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Care for patients with alteration in perception and coordination: EENT Disorders

Disease Signs ans Diagnostic Management


Symptoms tests

Eye lid

1.) Blepharitis

-Inflammation of 1.)Itchy , red and 1.)Slit Lamp 1.)Routine regimen eyelid


eyelid margins burning eyes Exam care

Greasy scales, Warm moist compress


malforming on followed by gentle scrubbing
the eyelids and with dilute baby shampoo
2.)Entropion eye lashes
margins Instruct patient not tu rub
-inversion of eyes because this can spread
eyelid that the infection to the other eye
results in structure
eyelashes
rubbing against
the conjunctiva 2.)Foreign body
- caused by sensation 2.)Surgery:
spasm of Pain and tearing
Eyelid is turned Tightening or orbicular
muscles of
inward muscle (moving eyelids to
eyelids as a
Conjunctive may normal position) – prevent
result of trauma,
looked inflamed inward rotation of eylid
chemical or
Corneal abrasion margin
thermal burns
irritatiojn in the Post op care:
eyelids)
Instillation of eye drops

Instruct to leave the eye


patch in place

Antibiotics
3.)Ectropion
-outward Surface care- Clean at suture
sagging and 3.)Corneal drying line with cotton swab ( with
oversion of or ulceration the prescribed solution)
eyelid Outward
deviation of Eye patch:
-caused is
congenital or eyelid
Non-pressure- 1 gauze
aging (relaxation
of obicular
muscles); injury Pressure eye patch- 2 gauze
or paralysis of 7th
cranial nerve
4.)Ptosis
-drooping of
eyelids, result of 3.)Surgery
ocular muscle
dysfunction; Post op care:
injury to the 3rd
Instillation of eye drops
craniola nerve
5.)External: Antibiotic oitnment
Localized
redness, swollen, Suture care and leave patch
tender area is in place
noted on the skin
5.)Hordelium/ surface side of
“Stye” the margin
External- Internal
infection of Localized
sweat glands in redness usually
4.)Surgery (appearance is
eyelid; occure affected one
adversely affected)
near exit of eyelid
Post op care:
eyelashes from Small, beady,
Asses s/s of infection
the eyelid edematous area
Cool compress after surgery
Internal- on the skin side
Eyeshield
infection of of eyelid
Mild analgesics:
eyelid sabaceous
acetaminophen
gland
Causative agent: 6.)Eye fatigue
5.)Warm compresses 4x a
Staphylococcus Sensitivity to
day
aureus, light
Antibiotic ointment
staphylococcus Epiphora
Remove ointment from the
epidermidis, (excessive
eye before driving or
streptococcus tearing)
operating machinery

6.)Chalazion

7.)Foreign body
sensation
6.)Warm compress
Burning and
Opthalmic ointment
Lacrimal itching eye
7.) Photophobia Excision when large enough
Kearatoconjuncti Corneal light to affect the risk
vitis sicca reflex distorted Post op:
-“dry eye Fear film Antibiotic oitment
syndrome” Non-pressure eyepatch after
warm moist compress
8.)Small, well
defined area of
hemorrhage 7.)Eye drops (Hypotecus) –
appear bright daytime
Conjunctiva Painless Night lubricating ointment
No visual
8.)Subconjunctiv imnpairement
al hemorrhage
-break on the
subconjunctival 9.)Inflammatory
blood vessels s/s:
due to increase Conjunctival
pressure from edema 8.)Resolves gradually 10-14
sneezing, Sensation of days – no treatment needed
coughing. burning
9.)Conjunctivitis Vascular
Inflammation of injection
conjunctiva Excessive tearing
and itching
Bacterial s/s: 9.)Inflammatory:
Marked blood Instillation of vasoconstrictor
vessel dilation and corticosteroid
Tearing (prednisone acetate)
Discharge is Bacterial:
watery at first Obtain specimen for culture
Broad spectrum topical
10.)Tearing antibiotic
10.)Trachoma Photophobia Prevent spread of infection
Chronic , Edema of eyelids Handwashing
bilateral Conjunctival Don’t touch the unaffec ted
scarring form of edema eye when washing
conjunctivitis Follicles form on Avoid sharing washclothes
CA: Chlamydia the upper eyelid
trachomatis conjunctiva;
( chief cause of eyelid scars 10.)Obtain specimen for
blindness) turns inward and culture
Incubation eylashes abrade Prevent spread of infection
period: 5-14 cornea 4 week course of tetracycline
days or erythromycin

