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FNP I > FNP I HEENT > Flashcards

FNP I HEENT Flashcards

0
Q

How is NPH diagnosed?

A

With CT or MRI

The only real way to tell is to slowly drain CSF & c if Sx’s gradually improve

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1
Q

Normal Pressure Hydrocephalus

A

Affects >60

Gradual (insidious onset)

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2
Q

What symptom triad is associated with NPH?

A

Magnetic Gait
Dementia
Urinary incontinence
(Wet, Wobbly, Wacky)

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3
Q

Bacterial Conjunctivitis

When does it occur?

A

Purulent discharge
Normal vision
Gritty/ Crusted lids

Occurs in the fall/winter

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4
Q

Treatment for Bacterial Conjunctivitis

A

Oral and topical abx
(erythromycin or azithromycin ung; gentamicin or Tobramycin gtts)
Sulfcetamid (>2yrs)
Flurooquinolone gtts (>1yr)

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5
Q

Treatment for Viral Conjunctivitis

A

Warm Compresses
Artificial Tears QID
NSAIDS

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6
Q

Viral Conjunctivitis

When does it occur?

A 
Watery discharge
Normal Vision
Itchy, burning, tearing
Eyes R really red
Pre-auricular Lymph node Palpable

Occurs after URI

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8
Q

Allergic Conjunctivitis

When does it occur?

A

Stringy Mucoid discharge
Normal Vision
Itching/ burning

Occurs in fall/spring

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8
Q

Treatment for Allergic Conjunctivitis

A

Oral/Topical antihistamines
(topical vasoconstrictors)
Cool compresses

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9
Q

Giant Papillary

What causes this?

A

Watery Discharge
Blurry Vision
Itchy/ gritty
Drooping eyelid

Characterized by bumps under the eyelids

Contact wear or contact solution

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10
Q

Treatment for Giant Papillary

A

D/C contacts

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11
Q

Bacterial conjunctivitis of the new born is ____

A

Ophthalmia neonatorum

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12
Q

Ophthalmia neonatorum is usually caused by

A

Gonorrhea or Chlamydia

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13
Q

How is ophthalmic neonatorum treated?

A

By erythromycin; given @ birth

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14
Q

C. Trachomatis (chlamydia) in adults…

A

You need to Cx it

Treat sexual partners as well

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15
Q

Herpes Zoster Eye Infections treatment

A

Start antiviral if early dx is made
Cool compresses

Refer to Ophthalmologist Immediately

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16
Q

Signs & Symptoms of Herpes Zoster Opthalmicus

A 
Pain
Tearing
Photophobia
Mucoid discharge
Moderate conjunctival hyperemia
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18
Q

Signs & Symptoms of Corneal Abrasions

A 
Pain
Tearing
Photophobia
Foreign Body Sensation (FOS)
Conjunctival Hyperemia
Decreased vision
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18
Q

What should the clinician do to inspect the eye for foreign objects or scratches related to corneal abrasion?

A

stain the eye with fluorescein dye and use cobalt blue filter light or slit lamp

May use tetracaine for evaluation but not for Rx for treatment

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19
Q

Treatment for Corneal Abrasion

A

Abx gtts or ung (ointments) for 5 days
w/ follow up daily until symptoms resolve
Tetanus
Eye rest

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20
Q

Patient education with corneal abrasion

A

Avoid wearing contacts until eye has healed

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21
Q

Hordeolum

A

Stye
swelling of the edge
erythamotus tender lump with in the eye

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22
Q

Subjunctival Hemorrhage

A

Caused by trauma and excessive straining such as with coughing
Sudden onset of painless red eye
Will resolve on its on within 2-4 weeks (does not require treatment – observe patient)

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23
Q

Treatment of hordeolum

A

Eye hygiene
Warm Moist Compresses QID
Topical ung

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24
Q

What is seborrhea?

A

inflammatory skin condition that causes flaky, white to yellowish scales

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25
Q

Blepharitis

A

Lid crusting and seborrhea

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27
Q

Treatment for Blepharitis

A 
Eye hygiene
Abx ung (erythromycin) @HS

tx for blepharitis of the scalp - anti-dandruff shampoos

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28
Q

Chalazion

A

Mid eyelid swelling and erythema

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29
Q

Treatment for Chalazion

A

Warm compresses (up to 6 weeks)
Abx-steroid ung
Excision

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30
Q

Lid Cellulitis

A

Can be related to recent URI, trauma to lid or lid infection

Characterized with painful lid edema

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31
Q

Plan for lid cellulitis

A

Refer to ophthalmologist
CT scan to RO orbital cellulitis
Red Flag

32
Q

Orbital Cellulitis Symptoms

A

Lid edema
H/A
Fever

33
Q

Plan for orbital cellulitis

A

Send to ER for IV abx to prevent vision loss
Ophthalmology consult ASAP
Restrict EOM

34
Q

Dacryocytitis

A

Erythema
Tearing
Swelling over lacrimal sac

35
Q

Treatment for Dacryocytitis

A

Eye Hygiene
Warm moist compresses
Topical opthalmic ung

36
Q

Uveitis

A

Inflammation of the uveal tract

37
Q

What are the two types of uveitis

A
  1. Anterior (effects the iris aka Iritis)

2. Posterior (effects choroids, retinitis)

38
Q

Iritis

A

Aka Anterior Uveitis

Uveitis inflammation of the iris or anterior chamber of the eye

39
Q

What is anterior uveitis associated with

A 
Juvenile Rheumatoid Arthritis
TB
Herpes simplex
Trauma
Kawasaki disease
40
Q

S/S of anterior uveitis (Iritis)

A 
Decreased vision
Pain
Photophobia
Pupil size decrease b/c iris crown the puli
Cilliary Flush
(no discharge or tearing)
Refer immediately to ophthalmologist
41
Q

Treatment for Iritis

A

Topical NSAIDs/ Corticosteroids

42
Q

What is the leading cars of blindness in African Americans?

