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NSG 320 (mcp) > Sensory > Flashcards

Sensory Flashcards

1
Q

What is Conjunctivitis?

A

Inflammation of the conjunctiva with or without infection

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2
Q

What causes non-infectious Conjunctivitis?

A

Allergens or Irritants

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3
Q

What causes infectious Conjunctivitis?

How does it spread?

A

AKA “Pink eye”
Bacteria or viruses
Person-to-Person

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4
Q

Allergic Conjunctivitis Assessment: (4)

A
  1. Burning sensation
  2. “Bloodshot” appearance
  3. Excessive tears
  4. Itching**
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5
Q

Allergic Conjunctivitis Interventions: (3)

A
  1. Vasoconstrictor
  2. Corticosteroid eyedrops
  3. No makeup
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6
Q

Infectious Conjunctivitis Assessment: (3)

A
  1. Edema–Blood vessel dilation
  2. Excessive Tears
  3. Discharge (watery then mucus
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7
Q

Infectious Conjunctivitis Interventions:
What do we need to know before implementing a treatment?
How do we treat it?
How can we prevent the spread?

A
  1. Obtain cultures
  2. Antibiotic eyedrops
  3. Prevent the spread of infection
    - Wash hands
    - Do not share washcloths and towels
    - Discard makeup & contacts used during infection
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8
Q

What is Trachoma and what causes it?

Where is it most commonly seen?

A

Chronic conjunctivitis caused by Chlamydia trachomatis

- Commonly seen in warm, moist climates

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9
Q

Trachoma Assessment:
Early Presentation is similar to what?
Late Presentation (if left untreated)

A 
Early Presentation (similar to infectious conjunctivitis)
1. Edema, excessive tears, discharge

Late Presentation

  1. follicles form on the upper lid
  2. Eyelid scars, turns inward, and lashes damage cornea
  3. BLINDNESS if left untreated!!
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10
Q

Trachoma Interventions:

A
  1. Antibiotic therapy
    - Oral azithromycin
    - Tetracycline eye ointment
  2. Infection Control (Prevention)
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11
Q

What is Cataracts?

A

Lens opacity/cloudiness due to changes in the lens resulting in areas of cloudiness

Areas can get larger over time and obstruct vision

  • water loss
  • protein clumping
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12
Q

What Causes Cataracts?

What is the most common cause?

A
  1. Aging** –> MOST COMMON CAUSE
  2. Certain conditions
  3. Medications/toxins
  4. Injury
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13
Q

At what age is Cataracts an expected finding?

A

> 70 years of age

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14
Q

Risk factors for Cataracts? (7)

A
  1. Age
  2. Injury
  3. Sun exposure
  4. Family history
  5. Diabetes
  6. Steroid use
  7. Eye disease
Sensitivity to light
”Halos”
Poor night vision
Absent red reflex +/-
Difficult to view the retina on exam
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15
Q

Early Presentation of Cataracts

A
  1. Blurred vision

2. Decreased color perception

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16
Q

Late Presentation of Cataracts

A
  1. Double vision
  2. Sensitivity to light
  3. ”Halos”
  4. Poor night vision
  5. Absent red reflex +/-
  6. Difficult to view the retina on exam
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17
Q

What are the only two interventions for Cataracts?

A
  1. PREVENTION (eye protection)

2. Surgery

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18
Q

Post-op Patient Teaching following Cataracts Surgery: (5)

A
  1. Post-op eyedrops
  2. Eye protection-dark lenses/night patch
  3. What to report to a provider (next flashcard)
  4. Activity restrictions (anything increasing ICP)
    - Avoid sneezing, coughing, straining while dooping
  5. Infection prevention
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19
Q

Post-op S/S a patient should report to a provider: (5)

A
  1. Pain accompanied by N/V –> ICP!!
  2. Sharp, sudden eye pain
  3. Bleeding
  4. Green or yellow discharge (infection)
  5. Lid swelling
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20
Q

What is Glaucoma? Is it preventable?

A

Group of disorders that cause increased IOP in the eye

NO; Tx goal is to prevent blindness!

