Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye

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Outline

Pathophysiology

Conjunctivitis, commonly referred to as “pink eye”, is an infection of the membrane that covers the eye and lines the eyelids (conjunctiva). Infective pink eye, caused by a virus or bacteria, normally occurs in only one eye, although it can spread to both eyes. Pinkeye is very contagious and is easily spread through poor hand hygiene, which is why it is so common in children.  

Etiology

Conjunctivitis in newborns is most often caused by Escherichia coli, Klebsiella pneumonia, or Staphylococcus epidermis from the vaginal flora during childbirth, although herpes simplex, gonorrhea, and chlamydia infections may also be the cause. Older children with bacterial conjunctivitis are primarily caused by H influenza (Hib) and cannot be prevented with the vaccine.  

Desired Outcome

The patient will be free from infection; the patient will have no change or loss of vision; the patient will be free from pain and discomfort

Infective Conjunctivitis / Pink Eye Nursing Care Plan

Subjective Data:

  • Itching of the eye(s)
  • Pain in the eye(s)
  • Sensitivity to light

Objective Data:

  • Erythema of one or both eyes
  • Swelling of the eyelid(s)
  • Crusty appearance around the eye(s)
  • Watery discharge from the eye
  • Purulent drainage (yellow or green) from the eye

Nursing Interventions and Rationales

  • Assess eyes and vision Assess for signs of ear infection
  The common signs of pink eye are erythema and clear or purulent discharge. Vision loss is not typical but may be distorted or blurred. Otitis media is a common co-infection and symptoms may overlap
  • Assess vitals
  Get baseline and help determine if there is an underlying systemic infection. Pink eye usually does not present with a fever.
  • Use proper PPE and disinfect all equipment per facility protocol
  Bacterial and viral conjunctivitis are spread through contact. Disinfect all equipment to prevent cross-contamination from other patients.
  • Obtain history from patient and parents, depending on the patient’s age
  Determine if others in the home have similar symptoms. Isolate the patient from these family members. Does the patient attend school or daycare where it is easy to pick up germs and bacteria? How long has the patient had symptoms?
  • Apply a warm compress over eye
  Make sure the compress is moist and warm (not hot) to help relieve discomfort.
  • Instill drops and apply ointments to eyes as necessary. Administer medications as required
  Antibiotic drops or ointments are used to treat bacterial infections. Antihistamines, decongestants, and steroids may also be given to relieve symptoms
  • Encourage patient to remain home from school or daycare for approximately 7 days
  Pink eye infections are highly contagious and easily spread through contact. Isolating the patient from other children will prevent the continued spread of the illness.
  • Educate patients and parents/caregivers of proper hygiene and how to prevent further spread of infection:
    • Avoid rubbing the eye(s)
    • Clean eye discharge with a tissue (dispose of carefully)
    • Do not share towels or clothing with others
    • Teach parent to instill eye drops or apply ointments at home for continued treatment
  Help patients and parents/caregivers understand the importance of proper care and hygiene to prevent the spread of infection to other children or family members. Correct installation of eye drops, and the correct administration of medications is imperative for optimal therapeutic benefit.

Writing a Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye

A Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye starts when at patient admission and documents all activities and changes in the patient’s condition. The goal of an NCP is to create a treatment plan that is specific to the patient. They should be anchored in evidence-based practices and accurately record existing data and identify potential needs or risks.


References

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Transcript

Let’s create a care plan for infective conjunctivitis. Conjunctivitis, or what’s commonly referred to as pink eye, is an infection of the membrane that covers the eye in lies, the eyelid, or the conjunctivitis. In fact, pink eye is caused by a virus or bacteria. It normally occurs in one eye, although it can spread to both eyes. Pink eye is very contagious and it’s easily spread through poor hand hygiene, which is why it’s so common in children. Uh, some nursing considerations are, we want to assess the eyes and assess the vision. While vision loss is not common, it can occur. We want to educate patients on precautions and we want to educate the parents on how to stop the spread and to perform proper hand hygiene. The desired outcome is for the patient to be free from infection. The patient will have no change or loss of vision, and the patient will be free from pain and discomfort. 

