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NSC 386 > Eyes & Ears > Flashcards

Eyes & Ears Flashcards

1
Q

Subjective Data for Eye Assessment

A 
Health History
Medications
Surgery
Other Treatments
Allergies
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2
Q

Objective Data Eye Assessment

A

Assessment of Drainage
Oculomotor Assessment
Vision Exam

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3
Q

When assessing visual acuity, does it matter which eye the nurse assesses first?

A

Assess right eye first. Then left eye.

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4
Q

Chart that assesses normal visual acuity.

A

Snellen Chart

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5
Q

Normal Vision

A

20/20

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6
Q

Legal blindness is defined as

A

20/200 or less in the better eye

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7
Q

Chart to assess near vision

A

Rosenbaum Chart

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8
Q

Normal vision using the Rosenbaum Chart

A

14/14

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9
Q

How far away should a Rosenbaum chart be held from the patient?

A

12-14 inches

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10
Q

What is a jaeger chart

A

Similar to rosenbaum chart
Assesses near vision in age 40 or older
No particular number recorded

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11
Q

Ishihara color test

A

Distinguishes a pattern of color in series of color palates

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12
Q

Ophthalmic tool to measure Intraocular Pressure

A

Tonometry

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13
Q

What is tonometry used for

A

Measure intraocular pressure

Diagnose and treat glaucoma patients

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14
Q

Age related changes in the eye

A
  1. Cornea is less transparent.. 2. Lens Hardens.. 3. Lens becomes yellow & cloudy b/c decreased amt of blue light entering the eye… 4. Pupil size = smaller… 5. Scattering of light w/in eye.. 6. Presbyopia
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15
Q

Nearsightedness due to aging

A

Presbyopia

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16
Q

Age related refractive errors

A

Presbyopia

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17
Q

Not age-related refractive errors

A

Myopia

Hyperopia

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18
Q

Myopia is

A

Nearsightedness - can see objects near clearly but objects in the distance are blurred

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19
Q

Hyperopia is

A

Farsightedness - distant objects clearly seen but close objects appear blurry

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20
Q

When light rays are unable to converge to single focus on the retina this is known as

A

Refractive error

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21
Q

Irregular corneal curvature which causes a split focus; type of refractive error

A

Astigmatism

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22
Q

Corrections for refractive errors

A

Eyeglasses
Contact lenses
Refractive surgery (LASIK and Lens Implantation)

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23
Q

Types of conjunctivitis

A

Bacterial
Viral
STI
Allergic

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24
Q

What is “pink-eye”?

A

Bacterial form of conjunctivitis caused by the bacteria S. Aureus

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25
Q

Assessment for Conjunctivitis

A 
Health History (subjective and objective data)
Recent Travel
Physical Assessment (visual acuity; v/s; physical inspection; surroundings)
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26
Q

Examples of bacterial conjunctivitis:

A

“Pink-eye”

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27
Q

Manifestation of viral conjunctivitis

A

Tearing; Foreign Body sensation; redness; mild photophobia

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28
Q

STI conjunctivitis causes

A

Usually chronic

Caused by chlamydia

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29
Q

Why is STI borne conjunctivitis so important to get treated right away

A

Major cause of blindness

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30
Q

How to avoid getting conjunctivitis

A

WASH YOUR HANDS!!!
AVOID Shared: towels, contacts, make-up
Avoid using old make-up
Avoid rubbing or scratching eye

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31
Q

Types of eye trauma

A

Penetrating
Burns
Blunt Force

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32
Q

Penetrating eye trauma causes

A

Foreign body - glass, knife, hook…

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33
Q

Penetrating eye trauma interventions

A

Irrigation and removal of LOOSE foreign body

Stabilize NOT loose objects

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34
Q

Types of Burns (EYE TRAUMA)

A

Chemical - insecticide; nail polish remover

Thermal

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35
Q

Blunt force (eye trauma cause)

A

Direct impact - fall, baseball bat, kicked

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36
Q

Chemical eye trauma interventions

A

Flush eye immediately for 15 minutes

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37
Q

Blunt force eye trauma interventions

A

Place the patient in semi-Fowler’s position (45 degree angle) and put eye shield over eye. Give meds and analgesia as ordered

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38
Q

Diagnostic Tests for Eye Trauma

A

X-ray (most common)

MRI, CT, Ultrasound

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39
Q

Leading cause of blindness worldwide

A

Glaucoma

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40
Q

What is glaucoma?

