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Sensory > Sensory Exam Study Guide > Flashcards

Sensory Exam Study Guide Flashcards

1
Q

Pilocarpine

A
  • Pharm class: cholinergic (direct-acting)
  • Therapeutic class: intraocular pressure reducing agent
  • Side effects: hypotension, syncope, cardiac arrhythmias, bronchospasm
  • Teachings: use ad directed. may sting when administered. drop into conjunctival pocket. hold lacrimal duct for 1 minute following administration to prevent systemic absorption. report immediately any unexpected changes in vision. do not drive at night.
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2
Q

What is an ear wick used for?

A

a piece of gauze soaked in treatment drops and pushed gently into the ear canal between the swollen walls. This makes sure that the treatment is held in contact with the sore skin for as long as possible. The wick is usually changed every 2-3 days until things have settled.

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3
Q

Betaxolol (Kerlone)

A
  • Pharm class: selective beta 1 adrenergic blocker
  • Therapeutic class: antihypertensive
  • Side effects:hypotension, bronchospasm, ocular disturbances
  • Teachings: check blood pressure often. discuss signs of hyper and hypotension. advise patient to avoid sudden position changes. avoid driving or activities that require mental alertness.
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4
Q

Timolol (timoptec)

A
  • Pharm class: beta blocker
  • Therapeutic class:
  • Side Pharm class: Therapeutic class: Side effects:dry mouth, sedative effects Teachings:observe patient for urinary retention, observe for sedation, contraindicated in angle-closure glaucoma patients.
  • Teachings -
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5
Q

Meclizine

A

Pharm class: Therapeutic class: Side effects:Sedation Teachings:restrict use in closed-angle glaucoma patients, observe for sedation.

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6
Q

Atropine sulfate (AtroPen)

A
  • Pharm class: anticholinergics
  • Therapeutic class: antiarrhythmics
  • Side effects: drowsiness, confusion, hyperpyrexia, blurred vision, photophobia, tachycardia, dry mouth, constipation, tachypnea
  • Teachings: may cause drowsiness, frequent oral hygiene may help relieve dry mouth, impairs heat regulation, males with BPH should report chances in urinary stream.
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7
Q

What diagnostic testing determines if a patient is at risk or is experiencing GLAUCOMA?

A

Visual assessments - decrease in visual acuity and peripheral vision

Tonometry - used to measure IOP (expected range is 10-21mm Hg). IOP is elevated with glaucoma, especially angle-closure

Gonioscopy - determines the draining angle of the anterior chamber of the eye

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8
Q

Describe what KERATITIS is. its cause. symptoms, treatment and patient teaching.

A

Keratitis: inflammation of the cornea. Cause: contact lenses, GRITTY SENSATION, dust, etc.

Symptoms: severe eye pain, SENSITIVE TO LIGHT, PHOTOPHOBIA.

Treatments: topical antibiotics. May need keratoplasty (corneal transplant) for scarring.

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9
Q

Meclizine (Dramamine II)

A
  • Pharm class: antiemetic (antihistamine)
  • Therapeutic class: antiemetic, antihistamine
  • Side effects:Sedation, fatigue, blurred vision, dry mouth
  • Teachings: take as directed. do not double dose. avoid driving. avoid CNS depressants. assess for level of sedation. administer with food, water, or milk.
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10
Q

What are the steps in performing EAR las-age/irrigation?

A

warm the solution to room/body temp, have patient turn toward the affected side, drape the patient with a plastic cover and towel, have the patient hold a large emesis basin under the ear to be irrigated, straighten the ear canal, expel air from the sterile syringe, draw up irrigating solution, insert the syringe into the meatus as far as can be seen, do not plug the canal with the syringe, irrigate gently with prescribed solution, note clients reaction, stop if it becomes uncomfortable to client, allow the client to lie on the affected side, dry the canal and ear.

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11
Q

What is TYMPANOPLASTY and patient education post procedure?

A

several operative procedures on tympanic membrane or ossicles to restore or improve hearing. USUALLY DONE WHEN YOUR EARDRUM IS PERFORATED.

