9.B Conjunctivitis

Neonatal HSV is treated vigorously with parenteral acyclovir for ___ days

14 days

The nurse is assessing a child with bacterial conjunctivitis. Which of the following would the nurse most likely assess? A. Crusting of eyelids and eyelashes B. Periorbital edema C. Severe eye pain D. Serous drainage from the affected eye

A. Crusting of eyelids and eyelashes Purulent exudate and crusting are characteristics of conjunctivitis. Therefore, the nurse would most likely assess crusting of eyelids and eyelashes. Conjunctivitis associated with foreign body can cause severe eye pain. Serous drainage and periorbital edema are not associated with conjunctivitis.

Which of the following instructions by the nurse is most appropriate for a client using contact lenses who is diagnosed with bacterial conjunctivitis? A. Discard all opened or used lens care products B. Disinfect contact lenses by soaking in a cleaning solution for 48 hours C. Put all cosmetics in a plastic bag for 1 week to kill any bacteria before resuing D. Disinfect all lens care products with the prescribed antibiotic drops for 1 week after infection

A. Discard all opened or used lens care products The client who wears contact lenses and develops an eye infection should discard all open or used lens care products and cosmetics to decrease the risk of reinfection from contaminated products.

Which term is commonly used by clients to describe conjunctivitis? A) Stye B) Pink eye C) Red eye D) Retinitis

B) Pink eye Explanation: Clients commonly refer to conjunctivitis as "pink eye," not red eye. Retinitis is a disease related to the retina, not the conjunctiva of the eye. Retinitis causes vision loss, not inflammation, redness, and discharge. A stye is a pimple-like infected oil gland on or near the edge of the eyelid.

A client who uses extended-wear contact lenses should be taught measures for reducing the risk of which of the following conditions? A) Conjunctivitis B) Cataracts C) Glaucoma D) Macular degeneration

A) Conjunctivitis Explanation: Individuals who use extended-wear contact lenses are at higher risk of developing conjunctivitis. Therefore, client teaching should include prevention of eye infections. These individuals are not at specific risk for other types of eye conditions, such as cataracts, glaucoma, or macular degeneration.

When planning care for a client with trachoma, which potential complication should the nurse consider? A) Scarring of the cornea B) Eye muscle weakness C) Damaged iris D) Retinal detachment

A) Scarring of the cornea Explanation: Trachoma is a chronic form of conjunctivitis that causes the formation of granulation tissue that is abraded by the lashes, leading to scarring of the cornea and eventual blindness. The other options are not potential complications to this type of conjunctivitis.

The nurse is providing care for a pediatric client with bacterial conjunctivitis. Which interventions should the nurse use as part of the collaborative management of the client? Select all that apply. A) Recommending dark sunglasses B) Recommending removing contacts at night C) Contacting the client's school nurse D) Performing careful hand hygiene E) Administering antiviral therapy

A, C, D Explanation: Dark glasses will help to reduce the photophobia that many clients with conjunctivitis experience. It is often appropriate for the nurse to contact the client's school nurse to discuss increased prevention and student education. Careful hand hygiene is a standard method for managing the client with conjunctivitis. Antibiotics, not antiviral medications, are prescribed with conjunctivitis. Contacts should not be worn during conjunctivitis.

A labor and delivery nurse is providing care for a neonate in the first few minutes after birth. One action the nurse will take to promote eye health and prevent conjunctivitis in the infant is administration of A) oral tetracycline. B) erythromycin as an eye ointment. C) ceftriaxone as an eye drop. D) parenteral acyclovir.

B) erythromycin as an eye ointment. Explanation:) Prevention of conjunctivitis in a newborn is provided by the administration of an antibiotic eye ointment, usually erythromycin. Tetracycline may be used instead of erythromycin immediately after birth, but it will be used as an eye ointment, not as an oral formulation. Ceftriaxone is only administered for a confirmed case of gonococcal conjunctivitis. Parenteral acyclovir is only administered for a confirmed case of conjunctivitis due to herpes simplex virus.

