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Gero Exam 1 > CH 23: Vision and Hearing > Flashcards

CH 23: Vision and Hearing Flashcards

1
Q

effects of aging on vision

A
  • Reduced elasticity and stiffening of muscle fibers in lens  decreased ability to focus  presbyopia  increased use of corrective lenses
  • Reduced pupil size, opacification of lens and vitreous, loss of photoreceptor cells in retina  decline in visual acuity
  • Light perception threshold decreases  difficult with vision at night
  • Cataract formation  Sensitivity to glare
  • Cells in retina are less sensitive distorting blue and green tones
  • Smaller visual fields  reduced peripheral vision
  • Decreased tear production  dry eyes
  • Changes in depth perception  ability to judge height of walking surfaces challenging
  • Impaired communication  changes in vision
  • Increase prevalence of blindness (diabetes, catiracs, macular)
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2
Q

older adults less likely to see things up close

A

presbiopia

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3
Q

effects of aging on hearing

A

Sensorineural hearing loss (presbycusis)  decreased ability to hear s, sh, f, ph, and w & inaudible speech
Impacted cerumen  decreased hearing
Decreased hearing  impaired communication and social isolation

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4
Q

conductive hearing loss

A

something blocking hearing on the outside
- wax
-

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5
Q

sensoneuronal

A

something from the brain causing hearing loss
- tumors
-ototoxicity

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6
Q

age related hearing loss

A

presbycusis

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7
Q

how to promote vision with older adults

A
  • Significant issues should be recognized early to prevent visual damage
  • Routine, thorough annual eye exams
  • Nurse can assess financial ability to afford visual care items
  • Prompt evaluation for significant problems
  • Ensure diet of vit A,B,C,E; zinc, flavonoid**
  • Manage diseases causing vision issues (diabetes and hypertension)
  • Implement techniques to maximize sensory functioning
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8
Q

how to promote hearing with older adults

A
  • start teaching them early in life
    Good care of ears throughout life
  • Prevention of trauma to ear
  • Prompt treatment for ear infections
  • Regular audiometric exams
  • Protect exposure from loud noise using ear-plugs or sound-reducing devices
    Cerumen removal via irrigation - positioning, warm water
  • avoid cotton tip applicators and their friends
  • fall precautions for potential
  • assistance for irrigation
  • don’t continuously irrigate - perforation of eardrum
  • implement techniques to maximize sensory functioning**
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9
Q

clouding of the lens from calcium deposits
leading cause of low vision in older adults

A

cataract

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10
Q

clear sign of cataracts**

A

blurred vision

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11
Q

causes of cataracts

A

exposure of UVB-B light, diabetes, cigarettes, alcohol use, eye injury

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12
Q

S/S of cataracts

A

no pain, decreased night vision, glare from sunlight, nuclear sclerosis (lens becomes yellow or yellow-brown), pupil changes to cloudy white, increased nearsightedness

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13
Q

ONLY treatment for cataracts**

A

surgery is the only cure
only one eye at a time (4-6 wks recovery)

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14
Q

increased intraocular pressure
second leading cause of blindness

A

glaucoma

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15
Q

demographics for glaucoma

A

Increases in prevalence with age,
ethnicity (African Americans and Hispanic/Latino), endocrine imbalance (diabetes)
family history
anticholinergic meds - increase intraocular

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16
Q

acute glaucoma vs chronic glaucoma

A

acute (narrow-angle)
- more severe
- vision loss in hours - EMERGENT
- eye pain
- N/V/HA/eyebrow pain**
- usually from trauma
- IOP: >30
- treatment: mannitol
chronic (open angle)
- no pain**
- loss of peripheral vision**
- more gradual
- IOP: 20s
- treatment: prostaglandins, sx

17
Q

normal intraocular pressure

A

10-20

18
Q

activities to avoid to prevent glaucoma

A
  • sneezing/ coughing
    -bending over
  • heavy lifting
19
Q

nursing considerations for glaucoma

A

Avoid activities that increase IOP
Wear a medical alert bracelet
Barriers to treatment leading to lack of adherence
Vision loss cannot be restored
Periodic ophthalmologist eval

20
Q

tonometry testing

A

air test for IOP

21
Q

Most common cause of blindness >65 years old
Damage of macula  Central vision loss

A

macular degeneration = central vision

22
Q

interventions for macular degeneration

A

use of magnifying glasses, reading lamps, and other aids

23
Q

s of macular degeneration

A

whole in the vision

24
Q

Forward displacement of retina from its normal position

A

detached retina

25
Q

s of detached retina

A

floating spots
curtain over the eye

26
Q

treatment for detached retina

A

bedrest, bilateral eye patches, prompt treatment, frequent checks, safety precautions; surgery

27
Q

Inflammation of the cornea; caused by febrile states, irritation, dietary deficiencies, CVA, lowered resistance

A

corneal ulcer

28
Q

causes of corneal ulcers

A

bloodshot eye, increased lacrimation, photophobia
tears

29
Q

treatment of corneal ulcers

A

Early care with cycloplegics (resting the eye)
sedatives, antibiotics, and heat; sunglasses, treat underlying cause (foreign body, abrasion, infection)

30
Q

measures to compensate for visual deficits

A
  • Face the person when speaking
  • With glaucoma, come to the person from the front
  • Exaggerate facial expressions and gestures
  • Use several soft indirect lights instead of one
  • Avoid glare from windows using sheer curtains/stained windows
  • Use large print reading material
  • Place frequently used items in the visual field
  • Avoid low-tone colors and use bright-toned colors
  • Use contrasting, bold colors
  • Identify personal belongings differently
31
Q

hearing deficits and older adults

A

very common
NOT a normal part of aging - underlying cause
higher incidence in MEN with loud occupations
tinnitus

32
Q

causes of hearing deficits

A

ototoxic drugs (aspirin, ibuprofen, naproxen, Lasix, -mycins)**
diseases
otosclerosis
vascular problems
viral infections
otitis media
neoplasms
cysts
cerumen - ear wax
dermatoses
exposure to loud noise

33
Q

nursing considerations for hearing problems

A
  • Audiometric examination
  • Prepare for anger, frustration, impatience, confusion during conversation, inappropriate reactions, social isolation, limited ability to hear danger  help with coping strategies
  • Place near nurses’ station -
  • Provide education in written form
  • NEVER purchase a hearing aid without consulting an otologist
  • Hearing aids
34
Q

use of hearing aids

A
  • Help to improve, not restore hearing to normal level
  • Speech is amplified and all environmental noise
  • Checked regularly
  • Hearing aid care
  • Connect with hearing and speech associations
35
Q

general nursing considerations for vision and hearing loss

A

Stimulate all senses during routine daily activities
Face the individual while speaking and exaggerate gestures and facial expressions
For peripheral vision loss, approach them from the front rater the side
Ample lighting
Use large print games, playing cards, and telephone dials

36
Q

nursing considerations for high-frequency hearing loss

A

high: talk slowly, distinctly
low-frequency voice; raising the voice/shouting can raise frequency and make hearing worse

37
Q

how to improve communication with loss of hearing/vision

A

Talk into the less impaired ear
face the individual when talking
use visual speech (sign language)
allow person to lip read
use a stethoscope
use flashcards and communication boards

Gero Exam 1 (9 decks)

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