Ears & Eyes: PowerPoint & Taylor Flashcards
Hyperopia
Vs
Myopia
Farsighted (see far objects better)
Nearsighted (see near objects better)
Myopia
Hyperopia
Nearsightedness ONLY SEE CLOSE
Farsightedness ONLY SEE FAR
______ is a common type of refractive error.
Part of your eye (either the cornea or lens) is more curved than it should be. This altered eye shape makes your vision blurry.
Treated eyeglasses or contact lenses.
Astigmatism
Miosis =
Midryasis =
Pupillary constriction
Pupillary dilation
Mydriasis =
Pupil dilation
Process of maintaining a clear visual image when the gaze is shifted from a distant to near object
Accommodation
Convergence
Ability of both eyes turn inward toward the nose at the same time
Difference between
Exophthalmos
Enophthamos
Exophthalmos: protrusion of eyes
Enophthamos: Sunken in eyes
Ptosis
Dropping of eyelid
Normal size of pupils
3 - 5 mm
Anisocoria
Noticeable difference in size of eyeballs
Diagnostic Assessment
Access eye, bony structures and muscles.
Also to look for tumors
CT scan
Diagnostic Assessment
Examine Orbits & Optic Nerves
Evalute Tumors
MRI
slit lamp exam is used to look for…
cataracts & glaucoma
Corneal Staining Test
test that uses orange dye (fluorescein) and a blue light to detect foreign bodies in the eye.
This test can also detect damage to the cornea. (Foreign Objects)
The cornea is the outer surface of the eye
Tonometry is a diagnostic test
Measures the pressure inside the eye, also known as intraocular pressure
(IOP).
Help determine if you’re at risk of developing glaucoma
Screen for glaucoma
Measure how well glaucoma treatment is working
Cataracts
Preop responsibility for nurse
Obtain informed consent?
Education
Medications to be avoid beforehand:
Yes, informed concent
Education: how to admin eye drops after procedure
Med his. Taking meds affext blood clotting
Cataracts
Post-op
Abnormal
Discharge Ed.
Ab. Sig swelling, pain, brusing, Discharge
Dark glasses outdoors
Eyedrops
Follow-up appointment
2 types glaucoma
Primary open-angle glaucoma
Primary angle-closure glaucoma
Explain differences
Primary open-angle glaucoma
Dev slowly, gradual loss of vision fields
Primary angle-closure glaucoma
Sudden onset of increased pressure. Is an Emergency
Sclera may appear reddened and the cornea foggy in this condition
Glaucoma
Start by tilting your head backward while sitting, standing, or lying down.
With your index finger placed on the soft spot just below the lower lid, gently pull down to form a pocket. Look up.
Squeeze one drop into the pocket in your lower lid.
True or False
True
Types of meds for glaucoma
- Prostaglandin (prost)
Reduce IOP via dilation of blood vessles
Nursing considerations.
Admin as prescribed
Beta-Adrengic Blockers (lol)
Reduce IOP LIMITS producción of aqueous humor and dilating pupil
Nursing Considerations:
Check pulse (Low HR & BP) concern & Glucose
Cholinergric agonist
Reduce IOP by limiting production of Aqueous Humor
Nursing considerations:
Report increase salvation
Trabeculectomy is used to treat…
How….
Glaucoma
Creates a drainage pathway in the eye
Leading cause of blindness in adults of 65
Deterioration of central vision
Macular degeneration
Onset is sudden and painless
Bright flashes
Floaters
Shadow side vision
Retinal Detachment
Pre & Post Op Eye patch is given for this problem
Post Op.
Avoid increased IOP
No bending / lifting
Blowing nose, sneeze, cough
Head in dependent posistion
Face-Down Recovery posistion
No work that requires close vision
Detached retina
How do the field of view differ
Retinal Detachment
Macular degeneration
Open-angle glaucoma
Retinal Detachment
Cant see Corner field of vision
Macular degeneration
Cant see center field of vision
Open-angle glaucoma
Only see center field of vision
Corneal ______
Deeper injury caused by infection leads to emergency due to blood supply being impaired ro the eye
Corneal Ulceration
Questions to ask for retinal Detachment
Have you had cataract or lazer eye surgery?
