NR602 / NR 602 Primary Care of the Childbearing and Childrearing Family Practicum Final Exam Study Guide | Highly Rated | LATEST| Chamberlain College

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NR602 / NR 602 Primary Care of the Childbearing and Childrearing Family Practicum Final Exam Study Guide | Highly Rated | LATEST| Chamberlain College Eye Disorders Strabismus- a defect in In oc... ular alignment, or the position of the eyes in relation to each other; It is commonly called lazy eye. And strabismus, the visual axes are not parallel because the muscles of the eyes are not coordinated; When one eye is directed straight ahead, the other deviates. Retinoblastoma is an intraocular tumor that develops in the retina. Although it is rare, this malignant retinal tumor is the most common tumor in childhood (some 4% of cancers in children younger than 15 years of age) Clinical findings • strabismus is the most common finding • there is a decreased visual acuity uni- or bilateral white pupil (leukocoria), described often as an intermittent “glow, glint, gleam, or glare” by parents, is usually seen in low light settings or noted in photographs taken with a flash i.e. (cat's eye reflex) • other symptoms include an abnormal red reflex, nystagmus, glaucoma, orbital Cellulitis and photophobia, hyphema, hypopyon (plus an anterior Chamber of eye); Signs of global rupture or also possible Bulbar or palpebral conjunctival injection is a common presentation, which can be unilateral or bilateral. differential diagnosis should include allergy, conjunctivitis, infection, foreign body, chemical exposure, or systemic inflammatory disease, irritation of the conjunctiva or cornea, and congenital glaucoma. Watery discharge can occur with allergies, nasolacrimal obstruction, foreign bodies, viral infection, and iritis. Purulent or mucoid discharge can be noted with chronic dacrocystitis or nasolacrimal obstruction. Advanced allergic conjunctivitis can have some mucoid production. To differentiate, microscopic investigation of discharge may lead to other clues. Photophobia is a symptom common of trauma and in infants with glaucoma or retinal disease. Other non-eye related causes of photophobia include migraines and meningitis. A white pupil, or leukocoria serious finding and demands immediate referral to the pediatric ophthalmologist. Causes of leukocoria include retinal detachment, cataract, retinal dysplasia, retinopathy of prematurity, and in newborns retinoblastoma. All newborns should have a fundoscopic examination within 24 hours of birth and yearly on physical examinations. Conjunctivitis chart Chalazion vs Stye CHALAZIONS – Benign, chronic lipogranulomatous inflammation of the eyelid Causes – blockage of the meibomian cyst Risk – hordeolum or any condition which may impede flow through the meibomian gland. Also mite species that reside in lash follicles Assessment – PAINLESS, NOT INVOLVING LASHES Lid edema, or palpable mass Red or grey mass on the inner aspect of lid margin Prevention – good eye hygiene Treatment – warm, moist compresses 3x per day Antibiotics not indicated because chalazion is granulomatous condition, if secondarily infected consider SULFACETAMIDE, ERYTHROMYCIN Follow up – 2-4 weeks, if still present after 6 weeks follow up with ophthalmologist Blepharitis- BLEPHARITIS – Inflamation/infection of the lid margins (chronic problem) 2 types – seborrheic (non ulcerative) : irritants (smoke, make up, chemicals) s&s – chronic inflammation of the eyelid, erythema, greasy scaling of anterior eyelid, loss of eyelashes, seborrhea dermatitis of eyebrows and scalp Ulcerative- infection with staphylococcus or streptococcus s&s – itching, tearing, recurrent styes, chalazia, photophobia, small ulceration at eyelid margin, broken or absent eyelashes ● the most frequent complaint is ongoing eye irritation and conjunctiva redness Treatment – clean with baby shampoo 2-4 times a day, warm compresses, lid massage (right after warm compress) For infected eyelids – antistaphyloccocal antibiotics BACITRACIN, ERYTHROMYCIN 0.05% for 1 week AND QUIONOLONE OINTMENTS For infection resistant to topical – TETRACYCLINE 250 MG PO X4 DOXYCYCLINE 100 MG PO X2 Dacryocystitis is an inflammation of the involved nasolacrimal duct; infection can result. Treatment: Gentle pressure applied in a downward and medial direction transmits hydrostatic force through the nasolacrimal duct to the obstruction. This technique should be performed two or three times a day. The eyelid should be cleaned with plain water after massage. Treatment of dacryocystitis is warm compresses AND oral or parenteral antibiotics For uncomplicated bacterial conjunctivitis, treatment includes the following: • Sodium sulfacetamide 10% ophthalmic solution or ointment; not effective against H. influenzae; stings; can cause allergic reactions (including Stevens-Johnson syndrome) • Trimethoprim sulfate plus polymyxin B sulfate ophthalmic solution • Erythromycin 0.5% ophthalmic ointment for patients with sulfa allergy and infants Azithromycin drops for children older than 12 months • Fluoroquinolone ophthalmic drops including besifloxacin, ciprofloxacin, gatifloxacin, levofloxacin, moxifloxacin, or ofloxacin for children older than 12 months The aminoglycosides (neomycin, tobramycin, and gentamicin) are to be avoided because of possible hypersensitization, severe allergic reactions, and increasing resistance. CONJUCTIVITIS – inflammation or irritation of conjuctiva Bacterial (PINK EYE) – in peds bacteria is the mosts common cause, contact lens, rubbing eyes, trauma, S&S – purulent exudate, initially unilateral, then bilateral Sensation of having foreign body in the eye is common Key findings – redness, yellow green, puru,ent discharge, crust and matted eyelids in am Self limiting 5-7 days. Eye drops – polytrim, erythromycin, tobramycin or cipro Improvement 2-4 days Most common organism H. influenza <7 [Show More]

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