ADVANCED NURSING NSG 6001 WEEK 4 EXAM
QUESTIONS AND ANSWERS LATEST UPDATE 2025/26
Chalazion
A chronic sterile, lipogranulomatous inflammation lesion of the mibomian gland.
What causes a Chalazion
meibomian glands secrete the oil layer of the tear film in the eye. NOT AN INFECTION.
More common in adults.
What are the risk factors of a Chalazion
Chronic Blepharitis, Seborrhea, Viral infection, rosacea
Clinical presentation of Chalazion
Chronic swelling at the inner eye lid. (NOT ON THE LASH LINE)
Swollen, palpable nodule in lid margin of the eye.
NONTENDER.
Discomfort or irritation due to swelling, feeling of foreign body in the eye, swelling of the
eyelid.
Treatment of Chalazion
Small lesions may not need any treatment.
Usually absorbs spontaneously in 2-8 weeks
Drains through the inner surface of the eyelid
May need intralesion steroid injection
Warm compress 3-5 times per day
Gentle massage of eyelid (do not try and pop it)
Abx not indicated unless lesion is associated with Blepharitis
Optho referral if develops cellulitis or does not respond to treatment.
Patient education for Chalazion
- Patient can wear contact lenses. They should be cleaned with disinfectant. Disposable
lenses do not need to be discarded any sooner than schedule.
- Discard eye makeup.
- Good hand hygiene
Hordeolum
"STYE"
An acute INFECTION of a glands in the eyelid, may be associated with blepharitis.
- On the lash line
Causes of Hordeolum
staph aureus is the most common associated organism, can progress to cellulitis or
abcess
- more common in children
Clinical presentation of Hordeolum
Gradual enlarging localized nodule
- in 2-4 days will start draining
-painful, tender
-lid erythema, warmth, tearing
Treatment of hordeolum
, - warm compresses for 5-10 min TID
- bactricacin or erythromcyin eye ointment
- Eyelid scrub (same as blepharitis)
- Good hand hygiene
- Monitor for Cellulitis- systemic antibiotics, optho referral
Otitis Externa
A cellulitis of the EXTERNAL AUDITORY CANAL that may extend into the auricle
Risk factors for Otitis Externa
Removal of protective cerumen, vigorous cleaning of external canal, maceration of skin
from accumulation of moisture infection. (Staph, pseudomonas)
Clinical presentation of Otitis Externa
Pain of affected ear and auricle, fullness in ear, itching, drainage from ear, hearing loss,
fever
Physical exam of Otits Externa
Pain and tenderness on palpitation of trigs or manipulation of auricle, ear canal is red
and or swollen, canal is filled with debris and sloughed tissue.
Diagnostics: Culture of drainage if possible
Treatment of Otitis Externa
- NSAID for pain
- topical anesthetics and corticosteroids for severe pain/swelling
- Topical Abs ( Cortisporin otic suspension, Ciprodex)
- Insert wick into affected ear if needed to ensure medication. gets in.
- systemic therapy if extends beyond the canal
Otitis Media
Inflammation and or infection of the middle ear
- inflammation and edema of ET and or adenoids
- narrowing of Eustachian tube, decreased drainage of fluid from the middle ear.
- accumulation of fluid in middle ear ( otitis media with effusion)
Causes of Otitis Media
Bacterial or viruses (often refluxes from nasopharynx into ear) occurs with or follows
URI, allergic rhinitis, exposure to smoke in young children, ET is short and more
horizontal, bottle feeding, attending daycare, GERD, pacifier use, craniofacial
abnormalities
- Most common organisms: Strep Pneumo, H.Flu, Moraxella Catarrhalis
- most frequent childhood infectious disease
Clinical Presentation of Otitis Media
Painful ear that is worse lying down, rubbing ear, rhinorrhea, vomiting, diarrhea, fever,
malaise, conductive hearing loss
associated s/s: imbalance, vertigo, mild stuffiness, fullness or popping sensation in the
ear
Diagnostic and Physical exam of Otitis Media
Diagnostic exam: Weber and Rhinne test, Tympanometry, CBC with Diff
Physical: Vitals, Complete HEENT exam
TM exam: pink or red TM with bulge, loss of landmarks, if fluid present= OM with
effusion, cloudy color or fluid.
