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3254/64 > Eye & Ear Disorders > Flashcards

Eye & Ear Disorders Flashcards

1
Q

Central loss of vision that affects the macula of the eye

A

Macular degeneration

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2
Q

T or F: macular degeneration has no cure

A

True

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3
Q

What is the most common cause of vision loss in older adults?

A

Age-related macular degeneration (AMD)

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4
Q

What are the two types of macular degeneration?

A

Dry and Wet

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5
Q

Most common type of macular degeneration caused by gradual blockage in retinal capillary arteries, resulting in ischemia and necrosis of the macula

A

Dry macular degeneration

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6
Q

Type of macular degeneration caused by new growth of blood vessels that have thin walls that leak blood and fluid

A

Wet macular degeneration

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7
Q

Risk factors for dry macular degeneration

A

Smoking, HTN, short body stature

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8
Q

Which sex is more at risk for dry macular degeneration?

A

Females

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9
Q

A diet lacking _____ and _____ may place an individual at higher risk for developing dry macular degeneration

A

Carotene and vitamin E

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10
Q

What type of macular degeneration can occur at any age?

A

Wet

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11
Q

Expected findings of macular degeneration

A

Lack of depth perception, objects appear distorted, blurred vision, loss of central vision, blindness

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12
Q

Dietary education for the client with macular degeneration

A

Encourage consumption of antioxidants, carotene, and vitamin E and B12

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13
Q

An opacity in the lens of an eye that impairs vision

A

Cataract

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14
Q

Common causes of cataracts

A

Age-related, trauma

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15
Q

Medications that can cause cataracts if used long-term

A

Corticosteroids, pheothiazine derivatives, beta blockers, miotic meds

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16
Q

Associated conditions that can cause cataracts

A

Diabetes, hypoparathyroidism, Down syndrome, chronic sunlight exposure

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17
Q

Intraocular diseases that can cause cataracts

A

Glaucoma, retinal detachment

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18
Q

Client education for prevention of cataracts

A

Sunglasses, protective eyewear (hazardous activities), annual eye exams (40+)

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19
Q

Cataracts expected findings

A

Decreased visual acuity, blurred vision, diplopia (double vision), visible opacity, absent red reflex

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20
Q

Tool used to measure visual acuity

A

Snellen chart

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21
Q

Tool used to examine internal and external eye structures

A

Opthalmoscope

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22
Q

MOA of atropine for cataracts

A

Prevents pupil constriction for prolonged periods of time (mydriasis) and relaxes muscles in the eye (cycloplegia)

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23
Q

Medication used to dilate the eye preoperatively and for visualization of the eye’s internal structures

A

Atropine

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24
Q

Client education for atropine

A

Effects can last 7-12 days; wear sunglasses (photosensitivity)

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25
Q

Client education following surgical removal of lens

A

Wear sunglasses, report signs of infection (yellow or green drainage), avoid activities that increase IOP

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26
Q

Activities that increase IOP

A

Bending over at waist, sneezing, blowing nose, coughing, straining, head hyperflexion, restrictive clothing, sexual intercourse

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27
Q

Indications of increased IOP or hemorrhage

A

Pain with N/V

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28
Q

Best vision is not expected until ___ to ___ weeks following lens surgery

A

4-6

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29
Q

Expected reference range for IOP

A

10-21 mmHg

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30
Q

What are the two primary types of glaucoma?

A

Primary open-angle and Primary angle-closure

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31
Q

Most common type of glaucoma by which aqueous humor outflow is decreased due to blockages in the eye’s drainage system, causing a gradual increase in IOP

A

Primary open-angle

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32
Q

Type of glaucoma in which the angle between the iris and sclera suddenly closes, causing a SUDDEN increase in IOP

A

Primary angle-closure

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33
Q

Glaucoma risk factors

A

Age, HTN, infection, trauma, diabetes, severe myopia, retinal detachment

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34
Q

Expected findings of primary open-angle glaucoma

A

headache, mild eye pain, loss of peripheral vision, decreased accommodation, halos seen around lights, elevated IOP (>21 mmHg; usually 22-32)

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35
Q

Expected findings of primary angle-closure glaucoma

A

Rapid onset of elevated IOP (>30 mmHg), decreased/blurred vision, colored halos seen around lights, pupils nonreactive to light, severe pain and nausea, photophobia

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36
Q

Diagnostic procedure that measures IOP

A

Tonometry

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37
Q

Client education for glaucoma medication administration

A

Instill one eye drop in each eye twice daily (q12h), wait 5-10 min between eye drops if more than one is prescribed, avoid touching applicator tip to eye, ALWAYS wash hands before and after use, apply pressure to inner corner of eye once eye drop is instilled (punctal occlusion technique)

