Module 3 exam Flashcards
Consensual response
exposure to light in one eye results in constriction of the pupil in the opposite eye
Assessment of pupillary reaction light
Darkened room
Have client focus on a distant object
Shine light obliquely into one eye and observe the opposite pupil’s reaction to light and constrict
Normally, pupils constrict
cataracts risks
- Increasing age – often starts developing at 30 years of age
- Exposure to ultraviolet B light
- Diabetes mellitus
- Cigarette smoking
- Alcohol use
- Diet low in antioxidant vitamins
- High blood pressure
- Eye injuries/surgery
- Steroid use
- Female gender
- Persistent diarrhea
- Gout
- Abdominal obesity
- Beta blocker use
accomodation- what does it test?
- normal finding
- example of how you would test on client
o occurs when the client moves focus of vision from far to near, causing the pupils to constrict
o Normally, pupils constrict when they focus on a near object and dilate on a distant object
Example: hold a pencil 12” away from clients face and bring it into their nose
eye abnormality- tearing -aka? -define -unilateral epiphora is? bilateral epiphora is?
o Aka epiphora
o Caused by exposure to irritants or obstruction of the lacrimal apparatus
o Unilateral epiphora is often associated with foreign body or obstruction
o Bilateral epiphora is often associated with exposure to irritants such as makeup or facial cleansers or it may be a system response
cataracts
o clouding of the usually clear lens of the eye, causing a person to see as though looking through a frosty or foggy window
When client is experiencing eye pain, discomfort, or feels something in the eye, observe for what?
(3 things)
o Foreign body that remains after gently washing
o Perforated globe
o Blood in the eye
Blunt eye trauma, observe for what?
3 things
o Lid swollen shut
o Blood in anterior chamber
o White/hazy cornea
glaucoma
- define
- normal finding
- increased IOP compromises what?
- what occurs as a result of deficient blood supply?
- if iop is left untreated, what results?
o an acute or chronic condition in which there is an increase of IOP which leads to damage of the retina and optic nerve, with resulting visual field losso
Normal IOP is 10-21 mm Hg
o Increased IOP compromises blood flow to the optic nerve and retina
o Tissue damage occurs as a result of the deficient blood supply
o If IOP is left untreated, blindness results. Often called the “silent thief of sight” because most patients are unaware they have experienced visual changes and vision loss.
signs and symptoms for glaucoma
gradual loss of peripheral vision
blurred vision
“halos” around lights
difficulty focusing
difficulty adjusting eyes in low lighting
loss of peripheral vision
aching or discomfort around the eyes and/or headaches
nystagmus
- define
- what test do you use to test for a nystagmus?
• An oscillating (shaking) movement of the eye
• Associated with an inner ear disorder
o Multiple sclerosis
o Brain lesions
o Narcotic use
• To test for a nystagmus, you use the positions test (6 cardinal fields of gaze)
o
how do you perform positions test?
Instruct the client to focus on an object you are holding
o Move the object thru the 6 cardinal positions of faze in a clock wise directions
o Observe the clients eye movements
normal finding of pupil (4)
-what is anisocoria?
o Round with regular border o Centerd in the iris o Equal in size (3 to 5 mm) o Inequality in pupil size of less than 0.5 mm occurs in 20% of clients Called anisocoria
abnormal findings of pupil assessment
-miosis
-mydriasis
define both
o Miosis
Aka Pin point pupils
Constricted and fixed pupils
d/t narcotic drugs or brain damage
o Mydriasis
Dilated fixed pupils
Resulted from: Cns injury, Circulatory collapse, Deep anesthesia
what does the snellen chart assess for?
distant visual acuity
distant visual acuity test
-how do you perform it?
If the client wears glasses, they should be left on unless they are reading glasses
Note any client behaviors such as leaning forward, head tilting, or squinting while performing test
• The top number is 20/20, etc. is the number of feet between the patient and the eye chart
o If distant vision is assessed in a small room or area, the patient may stand 10 feet from the chart, resulting in the top number being 10 rather than 20
• The bottom number in 20/20 is the number found on the chart row of the smallest print that the patient can read.
o The bottom number represents the distance (in feet) at which the “normal” eye can read the letters on that line
normal and abnormal finding of distant visual acuity test using the snellen chart
-refer any client with what vision for further evaluation?
