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Med Surg 2 > Ch 42 > Flashcards

Ch 42 Flashcards

1
Q

Emmetropia

A

Normal vision
Light rays are bent to focus images precisely on the retina

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2
Q

Myopia

A

Nearsightedness
People may hold things close to their eyes to see them well

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3
Q

Hyperopia

A

Farsightedness. People see objects far away better than objects that are close

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4
Q

Light doesn’t get to the retina in this condition

A

Myopia

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5
Q

Light goes beyond the retina in this condition

A

Hyperopia

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6
Q

Is associated with aging & results in difficulty with near vision

A

Presbyopia

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7
Q

A visual distortion caused by an irregularly shaped cornea

A

Astigmatism

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8
Q

People with ___ errors experience blurred vision. Some seek help for recurrent headaches caused by straining to see clearly

A

Refractive

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9
Q

Refractive errors are detected with the __ & __

A

Snellen & jaeger charts

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10
Q

___ usually are corrected with eyeglasses or contact lenses. The lenses bend light rays to compensate for the __

A

Refractive error x2

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11
Q

Definitions related to low vision refer to the ___

A

Best corrected visual acuity (BCVA)

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12
Q

Legal term for a BCVA of 20/200 or less even with corrective lenses

A

Blindness

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13
Q

___ is used to describe BCVA between 20/60 and 20/200 in the better eye with the use of glasses

A

Visually impaired

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14
Q

BCVA 20/400 to no light perception

A

Severe loss of visual field, also referred to as blind

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15
Q

___ can be congenital or caused by injury: a high fever that damages the optic nerve

A

Blindness

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16
Q

Diplopia

A

Double vision

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17
Q

Described as feeling gritty. There is tearing & the pt usually tries to relieve discomfort by squeezing eyelids closed to help control eye movement & reduce light from entering eye.

A

Eye trauma

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18
Q

During an eye injury, If the bony orbit is fractured, the eyes may appear __, and the pt has __

A

Asymmetrical
Diplopia (double vision)

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19
Q

Staining the surface with fluorescein dye identifies a minute foreign body or abrasion to the cornea

A

Diagnostic finding for eye trauma

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20
Q

Two types of ocular trauma that require quick responses

A

Chemical burns & foreign objects in the eye

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21
Q

Inflammation of the conjunctiva. Commonly called pinkeye because the inflammation of the subconjunctival blood vessels are more visible causing a reddish or pink appearance

A

Conjunctivitis

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22
Q

Results from a bacterial, viral or rickettsial infection and can affect one or both eyes

A

Conjunctivitis

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23
Q

In conjunctivitis the microorganism most often are introduced by ___ transmission, ___ with sources on the fingers, a contaminated face towel or washcloth

A

Air transmission
Direct contact

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24
Q

Untreated conjunctivitis, especially when caused by ___ and __ can lead to blindness

A

Neisseria gonorrhoeae
Chlamydia trachomatis

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25
Q

Clients may complain of photophobia in this condition

A

Conjunctivitis

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26
Q

In conjunctivitis a __ can identify the causative microorganism

A

C&S

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27
Q

Medical management for conjunctivitis

A

Warm soaks

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28
Q

Inflammation of the uveal tract, which consists of the iris, ciliary, body, and choroid

A

Uveitis

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29
Q

The causes of uveitis is not always identified, but one of the following may be the cause:

A

Eye injury or surgery
Infections or cancers such as lymphoma

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30
Q

Although the disorder occurs randomly, it is detected with some frequency among clients with juvenile RA, ankylosing spondylitis, TB and toxoplasmosis

A

Uveitis

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31
Q

Inflammation of the cornea

A

Keratitis

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32
Q

An erosion in the corneal tissue

A

Corneal ulcer

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33
Q

Treatment for keratitis and corneal ulcer is begun promptly to avoid ___

A

PERMANENT loss of vision

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34
Q

Keratitis is treated with ___, __ (drugs that dilate the pupil) and ___

A

Topical anesthetics
Mydriatics
Local and systemic antibiotics

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35
Q

Dark glasses are recommended to relieve photophobia. It is sometimes recommended that pts patch the effected eye

A

Keratitis

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36
Q

Treatment in the early stages of a __ is the same as for keratitis

A

Corneal ulcer

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37
Q

Inflammation of the lid margins, where eyelashes grow. It generally affects both eyes

A

Blepharitis

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38
Q

In blepharitis, the lid margins appear __. ___ cling to the eyelashes and are readily visible about the lids. __ may be missing. ___ may be present. __ eyelids

A

Inflamed
Patchy flakes
Eyelashes
Red swollen

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39
Q

Inflammation and infection of Zeis or Moll glands (types of oil glands at the edge of the eyelid)

