Question 70

how long is otitis media treated with antibiotics in children 2-5 y.o.

Answer 70

7-10 days

Question 71

how long is otitis media treated with antibiotics in children 6 + y.o.

Answer 71

5-7 days

Question 72

what is the first line therapy for otitis media

Answer 72

amoxicillin

Question 73

0what 2 things can be done for recurring otitis media

Answer 73

* myringotomy (equilizes pressure between external canal and middle ear) * tympanostomy tubes

Question 74

how much of everyday convo does a person with mild hearing loss lose?

Answer 74

50%

Question 75

what are some consequences of having a hearing imapirment for children?

Answer 75

* speech delay * imapired learning * poor congitivie learning

Question 76

what reflex is absent or diminished when a child has hearing loss

Answer 76

startle reflex

Question 77

describe babbling in child with hearing loss

Answer 77

little or none

Question 78

what is speech like in toddlers with hearing loss?

Answer 78

unintelligible (90% should be)

Question 78

what can hearing loss be confused for?

Answer 78

developmentally delayed

Question 79

manifestations of hearing loss in school age children

Answer 79

* asks for repeated isntruction * answer questions inappropriately * poor school performance * speech probs * sits close to TV * pefers to play alone

Question 80

what kind injuries occur to the external ear (pinna)?

Answer 80

* lacerations * infection * hematomas * cellulitis

Question 81

what kind if injuries occur to the ear canal?

Answer 81

* foreign body * insects

Question 82

what is done if theres an insect in the ear

Answer 82

mineral oil to immobilize and flush

Question 83

what kind of injury happens to the tympanic membrane

Answer 83

ruptures

Question 84

what is the source of blleding in nosebleeds?

Answer 84

kiesselbach's plexus (anterior nares, plentiful veins)

Question 85

what are the common causes of nosebleeds

Answer 85

1. irritation from picking 2. foreign bodies 3. low humidity

Question 86

what vitals should be taken in nosebleed

Answer 86

BP pulse

Question 87

how should a child with nosebleed be positioned?

Answer 87

upright, head forward so they dont choke on blood or get nauseous from it

Question 88

where and how long should nose be squezzed with nosebleed?

Answer 88

just below nasal bone 10-15 mins

Question 89

what kind of infection id nasopharyngitis?

Answer 89

URI (common cold)

Question 90

causes of nasopharyngitis?

Answer 90

* numerous viruses and bacteria

Question 91

which viruses and bacteria cause nasopharyngitis?

Answer 91

rhinovirus, coronavirus, group A streptococcus

Question 92

what are signs and symptoms of nasopharyngitis in infants less than 3 m.o.

Answer 92

* lethargic * irritability * poorm feeding * fever

Question 93

what are signs and symptoms of nasopharyngitis in infants 3 m.o. and older

Answer 93

* fever * vomit * diarrhea * sneezing * anorexia * irritable, restless

Question 94

what are signs and symptoms of nasopharyngitis in older children

Answer 94

* dry, irritated nose/throat * chills, fever * aches, headache * post-nasal discharge * sneezing * nasal discharge

Question 95

characteristics of viral pharyngitis

Answer 95

* gradual onset * cough, coryza, diarrhea * sore throat * low grade fever

Question 96

which kind of pharyngitis is most common?

Answer 96

viral (not strep)

Question 97

characteristics of bacterial pharyngitis (strep throat)

Answer 97

* abrupt * moderate/high fever * headache * red pharynx * painful swallowing * painful cervical nodes * petechial mottling of soft pallate * caused by group a strep

Question 98

what bacteria causes bacterial pharyngitis

Answer 98

groupo a strep

Question 99

what is the treatment of pharyngitis?

Answer 99

* pain relief (Acetaminophaen) (also used for fever) * cool, non-acidic, soft food, ice chips, gargle warm salt water * oral penicillin (erythromycin if allergic) (non contagious after 24h on antibiotic)

Question 100

symptoms of tonsillitis

Answer 100

* frequent throat infections * difficulty swallowing and breathing * persistent redness * enlargement of cervical nodes

Question 101

how is tonsillitis treated?

Answer 101

symptomatically, recurrent episodes= removal

Question 102

what defines a tonsillitis episode?

Answer 102

having a sore throat AND one of the following... * fever > 38.3 * cervical adenopathy * tonsillar exudate * + group b strep

Question 103

infection in what time frames qualifies for surgery (tonsillitis)

Answer 103

* 7 episodes in 1 year * 5 episodes a year for 2 years * 3 episodes a year for 3 years

Question 104

post-op tonsillectomy meds

Answer 104

no antibiotics after removal, one dose of intraoperative IV dexamethasone for swelling

Question 105

when to call the doctor after a tonsillectomy

Answer 105

if there is bright red bleeding or temp > 38.8

Question 106

post-op tonsillectomy care

Answer 106

* drink cool fluids or chew gum * acetaminophen as ordered * apply ice on childs neck * gargle with baking soda solution and salt in 8oz water * rinse mouth with viscous lidocaine, then swallow

Question 107

describe the three tooth injuries

Answer 107

fracture, partially knocked out, completely out

Question 108

what is luxation

Answer 108

partially knocked out tooth

Question 109

what is avulsion

Answer 109

completely knocked out tooth

Question 110

how should a tooth be handled?

Answer 110

by crown, not root

Question 111

what should you do if a tooth is fully knocked out?

Answer 111

place back in socket quickly!

Question 112

what kind of fluid should a knocked out tooth be transported in?

Answer 112

isotonic fluid, like cows milk