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Eye and Ear > Eye and Ear > Flashcards

Eye and Ear Flashcards

1
Q

Myopia

A

Near-sighted

focus rays anterior to retina

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2
Q

Hyperopia

A

Far-sighted

focus rays posterior to retina

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3
Q

Astigmatism

A

There are refractive errors where the light rays are diffusely spread; not sharp focus on the retina due to the curvature of the cornea

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4
Q

Presbyopia

A

decrease in accommodation related to aging

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5
Q

OD

A

R eye

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6
Q

OS

A

L eye

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7
Q

OU

A

Both eyes

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8
Q

Snellen chart

A

(20/20 standard); Tests distance vision
**If a patient’s vision is 20/40 then the patient can see at 20 feet what a patient with normal vision can see at 40 feet

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9
Q

Ishihara Plate Test

A

Tests for color blindness

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10
Q

Ptosis

A

Drooping of the eyelid

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11
Q

What does a healthy sclera look like?

A

Normally clear and white (African Americans can have a yellowish sclera, its normal)

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12
Q

Direct light reflex

A

Constriction of a stimulated pupil

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13
Q

Consensual light reflex

A

Constriction of the opposite pupil when the other pupil is stimulated

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14
Q

What is accommodation?

A

The ability to focus and refocus

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15
Q

Tonometry

A

Measure ocular tension which tells us the intraocular fluid pressure

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16
Q

Normal IOP range

A

10-21 mm Hg

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17
Q

What is a slit-lamp examination?

A

Is used to illuminate and examine the anterior segment of the eye under magnification

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18
Q

When is fluorecein dye used?

A

It is often used in a slit-lamp examination to highlight corneal irregularities

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19
Q

How do you test extraocular movement (EOM)?

A

By assessing the six cardinal fields of gaze

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20
Q

Amsler Grid

A

Geometric grid which tests for macular degeneration

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21
Q

What should be noted during an ophthalmoscopic exam?

A
  1. Papilledema - edema of ophthalmic nerve
  2. Vasculature - veins and arteries
  3. Lesions/Smudges - indicated hemorrhage
  4. Lipids - yellowish (indicates increased cholesterol)
  5. Microaneurisms/Hemorrhages - secondary to HTN or DM
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22
Q

Procedure for administering eye drops

A
  1. Evert lower lid and drop into conjunctival sac
  2. Apply pressure to inner canthus to prevent med from entering systemic circulation
  3. Only 1-7% of med is absorbed
  4. Tears dilute med
  5. Wait 30 seconds between drops of the same medicine
  6. Wait 5 minutes between instillation of separate medicines
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23
Q

Procedure for administering eye ointment

A
  1. Evert lower lid
  2. Squeeze med from inner to outer canthus
    * *Patient could complain of blurred vision
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24
Q

What is Phototherapeutic Keratotomy (PTK)?

A

A laser removes/reduces corneal opacities, smooths corneal surface, and changes eyeball shape

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25
Q

When would a patient undergo a phototherapeutic keratotomy (PTK)?

A

To improve vision and correct nearsightedness

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26
Q

Common complications of PTK

A
  1. Hyperopia

2. Stromal haze

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27
Q

What should a nurse do for a patient post PTK surgery?

A
  1. PO analgesic
  2. Pressure patch to heal
  3. Antibiotics and steroids
  4. NSAIDS for pain
    * *They should improve 1 week to 1 year
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28
Q

Causes of retinal detachment

A
  1. Trauma

2. Hemorrhage

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29
Q

S/Sx of retinal detachment

A
  1. Sudden flashes of light
  2. Blurred vision
  3. Floaters
  4. Veil in front of eye
  5. Painless
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30
Q

How is a retinal detachment managed medically?

A
  1. Reattach with surgery
  2. Immediate bedrest
  3. Eye patch
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31
Q

What can lead to retinal vascular disorder?

A

Retinal vascular disorder is secondary to CVD, HTN, DM, and glaucoma

  • *The vein or the artery can get occluded
  • *If the artery gets occluded, it is considered an emergency
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32
Q

S/Sx of retinal vascular disorders

A
  1. Decreased visual acuity
  2. Blurred vision
  3. Blindness
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33
Q

Treatment for retinal vascular disorder

A
  1. Laser photocoagulation
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34
Q

What is macular degeneration and what are the two types?

