Sensory Flashcards
1
Q
refraction
A
Bends light rays from the outside into the eye through curved surfaces and refractive media and finally to the retina
2
Q
pupillary constriction
A
Constriction and dilation control the amount of light that enters the eye
3
Q
Accommodation
A
Allows the healthy eye to focus images sharply on the retina whether the image is close to the eye or distant
4
Q
Convergence
A
The ability to turn both eyes inward toward the nose at the same time
5
Q
Coordinated eye movements ensure that both eyes…
A
eyes receive an image at the same time so only a single image is seen
6
Q
The muscles around the eye are innervated by cranial nerves
A
III oculomotor
IV trochlear
VI abducens
7
Q
the optic nerve II is
A
the nerve of sight, connecting the optic disc to the brain
8
Q
the trigeminal nerve V stimulates
A
the blink reflex when the cornea is touched
9
Q
the facial nerve VII innervates
A
the lacrimal glands and muscles for lid closure
10
Q
Vision testing:
A
visual acuity tests to measure both distance (using the Snellen eye chart) and near vision (using the Rosenbaum Pocket Vision Screener)
Record findings as a comparison between what the patient can read at 20 feet and the distance that a person with normal vision can read the same line
11
Q
Arcus senilis
A
an opaque, bluish white ring within the outer edge of the cornea, is caused by fat deposits
12
Q
presbyopia
A
near objects, especially reading material must be placed farther from the eye to be seen clearly
age-related problem which the lens loses its elasticity and is less able to change shape to focus the eye for close work
13
Q
ectropion
A
the lower eyelid may relax and fall away from the eye, leading to dry eye manifestations
14
Q
structural changes occur with aging including…
A
decreased eye muscle tone that reduces the ability to keep the gaze focused on a single object
15
Q
how does the clarity and shape of the cornea change with age
A
The cornea flattens, and the curve of its surface becomes irregular. This change causes or worsens astigmatism and blurs vision
16
Q
with age, the iris has less ability to dilate which…
A
which leads to difficulty in adapting to dark environments
17
Q
emmetropia
A
is the perfect refraction of the eye in which light rays from a distant source are focused into a sharp image on the retina
18
Q
Hyperopia (farsightedness)
A
occurs when the eye does not refract light enough; as a result, images actually converge behind the retina
19
Q
hyperopia signs and symptoms
A
Distant vision is normal
Near vision is poor
20
Q
hyperopia treatment
A
Corrected with a convex lens in eyeglasses or contact lenses
21
Q
Myopia (nearsightedness)
A
occurs when the eye overbends the light and images converge in front of the retina
22
Q
myopia signs and symptoms
A
Near vision is normal
Distance vision is poor
23
Q
myopia treatment
A
Corrected with a biconcave lens in eyeglasses or contact lenses
24
Q
Astigmatism
A
is a refractive error caused by unevenly curved surfaces on or in the eye, especially of the cornea. These uneven surfaces distort vision
Because light rays are not refracted equally in all directions, the image does not focus on the retina
25
Astigmatism nursing interventions
Eyeglasses
Contact lenses
Laser in-situ keratomileusis (LASIK) surgery or photorefractive keratectomy (PRK)
Both procedures can correct nearsightedness, farsightedness, and astigmatism
Powerful laser pulses reshape the deeper corneal layers
26
blindness
is having best corrected visual acuity that can range from 20/400 to no light perception. Legally defined by visual acuity with corrective lenses is 20/200 or less in the better eye or if the visual field is 20 degrees or less
can occur in one or both eyes
27
blindness nursing interventions
Communication
Safety
Ambulation
Self-care
Support
28
glaucoma is
a group of eye disorders resulting in increased IOP (intraocular pressure)
29
a normal IOP requires a...
balance between production and outflow of aqueous humor
30
if the iop becomes too high...
