Conjunctivitis Nursing Care Plans Diagnosis and Interventions
Conjunctivitis NCLEX Review and Nursing Care Plans
Conjunctivitis is the inflammation of the conjunctiva, which is a tissue that lines the eyelids and covers the sclera or the white part of the eye.
The inflammation affects the blood vessels in the eye, causing its reddish to pink appearance, and thus, conjunctivitis is also commonly known as “pink eye.”
Conjunctivitis is often caused by a bacterial or viral infection on the eye.
It is estimated that there are 6 million cases of conjunctivitis a year that are reported in the U.S. alone.
However, the data on its exact prevalence is not available.
Signs and Symptoms of Conjunctivitis
Conjunctivitis has the following signs and symptoms:
- Pink eye – the sclera may appear red to pink in color
- Chemosis – swelling of the conjunctiva
- Increased tear production
- The feeling of a foreign body stuck in the eye, which may be accompanied by an urge to rub the affected eye
- Itching, irritation, and burning sensation in the affected eye
- Eye discharge – may differ depending on the organism causing the conjunctivitis. Viral conjunctivitis produces thick discharge, while bacterial conjunctivitis has more of a watery discharge.
- Crusting of the eyelids or lashes – most noted in the morning
- In people wearing contact lenses, the feeling of the lens not staying in place may be experienced.
Causes of Conjunctivitis
Conjunctivitis is often caused by bacteria and viruses, but there are other reasons that can cause it to occur:
- Bacterial Conjunctivitis. Bacterial conjunctivitis is the infection caused by certain bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Chlamydia trachomatis and Neisseria gonorrhoeae. It can be easily spread, and it is more commonly seen in children than in adults.
- Viral Conjunctivitis. Viral conjunctivitis is commonly caused by adenoviruses and is very contagious. Since it is viral in origin, it is normally self-limiting.
- Allergic Conjunctivitis. Allergic conjunctivitis happens as a result of the body’s allergic reaction to allergens. It is not contagious, and it can be seasonal depending on what triggers the allergic reaction.
- Conjunctivitis secondary to eye irritants. Fumes, dust, smoke, chemicals, and any other foreign body that can irritate the eyes can cause conjunctivitis. Contact lens use can also lead to conjunctivitis. Proper handling of contact lenses is required to avoid introducing infection and irritants to the eyes.
Some factors make a person more susceptible to acquiring conjunctivitis.
Exposure to allergens and exposure to other people infected by it can increase an individual’s vulnerability to the infection.
Extended use of contact lenses is also a risk factor.
Complications of Conjunctivitis
Keratitis, the inflammation of the cornea, can occur because of conjunctivitis.
Normally, conjunctivitis has no effect on vision.
However, in cases of keratitis, vision may become affected prompting the need for a medical evaluation.
Diagnosis of Conjunctivitis
- History taking – a detailed medical history including the symptoms experienced is completed by the doctor
- Eye examination – in most cases, the cause of conjunctivitis is determined by the characteristics of the symptoms and of the eye discharge. The symptoms of conjunctivitis are generally the same, however, some are specific to the cause. A culture of the discharge is not always performed unless the symptoms do not appear to give the definitive cause of conjunctivitis.
In cases of viral conjunctivitis, the symptoms may be accompanied by common cold or respiratory tract infection.
Also, the discharge is watery rather than thick in nature.
Bacterial conjunctivitis on the other hand, commonly occurs with an ear infection and is noted in babies shortly after being born.
The characteristic discharge is thick.
Treatment of Conjunctivitis
A visit to the doctor is not always needed in most cases of conjunctivitis. Treatments are commonly home remedies that are focused in alleviating the symptoms.
- Eye drops. Artificial tears can be used to alleviate discomfort and avoid dryness in the affected eye.
- Hygiene. Cleaning of the eyelids with wet cloth will keep the surrounding of the eyes clean and it can also promote comfort. The use of cold or warm compress can help in alleviating the discomfort caused by conjunctivitis. Avoid sharing of washcloths and towels. Eye makeups are also advised to be replaced in case the infection is suspected from its use. Changing the pillow and pillowcases will avoid infecting the other eye.