  • do not fly in a plane for 6 months
  • do not blow nose. one nostril at a time
  • keep ear dry
  • avoid loud noises
  • mild pain
  • avoid bending and heavy lifting
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12
Q

When do patients usually start spiking a fever after surgery (think days/hours)?

A

48-72 hours to within the first 30 days after surgery

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13
Q

A patient is complaining after having an eye injury that it looks like a -curtain is blocking her vision’. what is your initial action after assessing pts eye and elaborate why?

A

retinal detachment. initial action: cover both eyes with patches to prevent further detachment.

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14
Q

Describe what MENIERE’S is. its cause, symptoms, treatment and patient teaching..

A

Meniere’s: INNER EAR DISORDER. overproduction or decreased reabsorption of endolymphatic fluid. Cause: viral or bacterial infections, allergic reactions, biochemical disturbances, vascular disturbance,long-term stress.

Symptoms: Feeling of fullness in ear, tinnitus, hearing loss, VERTIGO, nausea and vomiting, nystagmus, severe headaches.

tx: diuretics between attacks, dramamine, antivert, compazine, benadryl, and low sodium diet.
teaching: lay down, dim lights, dramamine, benedryl, don’t move head, quiet place.

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15
Q

What is peripheral vision?

A

side vision; what is seen on the side by the eye when looking straight ahead. aka tunnel vision

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16
Q

Atropine sulfate

A

Pharm class: anticholinergics belladonna alkaloids Therapeutic class: antiarrhythmics Side effects:bradycardia, increased intraocular pressure Teachings:contraindicated in those with glaucoma,monitor for urinary retention

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17
Q

What is the proper protocol for nurses inside of hospital on flushing eyes?

A

Foreign bodies: flush with normal saline if near sclera and conjunctiva, if imbedded, cover both eyes to prevent further injury chemical burns: flush eye for 15-20 min with copious amounts of water or normal saline if at hospital.

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18
Q

What is TYMPANOPLASTY and patient education post procedure?

A

several operative procedures on tympanic membrane or ossicles to restore or improve hearing.

  • do not fly in a plane for 6 months
  • do not blow nose. one nostril at a time
  • keep ear dry
  • avoid loud noises
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19
Q

What is the RATIONAL on why EAR drops need to be either room temp or body temp PRIOR to administering in ear?

A

solution temperature not close to room temp or the client’s body temp will cause ear injury, nausea, and vertigo.

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20
Q

Describe GLAUCOMA, cause, symptoms and treatment

A

aqueous humor. leading cause of blindness. disturbance of the optic nerve. decreased fluid drainage or increased fluid secretion increases intraocular pressure (IOP).

causes - age, infection, tumors, diabetes mellitus, genetic predisposition, HTN, african american.

symptoms: open-angle: headache, mild eye pain, loss of peripheral vision, tunnel vision, decreased accommodation, elevated IOP.

Angle-closed: rapid onset of elevated IOP, decreased or blurred vision, seeing halos, pupils nonreactive, severe pain and nausea, photophobia.

tx: open-angle- trabeculectomy, beta blockers (Timolol), miotics, carbonic anhydrase inhibitors. closed-angle-carbonic anhydrase inhibitors, osmotic diuretics, and iridectomy or iridotomy.

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21
Q

What is a CORNEAL transplant and patient education post procedure?

A

aka KERATOPLASTY. cornea transplanted from cadaver donor. Patient teaching post-op: no bending, lifting, or straining, limit activities that cause eye movement, teach s/s of graft rejection: blurred vision, discomfort, tearing, redness. takes awhile for vision to come back. slide 190

22
Q

Droperidol (Inapsine)

A
  • Pharm class: butyrophenones, antiemetic
  • Therapeutic class: antipsychotic agent
  • Side effects:hypotensive, seizures, respiratory depression
  • Teachings:report abnormal muscle movements or twitches. may cause drowsiness. avoid alcohol or other CNS depressants. avoids extremes of temperature.
23
Q

Why it is important to make sure we are aware of what medications along with the reason the pt medication prior to surgery?