A

Glaucoma

43
Q

2 types of glaucoma are

A
  1. Primary open angle (slow)

2. Primary angle closure (emergent) Intraocular pressure >22 mm Hg = glaucoma

44
Q

Primary Open Angle Glaucoma

A

Most common
Slow process with central vision affected late
Usually bilateral
Increase interocular pressure

45
Q

Symptoms of Primary Open Angle Glaucoma

A 
blurred vision
nausea
headache
halos around bright lights
Increase cup-disc ratio difference between eyes
46
Q

Treatment for Primary Open Angle Glaucoma

A

Refer

47
Q

Symptoms Primary Angle Closure Glaucoma

A 
Sudden eye pain
Brow aching
Corneal edema 
Decrease vision
Sensation of seeing halos around light
Photophobia
Sudden loss of vision
48
Q

Treatment for Primary Angle Closure Glaucoma

A

Referral: EMERGENT
Iridortomy laser hole in iris relieve pressure & damage
Beta blocker eye gtts Timoptic decreases aqueous humor production by ciliary body
Alpha agonists Alphagan dcrease aqueus prod. and increase ductal outflow
Marajuana decreases IOP

49
Q

PE for Glaucoma

A

Visual acuity, visual fields ophthalmic exam, IOP if equipped

50
Q

Macular Degeneration Dry

A

Develops slowly causing loss of central vision

No Tx. Affects both eyes, one before other

51
Q

Risk Factors for Macular Degeneration

A

Fhx, smoker (past or present), light skin light eyes, excessive sun exposure, obesity, female, dietary deficiencies in zeaxanthin and Lutein

52
Q

Wet Age Related Macular Degeneration (AMD)

A

new blood vessel growth behind retina causes bleeding and scarring 10% can be Tx’d with laser

53
Q

S/S of Macular Degeneration

A

Decrease in macula function: blurriness, dark cloud, difficult to read, straight line distorted
Peripheral Vision okay.

54
Q

Retinal Detachment S/S

A

SS increase floaters
Curtain like over field of vision
SS Depends where tear

55
Q

Treatment for Retinal Detachment

A

Surgery

56
Q

DM Retinopathy

A

develops from blood vessels that supply the retina and is the leading cause of blindness in adults age 20-64.Affects90% of Diabetics who have had DM >15 yrs.

57
Q

What causes Proliferative DM?

A

Proliferative DM retinopathy most severe and threatening to sight. Caused by a lack of O2 to retina stimulates abnormal blood vessel growth which tightens and pulls on retina which detaches from inner wall. No pain, severe sight loss or blindness

58
Q

Tx fro Proliferative DM

A

Laser surgery to reduce blood vessel growth, vitrectomy to remove blood in vitreous replace with saline

59
Q

Cataract

A

Cloudy lens to the degree vision is disturbed

60
Q

Causes of cataracts

A 
Smoking
Sun exposure
Poor diet
DM
Steroids
61
Q

S/S of cataracts

A

Gradual loss of vision: cloudy foggy vision

Light glare a problem reduces visual acuity: night driving

62
Q

Cataract treatment

A

Surgery

Refer for evaluation

63
Q

Further evaluation of visual acuity is necessary when

A

Adults & children ,>5yr: with visual acuity of 20/30 or worse
> 5y 20/50
Infants failing gross visual acuity (follow object or social response)
All who demonstrate more than one line difference between eyes

64
Q

Myopia

A

light focuses in front of retina ; sees near objects best (nearsightedness)

65
Q

Hyperopia

A

ight focuses behind the retina; sees far objects best (farsightedness)

66
Q

Presbyopia

A

lens less resilient; poor near vision (aging)

67
Q

Astigmatism

A

cornea or lens curvature causing unequal light refraction

68
Q

Anisometropia

A

different refractive error in each eye

69
Q

Amblyopia

A

Marked decrease in visual acuity in one eye due to interrutpion of normal visual development
Blinkin excessively, frowns, behavior closing or covering one eye
Refer

70
Q

Strabismus

A

one eye not working with the other

71
Q

Pseudostrbismus

A

Cross eyed

Genetic

72
Q

Eso

A

inwards

73
Q

Exo

A

outwards

74
Q

Tropia

A

constant turned eye

75
Q

Phoria

A

Both eyes are straight until coveredmisalignment of Visual axis revealed by the disassociation of the eyes

76
Q

Advice for healthy eye aging

A

Avoid cigarette smoke
Regular eye exams
Healthy eating
Wear UV protection outdoors

FNP I (4 decks)

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