Nursing Care Plan for Infective Conjunctivitis / Pink Eye

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 pneumoniae or Staphylococcus epidermidis 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 influenzae (Hib) and cannot be prevented with the vaccine.  

Desired Outcome

Patient will be free from infection; patient will have no change or loss of vision; 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 eye(s)
  • Watery discharge from the eye
  • Purulent drainage (yellow or green) from the eye

Nursing Interventions and Rationales

  1. Assess eyes and vision

    Assess for signs of ear infection

  2. 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

  3. Assess vitals

  4. Get baseline and help determine if there is underlying systemic infection. Pink eye usually does not present with fever.

  5. Use proper PPE and disinfect all equipment per facility protocol

  6. Bacterial and viral conjunctivitis are spread through contact. Disinfect all equipment to prevent cross contamination to other patients.

  7. Obtain history from patient and parents, depending on patient’s age

  8. Determine if others in the home have similar symptoms. Isolate 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 patient had symptoms?

  9. Apply warm compress over eye

  10. Make sure compress is moist and warm (not hot) to help relieve discomfort.

  11. Instill drops and apply ointments to eyes as necessary.

    Administer medications as required

  12. Antibiotic drops or ointments are used to treat bacterial infections.

    Antihistamines, decongestants and steroids may also be given to relieve symptoms

  13. Encourage patient to remain home from school or daycare for approximately 7 days

  14. 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.

  15. 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
  16. Help patients and parents / caregivers understand the importance of proper care and hygiene to prevent spread of infection to other children or family members.

    Correct instillation of eye drops and correct administration of medications is imperative for optimal therapeutic benefit.


References

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