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Nursing > HEENT/NECK (Advanced Physical Examination and D/D) > Flashcards

HEENT/NECK (Advanced Physical Examination and D/D) Flashcards

1
Q

What is the CAGE Questionnaire?

A

The 4 simple questions are “Have you ever:

(1) felt the need to cut down your drinking;
(2) felt annoyed by criticism of your drinking;
(3) had guilty feelings about drinking; and
(4) taken a morning eye opener?

A score of 2 to 3 indicates a high index of suspicion and a score of 4 is virtually diagnostic for alcoholism.

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2
Q

What is the Normal Vision of

  1. Newborn
  2. 2 months
  3. 4 months
  4. 6 - 10 months
  5. 3-5 years
  6. 6 years
A
  1. Newborn can fix and follow to midline
  2. 2 months can fix and follow greater midline
  3. 4 months fix and follow greater than or equal to 180 degrees
  4. 6-10 months can fix and follow in all directions
  5. 3-5 years 20/50 – 20/30
  6. 6 years 20/25 or 20
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3
Q

What is Refractive errors?

A

are the most common visual disorder in children

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4
Q

What is Myopia?

A

(nearsightedness) able to see close objects clearly, distant objects are blurry.

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5
Q

What is Hyperopia?

A

(farsightedness) able to see distant objects clearly, close objects are blurry.

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6
Q

What is Astigmatism?

A

is uneven curvature of the cornea or the lens. Vision is blurry at near and far distances

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7
Q

What is Amblyopia?

A

is subnormal visual acuity in one or both eyes due to defective development of the visual pathways
deprivational-something interferes with a clear retinal image
strabismic-disparity of the eye axes. Malalignment
refractive

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8
Q

What are Signs and Symptoms

of Abnormal Vision?

A 
Squinting
Fatigue
Headache
Eye pain
Dizziness
Unequal use of eyes
Developmental delay
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9
Q

What is Strabismus?

A

Known also as lazy eye. This is malalignment because the muscles of the eyes are not coordinated

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10
Q

Who does Strabismus

affect?

A

Affects 4% of children

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11
Q

What are the 2 Types of Strabismus?

A

Phoria

Tropia

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12
Q

What is Phoria?

A

intermittent deviation

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13
Q

What is Tropia?

A

consistent or intermittent deviation

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14
Q

What Terms explain the direction of the deviation?

A 
Hyper
                    Hypo
                    Exo
                    Eso
                   Cyclo
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15
Q

Signs and Symptoms of Strabismus?

A

Squinting
Head tilting
Face turning
Marked decrease in visual acuity

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16
Q

What is Subconjunctival Hemorrhage?

A

Ruptured conjunctival blood vessels occurring spontaneously or secondary to increase intrathoracic pressure

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17
Q

What are signs and symptoms of Subconjunctival Hemorrhage?

A

erythema in the bulbar conjunctiva

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18
Q

What is the treatment for Subconjunctival Hemorrhage?

A

Observation

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19
Q

What is Conjunctivitis?

A

An Eye Infection.

Inflammation of the palpebral or bulbar conjunctiva

Etiology often indicated by age

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20
Q

What is Bacterial conjunctivitis?

A

Unilateral,

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21
Q

Eye Infections

Signs and Symptoms

A

erythema, burning, stinging, itching, sensation of FB in the eye, photophobia, purulent discharge, and symptoms URI, OM, pharyngitis

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22
Q

S/S of Allergic Conjunctivitis

A

Signs and Symptoms: erythema of lids and conjunctiva, burning, stinging, itching (severe), sensation of FB in the eye, tearing (severe), mucoid discharge, cobblestone papillary hypertrophy in the tarsal conjunctiva, symptoms of rhinitis, eczema, and allergy

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23
Q

What is Allergic Conjunctivitis?

A

A bilateral. Seasonal allergies.

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24
Q

What is Hordelum?

A

Stye. Infection of the sebaceous glands of the eyelids (external) or the meibomian glands of the eyelids (internal)

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25
Q

What type of pathogens is associated with HORDEOLUM?

A

Pathogens: Staph, pseudomonas

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26
Q

What are the s/s of Hordeolum?

A

Signs and Symptoms: Painful swollen lesion along the eyelid margin

27
Q

What are some types of Exams of the Ear?

A

VS. Growth parameter. Developmental assessment
Gross Inspection: tags, pits, position
Palpation: push tragus, tap mastoid process
Otoscopic exam
Pneumatic otoscopy
Tympanometry
Acoustic Reflectometry
Audiometry-screening tests each ear at 20 dB and frequencies of 500. 1000. 2000. 4000Hz

28
Q

What is Normal Hearing?

A

20dB=whisper
35-40dB=normal speaking
90dB=produces pain

250-4000Hz=normal speaking range

Normal 2-25dB
Mild loss 26-40dB
Moderate loss 41-55dB
Severe loss 71-90dB
Profound loss 91+dB
29
Q

What is Frequency?

