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MEDICAL-SURGICAL > SENSORY FUNCTION: Assessment & Management of Patients with Eye and Vision Disorders > Flashcards

SENSORY FUNCTION: Assessment & Management of Patients with Eye and Vision Disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

Normal intraocular pressure is ______

A

10 - 21 mm Hg

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2
Q

The most common color vision test is performed using ______

A

Ishihara Polychromatic Plates

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2
Q

Two significant changes in the optic nerve that occur in patients with glaucoma are ____ and ______

A
  • Pallor (Lack of Blood Supply)
  • Cupping of the Optic Nerve Disc
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3
Q

The most common laser surgeries for glaucoma are ____ and ______

A
  • Laser Trabeculoplasty
  • Laser Iridotomy
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4
Q

____ is used to measure nerve fiber layer thickness and is an important indicator of glaucoma progression.

A

Laser Scanning Polarimetry

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5
Q

An initial treatment for a splash injury to the eye would be ____

A

Irrigation with Normal Saline

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6
Q

____, ____, and ____ are the three organisms that most commonly cause bacterial conjunctivitis.

A
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Staphylococcus aureus
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7
Q

A characteristic sign of viral conjunctivitis is ____

A

“Pink Eye”, or Dilation of the Conjunctivital Blood Vessels

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8
Q

One of the most serious ocular consequences of diabetes is ____

A

Diabetic Retinopathy

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9
Q

The most common cause of retinal inflammation in patients with acquired immune deficiency syndrome (AIDS) is ____

A

Cytomegalovirus (CMV)

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9
Q

The most common cause of retinal inflammation in patients with acquired immune deficiency syndrome (AIDS) is ____

A

Cytomegalovirus (CMV)

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10
Q

____, ____, and ____ are the three layers of a healthy tear.

A
  • Lipoid
  • Aqueous
  • Mucoid
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11
Q

The nurse is assessing a patients with a drooping eyelid and documents this as ____.

A

Ptosis

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12
Q

Area where most of the blood vessels for the eye are located

A

Choroid

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13
Q

Degree of convexity modified by contraction and relaxation of the ciliary muscles

A

Lens

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14
Q

Accommodates to the intensity of light by dilating or contracting.

A

Pupil

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15
Q

Contains nerve endings that transmit visual impulses of the brain.

A

Retina

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16
Q

Maintains the form of the eyeball

A

Vitreous humor

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16
Q

Maintains the form of the eyeball

A

Vitreous humor

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17
Q

Transparent part of the fibrous coat of the eyeball.

A

Cornea

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18
Q

White part of the eye

A

Sclera

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19
Q

Contractile membrane between the cornea and lens

A

Iris

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20
Q

The pigmented, vascular coating of the eye.

A

Uvea

21
Q

The edge of the cornea where it joins the sclera

A

Limbus

22
Q

Excesssive production of tears

A

Epiphora

23
Q

Another term for an external hordeolum

A

Sty

24
Q

Term for the RIGHT EYE

A

Oculus Dexter

25
Q

A term used to describe an inflammatory condition of the uveal tract

A

Uveitis

26
Q

Another term for nearsightedness

A

Myopia

27
Q

An inflammatory condition affecting the iris

A

Iritis

28
Q

Inflammation of the cornea

A

Keratitis

29
Q

Loss of cornea substance or tissue as a result of inflammation

A

Ulcer

30
Q

Abnormal sensitivity to light

A

Photophobia

31
Q

Term for the LEFT EYE

A

Oculus Sinister

32
Q

Absence of the lens

A

Aphakia

33
Q

Uneven curvature of the cornea

A

Astigmatism

34
Q

Drooping of the upper eyelid

A

Ptosis

35
Q

A tear in the eye tissue

A

Laceration

36
Q

A condition in w/c one eye deviates from the object at w/c the person is looking

A

Strabismus

37
Q

SITUATIONAL QUESTION:

An older adult patient informs the nurse, “I don’t see as well as I used to.” What will the nurse educate the patient about regarding why vision becomes less efficient with age? (Select all that apply)

a. There is a decrease in pupil size.
b. There is slowing of accommodation.
c. There is an increase in lens opaqueness.
d. Most older patients develop glaucoma.
e. The optic nerve begins to degenerate.

