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Adult Health II > Disorders of the Eyes & Ears > Flashcards

Disorders of the Eyes & Ears Flashcards

1
Q

What is tinnitus?

A

Ringing in the ears

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2
Q

List 6 age-related changes in the eyes.

A
  1. Cornea is less transparent
  2. Lens hardens
  3. Lens becomes yellow and cloudy (cataracts)
  4. Pupil size becomes smaller
  5. Scattering of light within the eye globe
  6. Presbyopia
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3
Q

What is presbyopia?

A

Impaired vision as a result of aging, harder to see closer up, muscle becomes weaker within the eye, starts around age 40

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4
Q

What is myopia?

A

Nearsightedness, can see close up but not far away

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5
Q

What is hyperopia?

A

Farsightedness, can see far away but not close up

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6
Q

What is astigmatism?

A

Blurred vision at any distance

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7
Q

What education should be provided for the eyes?

A

Proper screening for refractive errors, importance of wearing glasses/contacts if patient has them

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8
Q

What are clinical manifestations of refractive errors?

A

Blurred vision, headaches, eyestrain, ocular discomfort

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9
Q

How is the Snellen chart used?

A

20 feet away, read the smallest row you can read, cover one eye at a time then with both eyes open, bottom line is 20/20 vision

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10
Q

What does it mean to be legally blind?

A

If you cannot make out the E at the top of the Snellen chart

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11
Q

What is the Rosenbaum chart used for?

A

To test near vision or hyperopia/presbyopia

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12
Q

What are types of screening for the eyes?

A

Annual vision exam, colorblindness, tonometry

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13
Q

What is tonometry?

A

The measurement of intraocular pressure

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14
Q

What is the treatment for refractive errors?

A

Corrective lens (glasses, contacts), surgery (LASIK)

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15
Q

Will LASIK prevent presbyopia?

A

No, because LASIK only fixes the lens, not the muscle

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16
Q

What is visual impairment?

A

Legal blindness (20/200 or less), peripheral vision of 20 degrees or less

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17
Q

What are the roles of the nurse with eye disorders?

A

Health promotion/early detection, patient safety

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18
Q

What are safety risks with patients with impaired vision?

A

Fall risk, risk for poor communication, medication errors

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19
Q

What are nursing interventions for the visually impaired patient?

A

Normal tone of voice, alert client of approach, orient to environment, meal tray placement

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20
Q

What are types of eye trauma?

A

Blunt or penetrating, chemical or thermal burns, foreign bodies

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21
Q

What else should be looked for whenever a patient comes in with eye trauma?

A

Any other injuries (facial fractures especially)

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22
Q

What are clinical manifestations of eye trauma?

A

Pain, photophobia, erythema, edema, tearing, vision changes

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23
Q

What is photophobia?

A

Sensitivity to light

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24
Q

What diagnostics are used for eye trauma?

A

H&P, visual acuity, fluorescein

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25
Q

What is fluorescein?

A

Bright green fluorescent dye dropped onto the surface of the eyeball to highlight corneal abrasions

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26
Q

What is the first test that needs to be done if a patient complains of eye/vision problems?

A

Visual acuity exam

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27
Q

What are treatments for eye traumas?

A

Cover injury, maintain NPO (in case of procedure), analgesics, elevate head of bed (decrease pressure in eye), no medications in the eye

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28
Q

If a patient comes in with a chemical burn in the eye, what should be done first?

A

Flush with normal saline for 15-20 minutes

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29
Q

What are the top priorities for a patient with lawn chemicals in their eyes and swelling around the mouth and cheeks?

A
  1. Airway
  2. Irrigate the eyes
  3. Assess the extent of the injury
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30
Q

What are types of conjunctivitis?

A

Bacterial, viral, allergic, chlamydial

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31
Q

What is the most common cause of bacterial conjunctivitis?

A

S. aureus

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32
Q

What is conjunctivitis?

A

Inflammation or infection of the eye

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33
Q

What are clinical manifestations of bacterial conjunctivitis?

A

Mucopurulent discharge (yellow and thick), discomfort, redness, starts unilaterally

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34
Q

What are clinical manifestations of viral conjunctivitis?

A

Foreign body sensation, watery eye (clear drainage), redness, mild photophobia

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35
Q

What is the main clinical manifestation to determine chlamydial conjunctivitis?

A

Enlarged preauricular lymph node (in front of ear)

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36
Q

What are clinical manifestations of allergic conjunctivitis?

A

Itching, swelling, redness, watery eyes (bilaterally)

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37
Q

What supportive treatments are used for viral and allergic conjunctivitis?

A

Treat allergies (Flonase and oral antihistamines), artificial tears for itching and dryness, topical steroid if severe

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38
Q

What supportive treatment is used for bacterial and chlamydial conjunctivitis?