A

Hordeolum (sty)

40
Q

Sties are common in pts with

A

Diabetes because their glucose rich blood readily supports microbial growth

41
Q

__ is the most common causative pathogen

A

Staph aureus

42
Q

A sty appears as a __, __, ___, in the internal or external tissue of the eyelid

A

Tender
Swollen
Red pustule

43
Q

Treatment of a sty includes __ of the area and a __. Severe cases require __ & __

A

Warm soaks
Topical antibiotics
Incision & drainage

44
Q

The breakdown of or damage to the macula, the point in the retina where light rays converge for the most acute perception. Usually occurs in both eyes, but the vision in one eye tends to deteriorate more rapidly

A

Macular degeneration

45
Q

Can’t see bullseye; they see peripheral

A

Macular degeneration

46
Q

__ tends to affect older adults & is the leading cause of vision loss in clients older than 50

A

Age related macular disease (AMD)

47
Q

__ does not have any treatment or cure

A

Dry AMD

48
Q

When the macula becomes irreparably damaged, clients __

A

Compare their vision to a target in which the bulls eye are of the image is absent

49
Q

In __ macular degeneration, the client experience distortion of vision, such as straight lines appearing wavy or letters or words looking broken. A clients perception of color may also be diminished

A

Wet

50
Q

Med management for AMD

A

Amsler grid
Angiogenisis inhibitors

51
Q

What is the use of angiogenesis inhibitors

A

Used to inhibit the development and progression of abnormal blood vessel formation

52
Q

Group of eye disorders caused by an imbalance between the production of drainage and aqueous fluid

A

Glaucoma

53
Q

Glaucoma =

A

Increased IOP w progressive loss of peripheral vision

54
Q

In glaucoma, when the drainage system is obstructed, the __ chamber becomes congested with fluid and IOP rises. Optic nerve damage can occur as a result of the increased IOP. Although there is ___, the disease symptoms can be controlled, and optic nerve damage can be prevented

A

Anterior
Not a cure

55
Q

__ is the leading cause of blindness for people over 60 yrs old in the United States

A

Glaucoma

56
Q

Risk factors for being diagnosed with glaucoma include:

A

Being over 60
Being black or Hispanic
Having a family history of glaucoma
Having conditions such as myopia(nearsightedness)
Hypertension

57
Q

In normal eyes, the rate of secretion equals the rate of outflow and the IOP is between __ & __

A

10 & 21

58
Q

For clients with glaucoma, the ___ is impeded from flowing out properly

A

Aqueous humor

59
Q

__: as the IOP increases, it causes edema if the cornea, atrophy of nerve fibers in the peripheral areas of the retina and degeneration of the optic nerve. This type develops painlessly, and visual changes occur slowly. When discovered, the ocular damage can already be severe

A

Open-angle glaucoma
(Painless, tunnel vision, can see halo around light)

60
Q

This glaucoma is less common, but the onset is very sudden, and immediate recognition and treatment are required to prevent blindness

A

Angle closure glaucoma

61
Q

This type of glaucoma is an emergency and a delay in treatment may result in partial or total loss of vision in the affected eye

A

Angle-closure glaucoma

62
Q

Clients with __ glaucoma may be asymptomatic and the condition may not be discovered until the client has a routine ophthalmology exam. When symptoms do occur, they are often ignored because they are not dramatic. May complain of eye discomfort, occasional and temporary blurred vision, the appearance of halos around lights, reduced peripheral vision, and the feeling that their eyeglass prescription needs to be changed

A

Open angle glaucoma

63
Q

When the anterior chamber of the eye of a client with ___ glaucoma is inspected with a penlight or slit lamp, the angle between the iris and cornea is narrow. Tonometry reveals elevated IOP and reduced aqueous outflow. The visual field exam determines a loss of peripheral vision

A

Angle closure glaucoma

64
Q

Miotics =

A

Glaucoma

65
Q

Miotics such as __ & __ constrict the pupil. These meds pull the iris away from the drainage channel so the aqueous fluid can escape

A

Carbachol (miostat)
Pilocarpine (Pilocar)

66
Q

Purpose of Miotics

A

Construction the pupils. These meds pull the iris away from the drainage channels so the aqueous fluid can escape

67
Q

__ (drugs that dilate the pupil) must NEVER be administered to clients with glaucoma. Consult the provider if drugs with anticholinergic properties (atropine sulfate) are prescribed because dilation of pupil can further obstruct drainage, raise IOP & damage whatever vision remains

A

Mydriatics

68
Q

A condition in which the lens of the eye becomes opaque. One or both eyes may be affected. If both are affected each eye may progress differently

