Terms in this set (21)
Infection of the lacrimal sac resulting from obstruction of the nasolacrimal duct
Congenital or acquired (acute or chronic)
The lacrimal excretory system is a mucous membrane-lined tract that's contiguous with the conjunctival and nasal mucosa.
The conjunctival and nasal mucosa are normally colonized with bacteria.
Inability to drain tears due to a blocked lacrimal drainage system results in infection. (See A close look at tears.)
The congenital form is related to incomplete canal formation of the nasolacrimal duct.
Methicillin-resistant S. aureus
Methicillin-resistant S. aureus
Chronic mucosal degeneration
Fungi, such as Actinomyces or Candida albicans
Dacryocystitis is most common in adults older than age 40.
This disease occurs more commonly on the left side than on the right side.
It occurs rarely in Blacks.
Dacryocystitis affects females more commonly than males.
Cerebrospinal fluid leakage
Severe erythematous swelling around the nasal aspect of the lower eyelid
Tenderness of the eyelid
Tearing (more common with chronic form)
Palpable mass inferior to the medial canthal tendon
Decreased visual acuity
Diagnostic Test Results-Laboratory
Culture of discharge demonstrates organism.
White blood cell count is elevated.
Diagnostic Test Results-Imaging
X-rays after injection of a radiopaque medium locate atresia or skeletal facial anomalies.
Dacryocystography and dacryoscintigraphy identify anatomical abnormalities of the nasolacrimal drainage system.
Lacrimal sac massage
Eyedrops, such as trimethoprim sulfate and polymyxin B sulfate, gentamicin sulfate, levofloxacin, or tobramycin; corticosteroid eyedrops for chronic dacryocystitis due to allergic rhinitis
Antibiotics, such as oral amoxicillin and clavulanate or I.V. ampicillin and sulbactam, levofloxacin (for acute dacryocystitis with orbital cellulitis)
Intranasal saline (postoperatively) to keep surgical area clean and open
Incision and drainage
Nursing Considerations-Nursing Diagnoses
Impaired tissue integrity
Ineffective health maintenance
Risk for infection
Nursing Considerations-Expected Outcomes
express feelings of increased comfort
express feelings of decreased anxiety
have reduced swelling, redness, and pain
maintain current health status
remain free from signs and symptoms of infection.
Nursing Considerations-Nursing Interventions
Assist with obtaining a culture of the site to determine the underlying cause.
Give prescribed antibiotics. If I.V. antibiotics are prescribed, ensure patent I.V. access.
Apply warm compresses to the area as ordered.
Provide meticulous eye hygiene measures.
Institute appropriate infection control precautions based on the underlying infectious organism; ensure meticulous handwashing. Adhere to standard precautions.
Assist with lacrimal massage as indicated.
Prepare the patient and family for possible surgery.
Signs and symptoms of infection
Postoperative vital signs
Signs and symptoms of bleeding
Nursing Considerations-Associated Nursing Procedures
Blood pressure assessment
Eye compress application, warm
IV bag preparation
IV bolus injection
IV catheter insertion
Oral drug administration
Preparing a patient for ophthalmic surgery, OR
disorder, diagnosis, underlying cause, and treatment, including I.V. antibiotics for acute dacryocystitis with orbital cellulitis and appropriate eyedrops
prescribed medications, including antibiotics and ophthalmic drops
possible adverse reactions to prescribed medications
correct technique for instilling eyedrops
eye hygiene care measures
application of warm compresses
signs and symptoms of worsening infection
signs and symptoms of possible postoperative complications, including bleeding and infection, and the need to report them to a practitioner immediately
use of intranasal saline spray postoperatively.
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