Treatment of Otitis Media
QUESTIONS AND ANSWERS LATEST UPDATE 2025/26
Chalazion
A chronic sterile, lipogranulomatous inflammation lesion of the mibomian gland.
What causes a Chalazion
meibomian glands secrete the oil layer of the tear film in the eye. NOT AN INFECTION.
More common in adults.
What are the risk factors of a Chalazion
Chronic Blepharitis, Seborrhea, Viral infection, rosacea
Clinical presentation of Chalazion
Chronic swelling at the inner eye lid. (NOT ON THE LASH LINE)
Swollen, palpable nodule in lid margin of the eye.
NONTENDER.
Discomfort or irritation due to swelling, feeling of foreign body in the eye, swelling of the
eyelid.
Treatment of Chalazion
Small lesions may not need any treatment.
Usually absorbs spontaneously in 2-8 weeks
Drains through the inner surface of the eyelid
May need intralesion steroid injection
Warm compress 3-5 times per day
Gentle massage of eyelid (do not try and pop it)
Abx not indicated unless lesion is associated with Blepharitis
Optho referral if develops cellulitis or does not respond to treatment.
Patient education for Chalazion
- Patient can wear contact lenses. They should be cleaned with disinfectant. Disposable
lenses do not need to be discarded any sooner than schedule.
- Discard eye makeup.
- Good hand hygiene
Hordeolum
"STYE"
An acute INFECTION of a glands in the eyelid, may be associated with blepharitis.
- On the lash line
Causes of Hordeolum
staph aureus is the most common associated organism, can progress to cellulitis or
abcess
- more common in children
Clinical presentation of Hordeolum
Gradual enlarging localized nodule
- in 2-4 days will start draining
-painful, tender
-lid erythema, warmth, tearing
Treatment of hordeolum
, - warm compresses for 5-10 min TID
- bactricacin or erythromcyin eye ointment
- Eyelid scrub (same as blepharitis)
- Good hand hygiene
- Monitor for Cellulitis- systemic antibiotics, optho referral
Otitis Externa
A cellulitis of the EXTERNAL AUDITORY CANAL that may extend into the auricle
Risk factors for Otitis Externa
Removal of protective cerumen, vigorous cleaning of external canal, maceration of skin
from accumulation of moisture infection. (Staph, pseudomonas)
Clinical presentation of Otitis Externa
Pain of affected ear and auricle, fullness in ear, itching, drainage from ear, hearing loss,
fever
Physical exam of Otits Externa
Pain and tenderness on palpitation of trigs or manipulation of auricle, ear canal is red
and or swollen, canal is filled with debris and sloughed tissue.
Diagnostics: Culture of drainage if possible
Treatment of Otitis Externa
- NSAID for pain
- topical anesthetics and corticosteroids for severe pain/swelling
- Topical Abs ( Cortisporin otic suspension, Ciprodex)
- Insert wick into affected ear if needed to ensure medication. gets in.
- systemic therapy if extends beyond the canal
Otitis Media
Inflammation and or infection of the middle ear
- inflammation and edema of ET and or adenoids
- narrowing of Eustachian tube, decreased drainage of fluid from the middle ear.
- accumulation of fluid in middle ear ( otitis media with effusion)
Causes of Otitis Media
Bacterial or viruses (often refluxes from nasopharynx into ear) occurs with or follows
URI, allergic rhinitis, exposure to smoke in young children, ET is short and more
horizontal, bottle feeding, attending daycare, GERD, pacifier use, craniofacial
abnormalities
- Most common organisms: Strep Pneumo, H.Flu, Moraxella Catarrhalis
- most frequent childhood infectious disease
Clinical Presentation of Otitis Media
Painful ear that is worse lying down, rubbing ear, rhinorrhea, vomiting, diarrhea, fever,
malaise, conductive hearing loss
associated s/s: imbalance, vertigo, mild stuffiness, fullness or popping sensation in the
ear
Diagnostic and Physical exam of Otitis Media
Diagnostic exam: Weber and Rhinne test, Tympanometry, CBC with Diff
Physical: Vitals, Complete HEENT exam
TM exam: pink or red TM with bulge, loss of landmarks, if fluid present= OM with
effusion, cloudy color or fluid.
Treatment of Otitis Media