A
  • *Presence of Drusen bodies - tiny yellow spots beneath the retina; the central vision is most affected
    1. Dry/Non-Exudative Type
    2. Wet/Exudative Type
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35
Q

S/Sx of macular degeneration

A
  1. Blurred vision
  2. Straight lines become crooked
  3. Broken letters
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36
Q

Treatment of macular degeneration

A
  1. Carotenoids
  2. Fish oil PO
  3. Bright lights
  4. Magnification devices
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37
Q

Causes of cataracts

A
  1. Age
  2. Trauma
  3. Heredity
  4. DM
  5. Medications
38
Q

Risk Factors for cataracts

A
  1. Aging
  2. Prolonged corticosteroid usage
  3. Smoking
  4. DM
39
Q

S/Sx of cataracts

A
  1. Painless blurred vision
  2. Sensation of dimmed surroundings and fogged glasses
  3. Increased sensitivity to glare and contrast
  4. Diplopia
  5. Color shift
  6. Brunescence
40
Q

What diagnostic tests are used to confirm cataracts?

A
  1. Snellen chart
  2. Opthalmoscope
  3. Slit lamp
41
Q

How are cataracts corrected?

A
  • *By removing the lens
    1. Intracapsular extraction
    2. Extracapsular extraction
    3. Lens replacement after surgery
42
Q

Nursing Care pre-op cataract surgery

A
  1. Dilate pupil 1 hour before
  2. No ASA or anticoagulants
  3. Administer mydriatics and cycloplegics
43
Q

Nursing Care post-op cataract surgery

A
  1. No lifting

2. Call MD if there is an increase in pain, discharge, increased redness, increased edema

44
Q

Home care after cataract surgery

A
  1. Antibiotic drops
  2. Eye shield for 1 week
  3. Position themselves on their non surgical eye
  4. Cycloplegic
  5. No Valsalva maneuver
  6. PRN acetaminophen
45
Q

Why is IOP higher in glaucoma patients?

A
  1. Because there is an increased rate of aqueous production
  2. Increased passage flow resistance encountered
  3. Increased venous pressure
46
Q

Primary prevention of glaucoma

A
  1. Maintain ideal body weight
  2. No smoking
  3. Control HTN/DM/CVD
  4. Avoid increasing PO fluid
47
Q

Secondary prevention of glaucoma

A
  1. No alcohol/caffeine before an eye exam
  2. Side effect of hormone replacement therapy in females
  3. Regular eye exams with optic nerve assessment and tonometry
48
Q

Tertiary prevention of glaucoma

A
  1. No bending

2. No Valsalva maneuver

49
Q

Teaching for a patient with glaucoma

A
  1. No stress
  2. No excess fluids
  3. There is no cure, but meds can control it
  4. Carry drops at all times
  5. Medicalert bracelet
  6. Notify MD with pain, sudden change in vision, halos, or headache
50
Q

Risk Factors for glaucoma

A
  1. Alcoholism
  2. Drugs
  3. Chronic steroids
  4. Increased fluids
  5. HTN
  6. CVD
  7. DM
  8. Obese
  9. Smoking
  10. Caffeine
51
Q

Treatment of glaucoma

A
  1. Pharmacologic therapy
  2. Trabeculoplasty
  3. Peripheral iridotomy
  4. Filtering procedures - opening in the trabecular meshwork to drain excess humerous
52
Q

Trabeculoplasty

A

widens the canal of Schlemm (which drains excess aqueous humor)

53
Q

Peripheral iridotomy

A

Opening into iris to eliminate blockage

54
Q

What is enucleation?

A

Removal of the eyeball

55
Q

Why would an enucleation be done?

A
  1. Trauma that forces content of globe to escape
  2. Infection
  3. Intraocular tumors
  4. Eye without useful vision causing problems with the good eye
  5. Glaucoma, retinal detachment, or inflammation causing irritated, painful, blind eye
56
Q

Treatment for enucleation

A

Wear prosthesis or eye patch

57
Q

Legal criteria for blindness

A

20/400 vision

58
Q

S/Sx of diabetic retinopathy

A
  1. Asymptomatic
  2. Painless
  3. Blurred vision
59
Q

Treatment for diabetic retinopathy

A
  1. Prevent DM and increased BG

2. Photocoagulation

60
Q

What is cytomegalovirus (CMV)

A

It is an AIDS related complication causing retinal inflammation

61
Q

Treatment of cytomegalovirus (CMV)

A
  1. Ganciclovir
  2. Foscarnet
  3. Cidofoviar
    * *Side effect = nephrotoxic
62
Q

S/Sx of cytomegalovirus (CMV)

A
  1. Floaters

2. Decreased peripheral vision

63
Q

S/Sx of HTN related changes in eyesight

A
  1. Change in light reflex

2. Decreased visual acuity

64
Q

Procedure for a whisper test

A
  1. Examiner occludes the patient’s untested ear
  2. Examiner stands 1-2 feet behind the patient and whispers
  3. The patient should be able to repeat the words
65
Q

What does a Weber exam test for?