The nurse is providing discharge instructions for a client who has acute conjunctivitis from Staphylococcus. Which should the nurse include when teaching this client? Select all that apply. A) "It is OK to share makeup once the infection has resolved." B) "Do not share towels, makeup, or contact lenses with anyone else, as this can spread the infection." C) "You can soak your eyelids with a warm cloth to soften crusts and exudates that may form." D) "Wash your hands before cleansing the eye and administering eye drops." E) "You may go back to sharing towels when the infection is gone."

B, C, D Answer: B, C, D Explanation:) Sharing supplies, such as towels, makeup, or contact lenses, is never a good idea even after the infection is cleared, due to potential for cross-contamination. Handwashing (hand hygiene) will minimize the risk of bringing in other organisms to an already infected eye. Soaking the lids with a warm cloth will soften the crusts from exudates that accompany the Staphylococcus infection. The action of rubbing one's eyes can traumatize the eyes further and increase the risk of cross-contamination.

An important nursing intervention in the care of a child with conjunctivitis is A. administering oral antihistamine to minimize itching B. applying intermittent warm, moist compresses to remove crusts in the eye area C. applying continuous warm compresses to relieve discomfort D. administering optic cocrticosteroids to reduce inflammation

B. applying intermittent warm, moist compresses to remove crusts in the eye area The eye should be kept clean. Intermittent warm, moist compresses can soften the crusting for easier removal, maintaining the cleanliness of the eye. Antihistamines are not usually necessary for bacterial conjunctivitis. Continuous warm compresses would promote bacterial growth.Antibiotics are the treatment of choice for bacterial infections; optic corticosteroids are not warranted.

The nurse is teaching a mother how to administer optical antibiotics to her child who has conjunctivitis. Which statement made by the mother indicates teaching has been effective? A) "I will drop the medication onto the eyeball." B) "I will wait 10 seconds between drops." C) "I will wash my hands before instilling the medication." D) "I will rub the eye with a cotton ball after I administer the medication."

C) "I will wash my hands before instilling the medication." Explanation: Teach the client to wash hands thoroughly before and after instilling eye medications. Hand washing is the single most important means of preventing transmission of infection. Medication is dropped into the lower conjunctival sac and should not be rubbed after instillation. The time between drops is 1 to 5 minutes, depending on the type of medication.

The nurse is assessing a client who presents with purulent drainage and crusting of the eye. The nurse should recognize that these findings are most consistent with which type of infection? A) Viral conjunctivitis B) Allergic conjunctivitis C) Bacterial conjunctivitis D) Fungal conjunctivitis

C) Bacterial conjunctivitis Explanation: The major difference between bacterial and viral conjunctivitis is that bacterial conjunctivitis has a purulent discharge that may result in crusting, whereas the discharge from viral conjunctivitis is serous (watery). Allergic conjunctivitis produces watery to thick drainage and is characterized by itching. Fungi do not cause conjunctivitis.

The most common eye disease in which the conjunctiva becomes inflamed is referred to as?

Conjunctivitis

The nurse is assessing a college student who presents with red, swollen eyes; photophobia; and yellowish drainage from the conjunctiva. Which question should the nurse ask the client first? A) "Have you had extra caffeine this week?" B) "Did you get sand in your eye recently?" C) "Have you been exposed to HIV?" D) "Have any of your friends experienced these symptoms?"

D) "Have any of your friends experienced these symptoms?" Explanation: The client is exhibiting signs and symptoms of conjunctivitis. The nurse should explore ways in which the client may have been exposed. Most cases of conjunctivitis are spread by hand to eye contact. Exposure to HIV, sand in the eye, and caffeine are not known causes of conjunctivitis and would not be appropriate questions to ask this client to determine the cause of the symptoms.

All neonates born in the United States receive prophylactic treatment to prevent conjunctivitis. What is the most common ointment used that is typically applied immediately following birth?

Erythromycin

What are some prevention techniques the nurse could provide for an individual who is living with someone who has an active conjunctivitis infection?

Good hand hygiene Avoid sharing any items that touch the face such as towels, makeup, or pillows

What are some techniques the nurse could provide for a client who has an active conjunctivitis infection to decrease the transmission to others?

Good hand hygiene Avoid touching the eyes Wash discharge from the eyes several times daily Wash linens frequently Don't share towels or other objects touching the face Don't share eye drop dispensers

What is entropion? In the client with trachoma, what can it cause?

Inversion of the eyelid. It can cause loss of vision through ulceration and scarring of the cornea.

