NCLEX/HESI Pediatric Eye, Ear, and Throat Problems

otitis media prevention

Feed in upright position. Routine immunizations. Breastfeed for at least 6 months. Avoid tobacco smoke and allergens.

otitis media s/s

Fever. Ear pain. Crying. Irritability. Lost appetite. *Rolling head side to side. Pulling/rubbing ears. Purulent drainage. Bulging tympanic membrane. Hearing loss.

tonsilitis post-op

Position the child prone or side-lying to facilitate drainage. Have suction equipment. IF bleeding-swallowing/clearing throat, turn to side. Discourage cough. Ice collar. Antiemetics for vomiting. Ice pops. NO milk. NO sharp utensils.

The parent of a 6-year-old child arrives at a clinic because the child has been experiencing itchy, red, and swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis, the nurse determines that which requires further investigation?

Possible sexual abuse

The nurse is reviewing the laboratory results for a child scheduled for a tonsillectomy. The nurse determines that whhich laboratory value is most signifiant to review?

Prothrombin time *The prothrombin time results would identify a potential for bleeding.

The day care nurse is observing a 2-year-old child and suspects that the child may have strabismus. Which observation made by the nurse indicates the presence of this condition?

The child consistently tilts the head to see. *Strabismus is a condition in which the eyes are not aligned because of lack of coordination of the extraocular muscles. Headaches and squinting.

Conjunctivitis teaching

Do not touch the tip of the eye drops to the eye. Do not share towels. Do not rub the eye. Do not wear contacts. Good hand-washing. Discard makeup.

Otitis media interventions

Encourage fluids. Avoid chewing. Heat/cold. Lie on affected side and clean drainage. Analgestic. Antipyretic. Hearing screening. Myringotomy incision for drainage.

The nurse prepares a teaching plan for the parent of a child diagnosed with bacterial conjunctivitis. Which, if stated by the parent, indicates a need for FURTHER teaching?

"It is okay to share towels and washcloths." *Incorrect because it is highly contagious.

A child has been diagnosed with acute otitis media of the right ear. Which interventions would the nurse include in the plan of care? Select all that apply.

-Provide a soft diet. -Administer ibuprofen for fever every 4 hours as prescribed and as needed. -Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.

tonsilitis: pre-op

Assess for signs of active infection. Assess bleeding and clotting. Assess for any loose teeth. Prepare the child for a sore throat and inform the child that they will need to drink liquids

Antibiotics are prescribed for a child with otitis media who underwent a myringotomy with insertion of tympanostomy tubes. The nurse provides discharge instructions to the parents regarding the administration of the antibiotics. Which statement, if made by the parents, indicates understanding of the instructions provided?

Administer the antibiotics until they are gone.

ottitis externa (swimmers ear)

Inflammation of the external auditory canal, which can occur with or without infection. Rapid onset in 48 hours. otalgia, pruritus, fullness, drainage, and impaired hearing, tenderness.

epistaxis (nosebleed)

Rupture of a blood vessel inside the nose causes blood to flow out the nose and into the throat. From trauma, foreign body, nose picking or mucosal inflammation.

The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position?

Side lying to facilitate drainage

Tonsilitis S/S

Sore throat. White exudate. Difficulty swallowing. Mouth breathing. Mouth odor. Fever. Cough. Enlarged adenoids cause poor speech, hearing difficulty, snoring and sleep apnea.

After a tonsillectomy, the nurse reviews the surgeon's postoperative prescriptions. Which prescription would the nurse QUESTION?

Suction every 2 hours. *Incorrect because suctioning only occurs if there is airway obstruction.

Tonsillitis and Adenoiditis

Tonsillitis refers to inflammation and infection of the tonsils, which is lymphoid tissue located in the pharynx. Adenoiditis refers to inflammation and infection of the adenoids (pharyngeal tonsils), located on the posterior wall of the nasopharynx.

After a tonsillectomy, a child begins to vomit bright red blood. The nurse would take which initial action?

Turn the child to the side to prevent aspiration

allergic rhinitis

a condition in which children are sensitized to environmental allergens. 1. Itchy and watery eyes, runny nose, itchy throat. 2. May be a family history of atopic disease. 3. Dark circles under the eyes, cobblestoning of the conjunctiva, pale nasal mucosa, clear nasal drainage, nasal polyps, uid in the middle ear, cobblestoning of the posterior pharynx, wheezes, rhonchi, eczema, hives, angioedema

strabismus

crossed eyes due to muscle imbalance or paralysis. Squinting. Tilting head up. Loss of binocular vision. Impaired depth perception. Frequent headaches. Diplopia. Amblyopia-reduced vision acuity.

The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding?

frequent swallowing

Ear drop administration

in a child younger than 3 years, pull the earlobe down and back. In a child older than 3 years, pull the pinna up and back.

otitis media

infection of the middle ear, occurring as a result of a blocked eustachian tube, which prevents normal drainage. *Secondary to respiratory infections and the flu.

conjuctivitis

pink eye from allergy, infection or trauma for 7-14 days. Itching. Burning. Redness. Edema. Discharge. Give antiviral, antibiotic or allergy medication depending on the type.