\ \ \ \ \ is a suppurative infection in the lacrimal sac? - Maharashtra CHO - 2020

Maharashtra CHO - 2020

Medical Surgical Nursing

Easy

Appeared in: Maharashtra CHO - 2020

Explanation

Acute dacrocystitis is specifically defined as an infection and inflammation of the lacrimal sac.
The term 'suppurative' indicates the presence of pus, which is a characteristic feature of acute dacrocystitis due to bacterial infection in the stagnant tears.
This condition is most often a complication of nasolacrimal duct obstruction, which creates an environment for bacteria like Staphylococcus aureus or Streptococcus to proliferate.
The key anatomical location is the lacrimal sac, situated in the medial canthal region (the inner corner of the eye).

Option A: A stye, or external hordeolum, is an infection of the glands of Zeis or Moll, which are located at the base of the eyelashes on the eyelid margin, not in the lacrimal sac.
Option B: A hordeolum internum is an infection of a Meibomian gland, which is located deeper within the tarsal plate of the eyelid. It is not an infection of the lacrimal sac.
Option D: This option is incorrect because a stye and a hordeolum internum are infections of glands within the eyelid, whereas dacrocystitis is an infection of the lacrimal sac. They are distinct conditions affecting different anatomical structures.

Clinical Relevance

Nursing practice connection: Knowing Differential diagnosis of suppurative infections of the eye and adnexa helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must be able to differentiate these conditions to provide appropriate care. For dacrocystitis, care includes administering systemic antibiotics as prescribed, applying warm compresses to the affected area, and educating the patient to avoid pressing on the sac during the acute phase to prevent spreading the infection.
Patient education is crucial. Teach proper eyelid hygiene, the importance of completing the antibiotic course, and signs of worsening infection (e.g., orbital cellulitis) that require immediate medical attention.
What if? If a patient with dacrocystitis develops proptosis (bulging eye), pain with eye movements, or decreased vision, the nurse should suspect a progression to orbital cellulitis, a medical emergency, and escalate care immediately.

How to Approach the Question

First, identify the key terms in the question: 'suppurative infection' and 'lacrimal sac'.
The question asks for the specific medical term for an infection in this exact anatomical location.
Recall or look up the definitions of the options provided.
A 'stye' (hordeolum externum) is an infection of an eyelash follicle.
A 'hordeolum internum' is an infection of a meibomian gland inside the eyelid.
'Dacrocystitis' is the inflammation/infection of the lacrimal sac ('dacryo-' refers to tears/lacrimal apparatus, and '-cystitis' refers to inflammation of a sac).

Concept Tested & Keywords

Concept Tested: Differential diagnosis of suppurative infections of the eye and adnexa.
Stem keywords: suppurative infection, lacrimal sac
Lead-in keywords: is a
Negative lead-in flag: false

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 pp. 1781-1783, 1744-1746, 1748-1750