Which pitch is the first to not hear in Elderly (Low / High)
High
F, S,SH, PA sounds first to go
Conductive vs Sensorineural
hearing loss
Causes
Cerumen
Foreign body
Perforación of tympanic membrane
Infection external or middle ear
Prolonged noise exposure
Presbycusis
Ototoxic Substances
Meniere Disease
Diabetes Mellitus
Conductive
Cerumen
Foreign body
Perforación of tympanic membrane
Infection external or middlle
Sensorineural
Prolonged noise exposure
Presbycusis
Ototoxic Substances
Meniere Disease
Diabetes Mellitus
Presbycusis = bilateral age-related hearing loss
Meniere’s disease
A disease of the inner ear that can cause a person to get dizzy and have trouble hearing
often affects only one ear. Its exact cause isn’t known. But a buildup of fluid in the inner ear seems to set off the symptoms.
Most often it begins between the ages of 40 and 60.
Speaking softly
Hearing best in noisy environment
Evidence of obstruction
Conductive or Sensorineural
Conductive
Assessment Findings
Tinnitus (Ear Ringing) common
Occasional Dizziness
Speaking Loudly
Hearing poor in loud environment
Normal appearance of external ear canal
Conductive or Sensorineural
Sensorineural
Rinne: Tuning fork struck, placed on mastoid and infront of ears.
Normal findings
Abnormal findings indicate (This type of hearing loss)
Postive Rinne (Good or Bad)
Normal: Air conduction 2x long as bone conduction
Ab: Bone conduction longer than air. CONDUCTIVE HEARING LOSS
Positive = Good (Normal Findings)
Weber test: Tuning fork struck and placed on head
Normal findings
Abnormal
(Type of hearing loss)
Postive Result (Good or Bad)
Normal: Both sides are heard evenly
positiveWeber
Sensorineural hearing loss
:Sound is heard louder on the side of the intact ear.
Conductive hearing loss
:Sound is heard louder on the side of the affected ear.
Normal Weber test:Sound is heard equally in both ears.
S/ S
Vértigo
Tinnitus
Hearing loss
Causes
Exact cause unknown
Endolymph build-up, increased pressure, inner ear
Meniere Disease
Proprioception
Sense of body position, force, and movement.
Awareness of body position, and it helps us understand where our body parts are in space
_______ is a network of nerves in the brain stem that helps regulate wakefulness and sleep-wake transitions.
Filters out unnecessary noise that can interfere with message processing during sleep.
Filter between the conscious and subconscious mind, filtering out millions of pieces of data per second.
Only allows what is important and of interest to be brought into awareness
The reticular activating system (RAS)
Stereognosis is …
the ability to identify and recognize the shape and form of an object by using touch
This process happens when we get used to certain obnoxious stimulus
Adaption
Sensory Poverty….
Seeing images on a computer screen but not experiencing them in real life.
Presbycusis is…
Loss in high frequency hearing
Associated with aging
Gradual onset, progressive, bilateral
Ototoxic drugs includ
Furosemide, some chemotherapy, and aspirin
Which type of hearing loss is usually correctable
Conductive. Wax, foriegn object, infection
Sensorineural: inner ear problem usually gets worse
Patient at risk for sensory Deprivation due to limited physical activity related to RA.
Which interventions would be recommended
A. Use low tone when talking to patient
B. Provide interaction with children and pets
C. Decrease environmental noise
D. Ensure paitent eats with other members
E. Discourage use of sedatives
F. Provide adequate light and clear pathways
B,D,E
lower tone appropriate for hearing loss
Decrease environmental noise appropriate for sensory overload
Provide adequate lighting appropriate for Vision Problems
Assessment for Kinesthetic & Visceral disturbances. select all
A. Ask if bored, if so, why?
B. Ask if anything interferes with functionality of their senses
C. Ask any changes in way they precieve their body
D. Ask, if they find it difficult to express themselves verbally
E. If patient withdraws from being touched
F. Nurse notes if patient seems unsure of his body parts of posistion
C,E,F
11 year olds grades have dropped, difficultly finishing homework, rubs eyes/ squints, Snellin chart vision 160 / 20 .