A

Topical antibiotics, chlamydial may require STI treatment

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39
Q

Are oral antibiotics effective in treating eye infections?

A

No

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40
Q

What teaching can reduce eye infections?

A

Wash hands, don’t share makeup (throw away if infected), proper contact lens care

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41
Q

What are cataracts?

A

Lens of eyes become cloudy and opaque, can be seen by shining light into the eye, progresses slowly over time, decreases visual acuity, typically older adults

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42
Q

What are causes of cataracts?

A

Age-related, trauma, maternal rubella, UV exposure, long-term use of topical corticosteroids

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43
Q

How are cataracts diagnosed?

A

H&P, ophthalmoscopic exam

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44
Q

What are the first indicators of cataracts?

A

Vision decreased, having a hard time seeing at night

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45
Q

What are nonsurgical treatments for cataracts?

A

Visual aids, management (more light when reading, avoid driving at night)

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46
Q

What is the difference between nonsurgical and surgical cataract treatment?

A

Depends on the severity of the disorder and the patient’s age; if the patient has underlying conditions such as hypertension or diabetes, the provider would probably go ahead with the surgery

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47
Q

What is the surgical treatment for cataracts?

A

Removal of old lens and replace lens

48
Q

What is preoperative care for cataract surgery?

A

EKG, PT INR (clotting factor), chest x-ray, mydriatics, NSAIDs, antibiotics, antianxiety VS

49
Q

What are mydriatic eye drops used for?

A

Pupillary dilation (makes removal of lens easier)

50
Q

Why is antianxiety medication given before surgery?

A

Due to the patient being awake during the surgery

51
Q

What is postoperative care for cataract surgery?

A

Topical antibiotics and corticosteroids, activity restrictions, eye shield, teaching

52
Q

What are activity restrictions after eye surgery?

A

No bending, stooping, coughing, or lifting; these could increase intraocular pressure and prevent healing

53
Q

What is return demonstration?

A

Demonstration after the patient has first observed the teacher and then practiced the skill in mock or real situations

54
Q

What teaching should be provided for a patient having eye surgery?

A

Medications, s/s of infection, safety

55
Q

What are signs and symptoms of infection after eye surgery?

A

Purulent drainage, intense pain (some pain is normal), redness

56
Q

How long can it take for full vision to return after surgery?

A

1-2 weeks

57
Q

What is retinopathy?

A

Microvascular damage to the retina, red spots on the back of the eye

58
Q

What is the goal of treatment of retinopathy?

A

Treat the cause (diabetes/hypertension), blindness can occur if not treated

59
Q

What is retinal detachment?

A

Separation of retina from underlying structures (including the blood vessels), causes retina to be unable to get oxygen and nutrients

60
Q

What are risk factors for retinal detachment?

A

Age, severe myopia, trauma, cataract surgery, family or personal history

61
Q

What are types of retinal detachment?

A

Small tear or complete detachment

62
Q

What are clinical manifestations of retinal detachment?

A

Photopsia, floaters, ‘cobweb’ in field of vision, painless loss of vision

63
Q

What is photopsia?

A

Bright flashes of light

64
Q

What diagnostics are used for retinal detachment?

A

Visual acuity test, ophthalmoscopy (look into eye), ultrasound (look at blood supply and other structures)

65
Q

Why is teaching important after retinal detachment?

A

25% risks of developing detachment on opposite eye

66
Q

What is age-related macular degeneration?

A

Most common cause of irreversible central vision loss >60 years old, can be managed but not reversed

67
Q

What are risk factors for age-related macular degeneration?

A

Age, family history, hypertension, smoking, ethnicity, nutrition

68
Q

Which ethnicity is at a higher risk for AMD?

A

Caucasian

69
Q

Why is nutrition important for AMD?

A

Slows down progression, vitamins and supplements

70
Q

What are clinical manifestations of AMD?

A

Blurred/darkened vision, scotomas, metamorphopsia

71
Q

What are scotomas?

A

Blind spots

72
Q

What is metamorphopsia?

A

Distorted vision

73
Q

Why might a patient with AMD not notice a change if only one eye is affected?

A

The unaffected eye will take over

74
Q

What are drusen?

A

Yellow deposits on the eye

75
Q

What is the Amsler grid test?

A

Diagnosis for AMD, used to show progression of the disorder, will show distorted grid if they have the disorder

76
Q

What is the treatment for AMD?

A

Treat underlying conditions, medications, photodynamic therapy

77
Q

What medications would be used to treat AMD?

A

Intravitreal injections into the eyes to prevent progression

78
Q

What is photodynamic therapy?

A

Laser therapy for the eye

79
Q

In which ethnicity is glaucoma most common?

