EENT Disorders

T. Mcdonald
NUR 2310

Visual disorders: most

common
Common causes
Hyperopia-farsightedness
Myopia- nearsightedness
Astigmatism- blurred images

Nursing Management
Identification of disorders is
important
Observe for symmetry of
placement and movement
Ability to follow objects with each
eye
Abnormalities in appearance
Light reflex
Cover-uncover test
Visual acuity testing

Referral to a specialist

Identifying Visual Disturbances

Visual disorders that significantly affect vision

Etiology
Strabismus(Deviation of
the eyes)
Inward(Esotropia)
-crossed eyes
Outward (Exotropia)wall eyes
Amblyopia (lazy eye)
Cataracts
Opacity of lens
preventing refraction of
light rays into the retina
Glaucoma
Increased intraocular
pressure in the eye

Visual disturbances
Assessment and Diagnosis
Use developmental milestones that require vision
Following bright lights
Reaching for objects
Looking at pictures in a book

Visually Related
Developmental Milestones

As Children Grow
Eustachian Tube

Otitis Media
Inflammation of the
middle ear
Etiology
Specific cause unknown,
but appears to be related
to Eustachian tube
dysfunction
URI precedes the otitis
media
Most common causative
organisms of infection are
streptococcus
pneumoniae,
haemophilus influenzae,
and moraxella catarrhalis

Otitis Media
Manifestations
Pulling at the ear
Diarrhea,
vomiting and
fever
Acting out and
irritability may be
a sign of hearing
loss [if the child
cant hear you
they will start to
act out b/c there
is a lack of

Otitis Media: Nursing

Management
Nursing Diagnoses? [parental
anxiety, acute pain]
Interventions? [Tylenol to
help w/ the pain, antibiotics=
amoxicillin 48-72 hrs ,
monitor closely if they have
continuous ear infection]
Planning and Implementation
Preventative measures
[vaccines, no water in ear,
reduce pacificer]
Family stressor of chronic otitis
media
Pain relief Techniques
Hearing and Language exams

Otitis Media and

Otitis Media with Effusion
Acute otitis media- characterized by pain
and a red, bulging non-mobile membrane,
acute pain, tympanic membrane will look
red, white, yellow, gray

Otitis media with effusion-fluid line or

air bubbles, [usually have hearing loss
w/ fluid over 3 months period, dont
have as much pain, tympanic
membrane will look yellow and gray]

Hearing Impairment: Nursing

Interventions
Assessment and
Diagnosis
Deaf infants babble
the same as infants
that can hear, but it
ceases several
months later in the
hearing-impaired
child
Screening is key
As early as birth

Hearing disturbances
Facilitate ability to
receive spoken
language
Allow child to read lips,
position face
appropriately
Facilitate ability to send
information
Hearing aids
Use assistive
technologies to
communicate

Hearing disturbances

Help parents to meet

childs educational needs
Adjustments for child in
school
Support is needed
Should reach same
potential as hearing
children but may take
longer
Provide emotional support
Parents need support
and community
resources

Nursing interventions
Encourage use of all
senses
Promote socialization
Touch, rock sing to infants
Teach parents to read body
language
Describe procedures and allow
the child to touch [ex. NG tube]
Call the child's name and speak
to them prior to touching them
Encourage contact with peers
Teach parents to discipline the
same
Educational options
Provide emotional support

Pharyngitis
Acute pharyngitis is an infection that primarily affects the
pharynx including the tonsils
Major complaint is sore throat
Nursing Management
Symptomatic relief
Acetaminophen for pain and fever
Cool, non-acidic fluids and soft foods, ice chips, or frozen ice pops
[no red pops]
Humidification, chewing gum, warm salt water gargle
Home remedies more effective than O.T.C. throat sprays [1/2
teaspoon of honey throughout the day to soothe throat]

Teach parents to complete 10-day course of antibiotic if

prescribed for bacterial pharyngitis [they stop when there are
no more pills/ liquid]

Treating strep infections prevents infections

such as rheumatic fever, cervical adenitis,
sinusitis, glomerulonephritis, or meningitis

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