Eye/Ear

Question 1

Otitis Media

Answer 1

Inflammation of the middle ear with the presence of fluid

Question 2

Types of otitis media

Answer 2

1. Acute otitis media (AOM)

2. Otitis media with effusion (OME)

Question 3

Acute Otitis Media

Answer 3

Infected fluid in the middle ear

- Common secondary infection from an upper respiratory infection

Question 4

Acute Otitis Media (viral or bacterial?)

Answer 4

Could be either

Question 5

S/Sx of AOM

Answer 5

1. Pain
2. Fever
3. Pressure
4. Irritability
5. Tugging at the ears
6. Difficulty sleeping
7. Loss of appetite

Question 6

AOM Management

Answer 6

• Bacterial: antibiotics
• Viral: observational (let it run its course)
  1. Analgesics
  2. Hot/cool compresses
  3. Numbing eardrops
  4. Xylitol gum
  5. Flu vaccine

Question 7

AOM Complications

Answer 7

1. Hearing loss
2. Speech delay
3. Scarring of the tympanic membrane
4. Perforation

Question 8

Risk Factors for Acute Otitis Media

Answer 8

1. Eustachian tube dysfunction
2. Family history
3. Passive smoking
4. Absence of infant breastfeeding
5. Presence of allergies

Question 9

AOM Otoscopic Examination

Answer 9

The tympanic membrane will have a dull or opaque appearance and is bulging and/or red. Sometimes pus (green or yellow) may be visible.

Question 10

AOM Positioning

Answer 10

Instruct the family to have the child lie on the affected side with the heating pad or covered ice pack in place to that ear.

Question 11

S/Sx of perforation

Answer 11

If there is a perforation, the child may feel a decrease in pain as well as fluid draining from the site.

Question 12

Otitis Media with Effusion

Answer 12

Fluid within the middle ear space, without signs and symptoms of infection
- Can be independent of AOM or after the infection has resolved

Question 13

S/Sx of OME

Answer 13

1. May be asymptomatic

2. Complaints of “popping” of the ears or fullness

Question 14

OME Treatment

Answer 14

Resolves spontaneously (may take several months to resolve).

Persistent or problematic OME is treated with PE tubes.

Must be rechecked every 4 weeks until resolved.

** No bottle propping

Question 15

OME Complications

Answer 15

1. AOM
2. Hearing loss
3. Deafness

Question 16

PE Tubes

Answer 16

1. Standard treatment for OME
2. Surgically inserted via myringotomy
3. Stay in place for several months then fall out

Question 17

Nursing Management of PE tubes

Answer 17

1. Post op ear drops

2. Ear plugs when they take a bath or go swimming

Question 18

Conjunctivitis

Answer 18

“Pink Eye”

Inflammation of the conjunctiva

Question 19

Types of Conjunctivitis

Answer 19

1. Infectious (viral or bacterial)
2. Allergic
3. Chemical

Question 20

S/Sx of Conjunctivitis

Answer 20

1. Redness
2. Edema
3. Tearing
4. Discharge
5. Eye pain
6. Itching of the eyes

Question 21

Bacterial Conjunctivitis Treatment

Answer 21

Antibiotic drops, warm compresses

Question 22

Viral Conjunctivitis Treatment

Answer 22

Symptom relief or an antiherpetic

Question 23

Allergic Conjunctivitis Treatment

Answer 23

Antihistamine drops and/or oral antihistamine, avoid allergen exposure, cool compresses

Question 24

Chemical Conjunctivitis Treatment

Answer 24

Flushing of the eyes with saline

Question 25

Conjunctivitis Education

Answer 25

1. Hand hygiene 2. How to apply eye drops or ointments 3. Avoid rubbing/touching eyes 4. Rinse eyelids 5. Shower before bedtime 6. Contacts 7. When to return to school (when symptoms lessen or drainage lessens)

Question 26

Strabismus

Answer 26

Misalignment of the eyes | - Should resolve by 3-6 months of age

Question 27

Exotropia

Answer 27

Outward misalignment of the eyes

Question 28

Esotropia

Answer 28

Inward misalignment of the eyes

Question 29

Nursing Management of Strabismus

Answer 29

1. Patching the good eye to make the bad eye work harder to get stronger 2. Eye muscle surgery 3. Corrective lenses

Question 30

Strabismus Complications

Answer 30

1. Amblyopia (lazy eye) | 2. Visual deficits

Question 31

Amblyopia

Answer 31

"Lazy Eye" | Poor visual development in a structurally normal eye

Question 32

Amblyopia Treatment

Answer 32

1. Patching the good eye 2. Atropine drops in the good eye 3. Vision therapy 4. Eye muscle therapy

Question 33

Amblyopia Complications

Answer 33

Blindness in one or both eyes

Question 34

Indications for a Tonsillectomy

Answer 34

1. Recurrent tonsil infections 2. Chronic strep throat 3. Enlarged tonsils that cause upper airway obstruction

Question 35

Nursing Management of Postop Tonsillectomy

Answer 35

1. Side lying/prone, then elevate HOB when awake 2. Suction carefully 3. Monitor for bleeding 4. Encourage hydration 5. Control pain 6. Discourage coughing, blowing the nose, and using straws 7. Avoid citrus juice 8. Avoid red/brown fluids

Question 36

Tonsillectomy Complications

Answer 36

Bleeding for up to 10 days postop and vomiting