nr 602 primary care of the childbearing and childrearing family
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MIDTERM STUDY GUIDE: PART-1
Chamberlain College of Nursing, Course Code: NR602 ,Course Title:
Primary Care of the Childbearing and Childrearing Family
TOPICS Covered
o Chalazions
o Blepharitis
o Conjunctivitis
o Hand-foot-mouth syndrome
o Strep pharyngitis
o Kawasaki disease
o Rheumatic fever
o Milia
o Port-wine stain/Nevus flammeus
o Salmon patch
o Café-au lait spot
o Impetigo
o Molluscum Contagiosum
o Verruca Vulgaris
o Herpetic Whitlow
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 – 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
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
Viral– adenovirus, coxsackie virus, herpes, molluscum
S&S – profuse tearing, mucous discharge, burning, concurrent URI,
enlarged or tender preauricular nose
Antihistamines/decongestant
Improvement, self limiting, 7-14 days
Chlamydial – chlamydia trachomatis
S&S – profuse exudate, associated with genitourinary symptoms, 1-2
weeks after birth
Gonococcal – 2-4 days after birth, most concern can cause blidness
PO azithromycin, doxycycline (tetracyclines increase photosensitivity, don’t use in
pregnancy)
, Improvement 2-3 weeks
Allergic – IgE mast cell reaction, environmental, cosmetics
S&S – marked conjuctival edema, severe itching, tearing, sneezing
Topical antihistamine or topical steroids
Improvement 2-3 days
Chemical –thimerosal, erythromycin, silver nitrate
S&S conjuctival erythema, 30 minutes afer prophylactic antibiotics drops
Avoid contact
Can consider steroids
Conjunctivitis never accompany vision changes
Diagnostic studies: swap and scraping must be done, gram and Giemsa staining,
ELISA, PCR testing, newborn < 2 weeks needs to be tested for gonorrhea
Non –pharm – clean towels, change pillows, warm compress, no contacts, no eye
make up – mascara
Gonococcal conjunctivitis: newborn – give Ceftriaaxone IM once (don’t give if
hyperbilirubinemia,
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