11.)Blurred
Cornea vision
11.)Keartoconus
-degenerative
disease that
cause general
thinning and
forward
protrusion of
cornea
12.)Dystrophies
-Abnormal
deposition of
substance in
cornea
13.)Keratitis
-Inflammation of
cornea
Types:
Exposure 15.)Increase
keratitis- tearing
inflammation of Photophobia
cornea by upper
eyelid
14.)Acantamoeb
a Keratitis
-caused by
protozoa living in
h20 and soil 16.)General
15.)Corneal manifestations of
ulcers corneal disorder:
-breaking in the Increase tearing 16.)General Management of
corneal Photophobia corneal disorder:
epithelium can Cloudy/ purulent Non surgical:
provode fluid on eyelid 1. Drug therapy:
entrances for Patchy areas on Ciprofloxacin
bacteria cornea Gentamicin
Green coloring of Tobramycin
cornea Steroids
2. Vision enhancement
(sun glasses)
16.)Corneal
disorders Surgical:
1. Keratoplasty/ corneal
transplant- removal of
dead corneal tissues
2 approaches:
Lamellar aprroaches
(partial thickness
keratoplasty) –
superficial- cornea is
removed and replaced
with the donor’s tissue
2. Penetrating
Keratoplasty (full
17.)Eyeball penetrating
appears pink and keratoplasty)clients
purple cornea is removed and
Edema of replaced with the
episclera donor’s tissue
Hyperemia of the
episcleral vessels Post op:
Ocular redness Elevate head 30 degrees of
Pain donor
Lacrimation Monitor v/s, LOC, dressing
Sclera Monitor pressure patch
17.)Episcleritis Early:
-localized 18.)Blurred
inflammation of vision
sclera usually Decrease color
close to the perception 17.)Topical corticosteroids-
corneal margins Late: dexamethasone
Diplopia
Reduced visual
acuity
progressing to
Lens blindness
18.)Cataract Absene of red
-opacity of the reflex
lens that distorts Presence of
the image white pupil 18.)Extracapsular cataract
projected into extraction- removal of
the retina posterior lens only
19.)Decrease Intracapsular cataract
visual acuity extraction- removal of entire
Vitreous lens
“floaters” Phaloemulsification
Black streaks / Intraocular lens implantation
tiny black dots

19.)Glaucoma
Ocular 20.)Periorbital
chambers: aching
Vitreous blurred vision 19.)Absorbed slowly witn no
Hemorrhage Photophobia treatment
-bleeding of Vitreactomy
vitreous Visual
impairement
Visual loss
20.)Ulgal tract Irregular shaped
Anteriror uleitis- of pupil 20.)Steroids- prednisone
inflammation of Grayish-yellow Dexamethasone phosphate
iris, ciliary body patches Cool or warm compress
or both Darken the room
Posterior uleitis-
retinitis, 21.)“copperwire”
chorioretinitis arteriole
appearrance
Ischemia:
“cotton wool”
spots 21.)Manage HPN and IOP
Retina Vertigo
21.)Hypertensive
retinopathy 22.)Intraretinal
hemorrhage

22.)Laser beams
Vitrectomy
22.)Diabetic Endolaser
retinopathy Silicone oil-
23.)Atrophic (sulfahexaflouroside)
Exudative

23.)Maximize the use of the


remaining vision
23.)Macular 24.)See bright Alternative strategies (use of
degeneration flashes of light books of with large prints)

25.)Sensation of
certain being 24.)Cryotherapy
pulled over part Photocoagulation
of visual field

24.)Retinal
detachment

25.)Rhegmatoge 28.)Night
nous blindness well
detachment then lead to total
blindness 28.)No current therapy

26.)Traction
detachment
27.)Exudative 29.)Bed rest – semi fowler’s
detachment position
28.)Retinits No sudden movement of eye
pigmensosa Cycloplegic eye drops
-retinal cells Eye shield
degenerate Resolver 5-7 drops

Trauma
29.)Hyphema
-presence of 30.)Ice pack is applied
blood in the immediately followed
anterior thorough eye examination
chamber
31.)Eye irrigation with
normal saline solution
Gentle removal of particles
30.)Contussion- Eye patch
“black eye”

31.)Foreign body 32.)Eyelid is closed and a


small ice pack is applied
Penetrating objects must not
be removed
Antibiotic
32.)Laceration -surgery
-caused by sharp
objects 33.)-litmus paper dabbed in
conjunctiva
Anesthetic with proparacaine
hcl
33.)Penetrating
injuries 34.)Management of four
-poorest areas:
prognosis Orientation
Chemical burns -converse in normal tone
- orient to immediate
environment
34.)Blindness - mealtime: “clock method”
Legally blind – Ambulation
best visual -grasp the nurses arm at the
acuity with below
corrective lenses 35.)Pain, -arm is kept close to nurses
in the better eye redness, edema, body
is 20/200 or itching, presence -cane
decrease of exudates, Self-Care
hearing loss, -knocks the door before
plugged feeling entering
in ear -states the name and reaosn
for visiting
36.)Sensation of Support
fullness in the -honest and emphatic
ear support
Hearing loss -positive reinforcement for
Pain each success
Itching
Bleeding from 35.)Topical antibiotics
the ear Corticosteroids
Ear Oral analgesics
35.)External 37.)Swelling Local heat application
Otitis/ behind the ear
swimmer’s ear Pain and minimal 36.)Ear irrigation ( h20 with
movement of the hydrogen peroxide) 50-70
tragus, pinna or ml solution
the head Cerumenolytic product
36.)Cerumane or Red, dull, thick, (Cerumenex)
foreign bodies immobile Steroid ointment
tympanic
membrane
Tender and
enlarged 37.)Obtain specimen for
postauricular ; culture
lymph nodes Antibiotic therapy
37.)Mastoiditis Low grade fever, Simple or radical
- inflammation of malaise and mastoidectomy or
mastoid hair anorexia tympanoplasty
cells due to
untreated otitis
media

