Reply to professor question from my original discussion post. Reference evidence based and within 5 years.
From the professor: What would be the concerns in a patient who was previously fever free developing a new onset fever a week after symptoms first started? Is it common for viral conjunctivitis to be unilateral in nature?
My notes that you could use to answer but need reference: Explanation:
Question:1
Infection: A new onset fever a week after symptoms first started could be due to an infection. Infections can be caused by bacteria, viruses, or fungi. Antibiotics are frequently used to treat bacterial infections. Antiviral drugs are frequently used to treat viral infections. Antifungal medicines are frequently used to treat fungus infections.
Inflammation: A new fever that appears a week after the commencement of symptoms may potentially be caused by inflammation. The body’s reaction to an injury or an illness is inflammation. Anti-inflammatory drugs can be used to treat inflammation.
Autoimmune conditions: A new onset fever a week after symptoms first started could also be due to an autoimmune condition. Autoimmune conditions occur when the body’s immune system attacks healthy cells. Autoimmune conditions can be treated with immunosuppressive medications.
Question:2
An infection of the conjunctiva, the transparent membrane that covers the white of the eye and the inner surface of the eyelids, is known as viral conjunctivitis. The conjunctiva can become irritated and inflamed due to a variety of viral infections. These viruses can cause the blood vessels in the conjunctiva to become dilated and engorged, which leads to the characteristic redness of the eye. In addition, the viruses can cause the production of excess mucus, which can cause the eye to water. In most cases, only one eye is affected, although both eyes may be affected in some cases.
The most common symptom of viral conjunctivitis is a sudden onset of redness in the affected eye. Other symptoms may include watery eyes, itching, and a burning sensation. In some cases, the virus may also cause symptoms such as a runny nose, sore throat, or fever. Viral conjunctivitis is usually self-limited and will resolve on its own within two to three weeks. However, some viruses can cause more severe symptoms and may require treatment with antiviral medication.
Original post:The FNP should ensure they gather adequate patient history. In this case, the patient is a child; thus, they may need to collect patient information from their parent. The FNP should ask about the onset, severity, associated symptoms, relieving factors, and any history regarding the patient’s current medical concern. Since the patient presents with copious nasal discharge and soft-tissue swelling around the left eye, the healthcare provider may perform a physical examination focusing on the eyes, sinuses, nose and throat. Based on the patient’s presenting symptoms, they likely have an infection. Viral conjunctivitis may be a possible diagnosis for the patient. This infection is often characterized by swelling of the eye, a runny nose, and a sore throat (Johnson et al., 2022). The patient presents with some of these symptoms and thus may have the condition. The FNP should develop a treatment plan that aims at symptom relief. They may prescribe eye drops and analgesics such as paracetamol for pain relief to the patient. The FNP should educate the parent and child on non-pharmacological treatment approaches such as observing proper eye and oral hygiene, cleaning eyelids with a wet cloth, and applying warm compresses several times daily (Johnson et al., 2022). If the symptoms persist, the FNP will need to refer the patient to an ENT specialist or ophthalmologist, depending on the symptoms.
Difference in Treatment Plan
Adults than children are at risk of viral conjunctivitis caused by the herpes simplex virus (Johnson et al., 2022). In this case, adults aged 35 may need laboratory tests to detect if their infection may be caused by herpes simplex. If the virus is present, they may need antiviral therapy and eye drops for symptom relief (Cagini et al., 2020). Without the virus, the FNP may recommend letting the disease take its course. The infection is likely to resolve without treatment. The practitioner may need to offer education on proper hygiene and avoid anything that aggravates the symptoms. Unlike a 35-year-old patient, a 65-year-old patient may need medical attention. A 65-year-old has poor immunity; thus, the condition may progress to a severe state or take longer to resolve (Lee et al., 2018). The 65-year-old may need antiviral therapy, eye drops, and fluid replenishment therapy as they risk losing a lot of fluid through sweating due to fever.
References
Cagini, C., Mariniello, M., Messina, M., Muzi, A., Balducci, C., Moretti, A., Levorato, L., & Mencacci, A. (2020). The role of ozonized oil and a combination of tobramycin/dexamethasone eye drops in the treatment of viral conjunctivitis: a randomized clinical trial. International Ophthalmology, 40(12), 3209–3215. https://doi.org/10.1007/s10792-020-01503-4
Lee, S. B., Oh, J. H., Park, J. H., Choi, S. P., & Wee, J. H. (2018). Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department. Clinical and Experimental Emergency Medicine, 5(4), 249–255. https://doi.org/10.15441/ceem.17.261
Johnson, D., Liu, D., & Simel, D. (2022). Does This Patient with Acute Infectious Conjunctivitis Have a Bacterial Infection? JAMA, 327(22), 2231. https://doi.org/10.1001/jama.2022.7687