- Care of lenses. It is advisable that the use of contact lenses is avoided to prevent further infection and eye irritation. In people wearing hard lenses, it is recommended to disinfect the lenses before use.
- Use of antimicrobials. Antibiotics is not normally prescribed in cases of conjunctivitis. Its use is not particularly helpful specially if the cause is viral. Using antibiotics in viral cases can only cause possible reduction of susceptibility to the antibiotic in the future. Antivirals are sometimes prescribed in cases the conjunctivitis is caused by herpes simplex virus or herpes zoster virus.
Nursing Diagnosis for Conjunctivitis
Nursing Care Plan for Conjunctivitis 1
Nursing Diagnosis: Disturbed Sensory Perception (Visual) related to eye inflammation related to conjunctivitis as evidenced by verbal complaint of difficulty of seeing properly, pink eye, itching, irritation, and burning sensation in the affected eye
Desired Outcome: The patient will regain optimal vision.
|Nursing Intervention of Conjunctivitis||Rationale|
|Assess the vision ability of the patient using an eye chart, and I.V. fluorescein angiography.||To establish a baseline assessment of conjunctivitis in terms of vision capacity.|
|Encourage the patient to have follow up checkups with an ophthalmologist if there are any worsening of visual disturbances.||To monitor worsening of vision loss and treat accordingly. Keratitis, or the inflammation of the cornea, can occur because of conjunctivitis.|
|Encourage the patient to promote sufficient lighting at home.||The patient may not be able to perform activities of daily living as normal if he/she cannot see properly. Sufficient lighting also reduces the risk for injury.|
|Administer medications as prescribed.||Artificial tears can be used to alleviate discomfort and avoid dryness in the affected eye.|
|Encourage proper eye hygiene by cleaning the eyelids with wet cloth, throwing away eye makeup and washing pillow / pillowcases that were used recently prior to having conjunctivitis. Apply warm or cold compress on the eyes. Avoid sharing of washcloths and towels.||Cleaning of the eyelids with wet cloth will keep the surrounding of the eyes clean and it can also promote comfort. The use of cold or warm compress can help in alleviating the discomfort caused by conjunctivitis. Eye makeups are also advised to be replaced in case the infection is suspected from its use. Changing the pillow and pillowcases will avoid infecting the other eye.|
|Encourage the patient to avoid the use of contact lenses. In people wearing hard lenses, it is recommended to disinfect the lenses before use.||To prevent further infection and eye irritation.|
|Encourage the patient to add foods containing vitamins C, E, beta-carotene, zinc, and copper in his/her diet in accordance to daily recommended intake.||Foods containing vitamins C, E, beta-carotene, zinc, and copper can help promote better eyesight.|
Nursing Care Plan for Conjunctivitis 2
Nursing Diagnosis: Risk for Injury related visual problems related to viral conjunctivitis
Desired Outcome: The patient will be able to prevent trauma or injury by means doing activities that can be done within the parameters of visual limitation and by modifying environment to adapt to current vision capacity.
|Nursing Intervention of Conjunctivitis||Rationale|
|Assess the patient’s degree of visual impairment.||To establish a baseline of visual acuity and gain useful information before modifying the patient’s environment.|
|For severe conjunctivitis with effect on vision, place the bed in the lowest position. Place the call bell within reach (if there’s any). Keep the visual aides and patient’s phone and other devices within reach.||To prevent or minimize injury of the patient.|
|Promote adequate lighting in the patient’s room.||To promote safety measures and support to the patient in doing ADLs optimally.|
|Ensure that the floor is free of objects that can cause the patient to slip or fall.||To promote safety measures and support to the patient in doing ADLs optimally.|
|Advise the patient to wear sunglasses especially when going outdoors.||To reduce glare and help protect the eyes.|
Nursing Care Plan for Conjunctivitis 3
Nursing Diagnosis: Risk for Infection (Cross-contamination)
Desired Outcome: The patient will be able to avoid the cross-contamination of bacterial conjunctivitis.
