lOMoARcPSD|26582732
Saunders Eye, Ear, and Throat Problems
Nclex 2025
CHAPTER 34
Eye, Ear, and Throat Problems
Http://evolve.elsevier.com/Silvestri/comprehensivern/
Priority Concepts
Safety; Sensory Perception
I. Strabismus
A. Description
1.Called “squint” or “cross-eye”
2.Condition in which the eyes are not aligned
because of lack of coordination of the
extraocular muscles
3.Most often results from muscle imbalance or
paralysis of extraocular muscles, but also may
result from a congenital defect
4.Amblyopia (reduced visual acuity) may occur if
not treated early, because the brain receives
two messages as a result of the nonparallel
visual axes.
5.Permanent loss of vision can occur if not treated
early.
. This condition, considered a normal finding in
1006
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
A young infant, should not be present after
about age 4 months.
7. Treatment of the condition depends on the
cause.
B. Assessment
1.Crossed eyes
2.Squinting; tilts the head or closes one eye to
see
3.Loss of binocular vision
4.Impairment of depth perception
5.Frequent headaches
6.Diplopia; photophobia
C. Interventions
1. Corrective lenses may be indicated.
. Instruct the parents regarding patching
(occlusion therapy) of the “good” eye to
strengthen the weak eye.
3.Prepare for surgery to realign the weak
muscles as prescribed if nonsurgical
interventions are unsuccessful.
4.Instruct the parents about the need for follow-
up visits.
II. Conjunctivitis
A. Description
1.Also known as “pink eye”; an inflammation of
the conjunctiva
2.Conjunctivitis usually is caused by allergy,
infection, or trauma.
3.Types include viral, bacterial, or allergic;
bacterial or viral conjunctivitis is extremely
contagious.
B. Assessment
1.Itching, burning, or scratchy eyelids
2.Redness
3.Edema
4.Discharge
Chlamydial conjunctivitis is rare in older children; if diagnosed
In a child who is not sexually active, the child should be assessed for
possible sexual abuse.
C. Interventions
1. Viral conjunctivitis.
1006
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
a. The infection will usually resolve in
7 to 14 days; in some cases it can
take 2 to 3 weeks or more to
resolve.
b.Antiviral medication may be
prescribed to treat more serious
forms of conjunctivitis, such as
those caused by herpes simplex
virus or varicella zoster virus;
antibiotics are not effective against
viruses.
2. Bacterial conjunctivitis
a. Mild cases may improve without
antibiotic treatment.
b.An antibiotic, usually prescribed
topically as eye drops or
ointment, may be prescribed to
shorten the length of infection,
reduce complications, and reduce
the spread to others.
3. Allergic conjunctivitis
a. Removing the allergen from the
environment often improves the
condition.
b.Allergy medications and eye drops
such as topical antihistamine and
vasoconstrictors may be
prescribed.
4. General interventions
a. The primary health care provider
(PHCP) needs to be consulted
regarding going to school and
contact with others.
b. Instruct the child and parents
about the administration of the
prescribed medications.
c. Instruct in infection control
measures such as good hand
washing and not sharing towels
and washcloths.
d. Instruct the child to avoid rubbing
the eye to prevent injury.
e. Instruct a child who is wearing
contact lenses to discontinue
wearing them and to obtain new
lenses to eliminate the chance of
reinfection that can occur from use
of the old lenses.
1008
Downloaded by NELSON KIIRU ()
Saunders Eye, Ear, and Throat Problems
Nclex 2025
CHAPTER 34
Eye, Ear, and Throat Problems
Http://evolve.elsevier.com/Silvestri/comprehensivern/
Priority Concepts
Safety; Sensory Perception
I. Strabismus
A. Description
1.Called “squint” or “cross-eye”
2.Condition in which the eyes are not aligned
because of lack of coordination of the
extraocular muscles
3.Most often results from muscle imbalance or
paralysis of extraocular muscles, but also may
result from a congenital defect
4.Amblyopia (reduced visual acuity) may occur if
not treated early, because the brain receives
two messages as a result of the nonparallel
visual axes.
5.Permanent loss of vision can occur if not treated
early.
. This condition, considered a normal finding in
1006
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
A young infant, should not be present after
about age 4 months.
7. Treatment of the condition depends on the
cause.
B. Assessment
1.Crossed eyes
2.Squinting; tilts the head or closes one eye to
see
3.Loss of binocular vision
4.Impairment of depth perception
5.Frequent headaches
6.Diplopia; photophobia
C. Interventions
1. Corrective lenses may be indicated.
. Instruct the parents regarding patching
(occlusion therapy) of the “good” eye to
strengthen the weak eye.
3.Prepare for surgery to realign the weak
muscles as prescribed if nonsurgical
interventions are unsuccessful.
4.Instruct the parents about the need for follow-
up visits.
II. Conjunctivitis
A. Description
1.Also known as “pink eye”; an inflammation of
the conjunctiva
2.Conjunctivitis usually is caused by allergy,
infection, or trauma.
3.Types include viral, bacterial, or allergic;
bacterial or viral conjunctivitis is extremely
contagious.
B. Assessment
1.Itching, burning, or scratchy eyelids
2.Redness
3.Edema
4.Discharge
Chlamydial conjunctivitis is rare in older children; if diagnosed
In a child who is not sexually active, the child should be assessed for
possible sexual abuse.
C. Interventions
1. Viral conjunctivitis.
1006
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
a. The infection will usually resolve in
7 to 14 days; in some cases it can
take 2 to 3 weeks or more to
resolve.
b.Antiviral medication may be
prescribed to treat more serious
forms of conjunctivitis, such as
those caused by herpes simplex
virus or varicella zoster virus;
antibiotics are not effective against
viruses.
2. Bacterial conjunctivitis
a. Mild cases may improve without
antibiotic treatment.
b.An antibiotic, usually prescribed
topically as eye drops or
ointment, may be prescribed to
shorten the length of infection,
reduce complications, and reduce
the spread to others.
3. Allergic conjunctivitis
a. Removing the allergen from the
environment often improves the
condition.
b.Allergy medications and eye drops
such as topical antihistamine and
vasoconstrictors may be
prescribed.
4. General interventions
a. The primary health care provider
(PHCP) needs to be consulted
regarding going to school and
contact with others.
b. Instruct the child and parents
about the administration of the
prescribed medications.
c. Instruct in infection control
measures such as good hand
washing and not sharing towels
and washcloths.
d. Instruct the child to avoid rubbing
the eye to prevent injury.
e. Instruct a child who is wearing
contact lenses to discontinue
wearing them and to obtain new
lenses to eliminate the chance of
reinfection that can occur from use
of the old lenses.
1008
Downloaded by NELSON KIIRU ()