A

Frequency=pitch measured in Hertz units

30
Q

What is Intensity?

A

Intensity=loudness measured in decibels

31
Q

What is an Audiogram?

A

Audiogram measures the softest tone heard by the child at a given frequency

32
Q

What is Otitis Externa?

A

Swimmer’s Ear. An Inflammatory reaction of the external auditory canal (EAC).

33
Q

What Pathogens cause Otitis Externa?

A

Pathogens: pseudomonas. Staph, strep pyogenes, fungal, and FB

Causes a change in the acidic environment of the EAC which promotes the growth of bacteria and/or fungus

34
Q

What are some S/S of Otitis Externa?

A

Signs and Symptoms: Pain, esp. with movement of the tragus or pinna, erythema and edema of the EAC, debris in the EAC, rare otorrhea, regional lymphadenopathy

35
Q

Who does Otitis Media affect?

A

Most common reason children

36
Q

What is the Diagnosis of Acute Otitis Media?

A

Upper respiratory tract infection
Pain, irritability, pulling
Fever

37
Q

What is the Clinical Definition of Acute Otitis Media?

A

Recent, often abrupt, onset

signs, symptoms develop over

38
Q

What is Middle ear effusion?

A

bulging of the TM or limited or absent mobility of the

TM or air fluid level or otorrhea

39
Q

What is Middle ear inflammation?

A

erythema of the TM or otalgia interfering with activity

or sleep

40
Q

What is Otitis Media with Effusion (OME)?

A

Fluid within the middle ear without symptoms or signs of acute infection

41
Q

Middle Ear Effusion (MME)?

A

Fluid within the middle ear. Term which encompasses both AOM and OME

42
Q

List Two Disorders of the Nose?

A

Epistaxis

Foreign Body

43
Q

List Two Disorders of the Mouth?

A

Aphthous Stomatitis

Oral Candidiasis

44
Q

What are some Disorders of the Upper Airway?

A

Tonsillar Hypertrophy
Snoring
Obstructive Sleep Apnea

45
Q

What is Pharyngitis?

A

GABHS Group A Beta Hemolytic Steptococcus

46
Q

List 7 Viral Pharyngitis?

A 
Adenovirus
Epstein-Barr
Parainfluenza
Influenza
HSV
RSV

Other: M.pneumoniae

47
Q

List 3 types of Sinusitis?

A

Acute Bacterial Sinusitis

Subacute Bacterial Sinusitis

Recurrent Acute Bacterial Sinusitis

48
Q

What is Acute Bacterial Sinusitis?

A

infection lasting

49
Q

What is Subacute Bacterial Sinusitis?

A

infection lasting 30-90 days and symptoms reso

50
Q

What is Recurrent Acute Bacterial Sinusitis?

A

episodes each lasting

51
Q

What is Epiglottitis?

A

Life-threatening bacterial infection usually in children 2-7 years

52
Q

Characteristics of Epiglottitis?

A

Enlarged, indistinct epiglottis on lateral film (thumb sign)

53
Q

What are S/S of Epiglottitis?

A

Acute onset fever,distress, dysphagia, drooling,dysphonia

54
Q

What is another name for Laryngotracheobronchitis?

A

Croup

55
Q

Definition of Laryngotracheobronchitis?

A

Croup: acute upper airway obstruction at the larynx characterized by inspiratory stirdor and barking cough.

56
Q

Who is Laryngotracheobronchitis seen mostly in? And during what time?

A

Usually children 3months-5years.

Seen more in the late fall and winter

57
Q

How does Laryngotracheobronchitis present?

A

Gradual onset of symptoms, often after a mild URI

58
Q

What pathogens are associated with Laryngotracheobronchitis?

A

Pathogens: Parainfluenza1,2,3 adenovirus, RSV, and influenza

59
Q

What are some PMH associated with the Ear?

A 
PMH: pre and post natal factors
	maternal illness/drugs
	prematurity
	trauma/infections
	last hearing screen/audiology
	systemic disease
60
Q

What are some FH associated with the Ear?

A

FH: hearing impairment or loss
congenital defects
systemic disease

61
Q

What are some SH associated with the Ear?

A 
SH: daycare
	methods of feeding
	smokers
	swimming	
	pacifier use
62
Q

What are some PMH of Eye Disorders?

A

PMH: Pre and post natal factors (prematurity)
Trauma
Infections
Last vision screen/ophthalmologist
Systemic disease

63
Q

What are some FH of Eye Disorders?

A

FH: Eye disease
Congenital defects
Systemic disease

64
Q

What are some Exams for Eye Disorders?

A

Exam: VS. Growth parameters
Gross Inspection: lids, orbits, bulbar conjunctiva, lacrimal
structures, size, Symmetry, reactivity of pupils, EOM,
Red reflex (Bruchner test)
Fundoscopic
Peripheral visual fields
Ocular mobility and alignment (Hirshberg test or corneal
light reflex test and cover/uncover test)
Visual acuity

Nursing (2 decks)

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