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Health Assessment > Ch 13: Eye Assessment For Adv Practice And Specialty Practice > Flashcards

Ch 13: Eye Assessment For Adv Practice And Specialty Practice Flashcards

1
Q

What is the sensory organ of sight and where is it located

A

The eyes is a sensory organ of sight located within the skull

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2
Q

What’s the purpose of the orbital socket and what is its diameter

A

The orbital socket protects the complex internal eye structure (the sides and back of eye)

Diameter is 1 inch(2.5 cm) 

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3
Q

What is the purpose of the extraocular structures

A

Support and protect the eyeball

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4
Q

How do the loose in mobile eyelids support and protect the eye

(4 ways )

Main function
Protects from
Regulate
Distribute

A
  1. Cover eye
  2. Protect the foreign bodies
  3. Regulate light
  4. Distribute tears
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5
Q

What is the Palpebral Fissure (shape)

What does the upper palpebral fissure cover
what does a lower palpebral fissure cover

A

The pulp Pepper Fisher is the almond shape between eyelids

Upper palpebral fissure covers upper Eye

Lower palpebral fissure covers margin at limbus (outline of eye) 

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6
Q

Other than being the outline of the eye where exactly is the limbus also known as the lid margins

A

Limbus is the border between the cornea and sclera

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7
Q

What is the normal color of conjunctiva and if there is a conjunctiva infection what is it typically referred to as 

A

Normal conjunctiva color: clear

If infected conjunctiva: “pink eye”
- baceterial or viral 

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8
Q

What exactly is the sclera

A

The thin mucous membrane that lines the eye

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9
Q

What is the medical name for an eyelid infection/inflammation And how does it appear



A

Blepharitis

Will appear red swollen with drainage

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10
Q

What is the purpose of the lacrimal punctum and where is the lacrimal apparatus position

A

The lacrimal punctum distributes tears

Lacrimal apparatus located on the inner corner of the eye

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11
Q

When doing an assessment what cranial nerves are you testing and what is their specific function

A

CN2,3,4,6
2 (optic): visual acuity

3(ocular motor): cardinal feilds of gaze
Accomodation
Pupil rxn PERRLA

4(trochlear): cardial feilds of gaze

6(abducens): cardinal fields of gaze

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12
Q

What cranial nerve test for PERRLA and what does PERRLA stand for 

A

Cranial nerve 3( ocular motor) test for PERRLA

Pupils equal round reactive to light accommodation


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13
Q

What are the cranial nerves you test when doing extraocular movements EOM

What are the functions of the cranial nerves you’re testing ( what do they innervate)

Differentiate the normal V abnormal movement findings

A

Your testing cranial nerves 3,4,6

Function: innovate and control Eye motor nerve activity

norm: SMOOTH
Abnorm: nyastagmus

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14
Q

What are the three layers of tissue for the eye and give its components

A
  1.  outer
    - sclera and cornea
  2. middle (vascular)
    - Iris, ciliary body, choroids
  3. Retina
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15
Q

Give the three chambers of the eye and describe the last and most important chamber

A
  1. Anterior chamber
    - holds aqueous humor
  2. Posterior chamber
    - between Iris and lens
  3. Vitreous chamber
    - largest chamber filled with vitreous humor (Gel) that holds The retina in place and maintains eye shape
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16
Q

What does the retina receive and transmit to the brain

what are the three most important components its made of (use for sight)

A

The retina receives and transmits visual stimuli to brain

Made of:

  • Photo receptors
  • rods : Low light vison , black and white
  • cones: bright light, color image, fine sharp detail
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17
Q

What is in greatest concentration in the macula

A

Greatest cone concentration

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18
Q

What is the optic discs purpose and what cranial nerve sit here

A

Optic disc is the opening for the optic nerve this is where cranel nerve 2 (OCULAR) sits

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19
Q

Give the pathway of vision

5 step process

A
  1. light enters cornea
  2. Light bent onto Central Fovea
  3. light reflected inverted reversed, FOCUSED to retina
  4. Image communicated through the visual pathway
  5. Is image returns to normal form in brain
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20
Q

What are the parts of the neural pathway and what is the bigger structure or system it is part of

A

Optic nerve, optic Chiasm, optic tract
(Into cerbral cortex)

The neural pathway is part of the CNS



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21
Q

What are abnormal findings for older adults in relation to vision

1 is a disease

A

Photophobia: light sensitivity

Cataracts: opaque white color IN PUPIL

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22
Q

What are a few common considerations for older adults

Where the eyes sits, eyebrows
Conjunctiva
Iris piggemtation
Tear formation
Visual accuity 
Night and depth perception and how 
Lense (glare and peripheral vision) 
Up close vision
A
  • Eyes sits deeper(sinks in) , brows thin
  • Conjunctiva becomes yellowish/thins
  • ARCUS SENILLUS: blue/ white limbus circle around iris
  • decreased tear formation
  • decreased visual acuity
  • decrease night vision and death perception due to smaller pupils leading to loss of accommodation

Lens enlarges causing decreased glare tolerance and decreased peripheral vision

Presbyopia common after 40 need bifocals! 