A

Damage to the optic nerve caused by an increase in intraocular pressure.
Result = loss of peripheral vision

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41
Q

What is normal intraocular pressure?

A

10-21 mmHg

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42
Q

What is the goal of glaucoma treatment?

A

To decrease intraocular pressure

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43
Q

Modifiable risk factors for Glaucoma

A

Cardiovascular disease
High Blood pressure
Diabetes

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44
Q

Non-Modifiable Risk factors for Glaucoma

A

Older Age
Family History
African American
Migraines

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45
Q

Open-angle glaucoma

A

Angle between iris and cornea is wide open
Typically affects both eyes (may be asymptomatic)
Slow progression; Outflow is decreased and drainage channels become clogged which results in damage to the optic nerve

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46
Q

90% of all Glaucoma Cases

A

Open-angle glaucoma

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47
Q

Closed angle glaucoma

A

Narrow angle between iris and cornea; sudden blockage of drainage cannal which results in increased intraocular pressure
Requires immediate medical attention

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48
Q

Symptoms of Glaucoma

A

Severe eye pain (in or around eye)
Headache, N/V, Blurred vision
Tunnel vision
Ocular redness

49
Q

Glaucoma assessment

A

Comprehensive eye exam - annually
Optic Disc pictures - at eye exam
Visual field testing

50
Q

Type of glaucoma that developes slowly often w/o symptoms of pain/pressure

A

Open-angle glaucoma

51
Q

Medications to control glaucoma

A

Cholinergics (Mitotics)
Alpha-adrenergic agonists
Beta-adrenergic blockers ; Hyperosmotic agents
Carbonic Anhydrase Inhibitors; Prostaglandin analogs

52
Q

Mitotic used to control glaucoma. How does it function?

A

Increases outflow drainage to relieve IOP

Example: pilocarpine (Carbachol)

53
Q

How does alpha-adrenergic agonists control glaucoma symptoms? Give an Example.

A

Decreases production and increases outflow of drainage

Example: brimonidine (Alphagen)

54
Q

How do beta-adrenergic blockers control the effects of glaucoma? Give and example.

A

Decreases production of aqueous humor in the ciliary body

Example: Timolol (timoptic istalol)

55
Q

What is crucial in administering Timolol optically?

A

Close tear duct and hold to prevent systemic effects of beta blocker such as bronchospasm and decreased heart rate and blood pressure brought on by stimulation of the parasympathetic nervous system.

56
Q

What is the function of carbonic anhydase inhibitors. Give an example.

A

Decreases the production of aqueous humor.

Example: Acetazolamide (Diamox)

57
Q

What is the function of prostaglandin analogs r/t glaucoma treatment. Give an example.

A

Increases drainage outflow

Example: lantanoprost (Xalatan)

58
Q

What is the major side effect of lantanoprost?

A

Permanently changes the color of the iris and can cause color changes to the eyebrow.

59
Q

Effect of hyperosmolar agents on glaucoma treatment. Give an example.