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21
Q

Pathophysiology of Glaucoma:

A

If pressure is too high, compression of blood vessels, photoreceptors, and nerve fibers
–> Leads to nerve death and BLINDNESS!

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22
Q

What are the two types of Glaucoma?
Which is the most common?
Which is considered an Emergency?

A
  1. Primary
    - POAG –> Most common type
    - PCAG –> EMERGENCY!!
  2. Secondary
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23
Q

Primary Open-angle Glaucoma (POAG):

Does this affect one or both eyes?

A

Affects both eyes

Aqueous humor through chamber angle is reduced resulting in increased IOP

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24
Q

Primary Angle-closure Glaucoma (PACG):

A

Acute, Sudden onset

Forward displacement of the iris; closes chamber angle

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25
Q

Secondary Glaucoma

A 
Identifiable cause (injury, drugs, surgery, inflammation…)
- Associated with systemic disorders
26
Q

S/S of Primary Open-angle Glaucoma (POAG): (5)

A
  1. Foggy vision +/-
  2. Mild eye aching (but can be painless)
  3. Headache
  4. Halos
  5. SLOW LOSS of PERIPHERAL VISION
    • No improvement with glasses
27
Q

S/S of Primary Angle-closure Glaucoma (PACG): (5)

A
  1. Severe pain around eyes
  2. Pain radiates over face
  3. Reddened sclera
  4. Foggy cornea
  5. Dilated, nonreactive pupil*
28
Q

What’s the most important intervention to teach patients related to diagnosing Glaucoma?

A

REGULAR Eye Exams for EARLY DETECTION to prevent blindness!

29
Q

What is the main test used to diagnose Glaucoma?

Indicate Normal IOP and IOP for POAG and PACG

A
  1. Tonometry- measures IOP
    Normal: 10-21 mm Hg
    POAG: 22-32 mm Hg
    PACG: >30 mm Hg
30
Q

Other Diagnostic Tests for Glaucoma: (3)

A
  1. Perimetry- Visual field testing
  2. Gonioscopy- visualize front of the eye
  3. Imaging of optic nerve
31
Q 
Glaucoma Treatments (2)
What is the goal?
A

Tx Goal: PREVENT BLINDNESS!

  1. Ophthalmic drugs
  2. Implanted shunt
32
Q

Nurse’s Role related to interventions for Glaucoma?

A

EDUCATION!

33
Q

Glaucoma Patient Education (3):

A
  1. Drug adherence** (to prevent blindness)
  2. Proper technique with eye drops
    - Teach the importance of when & how to take them
    - Technique: Punctal occlusion
    - Wash hands
    - How to avoid Washout
  3. Promote Independence (if vision loss is present)
34
Q

What is Macular Degeneration?

A

Deterioration of the area of central vision (AKA macula)

35
Q

What are the types of Macular Degeneration?

A
  1. Dry Age-related Macular Degeneration

2. Wet (Exudative) Age-related Macular Degeneration

36
Q

What is the most common form of Macular Degeneration?

A

Dry Age-related Macular Degeneration (Dry AMD)

37
Q

Differentiate Dry and Wet Age-related Macular Degeneration: (Patho, Onset)

A

Dry AMD
Onset: old age; progresses faster w/ risk factors
Patho: Gradual blockage of retinal capillaries
–> ischemia –> necrosis

Wet AMD
Onset: occurs at any age
Patho: Growth of new blood vessels, causing a kind of blister that scars

38
Q

Risk Factors for Dry Age-related Macular Degeneration (Dry AMD)

A
  1. Smoking
  2. HTN
  3. Gender (female)
  4. Short stature
  5. Diet low in Carotene and Vitamin E
39
Q

How is Macular Degeneration Diagnosed?

A
  1. Amsler grid
    - Eye exam for central vision loss
  2. Fluorescein Angiography
  3. Optical Coherence Tomography
40
Q

Is Macular Degeneration Curable?

A

NO; Treatment goal is to slow the disease process

41
Q

Macular Degeneration Treatment:

A
  1. Drug therapy

2. Laser therapy (Wet AMD ONLY!)

42
Q

Prevention of Dry Age-related Macular Degeneration: (3)

A
  1. Smoking Cessation
  2. BP management
  3. Dietary modifications
    - Increase Carotene and Vitamin E

Especially important to teach patients with parents that have AMD

43
Q

Macular Degeneration Interventions

A
  1. Safety precautions for vision loss

2. Promote Independence

44
Q

What is Retinal Detachment?