A

to understand or avoid possible complications associated with the patients medications; deciding to continue or postpone administration until after surgery is performed.

24
Q

What is the difference between a MIOTIC and MYDRIATIC eye drop, in how it works on the eye

A

Miotic: Constricting
Mydriatic: Dilating

25
Q

Describe what PRESBYOPIA is, its cause, symptoms, treatment and patient teaching.

A

Presbyopia: farsightedness RT age. loss of elasticity of lens, cause: aging, symptoms: poor accommodation.

tx:

26
Q

Meperidine (demerol)

A
  • Pharm class: opioid agonists
  • Therapeutic class: opioid analgesic
  • Side effects: seizures, confusion, sedation, hypotension
  • Teachings:take as directed. may cause drowsiness, change positions slowly, avoid use of alcohol or CNS depressants, report constipation
27
Q

How does corticosteroid work in the patient who just had a lens transplant?

A

Corticosteroids are used as an anti-inflammatory medication. They reduce vision loss and potential scarring.

28
Q

When using eye drops is it a NORMAL response to have transited blurry vision, stinking! burning?

A

medications used for glaucoma may cause pain and blurred vision, especially when therapy is begun- saunders pg 783 eye lubricants have the side effect of burning on instillation and of pain or discomfort-

29
Q

Describe what a HORDEOLUM is. its cause, symptoms, treatment and patient teaching.

A

Hordeolum: “stye”, infection along the eyelid and/or the eyelashes. Inflammation of the oil gland on eyelid. Evidenced by pustule with edema, caused by . Apply warm, moist packs to promote drainage, and administer antibiotics if ordered.

30
Q

Describe what a CATARACT is. its cause, symptoms, treatment and patient teaching.

A

Cataracts: gradual clouding of the lens, cause: nutritional deficiencies, genetics, metabolic disease, infection(risk factors: advanced age, DM, trauma, sun, steroids).

symptoms: gradual blurred vision, diplopia( double vision), hazy vision, double vision, decrease in visual acuity, photosensitivity, glare, difficulty driving at night, white pupils.

Treatment: extracapsular cataract extraction ( removes lens and anterior capsule with intracapsular lens implant).

Teaching: instruct patient to wear dark glasses in bright light.

31
Q

Describe what ACUTE OTITIS MEDIA is, its cause, symptoms, treatment and patient teaching.

A

Acute Otitis Media: inflammation or infection of the MIDDLE EAR, cause:

Symptoms: severe throbbing pain behind tympanic membrane, FEVER,

Tx: narcotic analgesics, and ANTIBIOTICS, application of local heat, myringotomy to relieve pressure.

Teaching:

32
Q

Betaxolol

A

Pharm class: Therapeutic class: Side effects:hypotension, bronchospasm, ocular disturbances Teachings: if pulse is below 60BPM or the systolic pressure is below 90mmHg medication is withheld and provider is notified, monitor for SOB, instruct patient to change positions slowly due to orthostatic hypotension.

33
Q

Why it important to teach pts to cough with their mouths open after ear surgery?

A

To avoid increasing inner ear pressure or placing pressure on suture lines.

34
Q

Are type of glasses are bifocals?

A

For both Presbyopia and Myopia. TWO LENSES IN ONE

35
Q

Why is it important to assess the visual acuity of both eyes prior to one eye having surgery and after?

A

to monitor for any decrease or improvement in vision; setting a BASELINE for assessment.

36
Q

Describe what BACTERIAL CONJUNCTIVITIS is, its cause, symptoms, treatment and patient teaching.

A

Conjunctivitis: commonly called “pink eye” inflammation of the conjunctiva with exudate along lid. Cause: lack of hand hygiene (fecal matter).

Symptoms: exudate, inflammation. Treatments: topical antibiotics.

Teaching: do not share towels, cosmetics.