A

Immediate decrease in intraocular pressure

Examples: Glycerin (oral liquid); Isosorbide solution (Ismotic) - oral liquid; Mannitol (Osmitrol) - IV solution

60
Q

Glaucoma Surgical Treatments:

A

Laser Trabeculoplasty
Trabeculectomy
Peripheral laser irodotomy
Surgical irodotomy

61
Q

Goal of surgical interventions for glaucoma treatment:

A

Allow aqueous humor to flow through newly created opening in the iris and into normal outflow channels

62
Q

Nursing care: Glaucoma

A

Teach Signs and symptoms
Medication therapy
Health promotion: Risk factors and Annual Eye exams

63
Q

Opacity w/in the eye lens that may be in one or both eyes.

A

Cataracts

64
Q

Risk factors for Cataracts

A 
Congenital - (maternal rubella)
Aging
Toxicity (systemic or topical)
Accidents/Trauma
Radiation/Sunlight
Altered metabolism (diabetes)
Cigarette Smoking
65
Q

Symptoms of cataracts

A

Blurred vision
Inability to see in dim light
Seeing halos around lights
Vision loss

66
Q

Diagnosis of cataracts

A 
Visual acuity exam
Complaints of visual dysfunction
Opacity visible
Tonometry to measure IOP
Dilated eye exam
67
Q

Pre-/Postoperative Nursing Care (cataracts)

A

Monitor V/S
Assess Surgical Site
Avoid laying on stomach and surgical eye side
Protective eyewear
Avoid rubbing eyes
Contact provider if: pain increases; swelling; discharge; floaters; flash of light

68
Q

Nursing diagnoses (cataracts)

A

Self care deficits r/t visual deficit

Anxiety r/t lack of knowledge about the surgical & PostOp experience

69
Q

Irreversible central vision loss caused by deterioration of macula

A

Age-Related Macular Degeneration

70
Q

Types of Age-related macular degeneration

A

Non-exudative (Dry)

Exudative (Wet)

71
Q

Most common form of macular degeneration

A

Non-exudative (dry) AMD

72
Q

Dry AMD Symptoms

A

Gradual
Close vision tasks = more difficult
Macular cells atrophy
Virtually painless b/c slow onset

73
Q

More severe form and faster progression of macular degeneration

A

Exudative (Wet) AMD

74
Q

Wet AMD Etiology

A

Weak blood vessels in retina contribute to hemorrhage
Big cause of the majority of AMD-related blindness
Rapid onset
Had dry first

75
Q

Risk factors for Macular Degeneration

A

Aging; Smoking
Race (Whites)
Hypertension; Hyperopia
Chronic Inflammatory conditions

76
Q

What is macular degeneration like?

A

Blurred/Darkened vision
Blind spots in the visual field
Visual distortion

77
Q

How is AMD detected?

A

Visual acuity exam
Pupil dilation
Amsler grid

78
Q

Collaborative care - AMD

A

Improve modifiable risk factors
Health promotion; Protect eyes from UV light
Vitamin combinations (later forms)
Injections and Laser surgery

79
Q

What is retinal detachment?

A

Retina peels away from the inner wall of the eye

80
Q

Risk factors for retinal detachment

A

Aging
Myopia
Hx of cataract surgery; Eye trauma; Family/personal history

81
Q

Retinal Detachment Symptoms

A

“Cobwebs” in vision (“hairnet” or ring)
Flashes of light
Curtain coming into visual field
floaters

82
Q

Is retinal detachment a medical emergency? Why or why not.

A

Yes; requires prompt ophthalmologist referral

As retina detaches it becomes ischemic. This prompts us to worry about permanent and complete vision loss

83
Q

Treatment for retinal detachment

A

Laser photo coagulation
Scleral buckling
Pneumatic retinopexy

84
Q

Treatment in which an intense light beam triggers and inflammatory response to seal holes in the retina

A

Laser photocoagulation

85
Q

Treatment where the eye ball is intended and the sclera is folded to seal the tear in the detached retina

A

Scleral buckling

86
Q

Intravitreal injection of gas to form a temporary bubble in the vitreous that closes retinal breaks

