Monday, 14 April 2014

Nursing Care Conjunctivitis


A. definition
      Conjunctivitis is the inflammation of the mucous lining of the eye. ( Merenstein , Gerald et al , 2002). Conjunctivitis is inflammation and is characterized by swelling and exudate . In the visible eye conjunctivitis, so the eye is often called pink eye ( Smeltzer , Suzanne C. , 2001) .

B. Types of Conjunctivitis
    1 . Bacterial conjunctivitis
         a. Hyperacute and subacute bacterial conjunctivitis
         b . Chronic bacterial conjunctivitis
    2 . Conjunctivitis chlamydia
         a.  trachoma
         b . Inclusion conjunctivitis ( Blenorrhoe Inclusion , Paratrachoma )
         c . Chlamydial conjunctivitis caused by other agents
    3 . Conjunctivitis Virus
         a. Acute follicular conjunctivitis virus
         b . Chronic viral conjunctivitis
    4 . Conjunctivitis rickettsia
    5 . Conjunctivitis mushrooms
    6 . Conjunctivitis parasite
    7 . Immunologik Conjunctivitis ( allergic )
         a. Hay fever conjunctivitis
         b . conjunctivitis Vernalis
         c . atopic keratoconjunctivitis
         d . Konjuntivitis atopic
         e . Giant Papillary Conjunctivitis
         f . Phlyctenulosis
         g . Mild conjunctivitis secondary to contact blepharitis
    8 . Conjunctivitis due to autoimmune disease
         a. keratoconjunctivitis sicca
         b . pemphigoid sikatrikal
    9 . Chemical or irritant conjunctivitis
  10 . Conjunctivitis which causes no dikatahui
  11 . Conjunctivitis associated with systemic disease
  12 . Conjunctivitis in dacryocystitis or kanalikulitis



C. Maninfestasi Clinical Conjunctivitis
1 . Bacterial Conjunctivitis
a. Crusted eyelids , especially when you wake up
b . inflamed conjunctiva
c . Swollen eyelids
d . Usually both eyes are infected
2 . Conjunctivitis Virus
a. Conjunctivitis is usually accompanied by upper respiratory tract infection
b . serous drainage
c . inflamed conjunctiva
d . Swollen eyelids
e . Usually both eyes are infected
3 . Allergic Conjunctivitis
a. itch
b . Drainage of liquid until thick
c . inflamed conjunctiva
d . Swollen eyelids
e . Usually both eyes affected
4 . Conjunctivitis is disesbabkan by foreign banda
a. Tear out
b . painful
c . inflamed conjunctiva
d . Usually only on one eye

D. Therapeutic Management
Treatment of conjunctivitis depends on the cause . Conjunctivitis caused by a virus disappears by itself , and management is limited to making secretions that have accumulated . Conjunctivitis caused by bacteria treated with topical antibacterial agents . Eye drops can be used during the day and ointment at bedtime because ointment preparation remained in the eye longer . Ointment is not used during the day because it can obscure vision .

E. Consideration of Nursing
The purpose of nursing action to tackle conjunctivitis includes keeping the eye is kept clean and precise drug delivery to the eye . The buildup of secretions should always be taken with a rubbing of the medial canthi of the ground outside , away from the eyes of others . Lifting the crust is done by using a warm moist compresses . Compress should not be left in the eye due to an occlusive cover will increase the growth of bacteria . After the drug dripped eyes cleared .
Prevention of infection in other family members is an important consideration in cases of conjunctivitis caused by bacteria . Washcloth and towel children should be separated from the one used by other family members . Children must be able to resist the urge to rub the eyes and trained to wash their hands properly .

F. Management
Conjunctivitis usually resolves. Therapy can include systemic or topical antibiotics , anti-inflammatory ingredients , irrigation eye , eyelid cleansing , or warm compresses .
If conjunctivitis is caused by mokroorganisme , the patient must be taught how to avoid contamination of healthy eyes or eyes of others . Nurses can provide instructions to patients to not rub the affected eye and then touching your eyes healthy , to wash your hands after each time holding the affected eye , and use a washcloth , a towel and a separate new handkerchief . Special care should be made by health care personnel to avoid the spread of conjunctivitis among the patients .

G. Assessment
a. General data : name , age , occupation , address , gender , status
b . Assess ocular changes such as edema , decreased visual acuity , discomfort .
c . Assess psychosocial support aspects related to the patient's condition , especially in patients with decreased visual .
d . Assess the client's history ( the eyes ) eye trauma , diabetes , hypertension
e . Assess the client's problem that causes health seeking
f . Ask about pain in the eyes , photo phobia , sense terrbakar , itching , excessive tears ( nrocos ) , diplopia .
g . Assess family history of eye disease
h . Assess employment history , hobbies , recreational , use of safety goggles
i . When was the last eye check
j . Assess treatment that has been used to handle
k . Physical Pemerriksaan : conjunctiva and sclera , conjunctiva appears red

H. Nursing Diagnosis
a. Pain associated with irritation or infection
b . Anxiety associated with ignorance of the causes of disease or treatment outcome
c . The risk of spreading the infection to other people associated with less knowledge , eye care , the spread of disease .



Nursing Interventions I.
a. prevention
i . Aseptic action , hand washing to prevent the spread of organisms from one mat to the other eye , one client to another client
ii . Dispose of materials or equipment that has been contaminated at a special place
iii . Provide information to families about avoiding the source of irritation or infection and respond to problems that occur ocular
b . The state of acute
i . Give a warm or cold compress as indicated
ii . Provide appropriate analgesia to reduce discomfort
iii . Give antibiotics as indicated
iv . Give an explanation to parents about how the administration of drugs , doses , uses and side effects
c . Care at home
i . Provide information about the techniques of proper hygiene to prevent contamination or limit the spread of infection
ii . Provide information to families about proper drug delivery

J. Evaluation
a. The patient was cooperative with treatment planning and treatment
b . Patients showed a decrease in discomfort in the eye
c . Family repeat the information to prevent recurrence of the disease


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