This is just a look at conjunctivitis. So typical symptoms for conjunctivitis include erythema, or redness, watery, or purulent drainage. And across the appearance. If you notice here in the picture, you see her eyes are very red. It’s kind of swollen around. Like I said, there may be some drainage, like I said, watery or purulent drainage. So what is the patient going to tell you, what is the subjective data that we can put here for infective conjunctivitis? Well, the patient is definitely going to complain of itchiness; it is going to be very itchy. Okay. There may be some pain in one or both of the eyes and they are going to be very sensitive to light. Some things that we’re going to notice off the bat from an assessment standpoint is we’re going to notice redness; that eye is going to be fire red. 

There is also going to be some swelling in the eyelid. There’s going to be a crusty appearance around the eyes, especially when the patient first wakes up. There’s going to be some watery discharge from the eye or purely in drainage. What could be yellow or green in color from the eye. So we want to assess the eye. That’s our first nurse in the intervention. We want to assess the eye and assess for signs of eye infection. So the common side effects of pink eye include redness, clear drainage or purulent drainage, and visual loss. Like I said, it’s not typical, but it may be distorted or blurred. Otitis media or an ear infection is common. Coinfection and symptoms may often overlap. We want to make sure we use proper PPE and disinfect all equipment per a facility protocol. So bacterial and viral conjunctivitis are spread through contact. 

So we want to make sure we use contact measures. So we want to make sure we use gloves. We want to make sure that we’re wiping everything down, disinfecting all equipment so we can prevent cross-contamination from other patients. We want to encourage the patient to remain home from school or daycare for about seven days. Pink eye infections are common and highly contagious and easily spread isolated. The patient from other children will prevent the continued spread of the illness. I remember when my niece was in school and there was an outbreak of pink eye, and literally it went from one kid to the next, to the next to where just about all of her class was down. Had they isolated the child at home? Did some good hand hygiene? I’m sure that that outbreak would have been minimized. 

We want to educate. Education is key here. Education is key because it’s very important for this disease process to be managed at home. So the nursing intervention that we can do is we can educate the parents to apply warm compresses over the eye. We want to make sure that the compact, the calm press is moist and warm, not hot. It helped relieve some of the discomfort, drops may be ordered by the doctor and prescribed. We want to make sure that they’re instilling the drops and apply ointments to keep that eye comfortable. The medication, some of the medications that may be required would be some antibiotic drops or ointments. That’s going to treat that bacterial infection and to histamines decongestant steroids may also be used to release some symptoms. We want to make sure that the parent is on top of hand hygiene. We want to make sure that they don’t share towels or clothing with others. 

We want to teach patients and teach parents how to put the eyedrops in and in order to avoid cross contamination. And we want to clean any discharge with tissue. That’s disposed of carefully. Here is the completed care plan. Next, we’re going to focus on some key points that you want to keep in mind. So the pathophysiology behind it, in fact, if pink eye is caused by a virus or bacteria in the conjunctiva, or the eye is infected some subjective or objective data that we may receive from the patient, subjective, itchy, very itchy, the eyes are itchy pain, and they’re sensitive to light. We, as nurses are going to observe or some objective data, we’re going to gather, uh, it’s going to be red. There may be some watery or purely from the eye, and that can be one or both eyes. We want to make sure that the parents are adhering to and the patients are adhering to hand hygiene. Okay? Scrupulous hand-washing is very important for at least 20 seconds. Avoid touching eyes. It’s the best way to stop the spread of pink eyes at home. No rubbing, don’t share towels again, hand hygiene, a warm winter compress for comfort and staying home from school until this disease is resolved. 

We love you guys; go out and be your best self today as always happy nursing.

 

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