|Nursing Intervention of Conjunctivitis||Rationales|
|Assess visual acuity and monitor the signs of eye infection.||To establish patient’s baseline and monitor for any worsening of visual acuity or signs of eye infection.|
|Advise the patient to perform regular hand hygiene, avoid touching the affected eye, and limit close physical contact with others.||To reduce the risk of infecting other people at home or in the community.|
|Encourage proper eye hygiene by cleaning the eyelids with wet cloth, throwing away eye makeup and washing pillow / pillowcases that were used recently prior to having conjunctivitis. Avoid sharing of washcloths and towels.||To reduce the risk of infecting other people at home or in the community.|
|Teach the patient to self-administer eye drops on the affected eye while avoiding the medication’s tip from touching any part of the eye.||To avoid contaminating the eye drop container.|
Nursing Care Plan for Conjunctivitis 4
Nursing Diagnosis: Acute Pain related to inflammation of the conjunctiva secondary to conjunctivitis as evidenced by verbal complaints of soreness in the affected eye, blurry vision, and itching.
- The patient will report that the affected eye is feeling more comfortable.
- The patient will show increased activity levels and active engagement in required and desired activities.
|Nursing Intervention of Conjunctivitis||Rationale|
|Evaluate the severity of eye pain completely. Conduct an assessment to identify the features, length, recurrence, quality, and degree of pain. Assess the patient’s level of pain on a scale of 0 to 10.||The most accurate source of information concerning a patient’s discomfort is the patient themselves. Their ability to characterize the area, severity, and length of their pain makes their self-report the gold standard in pain evaluation. In order to develop the best pain management measures, the nurse does an interview to determine the patient’s level of discomfort. The 10-point pain scale is a widely used, precise, and useful method for measuring pain.|
|Determine the patient’s level of vision impairment and visual acuity||To develop a baseline evaluation of conjunctivitis’s impact on eyesight. Erythema and a colorless or mucous discharge are the typical symptoms of conjunctivitis. Loss of vision is uncommon, however, it could be distorted or blurred.|
|Check for indications of an ear infection.||Conjunctivitis and otitis media frequently co-infect one another, and their symptoms may overlap.|
|Get and keep track of the patient’s vital signs.||Establish a baseline and assist in identifying any systemic infections that may be present. Typically, conjunctivitis doesn’t start off feverish.|
|Promote effective eye hygiene by cleaning the eyes with a damp cloth, throwing away eye makeup, and switching out pillows and pillowcases that had recently been used before developing conjunctivitis. Tell the patient to apply a warm or cold compress to their eyes. Encourage the patient to only use their own washcloths and towels.||Keeping the area around the eyes clean and comfortable can both be achieved by wiping the eyelids with a damp cloth. Conjunctivitis can cause discomfort, which can be lessened by applying a cool or warm compress. In the event that the infection is thought to have been contracted while using eye makeup, replacement is also indicated. To prevent infecting the opposite eye, switch out the pillow and pillowcases.|
|While the eyes are closed, apply a saline solution to the corner of the eyelid and press for about three minutes.||To remove a sticky exudate from the border of the eyelid.|
|Administer medications as prescribed||Patients with conjunctivitis are given prescriptions for medications including antibiotics and analgesics in order to accelerate their recovery and prevent secondary viral conjunctivitis infections. Eye drops are used during the day to minimize the stickiness of the eyelids, and eye ointment is applied at night. Analgesics are used to reduce pain.|
|Within 30 to 60 minutes of giving the painkiller, have the patient rate their acute pain again.||A treatment’s effectiveness can be best evaluated by the patient’s pain rating.|
|Inform the patient about alternative pain management approaches, such as breathing exercises, relaxation techniques, and distraction tactics.||To minimize stress and encourage effective pain management without overly relying on pharmacological methods.|
|Encourage the patient to wear sunglasses, especially when outside.||To lessen glare and to protect the eyes.|
|Teach the patient how to self-administer eye drops to the affected eyes while avoiding contacting any area of the eye with the medication’s tip.||To protect the eye drop vial from contamination.|
|Encourage sufficient lighting in the patient’s location.||To encourage safety precautions and assist the patient in performing ADLs as well as possible.|
|Encourage the patient to refrain from wearing contact lenses as much as possible. It is advised to clean the lenses before use in those who wear hard lenses.||To prevent the spread of infection and irritation of the eyes.|
|If the patient’s eye pain gets worse, encourage them to attend follow-up appointments with an optometrist.||Monitor the progression of eye pain and treat it as needed. Conjunctivitis can result in corneal inflammation or keratitis.|
Nursing Care Plan for Conjunctivitis 5
Nursing Diagnosis: Deficient Knowledge related to lack of information about the disease process secondary to conjunctivitis as evidenced by incorrect information being verbally communicated and incorrect directions being followed.
