Define:
Strabismus
“Cross-eye”.
It is normal for children less than 4 months old.
Treatment:
Strabismus
- possible glasses
- patch the good eye to strengthen the bad eye
Describe:
Conjunctivitis
Known as “pink eye”. It can be from allergies or from an infection.
If it’s from an infection, it’s highly contagious and requires contact precautions.
Signs and Symptoms:
Conjunctivitis
Purulent drainage and eye crusts.
Teaching:
Conjunctivitis
- wash hands and don’t share towels
- don’t rub eyes
- throw away used contacts and makeup
Interventions:
Conjunctivitis
- if conjunctivitis is from a bacterial infection, give antibiotic eye drops
- If it’s viral, it will improve without treatment
- If it’s from allergies, give an antihistamine eye drops such as Visine
Describe:
Otitis media
An ear infection typically in the middle ear caused by a blocked eustachian tube.
It is a common complication of a respiratory infection.
What is the teaching to parents to prevent otitis media in an infant?
- feed infants sitting upright to prevent formula or breastmilk getting into middle ear
- avoid getting upper respiratory infections - get vaccinations
- avoid irritation - avoid smoking and allergens around infant
Interventions:
Otitis media
- Encourage fluid intake to break up secretions
- Can be painful
- apply heat or cold to ear
- lie with the affected ear down
Medications:
Otitis media
- analgesics or antipyretics to decrease pain and fever
- antibiotics PO or ear drops
How are ear drops administered in a child?
- < 3 years old, pull earlobe down and back
- > 3 years old, pull pinna up and back
Describe:
Tonsillitis and Adenoiditis
Infections and inflammations of the tonsils that are in the back of the throat.
It is caused by an infection, especially from strep throat.
What is the last resort treatment for tonsilitis and adenoiditis?
Surgery to remove the tonsils and adenoids.
How is a child positioned after a tonsillectomy and adenoidectomy?
On their side or prone to promote drainage of secretions.
What should be kept at the bedside in case of an emergency for a child post-tonsillectomy and adenoidectomy?
Suction for airway obstruction.
Do not use suction unless you absolutely have to. Trauma and bleeding can occur.
What types of foods and fluids should be avoided post-tonsillectomy and adenoidectomy?
- Avoid foods that are red, purple, or brown since it can mask bleeding.
- Avoid milk products such as ice cream, milk, and pudding since it can coat the throat and cause coughing and trauma.
What should NOT be placed in the mouth after a tonsillectomy and adenoidectomy?
Do NOT place straws, forks, or sharp objects in the mouth due to possible trauma.
What are the steps for a nose bleed (epistaxis)?
- have child sit up and lean forward (not lie down)
- apply continuous pressure to the nose with thumb and forefinger for at least 10 minutes
- If bleeding continues: gently insert cotton or wadded tissue in the nostril and apply ice to bridge of nose
