Eye, Ear, Throat & Respiratory Disorders in Pediatrics | Saunders NCLEX-PN Review Chapter 32

Chapter 32 of Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri offers a detailed, practical overview of pediatric eye, ear, throat, and respiratory conditions—providing the critical assessment, intervention, and parent education strategies you need to pass the NCLEX-PN and deliver safe nursing care.

Watch the full chapter summary and explore the complete NCLEX-PN review series at Last Minute Lecture:

Eye Disorders: Strabismus & Conjunctivitis

• Strabismus: Characterized by misaligned eyes (crossed eyes); may need patching of the strong eye, corrective glasses, or surgery to preserve vision.
• Conjunctivitis (“Pinkeye”): Common and highly contagious. Symptoms include redness, discharge, and itching. Use antibiotic drops as prescribed, teach families strict hand hygiene, no school until cleared, avoid sharing towels.

Ear Disorders: Otitis Media

• Otitis Media: Ear pain, fever, tympanic membrane changes. Common in infants/young children. Treatment includes antibiotics, acetaminophen/ibuprofen, upright positioning, and myringotomy for recurrent cases. Post-op: keep ears dry, monitor for drainage or hearing loss.

Throat Disorders: Tonsillitis, Adenoiditis, Epistaxis

• Tonsillitis & Adenoiditis: Sore throat, difficulty swallowing, snoring, mouth breathing. Pre-op: infection control and assessment for bleeding risk. Post-tonsillectomy: monitor for frequent swallowing (bleeding), provide cold fluids/soft diet, avoid red liquids and straws.
• Epistaxis (Nosebleed): Calm the child, lean forward, apply pressure and cold compress. Teach families about environmental prevention (humidifiers, nail trimming).

Airway Emergencies: Epiglottitis & Croup

• Epiglottitis: Sudden high fever, drooling, muffled voice, tripod position, and severe respiratory distress. Do NOT attempt throat exam or use tongue blade. Maintain airway, provide humidified oxygen, prep for possible intubation. Medical emergency!
• Croup (Laryngotracheobronchitis): Barking cough, inspiratory stridor, hoarseness. Interventions: cool mist, humidified oxygen, racemic epinephrine, corticosteroids, monitor for airway obstruction.

Bronchiolitis, RSV & Pneumonia

• Bronchiolitis (often RSV): Labored breathing, wheezing, retractions, poor feeding. Suction airway, maintain hydration, droplet/contact precautions. High-risk infants may get palivizumab prophylaxis.
• Pneumonia (viral, bacterial, atypical, aspiration): Fever, cough, tachypnea, rales. Diagnosis by CXR and symptoms. Provide oxygen, antibiotics if bacterial, chest physiotherapy, and hydration.

Asthma: Triggers, Meds, and Monitoring

• Asthma: Wheezing, cough, dyspnea, chest tightness. Recognize and avoid triggers (allergens, cold, exercise). Medications include rescue inhalers (albuterol), controllers (inhaled steroids), and spacers for young children. Teach PEFR monitoring and asthma action plan.

Cystic Fibrosis (CF): Care and Family Teaching

• Genetic disorder with thick mucus production affecting lungs and GI tract. Symptoms: chronic cough, recurrent infections, failure to thrive. Nursing: chest physiotherapy, bronchodilators, pancreatic enzyme replacement, high-calorie/high-protein diet, infection control, family/caregiver education.

Critical Safety Topics: SIDS, Foreign Body Aspiration, TB

• SIDS Prevention: Place infants supine to sleep, avoid soft bedding, promote breastfeeding and pacifier use, teach families risk factors and grief support after loss.
• Foreign Body Aspiration: Sudden coughing, choking, stridor, or cyanosis. Back blows/chest thrusts for infants, Heimlich for older children. Prevention: age-appropriate foods, toys, and supervision.
• Tuberculosis (TB): Chronic cough, weight loss, fever, night sweats. Test with TST (Mantoux), confirm with sputum. Airborne isolation, multi-drug therapy, DOT (directly observed therapy) for compliance.

Parent and Home Care Education

• Demonstrate inhaler/spacer technique, use humidifiers safely, recognize emergency signs, maintain immunizations, teach CPR, and prepare for common complications at home.

Conclusion:
Pediatric eye, ear, throat, and respiratory disorders are high-yield NCLEX topics that demand rapid recognition, evidence-based interventions, and clear caregiver communication. Mastering these will ensure safer pediatric care and NCLEX-PN exam success.

For more in-depth chapter summaries, visit Last Minute Lecture on YouTube or browse the complete NCLEX-PN playlist: Full Playlist