A

African Americans

80
Q

What is the group of disorders for glaucoma?

A

Increased intraocular pressure, optic nerve atrophy, vision loss/blindness

81
Q

What are the two types of glaucoma?

A

Open angle and angle closure

82
Q

What is open angle glaucoma?

A

Most common form, pressure build-up in the eye, damage to optic nerve, slower progression

83
Q

What is angle closure glaucoma?

A

Drug-induced mydriasis (pupillary dilatation), darkness, emotional excitement, very sudden attack

84
Q

What are the signs and symptoms of open angle glaucoma?

A

Loss of peripheral vision, ‘tunnel vision’

85
Q

What are the signs and symptoms of angle closure glaucoma?

A

Pain in or around the eye, nausea/vomiting, colored halos, blurred vision, redness of the eye

86
Q

What is the normal intraocular pressure?

A

10-21 mm/Hg

87
Q

What medications are used for open angle glaucoma?

A

B-adrenergic blockers (betaxolol), alpha-adrenergic blockers, cholinergics (decrease pressure)

88
Q

What medications are used for angle closure glaucoma?

A

Cholinergics, mannitol (osmotic diuretic), PO isosorbide

89
Q

What are important steps for administering eye drops?

A

Hand hygiene, pull down with index finger, drops go into pocket and don’t touch tip to eye, close eyes and put pressure on corners of eyes

90
Q

What are types of hearing loss?

A

Conductive, sensorineural

91
Q

What is conductive hearing loss?

A

External ear disorders (obstruction), middle ear disorders

92
Q

What is sensorineural hearing loss?

A

Inner ear disorders, presbycusis

93
Q

What can cause sensorineural hearing loss?

A

Sound exposure, trauma, age

94
Q

What is presbycusis?

A

Age-related hearing loss

95
Q

What are clinical manifestations of hearing loss?

A

Answering questions inappropriately or not at all, irritability when others don’t speak up, cupping ear, tinnitus, speaks softly

96
Q

What are treatments for hearing loss?

A

Hearing aid, speech/lip reading, assistive listening devices, cochlear implant

97
Q

What is important for hearing aid management?

A

Consistent use, restrict to quiet areas, disconnect battery when not in use, keep in a safe dry place

98
Q

What immunization can prevent hearing loss?

A

MMR vaccine, rubella in pregnancy can cause infant deafness

99
Q

What are toxic medications that can cause hearing loss?

A

Salicylates (aspirin), loop diuretics, chemotherapy, antibiotics

100
Q

How should you communicate with a patient with hearing loss?

A

Normal tone of voice, speak slowly, maintain eye contact, use touch, decrease distractions

101
Q

What is otitis externa?

A

Infection of outer ear and canal

102
Q

What are signs and symptoms of otitis externa?

A

Pain with palpation (tragus), drainage, externally red, puffiness of the ear canal

103
Q

What is otitis media?

A

Infection of the middle ear

104
Q

What are signs and symptoms of otitis media?

A

Pain radiating behind the ear, fever, redness/swollen, loss of landmarks

105
Q

How is otitis externa treated?

A

Antibiotic ear drops

106
Q

How is otitis media treated?

A

Oral antibiotics but doesn’t always have to be treated

107
Q

How are inner ear disorders characterized?

A

Tinnitus, sensorineural hearing loss, vertigo

108
Q

What is Ménière’s disease?

A

Increased accumulation of fluid in the ear, leads to dizziness and can be debilitating

109
Q

What are signs and symptoms of Ménière’s disease?

A

Fullness in ear, ‘drop attacks’, tinnitus, muffled hearing, intermittent (random attacks that last hours to days)

110
Q

What diagnostics are used for Ménière’s disease?

A

Glycerol test, positional test

111
Q

What is the glycerol test?

A

Oral glycerol is given and 3 hearing exams are taken, should have improved hearing due to pulling fluid off the ear

112
Q

How are acute attacks of Ménière’s disease managed?

A

Antihistamines (dry up ear), antivertigo drugs, antiemetics (treat N/V)

113
Q

What is the maintenance of Ménière’s disease?

A

Antihistamines used daily, CCB, diuretics (fluid balance), low sodium diet (keeps from retaining fluid)

114
Q

What is vertigo?

A

Free floating debris in semicircular canal (crystals get out of balance)

115
Q

What else should be checked for if someone complains of dizziness with positional changes?

A

Orthostatic hypotension, need a good cardio assessment

116
Q

What are signs and symptoms of vertigo?

A

Nystagmus (H test), dizziness and lightheadedness (with positional change), loss of balance

117
Q

What is the treatment for vertigo?

A

Physical therapy (reposition crystals), medications to treat symptoms

Adult Health II (2 decks)

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