Which alteration would the nurse document
A. Self-care dedicit
B. Altered Role Performance (Student)
C. Distrubed body image
D. Delayed growth and development
B. The term Role is referring to her Role in life.
Altered performance means she is doing poorly
Group home of mildly / moderate visually & auditory Impairments
What is the nurses Priority
A. Maintaining safety and prevention of sensory deterioration
B. Insisting on participation from all members in activities
C. Emphasize and reinforce individual strengths
D. Encourage reminiscence and life review in groups
A. Safty is always the priority
When caring for a patient with glaucoma
A. Assist to ambulate by walking behind then grasping their arm.
B. Concentrate on their sense of site and limit diversions of other senses
C. Stay outside POV when preforming personal hygine
D. Indicate when the conversation is over and when the nurse is leaving the room.
D.
When assisting with ambulation walk slightly ahead allowing patient to grasp onto hand.
Nurse should provide Not Limit, diversions using other sense
Short eyes (hyperopia/myopia)
Long eyes (hyperopia/myopia)
Short hyperopia farsighted ONLY SEE FAR
long myopia Nearsighted ONLY SEE CLOSE
Do scleara normally yellow with age?
Yes
Pupils have trouble constricting with age.
True or False
False they have trouble dilation
CLINICAL JUDGMENT MODEL vs ADPIE
Assessment
Recognize Cues
CLINICAL JUDGMENT MODEL vs ADPIE
Diagnosis/ Analysis (2)
Analyze Cues
Prioritize Hypothesis
CLINICAL JUDGMENT MODEL vs ADPIE
Planning
Generate Solutions
CLINICAL JUDGMENT MODEL vs ADPIE
Implementation
Take action
CLINICAL JUDGMENT MODEL vs ADPIE
Evaluation
Evaluate outcomes
_____patients often experience vision loss in the peripheral vision
This is often described as Tunnel vision or looking through a straw
Glaucoma
Exophthalmos is a problem with this gland
Thyroid
What is the name of the color blind test
Ishihara
___ is used to find a tumor
___ is used to get details on tumor
CT
MRI
Normal tonoity range
10 - 20
Corticosteroids can cause these 2 eye problems
Cataracts/ Glaucoma
This disease can cause a decreased blood flow to all areas (including eyes and ears)
Diabetes
Which is the only eye condition that is painful
Acute close glaucoma
Is Itching normal after cataract surgery
Yes, no need to call dr
Normal IOP Is a balance between production and out flow of….
Aqueous humor
IOP presses on _____ which can cause blindness
Optic nerve
Gradual loss of peripheral vision that progresses to tunnel vision
This disease
Open angle glaucoma
What is the cure for macular degeneration
No cure, manage symptoms
Sclera Buckling and Gas Bubble are used to correct this problem
Retinal Detachment
This procedure requires the use of an eye patch both pre and post opp
Retinal Detachment
Facedown recovery posistion is used after surgery for this eye problem
Retinal Detachment
Examines the anterior eye structure for problems with Lens, Cornea, Vitreous Humor
Slit-Lamp
Paitent History
Diabetes or HTN
Recent Surgery to eye
Traum to eye
Glaucoma
Non-surgical management includes (eyedrops)
Prostaglandin agonit
Beta-Adrenergic
Cholinergic agonis
(This eye disease)
Glaucoma
Macular Degeneration is a disorder or this part of the eye
Retina
Causes:
Cataract or Lazer surgery
Manifestaciones
Onset: Sudden & Painless
Bright flashes of light seen
FLOATERS
POV: Curtain Closing near end stage
Retinal Detachment
Scleral Buckling & Gas Bubble
Used to fix problem
Post Op. Eye Patch
Restrictions to avoid increasing IOP
Face-Down Recovery posistion
Retinal Detachment
Presbycusis is….
gradual, symmetrical loss of hearing
that occurs over many years. It’s also known as age-related hearing loss. The word presbycusis literally means “old hearing” or “elder hearing
Risk factors for Glaucoma
Age
Family History
Ethnicity
Diabetes/ HTN
Eye injuries
Corticosteroids use
Visiion changes with open angle glaucoma
Peripheral vision loss
Blurred or hazy vision
Dificultad adjust to darkness
Halos around lights
Dificultad focus on close objects
Interventions for glaucoma
Least to most invasive
Eye drops
Oral meds
Lazer therapy
Surgical (Trabeculectomy)
Symptoms of cataracts
Cloudy vision
Lights too bright / Halo
Double vision
Increased near sightedness