What are some clinical manifestations that a client with conjunctivitis may present with?

Itching, redness Scratchy, burning, gritty sensation Photophobia Tearing, discharge (may be purulent, serous, or mucoid depending on etiology) Associated manifestations: - Pharyngitis - Fever - Malaise - Swollen lymph nodes

Conjunctivitis in an infant under 30 days is called?

Ophthalmia neonatorium

Tetracycline is contraindicated in children under 8 years of age due to the risk of?

Permanent teeth staining

Contact with genital secretions infected with Gonococcus species can cause gonococcal conjunctivitis. This is a medical emergency due to the chance of which complication? a. Retinal detachment b. Corneal perforation c. Entropion d. Uveitis

b. Corneal perforation

The most common occurrence of viral conjunctivitis is seen in children with viral _____________ ___________________ _________________.

Upper respiratory infections

Which of the following clients would be considered to be at increased risk of developing conjunctivitis? [SATA] a. A 23 year old client who wears extended wear contact lenses b. A 4 year old in a day care center c. A nurse working in an intensive care unit d. An immunocompromised client on chemotherapy treatments

a, b, d Risk factors for conjunctivitis: - Contact lens wearers - Young children in school or daycare - Patients with compromised immune responses

A client presents to the clinic with reddened eyes with watery discharge and a conjunctiva with a "cobblestone" appearance and complaining of eye itching. The nurse would suspect which type of conjunctivitis to be the cause of the client's presentation? a. Allergic conjunctivitis b. Bacterial conjunctivitis c. Viral conjunctivitis

a. Allergic conjunctivitis

Administration of topical antihistamines and/or topical NSAIDs would be appropriate with which type of conjunctivitis? a. Allergic conjunctivitis b. Bacterial conjunctivitis c. Viral conjunctivitis

a. Allergic conjunctivitis

This type of conjunctivitis can present bilaterally, but typically presents unilaterally and is caused by hand-to-eye contact in most cases. a. Bacterial conjunctivitis b. Viral conjunctivitis

a. Bacterial conjunctivitis

Contact with genital secretions infected with Gonococcus species can cause gonococcal conjunctivitis. Which of the following drugs is the first line of treatment for this condition? a. Ceftriaxone b. Erythromycin c. Acyclovir d. Tetracycline

a. Ceftriaxone

An infant in a NICU has developed bacterial unilateral conjunctivitis. The priority nursing action is to a. Isolate the neonate from the other neonates to prevent spread b. Administer parenteral acyclovir c. Monitor vital signs d. Apply mittens to prevent scratching

a. Isolate the neonate from the other neonates to prevent spread

Which of the following are diagnostic tests that may be indicated for the client with conjunctivitis? [SATA] a. CT of head b. Culture and sensitivity of exudates c. Fluorescein stain d. Conjunctival scrapings

b, c, d

Which of the following are inappropriate actions for the treatment of conjunctivitis? [SATA] a. Soaking the eyelids with a warm saline compress to facilitate removal of crusting b. Using a cool cloth to clean away drainage c. Avoiding bright lights and reading d. Warm compresses to relieve irritation

b, d A warm cloth should be used to clean away drainage. Cool compresses help relieve eye irritation

A nurse is teaching a client about self-administration of antibiotic medications for conjunctivitis. Which of the following statements made by the client indicates to the nurse that further teaching is warranted? a. "I can tilt my head back and pull down the lower lid for administration." b. "I can lie down and pull up the upper lid for administration." c. "I can lie down and pull down the lower lid for administration." d. "I can lie on my side opposite to the eye getting the medication and put the medication in the corner nearest my nose."

b. "I can lie down and pull up the upper lid for administration." Eye medications are not administered under the upper lid. The client can stand or lie down with the head tilted back. The lower lid is pulled down and the medication administered. An alternative method is to lie on the side opposite the affected eye, put the medication in the corner of the eye and slowly turn to the affected side.

