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Ocular Infections (Conjunctivitis, Iritis) for Certified Emergency Nursing (CEN)

Ocular Infections (Conjunctivitis, Iritis) for Certified Emergency Nursing (CEN)

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Ocular Infections (Conjunctivitis, Iritis)

Definition/Etiology:

Any infection that occurs in or around the eye is considered an ocular emergency. The reason being is the concern for its effects on the patient’s vision.
The etiology of different infections is based on their origin. Ocular infections can be bacterial, viral, fungal, chemical, or allergic.
In this session we are going to talk about conjunctivitis (pink eye), as well as some infections of the eyelids and cornea.

Pathophysiology:

Most cases of pink eye are typically caused by adenovirus but can also be caused by herpes simplex virus, varicella-zoster virus, and various other viruses, including the virus that causes coronavirus disease 2019 (COVID-19). Yes you heard right, you could get eye covid!!!
Infections of the eyelids or the cornea are most likely caused by Staphylococcus aureus.

Clinical Presentation:

Pink Eye

Eyelids crusted shut when waking up
Sensation of a FB in the eye
Purulent drainage (bacterial)
Serous discharge (allergic or viral)
Pruritus (allergic)

With other infections of the eyelids and cornea

Burning and tearing of the eyes
Reddened lids and sclera
Pain
Photophobia
Decreased vision
Swelling

Collaborative Management:

First things first, and easiest… check visual acuity. This is usually done in the ED using a Snellen chart, placed about 20 feet from the patient. Check the affected eye first, then the unaffected, then both.
If the patient can’t see the Snellen, walk towards them while holding up several fingers. Stop walking when they can tell you how many. Document what you find, for example, “three fingers at 12 feet”.
You might want to instill some topical anesthetic before checking visual acuity. Might help to facilitate it.
The exception to all this is a patient with a chemical burn to the eye. That’s a true emergency and needs irrigation before you need anything else.

Evaluation | Patient Monitoring | Education:

Evaluation of interventions is basically how the patient is doing. How is their pain, how is their vision. If the case is too severe and infection has gotten bad, they might need optho consult.
Most of these patients will probably not need much more after their ED treatment and the symptoms should resolve. If not, they may require optho follow up.

Linchpins: (Key Points)

Visual Acuity is key eval
Anesthetic prior to test.

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

Emergency Nurses Association. (2022). Emergency Nursing Orientation 3.0. Cambridge, MA: Elsevier, Inc.
Sheehy, S. B., Hammond, B. B., & Zimmerman, P. G. (2013). Sheehy’s manual of emergency care (Vol. 7th Edition). St. Louis, MO: Elsevier/Mosby.

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Study Plan Lessons

Abdomen (Abdominal) Assessment

ABG (Arterial Blood Gas) Interpretation-The Basics

ABG (Arterial Blood Gas) Oxygenation

ABGs Nursing Normal Lab Values

ABGs Tic-Tac-Toe interpretation Method

Acetaminophen (Tylenol) Nursing Considerations

Acute Bronchitis

Acute Otitis Media (AOM)

Airborne Precaution Diseases Nursing Mnemonic (MTV)

Albuterol (Ventolin) Nursing Considerations

Alveoli & Atelectasis

Amoxicillin (Amoxil) Nursing Considerations

Anti-Infective – Antivirals

Anti-Infective – Macrolides

Anti-Infective – Penicillins and Cephalosporins

Anti-Infective – Fluoroquinolones

Appendicitis – Assessment Nursing Mnemonic (PAINS)

Appendicitis Case Study (Peds) (30 min)

Appendicitis for Certified Emergency Nursing (CEN)

Assessment of a Burn Nursing Mnemonic (SCALD)

Asthma Concept Map

Asthma management Nursing Mnemonic (ASTHMA)

Attention Deficit Hyperactivity Disorder (ADHD)

