Chapter 35: Pediatric Eye, Ear, and Throat Problems

Strabismus, characterized by misalignment of the extraocular muscles, requires early intervention through corrective lenses, occlusion therapy, or surgical correction to prevent amblyopia and permanent vision loss. Conjunctivitis presents as inflammation of the conjunctiva from allergic, traumatic, or infectious causes, with bacterial and viral forms being highly contagious; notably, chlamydial conjunctivitis in non-sexually active children warrants assessment for sexual abuse. Otitis media, a middle ear infection following eustachian tube obstruction, occurs frequently in children whose shorter and straighter anatomical structures predispose them to ascending infection from respiratory pathogens. Otitis externa manifests as external auditory canal inflammation with characteristic pain on pinna manipulation, treated with topical antibiotics. Myringotomy involves surgical drainage of middle ear fluid through tympanic membrane incision and tube placement, requiring postoperative ear protection and activity modification. Tonsillitis and adenoiditis cause pharyngeal inflammation that may lead to obstructive sleep apnea and swallowing difficulties, necessitating preoperative coagulation assessment due to the throat's high vascularity. Postoperative tonsillectomy care focuses on hemorrhage monitoring through observation of frequent swallowing and throat clearing, maintenance of appropriate positioning for drainage, careful airway management without routine suctioning, and dietary restrictions excluding red-colored liquids and dairy products. Epistaxis management emphasizes upright positioning with forward lean and sustained nasal pressure for hemostasis. Allergic rhinitis develops through environmental allergen sensitization, producing characteristic pale nasal mucosa, clear drainage, and periocular hyperpigmentation, managed through trigger identification and pharmacologic treatment with antihistamines and intranasal corticosteroids. Throughout these conditions, age-appropriate nursing interventions and infection control measures remain essential for optimal patient outcomes and safety.