Lecture 7 Vision and Hearing Disorders Flashcards
Emmetropia
Normal Vision
Myopia
nearsighted
Hyperopia
farsighted
astigmatism
change in the curve of the eye that causes blurred far vision
presbyopia
farsighted as a result of aging
lens loses elasticity and cannot focus on close up objects
how is visual acuity assessed
snellen chart
stand 20 feet away
test bad eye first
glaucoma
inadequate drainage of aqueous humor
closed angle glaucoma
anatomical blockage of drainage of aqueous humor
open angle glaucoma
no anatomical blockage of drainage of aqueous humor
risk factors for glaucoma
cardiovascular disease
diabetes
hereditary
long-term corticosteroid use
clinical manifestations of glaucoma
blurred vision
halos around light
difficulty adjusting to low lighting
loss of peripheral vision
aching or discomfort around eyes
headache
medical management of glaucoma
prevent further optic nerve damage
medications to decrease IOP
avoid activities that increase IOP
surgical management of glaucoma
laser trabeculoplasty - open canal and allow for drainage
trabeculectomy - create fistula to allow aqueous humor to drain
complications include bleeding and increase IOP
cataracts
lens opacity
can be traumatic, congenital, or age related
s/sx of cataracts
clouded, blurred, dim vision
difficulty seeing at night
sensitivity to light and glare
double vision in a single eye
painless
cataracts management
no medical management
surgical - lens replacement
post-op cataracts care
elevate HOB 30-45 degrees
position patient on back to non-operative side
administer stool softeners and increase fiber and fluid intake
postop eye drops
retinal detachment
retina detaches from the back of the eye
s/sx of retinal detachment
no pain
lose half of vision field
increase in the number of floaters
light flashes
causes of retinal detachment
aging
trauma
recent cataract surgery
diabetic retinopathy
management of retinal detachment
surgery - scleral buckling, vitrectomy
nursing care for retinal detachment
encourage rest - prone as much as possible for 6 weeks
avoid increasing IOP
education
monitoring for visual changes
sunglasses
risk factors for hearing loss
occupational hazards
environmental hazards
bacterial meningitis
perforation of tympanic membranes
family history
congenital malformations
recurrent ear infections
clinical manifestations of hearing loss
tinnitus
worsening ability to hear in groups
pretending to hear
change in ability to communicate
change in awareness of surroundings
isolation
refusing to seek medical care
management of hearing loss
prevention
hearing aids
cochlear implant
hearing aids
makes sound louder, does not improve ability to discriminate words or understand speech
may or may not amplify background noise
cochlear implant
auditory prosthesis
directly stimulates the auditory nerve
does not restore normal hearing
detects environmental sounds and conversation
surgery w extensive rehab - audiologist and SLP
nursing management of hearing impairment
don’t yell, talk into less impaired ear
make sure they can see your mouth when you speak
use ASL interpreter
other health problems may not receive attention, advocate
Meniere’s disease
excess endolymphatic fluid in the inner ear
clinical manifestations of meniere’s disease
unilateral sensorineural hearing loss
tinnitus
vertigo
N/V
pressure and fullness in ear
diaphoresis
treatment of Meniere’s disease
low sodium diet 1-1.5 g/day
medications - diuretics
surgery - vestibular nerve section, endolymphatic sac decompression, labyrinthectomy
conductive hearing loss
sound cannot get through ear
- ear wax
- hole in ear drum
- problems with small ear bones
- fluid in inner ear
sensorineural hearing loss
dammage to inner ear or auditory nerve
- Illness
- ototoxic drugs
- aging
- family history