- The patient will express their knowledge of the disease process, a potential treatment strategy, and any possible complications. Also, The patient will learn ways to avoid their symptoms getting worse.
- The patient will provide a list of services that can be accessed for more information or help upon recovery.
- The patient will demonstrate their capability to carry out procedures connected to reducing conjunctivitis symptoms.
|Nursing Intervention of Conjunctivitis||Rationale|
|To improve learning during health teaching, create an atmosphere where the patient and family are respected and trusted.||The foundation of a trustworthy relationship is consistency in behavior and speech, the patient’s capacity for sharing this understanding with others, and openness to new experiences|
|Observe the patient’s aptitude and openness to learning.||Self-care instruction must account for the physical, sensory, mobility, and psychosocial changes that come with aging.|
|Consider learning obstacles (e.g., perceived change in lifestyle, financial concerns, cultural patterns, lack of acceptance by peers or coworkers).||The patient contributes to the learning environment with their distinct personality, well-established social communication patterns, cultural beliefs and values, and lifestyle exposures.|
|Assess the patient’s prior knowledge of or abilities connected to conjunctivitis and the impact on willingness to learn.||Assimilation of new information may include bargaining, transformation, or stalling as it is integrated into prior hypotheses and facts.|
|Ensure that the patient’s sentiments and worries about earlier learning experiences are taken seriously.||The patient receives validation to know the nurse has listened and comprehended what has been communicated.|
|Engage patients in the writing process by asking them to specify the session’s learning objectives and what is most important to understand from their perspective and way of life.||The material is focused on objectives, which also serve as a venue for evaluation results and maintaining consistency. Patient participation enhances adherence to the health regimen and establishes a relationship between teaching and learning.|
|Make the patient as comfortable as possible physically.||This enables the patient to focus on the discussion or demonstration that is taking place. According to Maslow’s hierarchy of needs theory, patient education must come after basic physiological demands have been met.|
|Improve the patient’s literacy abilities through instruction.||Materials for patients with limited literacy skills should be concise and feature visuals that reflect their culture.|
|Share the information that is most important to the patient first, such as how to properly clean the eyes and how to administer eye drops for antibiotics or analgesics; provide further information once the patient’s most urgent educational requirements have been satisfied.||The process of developing information starts with the explanation of basic ideas and progresses to the explanation of challenging application scenarios.|
|Give the patient time to practice new abilities while giving prompt feedback on their performance.||This makes it possible for the patient to apply new information right away, improving retention. Instead of practicing the skill poorly, learners can make adjustments thanks to immediate feedback.|
|Determine the patient’s understanding of common medical terms such as “conjunctiva,” “pathogens,” and “sclera.”||Patients should comprehend and read pharmaceutical containers and product guide labels.|
|Analyze how easily the information in booklets or written instructions may be read.||Older persons’ apparent inability to follow new medication regimens may be due to physical restrictions, poor communication, and declining cognitive function.|
|Allow enough time for implementation that is indirectly opposed to established values or ideas.||Information that directly contradicts previously held beliefs necessitate a reassessment of the prior knowledge and are therefore absorbed more slowly.|
|Determine whether the patient’s family is willing to adopt new knowledge, practice good hygiene, and medical treatment, and observe proper hand washing techniques.||Family adjustment elements and social and relationship support need to receive attention since they have a higher success rate than modification alone.|
|Throughout multiple quick sessions, reiterate and reinforce the knowledge.||Learning new things requires an understanding of previous knowledge. Focus is placed on important material during condensed sessions.|
|Keep track of the teaching and learning process.||This enables further instruction to be based on the learner’s accomplishments, improving the learner’s sense of self-efficacy and promoting the most economical form of instruction.|
Nursing Care Plan for Conjunctivitis 6
Risk for Ineffective Therapeutic Regimen
Nursing Diagnosis: Risk for Ineffective Therapeutic Regimen related to visual problem secondary to conjunctivitis.