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23
Q

What is a normal finding arcus senillis or Cataracts

A

Arcus senillus : White/blue limbus ring around Iris is a normal finding

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24
Q

What’s a normal finding glare

Intolerance or light intolerance

A

 glare intolerance is a normal finding because of an enlarged lens

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25
Q

What is common to see in pregnant women in relation to their eyes

Moisture of eye
Accomodation
Pigmentation of skin 

A

Pregnant women have dry eyes

Loss of accommodation because of increased corneal curvature

Chloasma melasma

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26
Q

In an infant of three months what is something that they can do with their eyes

A

Infants contract objects and react to light

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27
Q

When doing a comprehensive physical exam of the eyes what three components are you testing

A

Visual security
PERRLA
EOM

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28
Q

We’re doing an urgent assessment what are you treating

What is an urgent assessment followed up by

A

You were treating the emergency

Urgent assessment followed up by comprehensive assessment

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29
Q

What characteristic of vision loss makes for an urgent assessment

A

Sudden vision loss requires urgent assessment 

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30
Q

If you get an eye trauma what is the number one thing that will threaten Eye function

A

A time delay of seeking care will threaten I function

31
Q

What are the types of traumas you can get in the eye and give an example

(Five)

A

Mechanical
-Blunt force/penetrating

Thermal

  • burn
  • USE NS

Radiation
-Uv

Chemical
-USE NS

Electrical

32
Q

What is a florescein exam for in relation to eye issues

A

A flourescein exam uses drops and UV light to assess for any abrasions or lacerations

33
Q

What is the medical term for blood in eye

If a patient has blood in eye what position is vital for them to maintain

A

Hyphema = blood in eye

It is vital to maintain high Fowlers position

34
Q

What kind of glaucoma is a medical emergency, describe it

Give a few signs and symptoms

A

Acute glaucoma which is blockage of fluid can lead to permanent vision loss

Signs and symptoms:
Blurry vision
Rainbows around lights

35
Q

If someone has a penetrating trauma what do you not want to do

If someone has a penetrating trauma or suspected fracture to orbital bone what does it mean

A

If there is a penetrating trauma you do not wanna take out object, stabilize it instead

A penetrating trauma or suspected orbital bone fracture =emergency

36
Q

When collecting subjective data what is important information to get

Eyes history
Glasses or occupation
Nutrition
Fam history

A

Eyes: 

  • any existing conditions
  • Eye surgeries

Glasses or occupation

  • corrective lenses?
  • Eye protection if occupation needs it

Any good diet

Any family history of
-myopia: nearsighted
-hyperopia: far sighted


37
Q

What are foods that help with vision

A

Deep water fish

Fruits

Vegetables
-carrots and spinach

Hydration

38
Q

What viruses if exposed young can cause neonatal blindness

A

Rubella and Congenital syphilis

39
Q

If a patient is diabetic what do you wanna ensure in relation to their eye health and DM and why

What are some risks

A

Ensure DM is being treated and monitored because of the risk of developing eye conditions

Diabetic retinopathy, cataracts, glaucoma

40
Q

Can toxins chemicals or stress increase vision problems

A



Yes

41
Q

 if a patient presents with Eye pain what is it classified as

If a patient presents with sudden vision changes what is it classified as

How do you know to suspect retinal detachment

A

1Emergency

2.
Emergeny

  1. If patient is seeing Blind spot, halos, floaters suspect retinal detachment
42
Q

What things can impact activities of daily living in relation to the eye

How many times you see of things and what is common among preg women

A

Diplopia And dry eye can change activities of daily living

43
Q

What do you want to assess for if a newborn lacks tears

A

If a newborn lacks tears assess for a blocked lacrimal apparatus

44
Q

What are cultural considerations to keep in mind when it comes to they eyes and their external appearance 

A

Eye color
Eye shape
Eyebrow shape

45
Q

Do we use abbreviations for each I and if not why do we not

A

We no longer use abbreviations for eyes we physically write out “right eye” because of errors

46
Q

When is it important to wear gloves when assessing the eyes

A

When a patient has
-blepharitis
-conjunctivitis


47
Q

When you’re assessing using the snellen test how far does a patient stand away from the chart