37
Q

Meperidine

A

Pharm class: Therapeutic class: Side effects: Teachings:

38
Q

Amoxicillin (amoxil)

A
  • Pharm class: aminopenicillins
  • Therapeutic class: anti-infective
  • Side effects:suprainfection, anaphylaxis
  • Teachings: educate family to inform provider of severe diarrhea, especially in a young child.
39
Q

Describe what EXTERNAL OTITIS is. its cause, symptoms, treatment and patient teaching.

A

External Otitis: AKA “swimmer’s ear” inflammation or infection of the external canal.

symptoms: pain and purulent, foul smelling drainage.
tx: analgesics, corticosteroids, and antibiotics, wick may be used to prevent medication loss.

teaching:

40
Q

What does “consensual pupil response” mean?

A

when the left eye constricts so does the right; reflex observed on either side.

41
Q

Describe what MYOPIA is, its cause. symptoms, treatment and patient teaching.

A

Myopia: nearsightedness, cause: muscles of the lens contract too tightly not allowing enough light to enter the eye (hereditary) Symptoms: close objects are clear, far objects are blurry
tx: glasses

myopia is an elongation of the eyeball

42
Q

When caring for patients with VISUAL problems keep in mind. YOU as the nurse have to be aware of what symptoms need to be report immediate/y.

A

Report decrease in vision, severe pain and/or signs of bleeding. PAIN AND NAUSEA IMPORTANT

43
Q

What are your nursing actions, and interventions, (elaborated why) if your pt complains of SOB.

A

high fowlers position. take vitals, and pulse ox. may need oxygen.

44
Q

Acyclovir (zovirax)

A
  • Pharm class: antiviral
  • Therapeutic class: purine analogue
  • Side effects: dizziness, headache, hallucinations, vomiting, acne, pain
  • Teachings: condoms should always be used. wash hands after touching affected areas to avoid spreading the viral infection
45
Q

Diphenhydramine (benadryl)

A
  • Pharm class: antihistamines
  • Therapeutic class: allergy, cold, and cough remedy
  • Side effects:drowsiness, fatigue, dyspepsia, dysmenorrhea
  • Teachings: assess allergy symptoms before and periodically during therapy. assess lung sounds and character of bronchial secretions. maintain fluid intake of 1500-2000mL/day to decrease secretions. Administer with food or milk.
46
Q

Describe what PRESBYCUSIS is, its cause, symptoms. treatment and patient teaching.

A

Presbycusis: sensorineural hearing loss associated with aging. Symptoms: gradual and bilateral hearing loss

47
Q

How do vou communicate with someone who is hard of hearing?

A

Using written words, getting the patients attention before speaking, facing patient when speaking, talk in normal volume and lower pitch, rephrasing sentences and repeating information, having patient repeat information to relay understanding.

48
Q

Pilocarpine

A

Pharm class: Therapeutic class: Side effects:decreased visual acuity, bradycardia,myopia, decreased vision in poor light Teachings: maintain oral hygiene due to increase in salivation,have atropine sulfate available as a remedy for pilocarpine.

49
Q

What are RISK factors that contribute to HEARING LOSS?

A

aging, infection, medications, ototoxicity, trauma, tumor, LOUD NOISE, DISEASE.

50
Q

Describe what a OPHTHALNIOSCOPE test is for.

A

to examine the back part of the eyeball (fundus) including the retina, optic disc, macula, and blood vessels, requires dilating the pupils with drops

51
Q

What are the normal findings during, your eye assessment you would expect to see and document?

A
  • The sclera appeared white
  • The pupils of the eyes are black and equal in size. The iris is flat and round. PERRLA
  • Pupils constrict when looking at near object and dilate at far object. Pupils converge when object is moved towards the nose.
52
Q

Scopolamine

A
  • Pharm class: anticholinergic
  • Therapeutic class: antiemetic
  • Side effects:dry mouth, sedative effects -Teachings:observe patient for urinary retention, observe for sedation, contraindicated in angle-closure glaucoma patients.

Sensory (1 decks)

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