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NU 340 > Ch. 39 > Flashcards

Ch. 39 Flashcards

1
Q

aging eye characterisitcs

A
  • iris fades
  • cornea less sensitive
  • pupil shrinks
  • lens becomes yellowed, cloudy
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2
Q

four eye functions

A
  1. refraction
  2. pupillary constriction
  3. accommodation
  4. convergence
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3
Q

refraction

A

bends light rays from the outside into the eye through curved surfaces and refractive media and finally to the retina

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4
Q

pupillary constriction

A

aka miosis
- controls the amount of light that enters the eye
- when the level of light to one or both eyes is increased, both pupils constrict (smaller)
- certain drugs can alter pupillary constriction

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5
Q

accomodation

A

the process of maintaining a clear visual image when the gaze is shifted from a distant to a near object
- healthy eyes can adjust its focus by changing the curve of the lens

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6
Q

convergence

A

the ability to turn both eyes inward toward the nose at the same time
- helps to ensure that only a single image of close objects is seen

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7
Q

refractory errors

A
  • myopia- nearsightedness
  • hyperopia- farsightedness
  • presbyopia- age-related problem which lens loses its elasticity
  • astigmatism- curve of the cornea is uneven
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8
Q

myopia

A

nearsightedness

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9
Q

hyperopia

A

farsightedness

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10
Q

presbyopia

A

age-related problem which lens loses its elasticity

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11
Q

astigmatism

A

curve of the cornea is uneven

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12
Q

non-surgical corrections for refractive errors

A
  • corrective glasses
  • contact lenses
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13
Q

surgical corrections for refractive errors

A
  • refractive surgery
  • intraocular lens implantation
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14
Q

age-related eye changes

A
  • reduced visual acuity
  • reduced visual function
  • structural changes: decreased eye muscle tone, ectropion and dry eye, arcus senilis
  • functional changes: near point of vision increases (presbyopia), far point of vision decreases
  • general color perception decreases
  • higher IOP
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15
Q

all adults should be screened _____ for visual acuity

A

annually

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16
Q

functional age-related eye changes

A
  • near point of vision increases (presbyopia)
  • far point of vision decreases
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17
Q

structural age-related eye changes

A
  • decreased eye muscle tone
  • ectropion and dry eye
  • arcus senilis
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18
Q

reduced vision interventions

A
  • communication regarding use of adaptive devices
  • safety in familiar settings
  • ambulation assisted with care
  • self-care and independence promoted
  • support for the difficulty of adapting to loss of sight
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19
Q

health promotion and maintenance

A
  • impairment of vision impacts physical and psychological well-being
  • many vision and eye problems can be avoided
  • educate about eye protection methods
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20
Q

eye protection methods

A
  • adequate nutrition, vitamins
  • regular eye exams
  • use of sunglasses
  • use of eye and head protection
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21
Q

conjunctivitis: what infections can cause it

A
  • bacterial infections
  • chlamydial infections (STD)
  • allergic infections
  • COVID-19
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22
Q

cataracts: etiology

A
  • may be present at birth
  • or develop over time
  • most common age related type change
  • also may be due to trauma or other health conditions
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23
Q

cataracts: pathophysiology

A

clouding and blurring of the lens distorts the image and color projected onto the retina
- visual acuity is restricted

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24
Q

cataracts: clinical manifestations

A
  • cloudy lens
  • no pain or eye redness is associated with age-related cataracts
  • blurry vision
  • decreased color perception
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25
Q

cataracts: assessments

A
  • gradual onset
  • eye dr follows
  • occurs with increased age
  • obtain thorough medical hx
  • physical assessment: blurred vision, decreased color perception, difficulty seeing at night
  • psychosocial assessment (could be depression as a result of losing independence)
26
Q

cataracts: diagnostic studies

A

done by MD

27
Q

cataracts: collaborative care

A
  • nonsurgical therapy
  • surgical therapy
28
Q

nonsurgical therapy of cataracts

A
  • avoid heavy sun or UV light exposure
  • wear sunglasses
  • wear eye and head protection
  • stop smoking
29
Q

as the cataract matures, ___ makes it difficult to see the retina

A

opacity

30
Q

collaborative management of cataracts: preoperative

A
  • educate patient that surgery is done as an outpatient
  • ask patients if they are on any blood clotting meds such as aspirin, clopidogrel, or anticoagulants (ie. warfarin)
  • educate about use of eye drops several times/day both before and after surgery
    • will someone be able to do that for them if they cannot do it by themself
31
Q

collaborative management of cataracts: education

A
  • discharged 1-2hrs after
  • light eye patch, dark glasses
  • avoid water in the eye
  • eye drops
  • next day follow-up appt (need driver)
  • s/sx to report (mild itching is normal, blurry vision initially is normal; should not be having any pain, moderate/purulent drainage)
32
Q

collaborative management of cataracts: postoperative

A
  • antibiotics are given subconjunctivally
  • eye is unpatched. discharge usually within 1hr with dark glasses
  • instill antibiotic-steroid eyedrops
  • mild itching is normal
  • pain indicates a complication
  • reduce IOP
  • prevent infection
  • assess for bleeding
33
Q