Autism Spectrum Disorders

Base Excess & Deficit

Bisacodyl (Dulcolax) Nursing Considerations

Blood Brain Barrier (BBB)

Blood Type O Nursing Mnemonic (Universally Odd)

Bronchiolitis and Respiratory Syncytial Virus (RSV)

Bronchodilators

Bupropion (Wellbutrin) Nursing Considerations

Burn Injury Case Study (60 min)

Burns for Certified Emergency Nursing (CEN)

Cardiac Glycosides

Care of the Pediatric Patient

Casting & Splinting

Cefaclor (Ceclor) Nursing Considerations

Cerebral Palsy (CP)

Cimetidine (Tagamet) Nursing Considerations

Ciprofloxacin (Cipro) Nursing Considerations

Cleft Lip and Palate

Cleft Lip Repair – Post Op Care Nursing Mnemonic (CLEFT LIP)

Congenital Heart Defects (CHD)

Constipation and Encopresis (Incontinence)

Corticosteroids

Cyanotic Defects Nursing Mnemonic (The 4 T’s)

Cystic Fibrosis (CF)

Day in the Life of a NICU Nurse

Day in the Life of a Peds (Pediatric) Nurse

Defects of Decreased Pulmonary Blood Flow

Defects of Increased Pulmonary Blood Flow

Diarrhea – Treatment Nursing Mnemonic (BRAT)

Digoxin (Lanoxin) Nursing Considerations

Diphenhydramine (Benadryl) Nursing Considerations

Diphenoxylate-Atropine (Lomotil) Nursing Considerations

EENT Assessment

Epiglottitis – Signs and Symptoms Nursing Mnemonic (AIR RAID)

Epispadias and Hypospadias

Famotidine (Pepcid) Nursing Considerations

Fever Case Study (Pediatric) (30 min)

Flu Symptoms Nursing Mnemonic (FACTS)

Fluid Compartments

Fluid Pressures

Fluid Shifts (Ascites) (Pleural Effusion)

Fluid Volume Deficit

Fluticasone (Flonase) Nursing Considerations

Gentamicin (Garamycin) Nursing Considerations

Glucose Lab Values

Gluten Free Diet Nursing Mnemonic (BROW)

Guaifenesin (Mucinex) Nursing Considerations

Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)

Hematocrit (Hct) Lab Values

Hemoglobin (Hbg) Lab Values

Hierarchy of O2 Delivery

Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)

Ibuprofen (Motrin) Nursing Considerations

Immunizations (Vaccinations)

Imperforate Anus

Indomethacin (Indocin) Nursing Considerations

Influenza – Flu

Integumentary (Skin) Assessment

Intussusception

Intussusception for Certified Emergency Nursing (CEN)

Iron Deficiency Anemia

Isolation Precaution Types (PPE)

Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)

Lactulose (Generlac) Nursing Considerations

Levels of Consciousness (LOC)

Levetiracetam (Keppra) Nursing Considerations

Marfan Syndrome

Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)

Meningitis for Certified Emergency Nursing (CEN)

Methylphenidate (Concerta) Nursing Considerations

Mixed (Cardiac) Heart Defects

Nephrotic Syndrome

Nephrotic Syndrome Case Study (Peds) (45 min)

Neuro Assessment

Nursing Care Plan (NCP) for Acute Bronchitis

Nursing Care Plan (NCP) for Appendicitis

Nursing Care Plan (NCP) for Asthma

Nursing Care Plan (NCP) for Asthma / Childhood Asthma

Nursing Care Plan (NCP) for Attention Deficit Hyperactivity Disorder (ADHD)

Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)

Nursing Care Plan (NCP) for Burn Injury (First, Second, Third degree)

Nursing Care Plan (NCP) for Celiac Disease

Nursing Care Plan (NCP) for Cerebral Palsy (CP)