the extra pressure compresses retinal blood vessels and photoreceptors and their synapsing nerve fibers
This compression results in poorly oxygenated photoreceptors and nerve fibers
These sensitive nerve tissues become ischemic and die. When too many have died, vision is lost permanently
Tissue damage starts in the periphery and moves inward toward the fovea centralis
When aqueous fluid production and drainage are in balance, the IOP is between 10 and 21 mmHg
31
Primary open-angle glaucoma (POAG)
also known as wide angle glaucoma; is the most common form of primary glaucoma; outflow of aqueous humor through the chamber angle is reduced
Usually affects both eyes and has no manifestations in the early stages
32
Primary angle-closure glaucoma (PACG)
also known as acute glaucoma or narrow angle glaucoma; is a forward displacement of the iris, which presses against the cornea and closes the chamber angle, suddenly preventing outflow of aqueous humor
Has a sudden onset and is an emergency
33
angle-closure glaucoma signs and symptoms
Severe pain in the eye or forehead
Redness
Decreased or blurred vision
Seeing halos or rainbows
Headache
N/V
34
open-angle glaucoma signs and symptoms
Early manifestations:
None
Painless
Loss of peripheral vision
Halos
35
glaucoma nursing interventions
Pharmacological
Prostaglandins agonists drugs reduce IOP by increasing aqueous humor outflow
Adrenergic agonists and beta-adrenergic blockers reduce IOP by limiting the production of aqueous humor and by dilating the pupil
Cholinergic agonists reduce IOP by increasing the outflow of the aqueous humor
Carbonic anhydrase inhibitors directly and strongly inhibit production of aqueous humor
Systemic osmotic drugs may be given for angle-closure glaucoma to rapidly reduce IOP
Oral glycerin and IV mannitol
Surgery
36
cataracts
is a lens opacity that distorts the image
Both eyes may have cataracts, but the rate of progression in each eye is different
37
cataracts signs and symptoms
Early manifestations
Slightly blurred vision
Decreased color perception
Blurred vision
Double vision
Opacity
38
cataracts nursing interventions
Prevention through smoking cessation, weight reduction, optimal blood sugar control, wearing sunglasses, etc.
Promote safety and independence
Surgery when symptoms interfere with ADLs
Post-surgery
Educate on the importance of close adherence to the eye drop regimen after surgery
Wear a light eye patch at night to prevent accidental rubbing
Assess for signs of infection
Remind the patient to avoid activities that might increase IOP
39
macular degeneration
is the deterioration of the macula (the area of central vision); with the most common type being the age-related macular degeneration (AMD)
40
Dry AMD
most common, caused by gradual blockage of retinal capillaries, allowing retinal cells in the macula to become ischemic and necrotic
41
Wet AMD
is the growth of new blood vessels in the macula, which have thin walls and leak blood and fluid
42
macular degeneration signs and symptoms
Central vision declines
Mild blurring
Distortion
Eventual loss of all central vision
43
macular degeneration nursing interventions
Prevention is key or slow the progression of vision loss
Dietary intake of antioxidants, vitamin B12, vitamin E, and the carotenoids
Control hypertension
Stop smoking
Supportive care
Wet AMD
Laser therapy to seal the leaking blood vessels can limit the extent of the damage
Ocular injections with the vascular endothelial growth factor inhibitors (VEGFIs), such as bevacizumab (Avastin) or ranibizumab (Lucentis)
44
retinal tear
is a more jagged and irregularly shaped break in the retina
45
retinal detachment
is the separation of the retina from the epithelium; classified by the type and cause of their development
46
retinal tear/detachment
signs and symptoms
Sudden onset
Painless
Bright flashes of light (photopsia)
Floating dark spots (floaters)
Shade or curtain coming across the vision
47
retinal tear/detachment nursing interventions
Education
Supportive care
Retinal hole or tear:
The defect may be closed or sealed with surgery
Retinal detachment:
Surgical repair via scleral buckling, to place the retina in contact with the underlying structures
48
conjunctivitis
is an inflammation with or without infection of the conjunctiva. Inflammation occurs from exposure to allergens or irritants