What is perfect vision

What does 20/60 mean 
(Numerator/denominator/both)

How do you note if a patient is having difficulty reading

What glasses must you remove for the exam

How do you document if a patient missed two letters in one line

What vision is considered legally blind

A
  • When doing a Snellen test patient stand 20 feet away from chart
  • 20/20 = perfect

-20 N= 20 ft /60 D= what patient can read
• together 20/60 means patient can read at 60 feet what normal I can read at 20

  • difficulty reading if leaning or squinting
  • Reading glasses must be removed for snellen

-if two letters missed 20/60-2

-Legally blind= 20/200

48
Q

When a patient is using an Allen test how far away do they stand from the chart and who is the Allen test for

 what does the allen test consist of

A

Patient stands 15 feet away from chart,
Patient is a child

Allen test  Consists of pictures

49
Q

When using the culture E test What is a good patient to use it on and how do they express their answer

A

Culture E tests are good to use on those who do not speak your language and the express answer by pointing in direction of E 

50
Q

What do the jaegar and Rosenbaum charts test for and how close

If you don’t have either test what can you use

A

Test for near vision 14 inches

If neither chess available you can use newspaper

51
Q

What is an ishaharas card test for

What is a patient looking for on the Ishihara‘s card

A

Test color blindness

Patient is looking to identify embedded figure

52
Q

Describe the static confrontation test

A

Static confrontation is presenting a number of fingers to each vision field assessing for differnces

53
Q

Describe the kinetic confrontation assessment and what assesses

A

Kinetic confrontation= peripheral vision

Patient will tell you when they notice fingers wiggling into peripheral vision

54
Q

What is vital to ensure regarding the nurse when doing field of vision exams a.k.a. confrontation exams

A

It’s important to ensure the nurse has normal field of vision to do exam

55
Q

What are normal and abnormal findings for the corneal light reflex and how do tou document normal

A

Normal: twinkle in Each eye is bilaterally symmetrical

Document :” cornea reflects light equally)

Abnormal: strabismus (crossed eyes) not aligned

56
Q

When doing the Cardinal Fields of gaze what are normal and abnormal findings

A

Norm: smooth movement

Abnorm: nystagmus jerky movements or strabismus 

57
Q

We’re doing a comprehensive physical eye exam give the components of exams in relation to the cranial nerves

A

Visual accuity: CN2

PERRLA: CN3

EOM: CN 3,4,6

58
Q

We’re doing the confrontation tests and patient covers left I what I do you cover and where do you tell them to look

A

If patient covers left a You cover right eye tell them to look at you not your fingers and say the number they see

59
Q

What nerve are you testing for when doing accommodation and convergence and how do you perform assessment

A

Accommodation and convergence assesses CN 3

Accomodation: have patient look at for object for 30 seconds then your pen light -distance =dilate
-close= constrict

Convergence: move pen close to patient and watch a Wyze come together

60
Q

In sclera what is a condition you can notice for a patient with heavy UV exposure

A

Ptyregium

61
Q

What can hypertension cause in relation to the conjunctiva

A

Hypertension can cause sub conjunctival bleeding

62
Q

What are a few things you note when assessing sclera cornea and lens

A

Color, any swelling, exudate, foreign bodies any lesions

63
Q

When assessing the lacrimal apparatus what do you want to assess for

A

Assess the punctum and for any tenderness

64
Q

What is an ophthalmoscope used for

A

To assess the internal structures of the eye

65
Q

What is normal findings V abnormal findings for the red reflex test

A

Normal: a red reflection on pupil

Abnormal: white (retinal blastoma)
. No red (Retinal detachment)

66
Q

What are mydriatic drops

A

Dilation drops

67
Q

What are miotic drops

A

Constriction drops

68
Q

What are the leading cause of blindness in the US

A

Cataracts and macular degeneration

69
Q

When assessing an older adults eyes with dementia what are a few strategies you can use

A

Go slow
Go step-by-step
Give clear precise directions

70
Q

What ethnic backgrounds are glaucoma more prevalent in

A

Hispanics in African-Americans

71
Q

What are few nursing outcomes(goals) in relation to the eyes

A

Patient will remain safe in home

Patient will state measures to reduce risk of visual loss

72
Q

Give a few nursing interventions that can be used in relation to the eye

A

Keep furniture at a pathway
Keep chords against wolves
Remove carpet
Ensure access to eyeglasses or magnifiers

73
Q

Give to nursing diagnosis one actual and potential for the eyes

A

Actual: disturbed sensory perception/reception

Potential: risk for injury related to impaired vision

Health Assessment (20 decks)

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