NR-511 Differential Diagnosis & Primary Care Practicum NR511 Midterm Exam The causative organism of viral conjunctivitis - Adenovirus Symptoms of viral conjunctivitis - Patients’ complaint of itchy, r ed eyes and may have clear to no discharge Hallmark for viral conjunctivitis - Preauricular lymph node swelling and tenderness Hallmark characteristics of HSV -1 or HSV -2 conjunctivitis - Skin vesicles (if present) and a corneal infection with a "dendrite" appearance Teaching for conjunctivitis - Avoid touching tip of eye drops, women should throw away makeup, dispose of contact lens, stay home from work or school until 24 hours of antibiotic treatment. Bacterial Conjunctivitis symptoms - Red eye with crusted eye lid. May have watery and itching eyes that may be associated with photophobia but visual acuity will be normal. Cataracts produce - A gradual, painless, and progressive loss of vision, although ma ny clients are unaware of any vision problems due to the gradual nature on onset No evidence that taking supplements such as Vitamin, E, C, and beta -carotene helps in the prevention and treatment of cataracts - True Age-related cataracts tend to be - Bilateral in nature and may manifest as blurred or distorted vision, with complaints of a glare when driving at night or in bright light. Blepharitis - Inflammation around the eyelid margins that is caused by staphylococcal infection at the lash base and dysfunctiona l Meibomian glands. Treatment of Blepharitis - Bacitracin 0.5% ointment Treatment for resistant staphylococcal infections - Discontinue the Bacitracin and order a quinolone antibacterial ointment or a sulfacetamide/corticosteroid combination that, like erythromycin, has been shown to be effective against Staphylococcus. Chalazion - A nodule or cyst, usually on the upper eyelid, caused by obs truction in a sebaceous gland. Usually not painful. A chalazion that persists for more than 4 weeks needs referral to an ophthalmologist for incision and drainage, biopsy, or local injection directly with glucocorticoids. Dry eyes - what hx to focus on - Focus on current medications, any symptoms of fever, genital discharge, rash or joint pain; smoking history or second -hand smoke exposure Examination for dry eyes - In addition to a slit -lamp examination, a Schirmer test to quantify lacrimal secretions may be do ne Self-care for dry eyes - Wearing goggles when swimming; using a preservative -free artificial tears preparation; taking frequent rest periods from the computer and hand -held electronic devices Epiphora - Is an overflow of tears onto the face, other than caus ed by normal crying. Is a result of insufficient tear film drainage from the eyes; tears roll down the face rather than through the nasolacrimal system. Epiphora at risk patients - It is an especially common complaint in elderly clients and individuals with allergies
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