Lecture 7 Vision and Hearing Disorders

Question 1

Emmetropia

Answer 1

Normal Vision

Question 2

Myopia

Answer 2

nearsighted

Question 3

Hyperopia

Answer 3

farsighted

Question 4

astigmatism

Answer 4

change in the curve of the eye that causes blurred far vision

Question 5

presbyopia

Answer 5

farsighted as a result of aging
lens loses elasticity and cannot focus on close up objects

Question 6

how is visual acuity assessed

Answer 6

snellen chart
stand 20 feet away
test bad eye first

Question 7

glaucoma

Answer 7

inadequate drainage of aqueous humor

Question 8

closed angle glaucoma

Answer 8

anatomical blockage of drainage of aqueous humor

Question 9

open angle glaucoma

Answer 9

no anatomical blockage of drainage of aqueous humor

Question 10

risk factors for glaucoma

Answer 10

cardiovascular disease
diabetes
hereditary
long-term corticosteroid use

Question 11

clinical manifestations of glaucoma

Answer 11

blurred vision
halos around light
difficulty adjusting to low lighting
loss of peripheral vision
aching or discomfort around eyes
headache

Question 12

medical management of glaucoma

Answer 12

prevent further optic nerve damage
medications to decrease IOP
avoid activities that increase IOP

Question 13

surgical management of glaucoma

Answer 13

laser trabeculoplasty - open canal and allow for drainage
trabeculectomy - create fistula to allow aqueous humor to drain

complications include bleeding and increase IOP

Question 14

cataracts

Answer 14

lens opacity
can be traumatic, congenital, or age related

Question 15

s/sx of cataracts

Answer 15

clouded, blurred, dim vision
difficulty seeing at night
sensitivity to light and glare
double vision in a single eye
painless

Question 16

cataracts management

Answer 16

no medical management
surgical - lens replacement

Question 17

post-op cataracts care

Answer 17

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

Question 18

retinal detachment

Answer 18

retina detaches from the back of the eye

Question 19

s/sx of retinal detachment

Answer 19

no pain
lose half of vision field
increase in the number of floaters
light flashes

Question 20

causes of retinal detachment

Answer 20

aging
trauma
recent cataract surgery
diabetic retinopathy

Question 21

management of retinal detachment

Answer 21

surgery - scleral buckling, vitrectomy

Question 22

nursing care for retinal detachment

Answer 22

encourage rest - prone as much as possible for 6 weeks
avoid increasing IOP
education
monitoring for visual changes
sunglasses

Question 23

risk factors for hearing loss

Answer 23

occupational hazards
environmental hazards
bacterial meningitis
perforation of tympanic membranes
family history
congenital malformations
recurrent ear infections

Question 24

clinical manifestations of hearing loss

Answer 24

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

Question 25

management of hearing loss

Answer 25

prevention
hearing aids
cochlear implant

Question 26

hearing aids

Answer 26

makes sound louder, does not improve ability to discriminate words or understand speech
may or may not amplify background noise

Question 27

cochlear implant

Answer 27

auditory prosthesis
directly stimulates the auditory nerve
does not restore normal hearing
detects environmental sounds and conversation
surgery w extensive rehab - audiologist and SLP

Question 28

nursing management of hearing impairment

Answer 28

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

Question 29

Meniere’s disease

Answer 29

excess endolymphatic fluid in the inner ear

Question 30

clinical manifestations of meniere’s disease

Answer 30

unilateral sensorineural hearing loss
tinnitus
vertigo
N/V
pressure and fullness in ear
diaphoresis

Question 31

treatment of Meniere’s disease

Answer 31

low sodium diet 1-1.5 g/day
medications - diuretics
surgery - vestibular nerve section, endolymphatic sac decompression, labyrinthectomy

Question 32

conductive hearing loss

Answer 32

sound cannot get through ear
- ear wax
- hole in ear drum
- problems with small ear bones
- fluid in inner ear

Question 33

sensorineural hearing loss

Answer 33

dammage to inner ear or auditory nerve
- Illness
- ototoxic drugs
- aging
- family history