A

Bone conduction and lateralization

66
Q

After a Weber test, what is conductive loss?

A

It means they heard the tuning fork better in the affected ear
**this could indicate otosclerosis or otitis media

67
Q

After a Weber test, what is sensorineural loss?

A

It means that the patient heard the tuning fork better in the unaffected ear
**This could indicated damage to the cochlear/vestibulocochlear nerve

68
Q

What does a Rinne exam test for?

A

Bone vs. Air

Conductive loss vs Sensorineural loss

69
Q

What does conductive loss mean?

Rinne exam

A

The bone sound is better than the air sound

**This could indicate otitis media, wax buildup

70
Q

What does sensorineural loss mean?

Rinne exam

A

The air sound is better than the bone sound

**This could indicate nerve damage

71
Q

Tympanogram

A

Measure the middle ear muscle reflex to sound stimulation

72
Q

Auditory brain stem response (ABR)

A

Measures electrical auditory potential from cranial nerve VIII to the brainstem

73
Q

Middle Ear Endoscopy

A

Microscopic visualization of the middle ear

74
Q

What is mixed loss?

hearing loss

A

Dysfunction of air and bone conduction

75
Q

What is functional loss?

hearing loss

A

Usually related to emotional disturbance

76
Q

What is presbycusis?

A

progressive hearing loss related to aging

77
Q

Causes of cerumen impaction/foreign body

A
  1. Excessive accumulation

2. Unintentional introduction of foreign body into the canal

78
Q

S/Sx of cerumen impaction/foreign body

A
  1. Otalgia (ear ache)
  2. Decreased hearing
  3. Aural fullness
79
Q

Treatment for cerumen impaction/foreign body

A
  1. Removal by irrigation
  2. Suction
  3. Do NOT use water to irrigate insect use mineral oil only
80
Q

How long should a patient hold their position after instillation of ear drops?

A

5-10 minutes

81
Q

What position should the patient be in after irrigation of the ear?

A

They should be lying on the side of the affected ear in order to promote drainage

82
Q

Dizziness

A

Altered sensation of orientation in space

83
Q

Vertigo

A

Misperception/illusion of motion

84
Q

Ataxia

A

Failure of neuromuscular coordination related to vestibular disease

85
Q

Nystagmus

A

Involuntary rhythmic movement of the eyes related to vestibular dysfunction

86
Q

Causes of Motion sickness

A
  1. Disturbance of equilibrium caused by constant motion (vestibular overstimulation)
87
Q

S/Sx of motion sickness

A
  1. Sweating
  2. Pallor
  3. N/V
88
Q

Treatment for motion sickness

A
  1. Antihistamines - dramamine
  2. Anticholinergics - scopolamine patch
  3. Instruct the patient about the side effects such as drowsiness
89
Q

Causes of Meniere’s disease

A

Unknown. Too much circulating fluid in the inner ear causing endolymphatic hydrops (edema) causing increased pressure and/or rupture of the inner ear membranes

90
Q

S/Sx of Meniere’s disease

A
  1. Fluctuating sensorineural loss
  2. Tinnitus
  3. Incapacitating vertigo
  4. Aural fullness
  5. N/V
  6. Weber to unaffected ear (sensorineural loss) and “Pike’s Peak” on audio
91
Q

Treatment for Meniere’s disease

A
  1. 2000 mg Na diet
  2. Meclizine
  3. Diazepam
  4. Promethazine
  5. Hydrochlorothiazide
  6. Vasodilators
  7. Surgery
92
Q

Surgical treatments for Meniere’s disease

A
  1. Endolymphatic shunt
  2. Ototoxic med perfusion into the middle ear and inner ear - gentamycin
  3. Intraotologic catheter
  4. Labyrinthectomy

Eye and Ear (1 decks)

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