NR 602 Final Exam Questions With Well Elaborated AnswersGraded A+.

A mother presents with her 3 month old child and complains of goopy eye that is sometimes matted shut after naps. Upon exam the conjunctiva is clear with some mild crusting to eye lashes. What is the diagnosis and patient teaching? - correct answer Probable lacrimal duct obstruction. -The baby will likely grow out if it somewhere between six and 12 months. -You can do a daily lacrimal duct massage and warm compresses to help open up the duct. -Watch for Periorbital cellulitis or bacterial conjunctivitis. Nine-year-old patient presents with tender, swollen, erythemic bump to eyelid. What is the diagnosis and patient education? - correct answer Hordeolum (stye) -warm moist compress - scrub eye lashes with baby shampoo BID - eye will feel better when stye pops, if doesn't will refer to optho. What is blepharitis? - correct answer inflammation of the eyelid - caused by blocked oil gland, allergies, or excessive bacteria What is the treatment for blepharitis? - correct answer Cleanse with baby shampoo TID - Warm, moist compress - resistant can prescribe Doxy or Tertracycline but not to pediatrics who don't have adult teeth, can cause discoloration. Pediatrics can have Bactrim. A 9 year old patient presents with acute swelling and erythema to eyelid with flaky, scaly debris to eyelid margins. Patient reports gritty, burning feeling to eyes. She has already attempted warm compresses and washing eyelids with baby soap with minimal relief. What is the diagnosis and treatment? - correct answer Patient has anterior blepharitis Treat with erythromycin ointment, ointment has longer contact with eye. Can use azithromycin ointment x 4 weeks for long term treatment Can use doxycycline or tetracycline for chronic in kids >8 years or Azithromycin oral for kids <8 What organism is likely to cause viral conjunctivitis? - correct answer -Adenovirus -HSV -Herpes What organism is likely to cause bacterial conjunctivitis? - correct answer -Staph aureus -strep pneumoniae -H. Influenza A 10-year-old patient presents with unilateral conjunctivitis with watery discharge x 2 days along with itching of the eye. Mother denies any other associated symptoms. What is the diagnosis and treatment? - correct answer Viral Conjunctivitis Patient should apply cold compresses for comfort *Bacterial conjunctivitis has purulent discharge. What is herpes keratitis? - correct answer Herpes viral infection to the eye caused by HSV. A 19-year-old male presents with blurred vision, watery discharge, photophobia, and eye redness. Upon exam you note fern-like lines under the woods lamp. What is the diagnosis and tx? - correct answer Herpes Keratitis Tx: Antivirals A 16-year-old female presents with complaints of sudden onset of red, watery, and painful left eye. She reports possible foreign body to eye. Upon inspection you visualize a n erythemic lesion to the eye. When using woods lamp you note a small superficial laceration. What is the dx and tx? - correct answer Corneal abrasion, refer to optho emergently or send to ER. A mother brings her nine-year-old overweight son to the clinic with complaints of pain to the groin, knee, and right hip. She reports patient has been walking with a limp for the last couple days but unable to ambulate today. Mother denies any recent trauma. Upon inspection there is external rotation of the right foot. What is the dx and tx? - correct answer Slipped capital femoral epiphysis Refer to ER, will need surgery. -most common in adolescent, obese males. Father presents with his four-year-old son and states that patient has been limping since this morning and was crying all night complaining of left hip pain. Upon exam you appreciate decreased range of motion of left hip but no external rotation or signs of trauma. What is the probable diagnostics, and treatment? - correct answer Toxic transient syndrome- most common cause of limp in peds. Order: CBC, ESR, and X-ray. WBC and ESR will be elevated. X-RAY will be normal. -advise father that will resolve in 2-6 weeks. - patient needs bed rest, NWB to left leg, and NSAIDS. - return if develops fever, swelling, pain that is unrelieved by rest or medication What degree is scoliosis is considered functional? - correct answer 5-10 degrees, continue to monitor. What degree of scoliosis is considered mild? - correct answer <20 degrees, monitor every 3-4 months A 13-year-old female presents to the office after having an x-ray order by you for her scoliosis. The reading on the x-ray reports a 30° curvature. What is the treatment plan? - correct answer Milwaukee brace for 23 hours per day