Nursing Care Plan (NCP) for Cleft Lip / Cleft Palate

Nursing Care Plan (NCP) for Clubfoot

Nursing Care Plan (NCP) for Congenital Heart Defects

Nursing Care Plan (NCP) for Constipation / Encopresis

Nursing Care Plan (NCP) for Cystic Fibrosis

Nursing Care Plan (NCP) for Decreased Cardiac Output

Nursing Care Plan (NCP) for Dehydration & Fever

Nursing Care Plan (NCP) for Eczema (Infantile or Childhood) / Atopic Dermatitis

Nursing Care Plan (NCP) for Enuresis / Bedwetting

Nursing Care Plan (NCP) for Epiglottitis

Nursing Care Plan (NCP) for Fluid Volume Deficit

Nursing Care Plan (NCP) for Hemophilia

Nursing Care Plan (NCP) for Hydrocephalus

Nursing Care Plan (NCP) for Impaired Gas Exchange

Nursing Care Plan (NCP) for Imperforate Anus

Nursing Care Plan (NCP) for Impetigo

Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye

Nursing Care Plan (NCP) for Influenza

Nursing Care Plan (NCP) for Intussusception

Nursing Care Plan (NCP) for Marfan Syndrome

Nursing Care Plan (NCP) for Meningitis

Nursing Care Plan (NCP) for Mumps

Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida

Nursing Care Plan (NCP) for Omphalocele

Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)

Nursing Care Plan (NCP) for Pediculosis Capitis / Head Lice

Nursing Care Plan (NCP) for Pertussis / Whooping Cough

Nursing Care Plan (NCP) for Phenylketonuria (PKU)

Nursing Care Plan (NCP) for Reye’s Syndrome

Nursing Care Plan (NCP) for Rheumatic Fever

Nursing Care Plan (NCP) for Rubeola – Measles

Nursing Care Plan (NCP) for Scoliosis

Nursing Care Plan (NCP) for Sickle Cell Anemia

Nursing Care Plan (NCP) for Tonsillitis

Nursing Care Plan (NCP) for Varicella / Chickenpox

Nursing Care Plan (NCP) for Vomiting / Diarrhea

Nursing Care Plan for (NCP) Autism Spectrum Disorder

Nursing Case Study for Pediatric Asthma

Obstructive Heart (Cardiac) Defects

Ocular Infections (Conjunctivitis, Iritis) for Certified Emergency Nursing (CEN)

Opioid Analgesics

Pancrelipase (Pancreaze) Nursing Considerations

Pediatric Bronchiolitis Labs

Pediatric Gastrointestinal Dysfunction – Diarrhea

Pediatric Oncology Basics

Pediatrics Course Introduction

Pediculosis Capitis

Pertussis – Whooping Cough

Phenylketonuria

Phenytoin (Dilantin) Nursing Considerations

Platelets (PLT) Lab Values

Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)

Pulmonary Function Test

Red Blood Cell (RBC) Lab Values

Respiratory Acidosis (interpretation and nursing interventions)

Reye’s Syndrome

Reyes Syndrome Case Study (Peds) (45 min)

Rheumatic Fever

ROME – ABG (Arterial Blood Gas) Interpretation

Rubeola – Measles

Salmeterol (Serevent) Nursing Considerations

Selegiline (Eldepyrl) Nursing Considerations

Sickle Cell Anemia

Spina Bifida – Neural Tube Defect (NTD)

Steroids – Side Effects Nursing Mnemonic (6 S’s)

Stoma Care (Colostomy bag)

Sudden Infant Death Syndrome (SIDS)

Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)

Thorax and Lungs Assessment

Topical Medications

Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)

Transient Incontinence – Common Causes Nursing Mnemonic (P-DIAPERS)

Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)

Umbilical Hernia

Vaccine-Preventable Diseases (Measles, Mumps, Pertussis, Chicken Pox, Diphtheria) for Certified Emergency Nursing (CEN)

Varicella – Chickenpox

Varicella Case Study (Peds) (30 min)

Vitals (VS) and Assessment

White Blood Cell (WBC) Lab Values