A

Pneumatic retinopexy

87
Q

Nursing Care for Retinal Detatchment

A

Recognize manifestations
Early interventions (contact provider)
Educate patient:
Assist w/ grieving process if vision is lost
Assess eye patch and provide infor
Activity restrictions (no bending/straining)

88
Q

Ear physical assessment

A

Physical inspection
Otoscopy (look inside); Hearing acuity
Weber and Rinne Tests (Tuning Fork tests)

89
Q

Types of hearing loss

A

Conductive
Sensorineural
Presbycusis
Tinnitus

90
Q

Hearing loss caused by obstruction of the ear canal

A

Conductive

91
Q

Hearing loss caused by inner ear/auditory nerve damage; loud impulse noise or ototoxic drugs

A

Sensorineural

92
Q

Hearing loss associated with aging

A

Presbycusis

93
Q

Hearing loss caused by toxicity, obstruction of the auditory meats or infection

A

Tinnitus

94
Q

Hearing loss presented by an equal loss of hearing at all frequencies. Speech discrimination is generally good.

A

Conductive

95
Q

Hearing loss presented with an initial loss of high pitch tones and conversational speech.

A

Presbycusis

96
Q

Hearing loss that impairs one’s ability to hear high frequency tones and speech discrimination is difficult

A

Sensorineural

97
Q

Hearing loss characterized by a buzzing, roaring, or ringing sensation.

A

Tinnitus

98
Q

Examples of ototoxic drugs

A

Furosomide (Lasix)

Aspirin

99
Q

Management of hearing loss

A

Prevention
Hearing Aids
Telecommunications device for the deaf (TDD)
Assistive devices

100
Q

Nursing care for Hearing Loss

A

Identification of type through assessment
Provide health promotion: ear cleaning, treatment of infection, avoid exposure to loud noise
Assessment: occupation, meds, unsteady gait/vertigo; health history

101
Q

Possible nursing diagnosis for hearing loss

A

Impaired verbal communication

102
Q

Conditions of the middle ear

A

Otitis media (chronic and acute)

103
Q

Otoscope showed red/inflamed or dull and bulging eardrum

A

Acute Otitis Media

104
Q

Bulging or retraction of the tympanic membrane

A

Chronic Otitis Media

105
Q

Complication of Otitis Media

A

Tympanic membrane perforation - whistling sound heard

106
Q

Conditions of the inner ear

A

Ménière’s disease
Labyrinthitis
Benign Paroxysmal Positional Vertigo

107
Q

Caused by increased pressure/rupture of the inner ear membranes

A

Meniere’s Disease

108
Q

Manifestations of Meniere’s disease

A

Gradual or sudden hearing loss
Vertigo, hearing loss, tinnitus
May be preceded by fullness in ears or ringing sensation

109
Q

Goals of Meniere’s disease

A

Prevention of exacerbation: teach low sodium diet, lower stress, monitor allergies

110
Q

Inflammation of the inner ear

A

Labyrinthitis

111
Q

Manifestation of Labyrinthitis

A

Vertigo

Hearing loss

112
Q

Disorder characterized by the sensation of movement when there is none

A

Benign Paroxysmal Positional Vertigo

113
Q

Vertigo =

A

Dizziness

114
Q

Health Promotion for vertigo

A

Early diagnosis may lower risk for injury

115
Q

When assessing patient for vertigo, the nurse should look for

A

Tinnitus, hearing loss, balance, nystagmus, and medications patient may be on.

116
Q

Priority for patients with vertigo

A

Sit patient down

Maintain safe environment

117
Q

Medications for patient with vertigo

A

Diazepam
Promethazine
Dexamethasone
Meclizine (Antivert)

118
Q

Vestibular rehabilitation excercises for vertigo

A

The Epley and Semont
The Brandt-Daroff
Log roll exercises

119
Q

Precautions for patient with vertigo

A

Driving a car/operating machinery
Working
(May not be able to drive or operate machinery and may also not be able to perform the duties of their jobs)

NSC 386 (11 decks)

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