• Normal finding
o 20/20 with or without corrective lenses
• Abnormal finding
Myopia
Impaired far vision
Present when the second number in the rest resul is larger than the first
20/40
The higher the second number, the poorer the vision
Refer any client with 20//30 for further evaluation
when do you measure pupils?
• Measure pupils against a gauge ONLY If they appear larger or smaller than normal or if they appear to be two different sizes
estotropia
- define
- it is an abnormal finding of what test?
inward turn of the eye
cover test
how to perform covered test (2)
-normal finding
Use opaque card to cover an eye to observe opposite eye for eye movement
Tests for deviations in alignment or strength or slight deviation in eye movement
• Normal finding
o Uncovered eye should remain fixed straight ahead
o The covered eye should remain fixed straight ahead after being uncovered
exotopia (2)
-define
- Abnormal finding of the cover test
* Outward turn of the eye
strabismus (3)
- Abnormal finding of the cover test
- Constant malalignment of the eyes
- May cause amblyopia
Eyelids
o Two movable structures composed of skin and two types of muscle: striated and smooth
o Protect the eye from foreign bodies and limit the amount of light entering the eye
o Serve to distribute tears that lubricate the surface of the eye
o Upper eye lid larger, mobile contains Meibomian glands which secrete an oily substance that lubricates the eyelid
• Lateral and medial canthus
o Where the eyelids join together
o Medial canthus contains puncta, two small openings that allow drainage of tears into the lacrimal system
o When closed, the eye lids should touchwhen open, the upper lid position should be between the upper margin of the iris and upper margin of the pupil
o Lower lid should rest on the lower border of the iris
eyelashes
o Projections of stiff hair curving outward along the margins of the eyelids that filer dust and dirt from air entering the eye
conjunctiva
o Thin
o Transparent
o Continuous membrane that is divided into two portions
Palpebral
• Lines inside of the eyelids
Bulbar
• Covers most of the anterior eye, merging wit the cornea at the limbus
lacrimal apparatus
o Consists of glands and ducts that lubricate the eye
extraocular muscles
o 6 muscles attached to the outer surface of each eyeball
4 rectus muscles
• Responsible for straight movement
2 oblique muscles
• Responsible for diagonal movement
spots or floaters
o which are common in clients with myopia (nearsighted-close objects appear clearly, but far ones don’t) or in clients over age 40
o Is a normal physiologic change due to aging and requires no intervention
halos arounds rings or lights
o Associated with narrow angle glaucoma
visual perception (4)
- Occurs as light rays strike the retina, where they are transformed into nerve impulses, conducted to the brain through the optic nerve, and interpreted
- Light must pass thru transparent media before reaching the retina
- The cornea and lens are the main eye components that refract light rays on the retina
- The left side of the brain vies the right side of the world
earache is aka?
otilgia
assessment of earache
- what do you want to ask the client first?
- what can an earache occur with?
o Ask the client “do you have any ear pain?” o If they respond yes, use coldspa o Can occur with: o Ear infections o Cerumen blockage o Sinus infections o Teeth/gum problems o May experience nausea and dizziness
otitis externa
o Swimmers ear
o Wiggle outer ear without pain
normal findings for cerumen
- Should be odorless
- Yellow, orange, red, brown, gray, black
- Soft
- Moist
- Dry
- Flaky
- Or hard
abnormal findings of cerumen?
4
o Otitis externa/impacted foreign body
Yellow sticky foul smelling discharge
o Otitis media with ruptured tympanic membrane
Bloody purulent discharge
o Skull trauma
Blood or watery drainage—cerebrospinal fluid
o Conductive hearing loss
Impacted cerumen blocking view of external ear canal
older adults cerumen
o Harder o Dry o Rigid o Coarse thick wire like hair can grow Abnormal only if it obstructs hearing
define conductive hearing loss
• something blocks or impairs the passage of vibrations from getting to the inner ear