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38
Q

Examples of miotic cholinergic agents

A

Carbachol, echothiophate, pilocarpine

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39
Q

MOA of miotic medications

A

Constrict pupil allowing for improved circulation and outflow of aqueous humor

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40
Q

Side effect of miotics

A

Blurred vision

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41
Q

Second line drug for POAG

A

Pilocarpine

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42
Q

Patient education for miotic cholinergic agents

A

Use good lighting to avoid falls

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43
Q

Examples of adrenergic agonists for glaucoma

A

Apraclonidine, brimonidine tartrate, dipivefrin hydrochloride

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44
Q

MOA of adrenergic agonists for glaucoma

A

Reduction of IOP by limiting production of aqueous humor and dilating pupils to improve fluid flow to site of absorption

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45
Q

Client education for adrenergic agonists for glaucoma

A

Wear sunglasses in bright light because of pupil dilation

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46
Q

First line drug therapy for glaucoma that decreases IOP by reducing aqueous humor production

A

Beta blockers (timolol)

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47
Q

Nursing considerations for timolol

A

Can be absorbed systemically causing bronchoconstriction and hypoglycemia — use cautiously in patients with asthma, COPD, and diabetes; can cause bradycardia and hypotension

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48
Q

Examples of carbonic inhibitors for glaucoma

A

Acetazolamide, dorzolamide, and brinzolamide

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49
Q

MOA of carbonic anhydrase inhibitors for glaucoma

A

Decreases IOP by reducing aqueous humor production

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50
Q

Nursing action for carbonic anhydrase inhibitors for glaucoma

A

Assess sulfa allergy

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51
Q

Examples of prostaglandin analogs for glaucoma

A

Bimatoprost and latanoprost

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52
Q

MOA of prostaglandin analogs for glaucoma

A

Increases outflow by dilating blood vessels draining aqueous humor at a more rapid rate

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53
Q

Client education for prostaglandin analogs for glaucoma

A

Can darken iris with long-term use

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54
Q

Osmotic diuretic used in the emergency treatment for primary angle-closure glaucoma to quickly decrease IOP

A

IV mannitol

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55
Q

Potential consequence of untreated glaucoma

A

Blindness

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56
Q

Regular glaucoma checks for individuals under 40

A

Every 2-4 years

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57
Q

Regular glaucoma checks for individuals ages 40-54

A

Every 1-3 years

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58
Q

Regular glaucoma checks for individuals ages 55-64

A

Every 1-2 years

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59
Q

Regular glaucoma checks for individuals 65+

A

Every 6-12 months

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60
Q

Function of the ears

A

Hearing and balance

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61
Q

Middle ear structures

A

Tympanic membrane (eardrum) and ossicles

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62
Q

Ossicles (smallest bones of body) of the middle ear

A

Malleus, incus, stapes

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63
Q

Structure that separates the middle ear from the inner ear

A

Oval window

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64
Q

Inner ear structures

A

Cochlea (hearing organ) and semicircular canals (balance)

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65
Q

Causes of conductive hearing loss

A

Otitis media, otosclerosis, foreign body (impacted cerumen)

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66
Q

Cause of sensorineural hearing loss

A

Damage to cranial nerve VIII (vestibulocochlear)

67
Q

5 senses

A

Visual, auditory, olfactory, gustatory, tactile

68
Q

Being aware of position and movement of body parts without seeing them

A

Kinesthetic

69
Q

__________ allow a person to recognize the shape, size, and texture of an object

A

Stereognosis

70
Q

3 components to any sensory experience

A

Reception, perception, reaction

71
Q

Reaction stops after continuous reception of the same stimulus EXCEPT for _____

A

Pain

72
Q

Deficit in the normal function of reception and perception

A

Sensory deficit

73
Q

Most common sensory deficits

A

Visual and hearing

74
Q

Reduced sensory input

A

Sensory deprivation

75
Q

The inability to perceptually disregard or selectively ignore multiple sensory stimuli

A

Sensory overload

76
Q

Colored portion of pupil

A

Iris

77
Q

Inner most layer of eye that contains the rods and cones

A

Retina

78
Q

Retinal structures responsible for peripheral vision and perception of low level light

A

Rods

79
Q

Retinal structures responsible for central vision and perception of bright level lights

A

Cones

80
Q

Eye structure located under the iris that bends light rays to focus properly on the retina

A

Lens

81
Q

“Blind spot” of the eye that contains nerve fibers, but lacks photoreceptors

A

Optic disc

82
Q

Eye structure that contains fovea where vision is most acute

A

Macula

83
Q

Visual test that assesses color blindness through detection of red and green colors

A

Ishihara color plate

84
Q

What vitamin deficiency can cause vision problems?