A

a.There is a decrease in pupil size.
b.There is slowing of accommodation.
c. There is an increase in lens opaqueness.

38
Q

SITUATIONAL QUESTION:

During a routine eye examination, a patient complains that she is unable to read road signs at a distance when driving her car. What should the patient be assessed for?

a. Astigmatism
b. Anisometropia
c. Myopia
d. Presbyopia

A

c. Myopia (nearsightedness)

It is a vision condition in which people can see close objects clearly, but objects farther away appear blurred.

39
Q

SITUATIONAL QUESTION:

It is determined that a patient is legally blind and will be unable to drive any longer. Legal blindness refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in the better eye?

a. 20/50
b. 20/100
c. 20/150
d. 20/200

A

d. 20/200

Based on visual acuity testing, a person is considered legally blind when their best corrected vision is 20/200, which means they need to be at least 20 feet away to see something that a person with normal vision can see from 200 feet away.

40
Q

SITUATIONAL QUESTION:

The ophthalmologist tells a patient that he has increased intraocular pressure (IOP). The nurse understands that increased pressure resulting from optic nerve damage is indicated by a reading of:

a. 0 to 5 mm Hg.
b. 6 to 10 mm Hg.
c. 11 to 20 mm Hg.
d. 21 mm Hg or higher

A

d. 21 mm Hg or higher

Normal intraocular pressure is 10-21 mm Hg

41
Q

SITUATIONAL QUESTION:

The nurse at the eye clinic is caring for a patient with suspected glaucoma. What report by the patient would be significant for a diagnosis of glaucoma?

a. A significant loss of central vision
b. Diminished acuity
c. Pain associated with a purulent discharge
d. The presence of halos around lights

A

d. The presence of halos around lights

Acute glaucoma causes the pressure inside your eye to increase rapidly. Wherein, the high intraocular pressure leads to corneal swelling (edema), which causes the patient to see haloes around lights.

42
Q

SITUATIONAL QUESTION:

The nurse is performing an assessment of the visual fields for a patient with glaucoma. When assessing the visual fields in acute glaucoma, what would the nurse expect to find?

a. Clear cornea
b. Constricted pupil
c. Marked blurring of vision
d. Watery ocular discharge

A

**c. **Marked blurring of vision

*People with glaucoma have optic nerve damage from fluid buildup in their eye. When a significant number of nerve fibers are damaged, blind spots develop in the field of vision. *

43
Q

SITUATIONAL QUESTION:

The nurse is educating a patient with glaucoma about medications. What medications will thenurse educate the patient about that decrease aqueous production? (Select all that apply.)

a. Alpha-adrenergic agonists
b. Carbonic anhydrase inhibitors
c. Beta-blockers
d. Miotics
e. Calcium channel blockers

A

a. Alpha-adrenergic agonists (reduce intraocular pressure by decreasing the production of aqueous humor by the ciliary body and increasing drainage through the uveoscleral pathway)
b. Carbonic anhydrase inhibitors (reduce the production of aqueous humor by the epithelium of the ciliary body by reducing the production of bicarbonate ions and presumably reducing fluid flow)
c. Beta-blockers (reduce the intraocular pressure (IOP) by blockade of sympathetic nerve endings in the ciliary epithelium causing a fall in aqueous humour production.)

44
Q

SITUATIONAL QUESTION:

A patient has had cataract extractions and the nurse is providing discharge instructions. What should the nurse encourage the patient to do at home?

a. Maintain bed rest for 1 week.
b. Lie on the stomach while sleeping.
c. Avoid bending the head below the waist.
d. Lift weights to increase muscle strength.

A

**c. **Avoid bending the head below the waist.

“High eye pressure can interfere with the incision before it fully heals. Positions that put your head below your waist, such as bending over, can also increase eye pressure and should be avoided initially after surgery.”