A

Cataracts

69
Q

Cataracts form on the __, which is behind the __ and the __. The normal lens focuses light that passes into the eye, producing distinct and sharp images on the retina

A

Lens
Iris & pupil

70
Q

In __ a clear sharp image is impeded, and vision becomes more blurred

A

Cataracts

71
Q

__ occurs as a result of the again process or are congenitally acquired, caused by injury to the lens, or secondary to other eye disease

A

Cataracts

72
Q

One of the earliest symptoms of cataracts

A

Halo around lights

73
Q

In cataracts, vision is restored with one of three methods: ___ implants (most common, ___ or a ___

A

IOL implant
Corrective glasses
A contact lens

74
Q

Involves insertion of an intraocular lens at the time of cataract surgery and is the most common method for improving vision

A

Intraocular lens implant

75
Q

In cataracts, a __ or __ is implanted and reduces the need for corrective glasses.

A

Monofocal (single vision) or
Multifocal lens

76
Q

Where are IOLs implanted

A

Behind the iris

77
Q

Complication of cataract surgery

A

Infection

78
Q

Cataract surgery is usually performed in an __ setting. The client wears a protective eye shield for __ after the procedure and then at __ and during __ for about a __. Clients need to wear __ when in bright light for at least __. __, used several times a day a prescribed for at least ___ to prevent infection

A

Outpatient setting
24 hrs after procedure
Night
Naps
A week
Sunglasses
1 week
Eye drops
1 week

79
Q

After cataract surgery, clients need to notify the eye surgeon if they experience new __ in their vision or increased __, __, or __. These are symptoms associated with retinal detachment, a complication of cataract surgery

A

Floaters
Redness
Flashing lights
Change in vision

80
Q

Symptoms of retinal detachment, a complication of cataract surgery

A

New floaters, increased redness, flashing lights or change in vision

81
Q

The sensory layer becomes separated from the pigmented layer of the retina

A

Retinal detachment *NO PAIN

82
Q

___ may fallow a sudden blow, penetrating injury, or eye surgery

A

Retinal detachment

83
Q

In retinal detachment, most clients notice __ in their vision or __. They describe the sensation of a curtain being drawn over their field of vision, and they often see flashes of light

A

Definite gaps
Blind spots

84
Q

In retinal detachment, complete loss of vision may occur in the affected eye. The condition is not __, but clients are usually extremely apprehensive.

A

NOT PAINFUL

85
Q

In ___, when the retina is inspected with an ophthalmoscope, the tissue appears gray in the detached area

A

Retinal detachment

86
Q

In retinal detachment, when the retina is inspected with an ophthalmoscope, the tissue appears __ in the __ area

A

Gray
Detached

87
Q

Indenting of the surface of the eye

A

Scleral buckling
* seen in retinal detachment

88
Q

A surgical procedure in which a tiny synthetic band is attached outside the eyeball to lightly push the wall of the eye against the detached retina

A

Scleral buckling
* seen in retinal detachment

89
Q

“Welds” the retina back in place

A

Scleral buckling

90
Q

Sjögren’s syndrome-
Decreased saliva production-

A

Dry eyes; dry mouth
Maslow (airway!!)

91
Q

If surgery is performed in retinal detachment, the client is kept __ with position ___ for several days. The head may be ___. The client is not __ or __ without orders. If an air bubble is instilled to promote contact between the retina and sclera, the client is positioned with the face __ to the floor so that the bubble floats to the posterior of the eye. If floaters are still seen after the eye heals, the nurse can tell the client that they eventually become absorbed or settled to the inferior floor of the eye, out of the line of vision.

A

On bed rest
Position restrictions
Immobilized
Turned or moved
Parallel

92
Q

In retinal detachment: ____ so floats to ___ eye

A

Prone
Posterior

93
Q

In retinal detachment surgery, ___ so floats to ___ of eye

A

Prone
Posterior

94
Q

When __ is performed, a metal or plastic ball is buried in the capsule of connective tissue from which the eyeball is removed

A

Enucleation

95
Q

Enucleation =

A

Pressure dressing applied to control hemorrhage, a complication of Enucleation

96
Q

After tissues have healed, during Enucleation, a shell-shaped prosthesis is placed over the buried ball. The shell is painted to match the clients remaining eye. THE __ is the ONLY PORTION THAT IS REMOVED FOR ___

A

Shell
Cleaning

97
Q

After Enucleation, the nurse monitors for S&S of _ or __. The client is usually allowed out of the __ the day after surgery. When healing is complete in about __ to __ weeks, the nurse teacher the client how to insert and remove the prosthetic shell

A

Bleeding or infection
Bed
1-4 weeks

Med Surg 2 (8 decks)

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