Eye & Ear Flashcards
Review the most important eye and ear diseases.
Name the parts of the eye on the diagram:
- bottom lid, cornea, iris, pupil, sclera, tear duct, top lid
What is tonometry?
A diagnostic test to assess for an increase in the intraocular pressure, which could indicate glaucoma.
What is normal intraocular pressure (IOP)?
IOP = 10 to 21 mm Hg
It is higher in the mornings, so document what time it was measured.
What are the risk factors for eye and ear problems?
- aging
- infections
- medications - some meds cause blurry vision or ototoxicity
- trauma and tumors
- diabetes mellitus increases risk for blindness - due to sugar destroying the small vessels
What are the safety precautions for a client with a vision problem or eye injury?
- no straining
- don’t rub the eye
- fall precautions
What is considered perfect vision?
20/20 vision
How should the nurse speak to a client who can’t see well or is legally blind?
- orient client to the environment by explaining where things are
- use the “clock method” of describing where foods are on the plate
- let client hold onto the nurse’s arm when ambulating
- provide equipment that gives the time orally
Describe:
Cataracts
An opacity of the lens that distorts what the client sees that can progress to blindness.
How do clients with cataracts see?
- blurry vision,
- double vision (diplopia), and
- have a harder time seeing color
Treatment:
Cataracts
Cataracts are surgically removed (one at a time) when the vision interferes with the client’s ability to function normally.
Describe:
Glaucoma
An increase in intraocular pressure of the eye, which can damage the ocular nerve causing blindness.
It occurs later in life and is hereditary.
Describe:
Acute angle-closure glaucoma
(Immediate complication)
Sudden eye pain and possible nausea and vomiting, resulting in blindness.
The client will receive antiglaucoma meds to lower the pressure.
What classification of medications are contraindicated with acute angle-closure glaucoma?
Anticholnergic medications
These meds cause the pressure to increase.
What is the most common type of glaucoma?
Open-angle glaucoma
Client can get loss of peripheral vision.
Interventions:
Glaucoma
Focus on lowering the pressure in the eye:
-
give eye drops
- latanoprost
- timolol
- dorzolamide
If meds don’t work, possible surgery to drain fluid.
Describe:
Retinal detachment
The separation of layers in the eye due to too much fluid or a tumor.
If untreated, blindness can occur.
What are the characteristic signs and symptoms of retinal detachment?
- flashes of light
- floaters
- blurry vision
- a sense that curtain is being drawn over the eye
- painless loss of vision
Interventions:
Retinal detachment
- avoid additional pressure on eyes
- surgery to drain fluid or remove tumor
Describe:
Macular degeneration
The loss of central vision more common in the elderly caused by leaking blood vessels.
Treatment:
Macular degeneration
Possible surgery to seal leaking blood vessels.
What are the post-op interventions for eye surgery?
- keep bed elevated to 30 - 45 degrees
- maintain an eye patch
- position belongings on non-operative side
- fall precautions
Teaching:
Eye surgery
- avoid straining (bending over, constipation, heavy lifting)
- administer stool softeners
- don’t rub the eye
- administer eye drops
- contact HCP for signs of infection
What are the interventions if a client has a penetrating object in the eye such as sharp metal?
(Immediate complication)
- DO NOT remove the object
- cover the eye with a cup and tape in place
- no bending, no straining
- surgery to remove object
What is the intervention if a client gets chemicals splashed in the eye?
Flush eyes with water for at least 15 to 20 minutes.
What is an eye contusion?
A “black eye” from the result of an injury.
Interventions:
Eye contusion
- apply an ice pack immediately
- assess vision and refer to an eye doctor
Name the parts of the ear on the diagram:
- outer ear, inner ear, middle ear and pinna.
What are the 2 functions of the ear?
hearing and maintaining balance
Which cranial nerve is responsible for hearing and balance?
The 8th cranial nerve.
What are signs of hearing loss?
- frequently asking others to repeat statements
- turning or leaning forward to favor one ear
- shouting
- raising the volume on the TV
What can occur socially with a client that can’t see or hear well?
The client may become isolated due to unable to communicate well, causing depression and anxiety.
How does the nurse communicate with a client that can’t hear well?
- use a firm volume, calm and low-pitched voice
- speak slowly with simple words
- don’t yell or speak in a loud voice
- stand in front of client and maintain eye contact
- repeat questions, don’t rephrase questions
- minimize background noise: turn off TV and close door
- use a communication board
What should never be placed in the ear?
Never put cotton-tipped applicators in the ears such as Q-tips.
It can puncture the eardrum.
Teaching:
Hearing aids
- put volume at minimum and then adjust the volume up to avoid feedback squealing
- keep hearing aid dry and don’t get lotions or sprays on it
- remove battery when not using
- don’t place on food tray due to risk of getting thrown out
Describe:
Otitis media
An ear infection typically in the middle ear caused by a blocked eustachian tube.
It is a common complication of a respiratory infection. The treatment is to give antibiotics.
Describe:
Meniere’s syndrome
An inner ear disorder that can cause vertigo (dizziness), hearing loss and tinnitus (ringing in the ears).
What is the priority intervention for a client with Meniere’s syndrome?
Prevent risk of falling due to vertigo.
Don’t drive if symptoms are severe.
Define:
Myopia
Nearsightedness: the client has trouble seeing objects far away.
Define:
Hyperopia
Farsightedness: the client has trouble seeing objects close up.
Define:
Presbycusis
hearing loss
Define:
Tinnitus
Ringing or other sounds in the ear.
What are the risk factors of hearing loss?
- frequent ear infections
- older age
- loud noise
- exposure to smoke
Which medications can be given to treat Meniere’s syndrome?
- Antivertigo meds such as meclizine
- Antiemetics and antianxiety meds are also given if client is showing symptoms