A

Separation of the retina from the epithelium

  • Visual field loss corresponds to area of detachment
  • Seen as gray bulges in the retina or folds in retina
45
Q

Onset and S/S of Retinal Detachment:

A

Onset: Sudden

  1. Painless
  2. Photopsia
    - flashes of light
    - floaters
46
Q

What is the only Treatment for Retinal Detachment?

A

SURGERY under general anesthesia!

a) Scleral buckling
b) placement of silicone oil (promotes reattachment)

47
Q

Interventions related to Retinal Detachment Surgery

A
  1. Prevent further damage (tear getting worse)
    - Eye patch (pre-and post-op**)
    - Restrict head movement (stationary position)
  2. Stress management!
    - Alleviate stress
    - Comfort “taking really good care of your ass”
    - Reassurance “surgery is very successful”
  3. Infection prevention
  4. Educate on the increased risk for detachment occurring again and what S/S to look for
  5. Post-op Restrictions
    - Avoid activities that require fine eye movement
    - No reading for ~2 weeks
48
Q

What are the 3 types of Hearing Loss?

A
  1. Conductive
  2. Sensorineural
  3. Combined
49
Q

What is Conductive Hearing Loss? Causes?

Can this be Corrected?

A

Sound waves are blocked from contact with inner ear nerve fibers from middle/external ear damage/disorder
- Infection, malformed ear bones
Yes with minimal to no damage

50
Q

What is Sensorineural Hearing Loss? Causes?

Can this be Corrected?

A

Inner ear sensory nerve damage
- Repeated exposure to loud noises
No, often permanent

51
Q

Priority Assessment and Interventions for Hearing Loss are focused on _______ and _______.

A

communication and anxiety

52
Q

Hearing Loss Assessment + S/S

A

HISTORY** very important to identify risk factors

  1. Presence of vertigo
  2. Presence of tinnitus
  3. High-frequency consonants
  4. Hearing mumbling
53
Q

Diagnostics for Hearing Loss

A
  1. Tuning fork
  2. Otoscopic exam
  3. Audiometry
54
Q

Hearing Loss Prevention: (3)

A
  1. Reduce ​​Noise pollution (earplugs)
  2. Ear probing
    - Nothing larger than a fingertip; no cotton swabs
  3. Regular Hearing tests
55
Q

What are Interventions aimed at related to Hearing loss? (3)

A

Aimed at

  1. Identifying cause
    - Early detection with Hearing exams
  2. Stopping the progression
    - Drug therapy
  3. Restoring hearing
    - Assistive devices, surgery
56
Q

What are Nursing Interventions aimed at related to Hearing loss? (4)

A
  1. Use of assistive devices
  2. Improved communication
  3. Support for family and client
  4. Finding support services
57
Q

Nursing Interventions:

Use of Assistive Devices

A
  1. Portable amplifiers
  2. Use of flashing lights (instead of alarms)
  3. Service dog
  4. Hearing Aids
58
Q

Nursing Interventions:

Hearing Aids

A
  1. SLOWLY introduce hearing aid
    - wear them for short periods
    - Avoid loud, crowded areas
    Educate on hearing aid care
59
Q

Hearing Aid Care:

A
  1. Keep it dry
  2. Clean w/ mild soap and water, avoiding excess water
    - Use a soft toothbrush or cleaning device
  3. Turn off when not in use
  4. Check and replace batteries frequently
    - Keep extra batteries on hand
  5. Handle with care
    - Don’t drop it, avoid extreme temps.,
  6. Adjust volume to lowest setting that you can hear
60
Q

Nursing Interventions:

Surgery

A

Infection prevention
Education
Ear-up for 12 hours post-op

61
Q

Nursing Interventions:

Improved communication

A
  1. Stand on the patient’s unaffected side when communicating
  2. ASL Interpreter

NSG 320 (mcp) (24 decks)

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