The following interventions are used with which type of conjunctivitis? - Antibiotic eyedrops or ointment - Soaking eyelids with warm cloth - Eye irrigation to remove discharge - Avoiding bright lights - Infection-control techniques - Cool compresses a. Allergic conjunctivitis b. Bacterial conjunctivitis c. Viral conjunctivitis

b. Bacterial conjunctivitis

A 5 year old client presents to the clinic with a unilateral reddened eye and purulent drainage that has resulted in crusting. The client attends day care with many other children, and shares toys frequently. The nurse would suspect which type of conjunctivitis to be the cause of the client's presentation? a. Allergic conjunctivitis b. Bacterial conjunctivitis c. Viral conjunctivitis

b. Bacterial conjunctivitis Young children and adolescents in schools and child care centers and college students in dormitories or on sports teams are at increased risk of bacterial conjunctivitis due to hand-to-eye contact.

A neonate is born vaginally to a mother with an active infection of herpes simplex virus (HSV). The nurse recognizes that prompt intervention is needed to prevent which complication of conjunctivitis caused by HSV? a. Hearing loss b. Blindness c. Color-blindness d. Myopia

b. Blindness

The nurse who is caring for a client diagnosed with acute bacterial conjunctivitis should choose which of the following outcomes for the client's plan of care? a. Client will avoid infecting others until receiving treatment for 24 hours. b. Client will perform hand hygiene after touching the eyes. c. Client will report absence of eye pain within 48 hours of beginning treatment. d. Client will report vision has improved within 24 hours of beginning treatment.

b. Client will perform hand hygiene after touching the eyes. Performance of hand hygiene is an appropriate goal for the client with conjunctivitis. Pain and altered vision are not associated with conjunctivitis. The client's outcomes are specific to the client and not the infection of others, although client behaviors that reduce the risk of infecting others are appropriate.

The nurse who is conducting a class to reduce the spread of conjunctivitis in a day care center should instruct the day care attendants that the best way to accomplish this goal is to: a. Isolate children with conjunctivitis in a separate room away from other noninfected students. b. Follow hand hygiene guidelines and teach the children how to practice hand hygiene. c. Require all students with conjunctivitis to remain home until there is no further eye drainage. d. Wear clean gloves when changing diapers or touching children in the day care center.

b. Follow hand hygiene guidelines and teach the children how to practice hand hygiene. The best way to reduce the spread of any infection is by following hand hygiene guidelines. Children can also be taught how and when to wash their hands. Isolating infected children is not necessary, especially because children who are not infected can develop conjunctivitis following viral infections. Wearing gloves is neither the best nor most practical method of reducing spread of infection in a day care center.

This type of conjunctivitis is commonly bilateral. a. Bacterial conjunctivitis b. Viral conjunctivitis

b. Viral conjunctivitis

The mother of a pediatric client tells the nurse that the child's eyes were "glued shut with thick yellow drainage from his eyes." The mother reports the child has had a cold for the past few days and seemed to be getting better. The nurse should instruct the mother to: a. Take the child to the emergency department immediately. b. Wash the drainage away using a warm wet cloth or cotton ball. c. Bring the child to the office later today. d. Call 911.

b. Wash the drainage away using a warm wet cloth or cotton ball. The nurse should teach the mother how to remove the drainage. This is not an emergency situation and the child does not need to be seen by a health care provider unless there are aggravating factors. The mother should simply be taught how to care for the child and how to identify the symptoms that would indicate potential complications.

Which of the following clients would be considered to have contagious conjunctivitis? [SATA] a. Client with allergen-associated conjunctivitis b. Client with conjunctivitis from prolonged tanning bed usage c. Client with conjunctivitis caused by Staphylococcus aureus d. Client with conjunctivitis caused by herpes simplex virus (HSV)

c, d Conjunctivitis caused by allergens, irritants, or radiant energy exposure is not contagious. Viral and bacterial conjunctivitis can be easily spread from person to person and can cause epidemics.

A client with conjunctivitis associated with an adenovirus has been prescribed erythromycin eye ointment. Which of the following actions by the nurse would be appropriate? a. Administer the erythromycin as prescribed to the inner conjunctival lining, allowing the client to blink after administration. b. Take the client's vital signs to ensure safety and then administer the medication. c. Hold the medication, contact the provider, and clarify the erythromycin prescription

c. Hold the medication, contact the provider, and clarify the erythromycin prescription Erythromycin is an antibiotic. Antibiotics are not indicated for viral infections. Viral conjunctivitis is typically not treated with pharmacologic therapy, unless HSV is the cause.

