PEDS exam 4 Eyes and Ear disorders

What is important to know about eyes?

color is determined by 6-12 months, vision reaches 20/20 by age 5 with increased risk for injury

What is strabismus?

misalignment of the eyes (squinting, turn or tilt head to see, double vision)

What is amblyopia?

poor vision in a structurally normal eye, lazy eye as a result of strabismus, astigmatism, trauma ptosis (leads to blindness in weaker eye)

How do we treat strabismus and amblyopia?

eyeglasses, eye patching, chemical eye patching or surgery for strabismus (see by cover uncover test, corneal light reflex or visual acuity test)

What is nystagmus?

rapid irregular eye movement that may affect vision

What is conductive or middle hearing loss?

interference transmission of sound from reoccurring otitis media

What is sensorineural hearing loss?

damaged inner ear structure or auditory nerve from congenital defects, ototoxic meds or loud noise

What are symptoms of hearing impairment?

lack of startle reflex, no babbling, absence of well-formed syllables, indifference to sound, speech delay, monotone voice, yelling, shy and inattentiveness

How do we manage hearing impairment?

antibiotics or hearing aids for otitis media, cochlear implant for sensorineural, visual cues, sign language, encourages spoken language and speech therapy

What is otitis externa?

infection and inflammation of the EAR CANAL from water remaining in ear

What are signs of otitis externa?

pruritus, erythema, discomfort when pulling on the pinna, clear odorless drainage (OTIC DROPS and acetaminophen for pain)

What is otitis media?

infection and inflammation of the MIDDLE EAR related to malfunction of the eustachian tube by infection of obstruction (acute, effusion is water retained in ear or chronic)

What are risk factors for otitis media?

short horizontal eustachian tubes, recent respiratory infections, bottle fed infants, winter and spring months, daycare, cleft lip/palate, down syndrome

What are signs of otitis media?

follows URI, earache, fever, purulent, tympanic membrane is bulging and red, restlessness, pulling on ear, hard to comfort, irritability, loss of appetite, hearing loss, speech issues, tinnitus or vertigo

How do we treat otitis media?

analgesics, antipyretics, antibiotics after 48-72 hours or severe symptoms, if repeated infection, then myringotomy and tympanoplasty tubes

What are the differences in a child’s airway?

larger tongue with shorter mandible, large occiput caused flexion, airway smaller and shorter, trachea at increased risk for collapse and obstruction, prominent adenoids and tonsils and underdeveloped chest muscles

What is nasopharyngitis?

common cold with infection of nose and throat for 2-3 days

What are signs of nasopharyngitis in children under 3?

fever, fussiness, irritability, decreased appetite, sneezing, coughing, nasal mucus, mouth breathing, possible n/v and decreased activity

What are signs of nasopharyngitis in children over 3?

nasal inflammation, irritation of nose, nasal discharge, chills with low grade fever, muscular aches, coughing and sneezing

How do we treat nasopharyngitis?

antipyretics, home management, vaporized air, decongestants, cough suppressants with caution, fluid and rest, good handwashing and avoid touching the eyes, ears, or mouth

What is acute pharyngitis?

group A strep infection of upper airway

What are signs of acute streptococcal pharyngitis?

erythema, sore throat that is worse when swallowing, difficulty swallowing, headache, fever, abd pain, enlarged tonsils with exudate

How do we treat acute streptococcal pharyngitis?

antibiotics, IM penicillin G after strep test and cultures, warm saline gargles, encourage cool liquids

What is tonsilitis?

infection and inflammation of tonsils/adenoids (sore throat, excess drooling, fever, lethargy, enlarged tonsils with exudate, change in voice, snoring, mouth breathing, difficulty hearing

How do we treat tonsillitis?

antipyretic/analgesic, I/O, tonsillectomy, antibiotics (WATCH FOR HEMORRHAGE 5-10 days post op and signs of dark red blood in nose or saliva)

What are some respiratory infections?

epiglottitis, croup, brochiolitis, pertussis, asthma, foreign body aspiration, cystic fibrosis

What are signs and symptoms of respiratory distress?

restlessness, anxiety, tachypnea, tachycardia, dyspnea, pallor, diaphoretic, decreased LOC, cyanosis