cataracts: health teaching

A
  • signs of complications
  • avoid activities that might increase IOP
    • no heavy lifting
    • no bouncing around
    • try to sneeze/cough/blow nose gently
  • review procedure for use of eyedrops
    • wash hands 1st!
    • patient look up at ceiling, head tilted back
    • pull down conjunctival sac to put drop into corner of eye
    • cant give steroid and antibiotic drops back to back- wait 5 minutes (will be diluted if not given time to absorb)
34
Q

signs of complications post-op cataract surgery

A
  • sudden, sharp pain in eye
  • bleeding or increased discharge
  • lid swelling
  • decreased vision
  • flashes of light or floating shapes
35
Q

cryopexy

A

the doctor uses a specially designed probe that applies intense cold therapy to the back wall of the eye (sclera/retina) in order to create a scar tissue around the retinal tear
- used to repair retinal tear/detachment

36
Q

laser photocoagulation

A

eye surgery using a laser to shrink or destroy abnormal structures in the retina, or to intentionally cause scarring
- used to repair retinal tear/detachment

37
Q

age-related macular degeneration: etiology

A
  • leading cause of blindness in adults over 65 years
  • age related macular degeneration
  • two types: dry (more common) and wet
38
Q

age-related macular degeneration: pathophysiology

A
  • blockage in the retinal capillaries
  • blood and oxygen cant get to macula, causing degeneration
39
Q

age-related macular degeneration: clinical manifestations

A
  • blurry vision
  • loss of central vision (cant see directly in front of them, can only see peripherally)
40
Q

age-related macular degeneration: collaborative care/treatment

A
  • treatment focuses on slowing the process (laser surgery, intraocular injections)
  • NO CURE
41
Q

glaucoma: etiology

A
  • African-Americans over 40 years old
  • increased age: any individual over 60 years old (esp. Mexican Americans)
  • family history of glaucoma
  • adults with high BP
  • adults with corneal thinness
  • adults with optic nerve abnormality
  • gradual onset
  • common cause of blindness
42
Q

glaucoma: pathophysiology

A
  • increased ocular pressure
  • cupping and atrophy of optic disc
43
Q

glaucoma: primary open-angle

A
  • most common
  • asymptomatic early stages
  • loss of peripheral vision with progression
44
Q

glaucoma: angle-closure

A
  • sudden visual loss
  • pain
  • conjunctival erythema
  • corneal edema
45
Q

glaucoma: clinical manifestations/symptoms

A
  • headache or brow pain
  • N/V
  • colored halos around lights
  • sudden blurred vision with decreased light perception
46
Q

priority collaborative problems for patients with glaucoma

A
  • decreased visual acuity due to glaucoma
  • need for health teaching due to treatment regimen of glaucoma
47
Q

purpose of glaucoma drug therapy

A

goal is to decrease IOP
- constrict the pupil
- reduce production or increase absorption of aqueous humor

48
Q

patient teaching plan for glaucoma drug therapy

A
  • how eyedrops work
  • how to administer eyedrops
  • monitor for side effects (check if on BP med eye drop, that their BP/HR does not drop too low)
  • compliance, timely dosing
49
Q

conjunctivitis treatment options

A
  • antibiotic ointment
  • antibiotic eyedrops
50
Q

how to prevent spread of conjunctivitis

A
  • not sharing things that come in contact with the infected eyes (ie. towels)
51
Q

retinal holes, tears, and detachments are often caused by ___

A

often caused by posterior vitreous detachment

52
Q

retinal holes, tears, and detachments: assessment

A
  • sudden onset in 1 eye
  • painless
  • bright flashes of light or floating dark spots
53
Q

retinal holes, tears, and detachments: interventions

A
  • laser photocoagulation & cryopexy
  • surgical repair
54
Q

glaucoma: secondary

A

results from another health condition

55
Q

glaucoma: diagnostic methods

A
  • use machine to look at IOP
  • look at lens
  • look at macula
56
Q

what would the RX be for a patient diagnosed with glaucoma

A

lifelong eye drops to reduce IOP

57
Q

glaucoma drug therapy- table 39.1

A
  • prostaglandin agonists: latanoprost
  • adrenergic agonists: bromonidine
  • beta-adrenergic blockers: timolol maleate
  • cholinergic agonists: pilocarpine
  • carbonic anhydrase inhibitors: dorzolamide
58
Q

what needs to be done before administering a beta blocker (ie timolol)?

A

BP & HR
-don’t give if BP and HR are low/below normal because the drugs will only decrease HR/BP more

59
Q

glaucoma: care coordination and transition management

A
  • instill eyedrops regularly
  • follow-up every 1-3 months or as directed
  • good handwashing
  • keep tip of eyedrops clean
  • s/sx of choroidal detachment and hemorrhage
  • referrals
60
Q

arcus senilis

A
  • does not affect vision
  • has to do with fatty deposits in the eye (ring around outer cornea of eye)

NU 340 (26 decks)

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