- The patient will demonstrate proper self-care techniques for conjunctivitis.
- The patient will express understanding of the conjunctivitis disease process and appropriate therapeutic regimen.
- The patient will appropriately carry out the necessary steps and provide justifications for their decision.
|Nursing Intervention of Conjunctivitis||Rationale|
|Examine any relevant circumstances that might have an impact on how well the treatment regimen will be implemented.||Understanding the potential contributing elements gives direction for an immediate follow-up intervention. This can include both physical and financial limits.|
|Analyze the patient’s prior efforts to adhere to a regimen.||Understanding any difficulties with treatment plan implementation can be greatly aided by this information.|
|Evaluate each patient’s personal perceptions of their health.||The Health Belief Model states that a patient’s adherence to the regimen is influenced by their perception of their vulnerability to, the seriousness of, and the threat from sickness.|
|In order to do the required behavior, determine the patient’s confidence in performing a skill.||Performance and successful outcomes are correlated with a positive belief that one can successfully carry out an action.|
|Conjunctivitis symptoms, causes, treatments, and prevention should be determined and ensured to be known by the patient.||The need to review therapy management is indicated by infection recurrence.|
|Determine the patient’s capacity comprehension or be aware of the desired health-related action.||It is important to identify cognitive deficiencies so that an appropriate alternative strategy can be created. Alternative measures can be taken when problems are classified.|
|Give a concise description of the treatment plan.||Some patients may find it overwhelming and challenging to follow instructions for conjunctivitis therapy.|
|Encourage patient involvement in the development of the treatment strategy.||The likelihood of a successful outcome is higher for patients who actively participate in their care.|
|Explain to the patient the benefits of complying with the advised regimen.||Patients who comprehend the efficacy of the recommended treatment to minimize risk or increase health are more inclined to use it.|
|In a clear and patient-friendly manner, explain the regimen to the patient. Offer long-acting drugs and stop taking those that are not necessary.||If prescriptions have to be taken many times each day, patients are more prone to disregard them.|
|Adopt a lifestyle-based approach to therapy.||This strategy increases compliance. It rarely works to apply a “one size fits all” approach.|
|Together with the patient, devise a system for rewarding effective follow-through.||Verbal praise, gifts, special privileges (such as free parking or an earlier appointment with the doctor), or phone calls are all examples of rewards.|
|Create a system that will allow the patient to monitor their own development.||An effective behavioral change requires careful self-monitoring.|
|Describe to the patient how side effects or unwanted side effects of the therapy can be controlled or avoided.||This determines if something needs to be revised.|
|Concentrate on the action that will have the biggest impact on the patient’s therapeutic outcome.||It is never easy to modify behavior. Activities that are known to provide a particular advantage should receive the majority of the patient’s attention.|
|Assess the patient’s financial capacity to pay for medical care.||Patients with limited financial means may encounter obstacles due to the expense of their medications and the supplies needed for the treatment of conjunctivitis.|
|If the patient doesn’t have enough assistance during the course of the recommended treatment, initiate the referral process to a support group.||Groups that work together for mutual support and expertise can be beneficial.|
|Include close friends and family in making explanations and giving instructions. Encourage their cooperation and help in carrying out plans.||Engaging significant others encourages support and aid in reinforcing healthy habits and fostering lifestyle modification.|
More Nursing Diagnosis for Conjunctivitis
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon
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