A

Vitamin A (found in fruit colors orange, red, and green)

85
Q

PERRLA

A

Pupils equal, round, reactive to light and accommodation

86
Q

Which sex is at higher risk for retinal detachment?

A

Men

87
Q

Medical management of cataracts

A

Surgical removal of lens, replacement with artificial lens

88
Q

Increased intraocular pressure (IOP) causing progressive damage to the optic nerve

A

Glaucoma

89
Q

Production of aqueous humor

A

5 mL per day, but only about 1 mL preset at a time

90
Q

Last resort medical management for glaucoma

A

Laser surgery

91
Q

MOA of glaucoma medications

A
  1. Reduce production of aqueous humor
  2. Increase absorption of aqueous humor
92
Q

T or F: glaucoma medications improve lost vision

A

False; vision loss is irreversible

93
Q

The separation of the retina from the epithelium in the back of the eye

A

Retinal detachment

94
Q

Behaviors of retinal detachment

A

Small flashes of light (“shooting stars” or “lightening streaks”), floaters

95
Q

Most common cause of retinal detachment

A

Posterior vitreous detachment

96
Q

The shrinking of fluid causing retina to become detached from back of eye

A

Posterior vitreous detachment

97
Q

Example of surgical management for detached retina

A

Scleral buckling

98
Q

Leading cause of blindness in individuals 65+

A

Macular degeneration

99
Q

Adverse events of miotic

A

Drug-induced myopia (near-sightedness), accommodative spasms, vascular congestion, ocular inflammation

100
Q

Anticholingeric medications that paralyze ciliary muscle resulting in pupil dilation

A

Cycloplegics

101
Q

Adrenergic medications used in primary open-angle glaucoma that mimic norepinephrine and epinephrine

A

Mydriatics

102
Q

Outer ear structures

A

Pinna, ear canal, tympanic membrane

103
Q

Structure that touches the eardrum

A

Malleus

104
Q

Assessment of tympanic membrane

A

Should be pearly-gray and clear

105
Q

Hearing tests

A

Tuning fork (Weber and Rinne); audiometry

106
Q

Abnormal growth of bone in middle ear, primarily affecting the stapes, causing hearing loss

A

Otosclerosis

107
Q

Behaviors of otosclerosis

A

Hearing loss, dizziness, balance problems, tinnitus

108
Q

Otosclerosis management

A

Surgery (stapedectomy, prosthetic replacement), hearing aids

109
Q

Hearing loss than can be corrected

A

Conductive

110
Q

Permanent hearing loss

A

Sensorineural

111
Q

Eye disorder caused by excess endolymphatic fluid that distorts the inner ear system

A

Ménière’s disease

112
Q

Ménière’s disease occurs in individuals between the ages ___ and ___ initially

A

20-50

113
Q

Behaviors of Ménière’s disease

A

Tinnitus, one-sided sensorineural hearing loss, vertigo, headache, increasing tinnitus and fullness of ear can precede episodes

114
Q

Ménière’s disease impacts vital signs increasing ___

A

BP

115
Q

Ménière’s disease drug therapy

A

Antiemetics, pulse pressure treatment

116
Q

Surgical management of Ménière’s disease

A

Labyrinthectomy (resection of vestibular nerve)

117
Q

Effects of hearing impairment in the pediatric population

A

Speech and language developmental delays, learning problems

118
Q

Effects of hearing impairment in the elderly population

A

Loss of independence, inability to live alone and perform ADLs, inability to communicate, social isolation

119
Q

Assessment of sclera

A

White; no redness or yellowing

120
Q

Assessment of conjunctiva

A

Pink; no drainage

121
Q

Assessment of visual acuity using snellen chart

A

Patient should stand 20 ft from chart, cover one eye then other (assess both eyes), have patient read chart backwards when assessing second eye (prevents memorization), may assess with and without glasses

122
Q

Behaviors indicative of vision loss

A

Inability to perform ADLs, falls/accidents, poor hand/eye coordination, head tilt, short attention span, inconsistent reading pace

123
Q

Post operative teachings cataracts

A

Avoid aspirin, wear eyepatch at night, report significant swelling, bruising, or loss of vision

124
Q

Instillation of eye drops

A

Put on gloves, tilt head back, pulls down lower lid, instill drops into inner canthus

