Chalazion – Flashcard

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Overview
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Painless, slowly growing nodule on the eyelid Common disorder of the sebaceous gland in the eyelid May become large enough to press on the eyeball, producing astigmatism May be chronic
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Overview-Pathophysiology
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Breakdown of lipid products by bacterial enzymes or retained sebaceous secretions collect in the surrounding tissues and initiate an inflammatory response. A granulomatous inflammation in the upper or lower eyelid is the result of an obstruction of a duct of the meibomian or Zeis sebaceous glands (superficial chalazion). Edema is usually contained on the conjunctival portion of the eyelid.
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Overview-Causes
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Chronic blepharitis Meibomian cancer Rosacea Seborrhea Viral infection
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Overview-Incidence
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Chalazion is common but the exact incidence is unknown. It affects males and females equally. Chalazion affects all age groups.
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Overview-Complications
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Cosmetic deformity Bleeding after surgery Infection Vision disturbance
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Assessment-History
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Complaints of lid discomfort, tenderness, or swelling Nodule on eyelid History of rosacea or blepharitis
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Assessment-Physical Findings
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Palpable, small lump in the eyelid that's nontender, nonerythematous, and nonfluctuant, most commonly on the upper eyelid Red, elevated area on the conjunctival surface (see Recognizing chalazion)
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Diagnostic Test Results-General
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Visual examination and palpation of the eyelid reveals presence of chalazion. Biopsy rules out meibomian cancer.
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Treatment-General
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Warm compresses to the affected eyelid Lid hygiene (cleansing with mild shampoo lathered onto and washed off) Lid massage
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Treatment-Medications
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Intralesional injection of corticosteroid (triamcinolone acetonide) to cause inflammation and regression Oral tetracyclines such as doxycycline or minocycline hydrochloride to reduce inflammation and prevent secondary infection or treat acute infection Antimicrobial eyedrops after surgical removal
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Treatment-Surgery
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Incision and curettage under local anesthetic
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Nursing Considerations-Nursing Diagnoses
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Anxiety Disturbed body image Ineffective health maintenance Risk for injury
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Nursing Considerations-Expected Outcomes
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express feelings of decreased anxiety maintain positive outlook regarding body image regain normal visual functioning maintain current health status remain free from injury.
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Nursing Considerations-Nursing Interventions
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Provide eyelid hygiene as ordered; assist with eyelid massage and/or cleansing routine. Apply warm compress for 15 minutes four times per day Encourage meticulous handwashing, especially when performing eyelid hygiene and applying warm compresses. Continue warm compress application after surgery. Apply eye patch or dressing to the affected eye as ordered for 24 hours after surgery. (See Applying an eye patch.) Instill postoperative eyedrops, as ordered.
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Nursing Considerations-Monitoring
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Appearance of eyelid Visual ability Bleeding (after surgery) Signs and symptoms of infection
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Nursing Considerations-Associated Nursing Procedures
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Eye compress application, warm Eye patch application Eyedrop administration Postoperative care Preoperative care Preparing a patient for ophthalmic surgery, OR
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Patient Teaching-General
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disorder, diagnosis, possible causes, and treatment, including possible excision if indicated technique for applying warm compresses, for 15 minutes per application, four times per day technique for performing lid hygiene using diluted baby shampoo (which doesn't sting the eyes) technique for massing the eyelid to promote drainage of the meibomian glands need to refrain from attempting to pop or drain the chalazion proper instillation of eyedrops, if ordered to help suppress formation signs and symptoms of infection signs and symptoms of a recurrence and the need to report them to a practitioner need for follow-up care to ensure resolution.
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Patient Teaching-Discharge Planning
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Refer the patient to an ophthalmologist for visit in 2 to 4 weeks for evaluation Encourage follow-up care, as ordered.
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