NURS 5433 Module 1 EXPECTED QUESTIONS WITH
VERIFIED ANSWERS
Question 1.
Blepharitis
ANSWER
nonulcerative form associated w/ seborrhea
- commonly seen in those w/ trisomy 21
- tends to affect people w/ psoriasis, seborrhea, eczema, allergies, and lice infestations
- contributing factors: chemical or environmental irritants, use of eye makeup and contact
lenses
ulcerative form
- involves lash follicle and meibomian glands of eyelid
- may be pustules at base of hair follicles that may crust or bleed
- lashes become thick and break easily
Question 2.
Blepharitis RF
ANSWER
- dry eye
- frequent hordeola or chalazia
- facial or scalp seborrhea
- immunocompromised state
- acne
- DM
- isotretinoin
Question 3.
Blepharitis assessment finding
ANSWER
ulcerative
- itching, tearing, chalazia, recurrent styes, photophobia, small ulcerative at eyelid margin,
broken or absence of eyelashes
seborrheic
- chronic inflammation of eyelid, erythema, greasy scaling of anterior eyelid, loss of eyelashes,
seborrheic dermatitis of eyebrows and scalp
,Question 4.
Blepharitis Management (pharm/non-pharm)
ANSWER
- warm moist compresses
- lid scrubs w/ baby shampoo
- lid massage to empty meibomian glands
- remove contact lids and disinfect
pharm management
- bacitracin, erythromycin, quinolone ointments
- consider oral atbx for resistant infections
- doxycyline 100 mg po BID
- tetracycline 250 mg po QID
Question 5.
Hordeolum (stye)
ANSWER
erythematous, tender lump within eyelid
- external hordeolum: inflammation/infection of eyelid margin affecting hair follicles of
eyelashes
- internal hordeolum: inflammation/infection of meibomian glands
Question 6.
Chalazion
ANSWER
- granulomatous infection of a meibomian gland
- painless swelling on eyelid
- may be tender and erythematous before evolving into a nontender lump
- blepharitis is frequently associated w/ chalazia
Question 7.
Chalazion Treatment
ANSWER
- warm moist compresses
- intralesional steroid injection
- lid massage
- lid scrubs
,Question 8.
Conjunctivitis (red eye)
ANSWER
inflammation of conjunctiva covering the front of eye
common causes
- bacterial, viral, or fungal
- sexual transmission and ophthalmia neonatorum
- HSV 1
- trachoma
- toxicity (from an inciting agent of some sort)
- allergy
- viral
- adenoviruses, Coxsackie virus, varicella, HSV, herpes zoster virus
Question 9.
Conjunctivitis assessment
ANSWER
ALLERGIC: Pruritus; conjunctival hyperemia, chemosis; a watery or stringy discharge
BACTERIAL: Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash mattering;
edema; hyperemia; preauricular adenopathy only w/ hyperacute disorder
VIRAL: Acute onset often A/W systemic illness; photophobia or foreign body sensation;
preauricular adenopathy; hyperemia; chemosis; watery discharge; classic dendritic corneal
lesion present w/ herpes simplex; periocular lesions present w/ herpes zoster opthalmicus
Question 10.
Conjunctivitis diagnostics
ANSWER
- snellen
- visual acuity
- dilated pupil exam for proptosis, optic nerve dysfunction, decreased visual acuity, diplopia, or
anterior chamber inflammation
- fluorescein staining to rule out corneal involvement or keratitis
- blue penlight illumination to see corneal scratches, corneal dendrites, or corneal ulcerations
, Question 11.
Conjunctivitis red flags
ANSWER
- diminished visual acuity, photophobia, severe foreign body sensation preventing pt from
keeping eye open, corneal opacity, fixed pupil, severe headache w/ nausea
- refer to ophthamologist
Question 12.
conjunctivitis management
ANSWER
allergic
- topic decongestant antihistamine combos (OTC)
- naphazoline hydrochloride 0.025% (Naphcon- A)
- naphazoline-antazoline 0.3% (vasocon-A)
- levocabastine hydrochloride 0.05% (Livostin)
- emedastine 0.05% (emadine)
- mast cell stabilizers
- olopatadine 0.1% (patalol)
- azelastine 0.05% (Optivar)
Bacterial
- sulfacetaminde 10% (Bleph-10, Isopto CEtamide, or Sodium Sulamyd)
- Tobramycin
- Ciprofloxacin 0.3%
- ofloxacin 0.3%
- moxifloxacin 0.5% more severe cases
- gatifloxacin 0.3% more severe cases
-chlamydial and gonococcal
- topical and systemic
- systemic
- penicillin and doxycycline
- ocular
- should be managed by ophthalmology
- gentamicin 3mg/ml
- ofloxacin 0.3%
- norfloxacin
- tetracycline ophthalmic ointment
- non pharm management
- hand hygiene
- use clean wash cloth every time
- change pillowcase daily
- warm compresses
- cool compresses for allergy
VERIFIED ANSWERS
Question 1.