125
Q

Retinal detachment post-op patient education

A

Avoid close work such as reading, writing, sewing for first week

126
Q

Body language cues when caring for a patient with hearing impairment

A

Directly face the patient

127
Q

Otoscopic examination for adult

A

Pull pinna up and back

128
Q

Otoscopic examination for children

A

Pull ear down and back

129
Q

Behaviors indicative of hearing loss

A

Turning good ear toward speaker, failure to respond, answering questions incorrectly, asking people to repeat, shouting in conversation

130
Q

nursing care for the client with hearing loss

A

Speak slowly and clearly with low voice, directly facing the patient. Provide alternate forms of communication

131
Q

Hearing aids education

A

Keep hearing aids clean and dry, do not apply moisture, avoid cleansing with alcohol, turn them off if not in use, store them in same place at all times

132
Q

Nursing care for Ménière’s disease

A

Teach pt. To move head from side to side slowly, institute fall precautions, smoking cessation (causes vasoconstriction)

133
Q

Drug therapy for Ménière’s disease

A

Antiemetics, antihistamines, anti-vertigo

134
Q

Patient education for labyrinthectomy

A

Will result in total hearing loss on that side

135
Q

Nothing smaller than a __________ should be inserted into the ear canal

A

Fingertip

136
Q

Condition of the inner ear that occurs when the client has the sensation that they or their surroundings are in motion

A

Vertigo

137
Q

Type of vertigo that has a sudden onset and occurs in response to a change in position. May last for a few weeks or years

A

Benign paroxysmal positional vertigo

138
Q

Treatment for benign paroxysmal positional vertigo

A

Bed rest and short course of meclizine

139
Q

Inflammation of the labyrinth in the inner ear, often secondary to otitis media

A

Labyrinthitis

140
Q

Manifestations of labyrinthitis

A

Sudden onset of severe vertigo, N/V, and possible hearing loss and tinnitus

141
Q

Treatment for labyrinthitis

A

Bed rest in a darkened environment, meclizine and dimenhydrinate for nausea and vertigo, systemic antibiotic therapy

142
Q

Viral or bacterial infection of the middle ear

A

Otitis media

143
Q

manifestations of otitis media

A

Ear pain, pressure, fever, headache, conductive hearing loss, purulent/bloody drainage

144
Q

Otoscopic exam findings related to otitis media

A

Redness, bulging of tympanic membrane, inability to visualize landmarks

145
Q

Medical management of otitis media

A

Systemic antibiotic therapy, analgesics and heat for pain, decongestants

146
Q

Surgical management of otitis media

A

Myringotomy (surgical opening of eardrum) and placement of grommet to equalize pressure

147
Q

A non-invasive test of hearing ability, including frequency, pitch, and intensity, in which the client indicates when a tone is heard through earphones

A

Audiometry

148
Q

Diagnostic tool that measures the mobility of the tympanic membrane and middle ear structures relative to sound

A

Tympanogram

149
Q

Examples of ototoxic antibiotics

A

Gentamicin, erthyromycin

150
Q

Examples of ototoxic diuretics

A

Furosemide, ethacrynic acid

151
Q

Examples of ototoxic NSAIDs

A

Aspirin, ibuprofen

152
Q

Example of ototoxic chemotherapeutic agent

A

Cisplatin

153
Q

Medication that has antihistamine and anticholinergic effects used to treat the vertigo that accompanies inner ear problems

A

Meclizine

154
Q

Patient education for meclizine

A

Sedative effects (avoid driving or operating heavy machinery)

155
Q

Example of antiemetics used to treat N/V associated with vertigo

A

Ondansetron

156
Q

Ondansetron contraindication

A

Clients with certain cardiac rhythm disorders

157
Q

Ondansetron patient education

A

Report dizziness or rash

158
Q

Examples of antihistamines for the treatment of vertigo and nausea that accompany inner ear problems

A

Diphenhydramine and dimenhydrinate

159
Q

side effects of antihistamines

A

Urinary retention, dry mouth (anticholinergic effects), sedation

160
Q

Example of anticholinergic medication for treatment of nausea related to inner ear problem

A

Scopolamine

161
Q

Patient education on vertigo prevention

A

Restrict movement of head, change positions slowly, avoid caffeine and alcohol, decrease sodium intake, maintain safe environment free of clutter

162
Q

Nursing actions following labyrinthectomy

A

Patient will have severe nausea and vertigo following procedure. Implement safety precautions and given antiemetics as needed

163
Q

Client education following middle ear surgery

A

Avoid air travel for 2-3 weeks, avoid straining or coughing, blow nose gently with mouth open for 2-3 weeks, keep ear canal clean and dry (avoid showering for several days to one week), loosely place cotton ball with petroleum jelly in ear when able to shower to prevent water from entering, temporary hearing loss normal in affected ear, report drainage

3254/64 (3 decks)

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