chapter 52: nursing care of patients with sensory disorders - vision and hearing Flashcards
1
Q
conjunctivitis
A
- inflammation of the conjunctiva
2
Q
blepharitis
A
inflammation of the eyelid margins
3
Q
keratoconjunctivitis sicca
A
dry eye disease
4
Q
hordeolum
A
- staphylococcal abscess in sebaceous gland
5
Q
chalazion
A
- abscess in tarsal (meibomian) glands
6
Q
keratitis
A
inflammation of the cornea
7
Q
nursing diagnoses for eye infections and inflammation
A
- acute pain
- risk for injury
- deficient knowledge
8
Q
refractive disorders
A
emmetropia
hyperopia
myopia
astigmatism
presbyopia
9
Q
emmetropia
A
normal vision
10
Q
hyperopia
A
farsightedness
11
Q
myopia
A
nearsightedness
12
Q
astigmatism
A
unequal curvatures in cornea
13
Q
presbyopia
A
loss of lens elasticity
14
Q
blindness
A
- obstacle to rays of light
- disease of optic nerve or tract of brain connected w/ vision
15
Q
nursing diagnoses for refractive disorders
A
- self care deficit (bathing, dressing, feeding)
- risk for injury
- deficient knowledge
16
Q
diabetic retinopathy
A
- vascular changes in retinal blood vessels
17
Q
types of diabetic retinopathy
A
- microaneurysms
- preproliferative retinopathy
18
Q
therapeutic interventions of diabetic retinopathy
A
- laser photocoagulation
- vitrectomy
19
Q
nursing diagnosis for diabetic retinopathy
A
- ineffective health management
20
Q
retinal detachment
A
separation of retina from choroid layer of eye
21
Q
signs and symptoms of retinal detachment
A
- sudden change in vision
- flashing lights, floaters
- looking through a veil
- curtain being lowered over vision
- no pain
22
Q
therapeutic interventions for retinal detachment
A
- laser surgery
- cryoplexy
- pneumatic retinopexy
- scleral buckling
23
Q
glaucoma
A
- group of diseases
- most have elevated pressure within eye
- damage is silent, progressive, irreversible
- optic nerve is damaged
- can lead to blindness
- lifelong treatment needed
- no cure
24
Q
primary open angle glaucoma (POAG)
A
- degeneration of drainage system blocks aqueous fluid
- increased intraocular pressure >20 mms of mercury
- gradual and painless
25
signs and symptoms of glaucoma
- mild eye aching
- headache
- halos around lights
- frequent visual changes
26
angle closre glaucoma (ACG)
- narrowed angle blocks aqueous fluid
- medical emergency
- increased intraocular pressure may be >50 mm of mercury
27
signs and symptoms of angle closure glaucoma
- severe eye pain
0 blurred vision
- halos around light
- eye redness, cloudy conea
- nausea and vomiting
28
medications for glaucoma
- miotics
- agents to decrease production of aqueous fluid
29
miotics
- physostigmine (isopto eserine)
- pilocarpine (pilocar)
30
agents to decrease production of aqueous fluid
- betaxolol (betoptic)
- timolol (timoptic)
31
***contraindicated in ACG
- mydriatics
- dilate pupil, which leads to increased ocular pressure
32
***medications contraindicated in ACG (can cause blindness)
- atropine
- diphenhydramine
- hydroxyzine
33
surgery for glaucoma
- laser trabeculoplasty
- trabeculectomy
- glaucoma drainage devices (shunts)
- laser peripheral iridotomy
- surgical refectory
34
nursing diagnoses for glaucoma
- acute pain
- self care deficit (bathing, dressing, feeding, toileting)
- risk for injury
- deficient knowledge
35
cataracts
- opacity in eye lens
- loss of visual acuity
- difficulty with night vision
- difficulty reading fine print
- sensitivity to glare
- increase in nearsightedness
36
surgica management for cataracts
- no stitch surgical removal of lens
- laser removal
- lens implant
37
nursing diagnoses for eye surgery
- risk for injury
- deficient knowledge
- anxiety
38
macular degeneration
- deterioration in macula: wet or dry
- common over age 64 yeras
- slow, progressive loss of central/near vision
- daily screening: Amsler grid
39
therapeutic interventions for dry macular degeneration
none
40
therapeutic interventions for wet macular degeneration
- antiangiogenesis medication
- ranibizumab (lucentis) ---> monoclonal antibodies
- aflibercept (eylea)
41
nursing diagnoses for macular degeneration
- self care deficit (bathing, dressing, feeding)
- risk for injury
- deficient knowledge
42
eye trauma: emergencies
- foreign bodies
- burns
- abrasions
- lacerations
- penetrating wounds
43
therapeutic measures and nursing care for foreign object in eye
- irrigate w/ normal salie
44
therapeutic measures and nursing care for chemical eye trauma
15-20 minute irrigation
45
therapeutic measures and nursing care for penetrating object in the eye
do not remove
46
therapeutic measures and nursing care
- antibiotic ointment
- surgery
0 enucleation
47
enucleation
entire eyeball removal
48
hearing loss
- conductive hearing loss
- sensorineural hearing los
49
conductive hearing loss
interference w/ sound conduction to external auditory canal, eardrum, middle ear
50
sensorineural hearing loss
involves hair cells and nerve endings
51
presbycusis
normal part of aging process
- degeneration of organ of corti
- inability to decipher high frequency sounds
52
therapeutic measures for hearing loss
- hearing aid(not usually covered by insurance)
- cochlear implants
53
nursing diagnosis for hearing loss
impaired verbal communication
54
external ear infections
external otitis
ear canal furuncle
otomycosis
perichondritis
masses
trauma
55
impacted cerumen
- normally ear self cleaning
- older adults at risk
- hearing loss
- feeling of fullness
56
therapeutic interventions for external ear
- topical antibiotics
- irrigations
- analgesics
- incision and drainage
57
nursing diagnoses for external ear
- acute pain
- risk for injury
- deficient knowledge
58
otitis media (middle ear infection)
- fever, earache, and feeling of fullness
- antibiotics
- myringotomy
59
otosclerosis
- new bone along stapes
- conductive hearing loss
- more common in women than in men
- both ears
- hereditary disease
- no cure
60
therapeutic interventions for otosclerosis
- ossiculoplasty
- stapedectomy
61
nursing care for otosclerosis
- operative ear is upward when lying
- insert earplug to protect
- promote safety
62
nursing care for otosclerosis: teach not to
- cough, sneeze
- blow nose
- vomit
- fly
- lift heavy objects
- shower
63
ear trauma
tympanic membrane perforation
middle ear ossicle fracture
64
nursing diagnoses for middle ear, tympanic membrane and mastoid disorders
- risk for infection
- acute pain
- deficient knowledge
65
labyrinthitis
- inflammation or infection of inner ear
- vertigo, tinnitus, sensorineural hearing loss
- antibiotics
- sedation
- besdrest
66
neoplastic disorders: acoustic neuroma
- tumor of the 8th cranial nerve
- benign or malignant
67
meniere's disease
- balance disorder due to fluid disturbance
- triad of symptoms
- episodic bouts 2-3 times of a year
68
acute treatment for Meniere's Disease
- tranquilizers
- vagal blockers
- bed rest
69
prophylactic treatment for Meniere's Disease
- salt restricted diet
- diuretics
- antihistamines
- vasodilators
- avoid alcohol, caffeine, tobacco
70
nursing diagnoses for inner ear disorders
- anxiety
- risk for injury
- imbalanced nutrition: less than body requirements