39.)triad:
Tinnitus 38.)Tympanic perforation
Unilateral / heals in 24 hours
sensorineural Hearing aids
38.)Trauma to hearing loss Surgical reconstitution of the
tympanic Vertigo ossicles or tympanic
membrane – due membrane
to rapid change 40.)Conductive Slow head movements
of pressure Sensorineural
Mixed 39.)Salt and fluid restrictions
Stop smoking
Anit-histamines
39.)Meniere’s Anti-emetics
Syndrome
41.)Nasal
irritation
Sneezing
Fatigue
Nasal congestion
40.)Hearing loss Rhinorrhea
Itchy, watery
eyes
41.)Symptomatic treatment
Antihistamine
Decongestants
Nose Antipyretics
41.)Rhinitis Proper rest
-inflammation of Increase fluid intake (2000
the nasal ml/day)
mucosa
Types: 31.)Direct
Acute rhinitis- Opthalmoscop
allergies, caused 42.)Nasal y
by bacteria swelling and Indirect
Allergic rhinitis- congestion opthalmoscop
“Hay fever” – Facial pressure y
allergies; and pain Slit lamp exam
sensitivity Low grade fever
reaction Purulent / bloody
Chronic/ nasal drainage 42.)Broad spectrum
Perrenial rhinitis antibiotic
– present Functional endoscopic
intermittent or surgery
continuously
when person is
exposed to
certain allergens 43.)Soreness and
Acute viral dryness of the
rhinitis- “Coryza/ throat
common cold” – Pain
spread from one Fever
person to Nasal discharges
another “Hot potato
42.)Sinusitis- voice” 43.)Rest
inflammation of Increase fluid intake
mucous Humidification of air
membrane 44.)Mild severe Analgesics
Acute sinusitis- sore throat Warm saline throat gargle
obstruction of Fever Bacterial- Penicillin V
the flow of Muscle aches (antibiotic)
secretions from Chills
the sinuses Dysphagia
which may Anorexia 44.)Systemic antibiotic
become infected Warm saline throat gargle
Chronic sinusitis- 45.)Acute Tonsillectomy
permanent hoarseness Adenoidectomy
thickening from Dry cough
prolonged or Dysphagia
repeated aphonia
inflammation or 45.)Voice rest
infection Steam inhalation
Throat Increase fluid intake
43.)Pharyngitis Antibiotic therapy
-inflammation of Bronchodilators
the pharynx Infection prevention:
Avoidance of alcohol,
tobacco and pollutants
Speech therapy
44.)Tonsillitis
Acute tonsillitis-
lasts 7-10 days
Chronic
tonsillitis-
recurrent
infection

45.)Laryngitis-
inflammation of
the larynx

40.)Otoscopy
Weber’s tesrt
Rinne’s test
Romberg test

Additional:

EyeS – 17% of sensory receptors are in the eyes

-Extraocular-

Eyebrows, eyelids, and eyelashes - protects the inner structure from foreign
substances

Conjunctiva- lubricates the eye

-Intraocular

Sclera- clear membrane


Cornea- window as light enters the eye

Irirs- controls the light coming in the eyes

Pupils- light enters

Aqueous humor - 10-21 mmHg IOP- nourish the different structures of the eyes

Retina- RODs (dim) and CONS (light) – visualize night and day

Myopia- nearsighted; biconcave lens – Management; Phoreactive Keratotomy; LASIK

Hyperopia- farsighted; biconvex lens

Astigmatism- an irregularity in the curve of the cornea

Presbyopia- farsightedness related to aging

Diagnostic exams;

Snellens’ chart

E-chart- for patient who could not read

Rosenbaum chart- near vision

Strabismus

-deviation from perfect ocular alignment caused by imbalance intraocular muscles.

Assessment:

Esotopia- medial rectus muscle –“turning in”

Exotopia – lateral turning out

Hypertropia – turning up

Hypotropia- turning down

Mangement:

Maintain a safe environment

Put things in the same place and tell the patient about the locations