Blepharitis
ANSWER
nonulcerative form associated w/ seborrhea
- commonly seen in those w/ trisomy 21
- tends to affect people w/ psoriasis, seborrhea, eczema, allergies, and lice infestations
- contributing factors: chemical or environmental irritants, use of eye makeup and contact
lenses
ulcerative form
- involves lash follicle and meibomian glands of eyelid
- may be pustules at base of hair follicles that may crust or bleed
- lashes become thick and break easily
Question 2.
Blepharitis RF
ANSWER
- dry eye
- frequent hordeola or chalazia
- facial or scalp seborrhea
- immunocompromised state
- acne
- DM
- isotretinoin
Question 3.
Blepharitis assessment finding
ANSWER
ulcerative
- itching, tearing, chalazia, recurrent styes, photophobia, small ulcerative at eyelid margin,
broken or absence of eyelashes
seborrheic
- chronic inflammation of eyelid, erythema, greasy scaling of anterior eyelid, loss of eyelashes,
seborrheic dermatitis of eyebrows and scalp
,Question 4.
Blepharitis Management (pharm/non-pharm)
ANSWER
- warm moist compresses
- lid scrubs w/ baby shampoo
- lid massage to empty meibomian glands
- remove contact lids and disinfect
pharm management
- bacitracin, erythromycin, quinolone ointments
- consider oral atbx for resistant infections
- doxycyline 100 mg po BID
- tetracycline 250 mg po QID
Question 5.
Hordeolum (stye)
ANSWER
erythematous, tender lump within eyelid
- external hordeolum: inflammation/infection of eyelid margin affecting hair follicles of
eyelashes
- internal hordeolum: inflammation/infection of meibomian glands
Question 6.
Chalazion
ANSWER
- granulomatous infection of a meibomian gland
- painless swelling on eyelid
- may be tender and erythematous before evolving into a nontender lump
- blepharitis is frequently associated w/ chalazia
Question 7.
Chalazion Treatment
ANSWER
- warm moist compresses
- intralesional steroid injection
- lid massage
- lid scrubs
,Question 8.
Conjunctivitis (red eye)
ANSWER
inflammation of conjunctiva covering the front of eye
common causes
- bacterial, viral, or fungal
- sexual transmission and ophthalmia neonatorum
- HSV 1
- trachoma
- toxicity (from an inciting agent of some sort)
- allergy
- viral
- adenoviruses, Coxsackie virus, varicella, HSV, herpes zoster virus
Question 9.
Conjunctivitis assessment
ANSWER
ALLERGIC: Pruritus; conjunctival hyperemia, chemosis; a watery or stringy discharge
BACTERIAL: Photophobia w/ blepharospasm; mucopurulent discharge w/ eyelash mattering;
edema; hyperemia; preauricular adenopathy only w/ hyperacute disorder
VIRAL: Acute onset often A/W systemic illness; photophobia or foreign body sensation;
preauricular adenopathy; hyperemia; chemosis; watery discharge; classic dendritic corneal
lesion present w/ herpes simplex; periocular lesions present w/ herpes zoster opthalmicus
Question 10.
Conjunctivitis diagnostics
ANSWER
- snellen
- visual acuity
- dilated pupil exam for proptosis, optic nerve dysfunction, decreased visual acuity, diplopia, or
anterior chamber inflammation
- fluorescein staining to rule out corneal involvement or keratitis
- blue penlight illumination to see corneal scratches, corneal dendrites, or corneal ulcerations
, Question 11.
Conjunctivitis red flags
ANSWER
- diminished visual acuity, photophobia, severe foreign body sensation preventing pt from
keeping eye open, corneal opacity, fixed pupil, severe headache w/ nausea
- refer to ophthamologist
Question 12.
conjunctivitis management
ANSWER
allergic
- topic decongestant antihistamine combos (OTC)
- naphazoline hydrochloride 0.025% (Naphcon- A)
- naphazoline-antazoline 0.3% (vasocon-A)
- levocabastine hydrochloride 0.05% (Livostin)
- emedastine 0.05% (emadine)
- mast cell stabilizers
- olopatadine 0.1% (patalol)
- azelastine 0.05% (Optivar)
Bacterial
- sulfacetaminde 10% (Bleph-10, Isopto CEtamide, or Sodium Sulamyd)
- Tobramycin
- Ciprofloxacin 0.3%
- ofloxacin 0.3%
- moxifloxacin 0.5% more severe cases
- gatifloxacin 0.3% more severe cases
-chlamydial and gonococcal
- topical and systemic
- systemic
- penicillin and doxycycline
- ocular
- should be managed by ophthalmology
- gentamicin 3mg/ml
- ofloxacin 0.3%
- norfloxacin
- tetracycline ophthalmic ointment
- non pharm management
- hand hygiene
- use clean wash cloth every time
- change pillowcase daily
- warm compresses
- cool compresses for allergy