Often called "pink eye," it is a common eye disease, especially in children
49
conjunctivitis signs and symptoms
A gritty feeling in one or both eyes
Itching or burning sensation in one or both eyes
Excessive tearing
Discharge from one or both eyes
Swollen eyelids
Pink discoloration to the whites of one or both eyes
Increased sensitivity to light
50
allergic conjunctivitis
occurs more commonly among people who already have seasonal allergies; they develop these symptoms when they come into contact with a substance that triggers an allergic reaction in their eyes
51
allergic conjunctivitis signs and symptoms
Edema, a sensation of burning, a “bloodshot” eye appearance, excessive tears / watery drainage, extreme itching, severe photophobia
52
allergic conjunctivitis treatment
Cool compresses and artificial tears sometimes relieve discomfort in mild cases
NSAIDs and antihistamines
Vasoconstrictor and corticosteroid eye drops
Instruct patients to avoid using makeup near the eye until all symptoms are gone
53
viral conjunctivitis
is most commonly caused by contagious viruses associated with the common cold
54
viral conjunctivitis signs and symptoms
Tearing / drainage, itchiness, redness, and light sensitivity
Recent or current upper respiratory infection
Possibly preauricular lymphadenopathy
55
viral conjunctivitis treatment
Symptoms can often be relieved with cool compresses and artificial tear solutions
Topical steroid drops may be prescribed to reduce the discomfort from inflammation in severe cases
56
bacterial conjunctivitis
an infection most often caused by staphylococcal or streptococcal bacteria from your own skin or respiratory system
57
bacterial conjunctivitis signs and symptoms
Blood vessel dilation, redness, edema, burning, and discharge
The discharge is watery at first and then becomes thicker, with shreds of mucus
Crusting in the morning
58
bacterial conjunctivitis treatment
Cultures of the drainage may be obtained to identify the organism
Ophthalmic antibiotics are prescribed to eliminate the infection
Teach the patient the importance of preventing the spread of the infection to the other eye or to other people
59
eye trauma
Foreign bodies, lacerations or penetrating trauma
60
eye trauma signs and symptoms
Feeling of something being in the eye
Blurred vision
Pain
Tearing
Photophobia
61
eye trauma treatment
Immobilize; DO NOT apply a pressure patch to the affected eye
Antibiotics
Surgery?
62
auditory sensory perception is the main function of the ear and occurs when...
sound is delivered through the air to the external ear canal
sound waves strike the movable eardrum, creating vibrations
The eardrum is connected to the first bony ossicle, which allows the sound wave vibrations to be transferred from the eardrum to the malleus, the incus, and the stapes
Receptors at the cochlea transduce (change) the vibrations into action potentials. The action potentials are conducted to the brain as nerve impulses by the cochlear portion of the eighth cranial (auditory) nerve
The nerve impulses are processed and interpreted as sound by the brain in the auditory cortex of the temporal lobe
63
age related changes to the ear
Pinna becomes elongated because of loss of subcutaneous tissues and decreased elasticity
Hair in the canal becomes coarser and longer, especially in men
Cerumen is drier and impacts more easily, reducing hearing function
Tympanic membrane loses elasticity and may appear dull and retracted
Hearing acuity decreases
The ability to hear high-frequency sounds is lost first
Older adults may have particular problems hearing the f, s, sh, and pa sounds
Presbycusis: is hearing loss that occurs with aging; caused by degeneration of cochlear nerve cells, loss of elasticity of the basilar membrane, or a decreased blood supply to the inner ear
64
ear assessment
Ask about any vertigo
Ask about any tinnitus
Ask about any medications
65
ear exam
Inspection and palpation
Otoscope
Hold the otoscope in your dominant hand, and gently pull the pinna up and back with your other hand to straighten the canal
66
Cerumen (earwax)
the most common cause of an impacted canal
A canal can also become impacted as a result of foreign bodies that can enter or be placed in the external ear canal, such as vegetables, beads, pencil erasers, and insects
67
cerumen impaction signs and symptoms
