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2021 chamberlain college of nursing
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NR 602 / NR602 (NR602/NR602)
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NR 602 Midterm Exam Review
Chalazion
Chalazion is a chronic sterile inflammation of the eyelid resulting from a
lipogranuloma of the meibomian glands that line the posterior margins of the
eyelids (see Fig. 29-7). It is deeper in the eyelid tissue than a hordeolum and
may result from an internal hordeolum or retained lipid granular secretions.
Clinical Findings
Initially, mild erythema and slight swelling of the involved eyelid are seen.
After a few days the inflammation resolves, and a slow growing, round,
nonpigmented, painless (key finding) mass remains. It may persist for a long
time and is a commonly acquired lid lesion seen in children (see Fig. 29-7).
727
Management
• Acute lesions are treated with hot compresses.
• Refer to an ophthalmologist for surgical incision or topical intralesional
corticosteroid injections if the condition is unresolved or if the lesion
causes cosmetic concerns. A chalazion can distort vision by causing
astigmatism as a result of pressure on the orbit.
Complications
Recurrence is common. Fragile, vascular granulation tissue called pyogenic
granuloma that enlarges and bleeds rapidly can occur if a chalazion breaks
through the conjunctival surface.
Types of Conjunctivitis
Clinical
Type Incidence/Etiology Findin Diagnosis Management*
gs
Saline irrigation
Ophthal Neonates: Chlamydia Erythem Culture to eyes until
mia trachomatis, a, (ELISA, exudate gone;
neona Staphylococcus chem PCR), Gram follow with
torum aureus, Neisseria osis, stain, erythromycin
gonorrhoeae, HSV purule R/O N. ointment
(silver nitrate nt gonorrhoeae For N.
reaction occurs in exuda , chlamydia gonorrhoeae:c
, 2
Clinical
Type Incidence/Etiology Findin Diagnosis Management*
gs
eftriaxone or
10% of neonates) te IM or IV
with For chlamydia:
N. erythromycin
gonor or possibly
rhoea azithromycin
e; PO
clear For HSV:
to antivirals IV
mucoi or PO
d
exuda
te
with
chlam
ydia
Neonates:
Bacterial In neonates 5 to 14 days Erythem Cultures Erythromycin
conju old, preschoolers, and a, (required in 0.5%
nctivit sexually active chem neonate); ophthalmic
is teens: Haemophilus osis, Gram stain ointment
influenzae(nontypeab itchin (optional); ≥1 year old:
le), Streptococcus g, chocolate Fourth-
pneumoniae, S. burni agar (for N. generation
aureus, N. ng, gonorrhoeae fluoroquinolon
gonorrhoeae muco ) R/O e
purule pharyngitis, For concurrent
nt N. AOM: Treat
exuda gonorrhoeae accordingly
te, , AOM, for AOM
matter URI, Warm soaks to
in seborrhea eyes three
eyelas times a day
, 3
Clinical
Type Incidence/Etiology Findin Diagnosis Management*
gs
until clear
hes; ↑ No sharing
in towels, pillows
winter No school until
treatment
begins
Depends on
Chronic School-age children and Same as Cultures, Gram prior
bacter teens: Bacteria, above stain; R/O treatment,
ial viruses, C. ; dacryosteno laboratory
conju trachomatis foreig sis, results, and
nctivit n blepharitis, differential
is body corneal diagnoses
(unres sensat ulcers, Review
ponsi ion trachoma compliance
ve and prior drug
conju choices of
nctivit conjunctivitis
is treatment
previo Consult with
usly ophthalmologi
treate st
d as
bacter
ial in
etiolo
gy)
Neonates:
Inclusion Neonates 5 to 14 days Erythem Cultures Erythromycin
conju old and sexually a, (ELISA, or
nctivit active teens: C. chem PCR), R/O azithromycin
is trachomatis osis, sexual PO
, 4
Clinical
Type Incidence/Etiology Findin Diagnosis Management*
gs
Adolescents:
clear activity Doxycycline,
or azithromycin,
mucoi EES,
d erythromycin
exuda base,
te, levofloxacin
palpe PO
bral
follicl
es
Refer to
Viral Adenovirus 3, 4, 7; Erythem Cultures, R/O ophthalmologi
conju HSV, herpes zoster, a, corneal st if HSV or
nctivit varicella chem infiltration photophobia
is osis, present
tearin Cool
g compresses
(bilate three or four
ral); times a day
HSV
and
herpe
s
zoster
:
unilat
eral
with
photo
phobi
a,
fever;
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