The nurse caring for a pediatric client with acute bacterial conjunctivitis develops a plan of care and appropriately chooses which of the following nursing diagnoses? a. Disturbed Sensory Perception b. Acute Pain c. Infection d. Risk for Caregiver Role Strain

c. Infection Infection is an appropriate nursing diagnosis for conjunctivitis unless it is caused by chemical irritation, in which case risk for infection would be more appropriate. Pain is rarely associated with conjunctivitis, although a scratchy sensation may be felt. Vision is not normally impacted and care is not significant enough to cause role strain.

A client who has just recovered from an adenovirus infection presents to the clinic with bilateral reddened eyes and serous drainage. The nurse would suspect which type of conjunctivitis to be the cause of the client's presentation? a. Allergic conjunctivitis b. Bacterial conjunctivitis c. Viral conjunctivitis

c. Viral conjunctivitis

The following interventions are used with which type of conjunctivitis? - Antiviral drugs (HSV only) - Cool compresses - Avoiding bright lights - Infection-control techniques - Removing discharge with wet cloth a. Allergic conjunctivitis b. Bacterial conjunctivitis c. Viral conjunctivitis

c. Viral conjunctivitis

The home care nurse teaching the family of a client with acute conjunctivitis regarding the disease process should emphasize which of the following statements as most important? a. Use a cotton-tipped swab to cleanse the right and then the left eye. b. Ask client to gently massage the eyes to circulate eye drops after administration. c. Wash hands before and after instilling eye drops. d. Cleanse the client's contact lenses twice each day.

c. Wash hands before and after instilling eye drops. Acute conjunctivitis is highly contagious. Teach the family to wash hands thoroughly before and after instilling eye medication. Contact lens use should be avoided until the infection has cleared. Rubbing the eyes increases the risk of corneal trauma. Using a new swab for each eye prevents cross-contamination.

A client diagnosed with conjunctivitis tells the nurse, "I'd like to just rub my eye because it feels so scratchy and irritated." What actions will the nurse advise for this client to reduce symptoms? a. Apply an ice bag to the eyes four times a day. b. Wipe the eyes hourly with a warm wet cotton ball. c. Wet a washcloth with cool water and place on the infected eye. d. Take acetaminophen every four hours until symptoms subside.

c. Wet a washcloth with cool water and place on the infected eye. c. wet washclothApplication of a cool washcloth will reduce symptoms, but an ice bag would be too cold and too heavy. Wiping the eyes hourly or using ice can cause trauma to the eye. Pain is not associated with conjunctivitis, but inflammation is, and acetaminophen does not have anti-inflammatory properties.

Care for a newly admitted neonate is to include bathing, receiving prophylactic eye medication, and being breastfed by the mother. In what order will the nurse perform these interventions? a. Bathe the neonate, apply eye ointment, and take the newborn out to breastfeed. b. Have the baby breastfeed, apply eye ointment, and perform the bath. c. Apply eye ointment, take the baby out to breastfeed, and perform the bath. d. Apply eye ointment, wait 10 minutes, bathe the baby, and then take the newborn out to breastfeed.

d. Apply eye ointment, wait 10 minutes, bathe the baby, and then take the newborn out to breastfeed. Eye ointment should remain in the eye for at least 10 minutes before bathing. The eye ointment should be removed before the baby is taken out to the mother to breastfeed; eye to eye contact promotes bonding. Infants should not be bathed immediately after eating; babies often cry during bathing and there is increased risk of vomiting and aspiration. The ointment should be administered and, after a 10-minute wait, the baby can be bathed and then fed.

The thin, transparent membrane that covers the anterior surface of the eye and lines the inner surfaces of the eyelids a. Sclera b. Iris c. Papilla d. Conjunctiva

d. Conjunctiva

Chronic conjunctivitis caused by Chlamydia trachomatis is referred to as? a. Photophobia b. Entropion c. Uveitis d. Trachoma

d. Trachoma

Initially presents with redness, eyelid edema, tearing, and photophobia. Progresses to a sclera with a cobblestone appearance and scarring of the conjunctival lining that leads to entropion. a. Photophobia b. Herpes simplex virus c. Uveitis d. Trachoma

d. Trachoma