Otalgia
Hearing loss
Itching
Dizziness
68
cerumen impaction nursing interventions
Watchful waiting
Manual irrigation
Manual removal
Ceruminolytics
69
external otitis
to an inflammation of the external auditory canal and is a painful condition caused when irritating or infective agents come into contact with the skin of the external ear
External otitis occurs more often in hot, humid environments, especially in the summer, and is known as swimmer's ear because it occurs most often in people involved in water sports
70
external otitis signs and symptoms
Redness and tender to touch or movement
Mild itching
Swelling of the ear canal can lead to temporary hearing loss from obstruction
71
external otitis nursing interventions
Applying heat to the ear for 20 minutes 3 times a day
Teach the patient that minimizing head movements reduces pain
Avoid any water sport activity for approximately 7-10 days to allow the canal to heal
Pharmacological
Topical antibiotic drops
Steroid therapies
Oral or IV antibiotics are used in severe cases
Analgesics
72
applying ear drops
Remove and discard any ear packing
Irrigate the ear if the eardrum is intact
Place the bottle of eardrops in a bowl of warm water for 5 minutes
Tilt the patient’s head and place the drops in the ear
More the head back and forth 5 times
Insert a cotton ball into the opening of the ear to act as packing
73
otitis media
an infecting agent in the middle ear causes inflammation of the mucosa, leading to swelling and irritation of the ossicles within the middle ear, followed by purulent inflammatory exudate
Pathogens enter the middle ear after eustachian tube dysfunction - caused by obstruction related to upper respiratory infections, inflammation of surrounding structures, or allergic reactions
74
otitis media signs and symptoms
Fever, ear pain, otalgia
Reduced hearing
Tinnitus, dizziness
Headache
Nausea/vomiting
75
otitis media nursing interventions
Supportive care
Quiet environment
Low heat application
Reduce head movements
Pharmacological
Antibiotics PO
Analgesics
Antipyretic
Surgery
76
tinnitus
continuous ringing or noise perception in the ear; is a common ear problem that can occur in one or both ears
77
tinnitus signs and symtoms
Mild ringing to loud roaring
78
tinnitus contributing factors
Age
Sclerosis of the ossicles
Underlying disorders
Drugs
Exposure to loud noise
79
tinnitus nursing interventions
Supportive care
Decrease background noise
Ear mold hearing aids
Support groups
Pharmacological
Mirapex
80
vertigo and dizziness
is a sense of whirling or turning in space, whether it be the person or the surroundings
aka lightheadedness, is a disturbed sense of a person's relationship to space
81
vertigo and dizziness S/S
Nausea/vomiting
Falling
Nystagmus
Hearing loss
Tinnitus
82
vertigo and dizziness nursing interventions
Supportive care
Restrict head motion and change position slowly
Pharmacological
Dimenhydrinate OTC
Meclizine
Scopolamine
Diazepam
83
meniere's disease
is an abnormality in inner ear fluid balance caused by a malabsorption in the endolymphatic sac or a blockage in the endolymphatic duct
84
meniere's disease has three features...
Tinnitus
One-sided sensorineural auditory sensory perception loss
Vertigo, occurring in attacks that can last for several days
85
meniere's disease nursing interventions
Supportive care
Move the head slowly to prevent worsening of the vertigo
Nutrition and lifestyle changes can reduce the amount of endolymphatic fluid
Pharmacological
Mild diuretics to relieve symptoms by lowering the pressure of the ear
Antihistamines to shorten attacks
Benzodiazepines in acute instances to help control vertigo
Antiemetics to control N/V
Surgery
86
deafness
partial or complete loss of the ability to hear
87
deafness S/S
Tinnitus
Increasing inability to hear when in a group
A need to turn up the volume of the television
Can trigger changes in attitude
Inability to communicate
Unawareness of surroundings
The ability to hear high-frequency consonants—especially s, sh, f, th, and ch sounds—is lost first
88
deafness diagnostic test
Weber test
Rinne test
Audiometry
X-ray
CT
MRI
89
deafness nursing interventions
Protective measures
Ear muffler, avoiding ototoxic medications
Correct the underlying problem
Assistive devices
Portable amplifiers
Hearing aids
Learning lip reading / sign language/brail
Surgery
