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NR569 Differential Diagnosis in Acute Care 2025

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Allergic Conjunctivitis - Inflammation of the conjunctiva due to allergies is common, occurring in up to 40% of the population. Itching is the most consistent sign of allergic conjunctivitis; it is also characterized by red eyes and other allergic disease symptoms such as sneezing. - Symptoms: severe itching (MOST PROMINENT) , generalized hyperemia of the conjunctiva, & mild-moderate tearing. Rubbing of eyelids can lead to eyelid edema and temporary hyperpigmentation (allergic shiners/raccoon eyes). Allergic conjunctivitis often accompanied by s/s of allergic rhinitis, including the presence of a crease on the nose from frequent manipulation (toddler salute). - Treatment: Mild-moderate symptoms ma be managed with artificial tears and cool/cold compresses. Severe s/s may require an ophthalmology consultation, and immune modulation with topical antihistamine, mast cell stabilizer, or mild steroid.

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2025/2026
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NR569 Differential Diagnosis in Acute Care 2025




Allergic Conjunctivitis

- Inflammation of the conjunctiva due to allergies is common, occurring in up to 40% of the population.
Itching is the most consistent sign of allergic conjunctivitis; it is also characterized by red eyes and other
allergic disease symptoms such as sneezing.

- Symptoms: severe itching (MOST PROMINENT) , generalized hyperemia of the conjunctiva, & mild-
moderate tearing. Rubbing of eyelids can lead to eyelid edema and temporary hyperpigmentation
(allergic shiners/raccoon eyes). Allergic conjunctivitis often accompanied by s/s of allergic rhinitis,
including the presence of a crease on the nose from frequent manipulation (toddler salute).

- Treatment: Mild-moderate symptoms ma be managed with artificial tears and cool/cold compresses.
Severe s/s may require an ophthalmology consultation, and immune modulation with topical
antihistamine, mast cell stabilizer, or mild steroid.

Bacterial Conjunctivitis

Bacterial conjunctivitis is the second most common cause of infectious conjunctivitis, Red, itchy eyes are
associated with this condition, as is purulent or mucopurulent discharge in one or both eyes.

- Symptoms: copious mucopurulent discharge (MOST PROMINENT), often unilateral (helps distinguish
from allergic/viral etiology) but may spread to both eyes via hands when rubbing eyes, and
pain/irritation with severe hyperemia. **There should be NO frank vision loss.**

- Treatment: Usually with topical antibiotic ointments or drops.

**Otherwise immunocompetent patients with unilateral disease may be treated empirically with topical
fluoroquinolones such as moxifloxacin or gatifloxixin. If no improvement within 48 hours, cultures
should be repeated and ophthalmology should be consulted.

Toxic Conjunctivitis

- Inflammation of the conjunctiva due to medications, chemicals, or toxins can cause red, itchy eyes.

Viral Conjunctivitis

- Viral conjunctivitis is the most common cause of infectious conjunctivitis. Red, itchy eyes are
associated with this condition, as is a watery discharge.

**65-90 % of viral conjunctivitis are caused by adenoviruses, which are highly contagious and spread
through direct contact. Communicability is estimated to be 10-14 days. Topical ophthalmic
antihistamines (preferably OTC) may be recommended to reduce itching and soothe the eyes.

- Symptoms: Usually presents bilaterally, but symptoms often start in 1 eye 1-2 days prior. Pain and
burning are the MOST PROMINENT symptoms, and eyes are very red with copious tearing. Preauricular
lymph node may be palpated, which is relatively specific to viral etiology. **Symptoms tend to worsen
for the first few days, and generally resolve within 1-2 weeks.**

, NR569 Differential Diagnosis in Acute Care 2025

PTA core competencies for acute care

sound clinical decision making

safety

skills

planning

communication

normal BP

<120 and <80

elevated BP

120-129 and <80

stage I hypertension

130-139 or 80-89

stage II hypertension

140+ or 90+

hypertensive crisis

180+ and/or 120+

arterial blood gases (ABCs)

evaluate patient's ventilatory, acid-base, and oxygenation status

possible critical values for pH

<7.25 or >7.55

possible critical values for PaCO2

<20 or >60

possible critical values for HCO3

<15 or >40

possible critical values for PaO2

<40

standard nasal cannula

, NR569 Differential Diagnosis in Acute Care 2025

delivers inspiratory oxygen of 24-44% at supply flows ranging from 1-6L/min

simple mask

delivers O2 at 35-55% at flow rates of 5-10L/min

humidification at >30% O2

non-rebreather (NRB) mask

consists of mask and reservoir that allows high O2 percentages to be delivered (60-80%)

no humidification

venturi mask

designed to deliver high flow O2

4-10L/min at 24-50%

BIPAP

bilevel positive airway pressure device

type of mechanical ventilation where the machine pushes air into the lungs using positive pressure

similar to CPAP but can separate inspiration/expiration pressures

CPAP

continuous positive airway pressure device

type of mechanical ventilation that uses continuous pressure to help push air into lungs (can be more
challenging to exhale)

weaning mode

mechanical ventilation

emergent intervention for someone who is unable to maintain respiration on their own or meet the
demands of their respiratory system

endotracheal ventilation

artificial airway inserted through trachea via the mouth

tracheostomy

airway opening surgically created directly over the trachea

(T/F) patients cannot ambulate with endotracheal ventilation or a tracheostomy
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