45
Q

SITUATIONAL QUESTION:

A patient is being seen in the ophthalmology clinic for a suspected detached retina. What clinical manifestations does the nurse recognize as significant for a retinal detachment? Select all that apply.

a. A visual field of floating particles
b. A definite area of blank vision
c. Momentary flashes of light
d. Pain
e. Halos around the eyes

A

a. A visual field of floating particles
b. A definite area of blank vision
c. Momentary flashes of light

46
Q

SITUATIONAL QUESTION:

An older adult patient has noticed a significant amount of vision loss in the last few years. Which does the nurse recognize as the most common cause of visual loss in older adults?

a. Macular Degeneration
b. Ocular trauma
c. Retinal vascular disease
d. Uveitis

A

**a. **Macular Degeneration

(AMD is a common condition — it’s a leading cause of vision loss for older adults.)

47
Q

SITUATIONAL QUESTION:

A patient is brought into the emergency department with chemical burns to both eyes. Which is the priority action of the nurse for this patient’s care?

a. Administering local anesthetics and antibacterial drops for 24 to 36 hours
b. Applying hot compresses at 15-minute intervals
c. Flushing the lids, conjunctiva, and cornea with tap water or normal saline
d. Cleansing the conjunctiva with a small cotton-tipped applicator

A

c. Flushing the lids, conjunctiva, and cornea with tap water or normal saline

(If a patient has suffered a chemical burn in the eye, immediate, high-volume irrigation is essential in order to wash out the chemicals and save her or his vision.)

48
Q

SITUATIONAL QUESTION:

A patient comes to the clinic with a suspected eye infection. The nurse identifies that the patient most likely has conjunctivitis, as evidenced by which symptom?

a. Blurred vision
b. Elevated IOP
c. A mucopurulent ocular discharge
d. Severe pain

A

**c. **A mucopurulent ocular discharge

(A mucopurulent discharge, often associated with morning crusting of the eyes, suggests a bacterial infection.)

49
Q

SITUATIONAL QUESTION:

Which type of medication will the nurse use in combination with mydriatics to dilate the patient’s pupil?

a. Anti-infectives
b. Corticosteroids
c. Cycloplegics
d. NSAIDs

A

**c. **Cycloplegics

(Cycloplegics/mydriatics are often administered as combination drugs to achieve dilation of the pupil. )
(Cycloplegic drops have a greater impact on relaxing the focusing system. Mydriatic drops have a stronger dilating effect.)

50
Q

SITUATIONAL QUESTION:

A patient is to have an angiography done using fluorescein as a contrast agent to determine if the patient has macular edema. Which laboratory studies will the nurse monitor prior to the angiography?

a. BUN and creatinine
b. AST and ALT
c. Hemoglobin and Hematocrit
d. Platelet count

A

a. BUN and creatinine

(The increase of serum creatinine by 25% from the baseline readings will lead to contrast-induced nephropathy (or acute kidney injury).)

51
Q

SITUATIONAL QUESTION:

The nurse is administering an ophthalmic ointment to a patient with conjunctivitis. Which disadvantage of the application of an ointment does the nurse explain to the patient?

a. It does not work as rapidly as eye drops do.
b. Blurred vision results after application.
c. It has a lower concentration than eye drops.
d. It has more side effects than eye drops.

A

b. Blurred vision results after application.

(Gels and ointments can cause blurry vision for a while after you put them in your eyes, so most people only use these treatments right before they go to sleep.)
(Such visual change is considered to result from an irregular spreading behavior of ointment on the ocular surface.)

52
Q

When is Amsler grid test used?

A

It is a test often used for patients with macular problems, such as macular degeneration.

53
Q

What should nurse educate the patient about when performing tonometry?

Tonometry is a test to measure the pressure inside your eyes.

A

Patients are cautioned to AVOID…
* Squeezing the eyelids
* Holding the breath
* Performing a Valsalva maneuever
as these may result in abnormally increased IOP

Valsalva maneuver is the performance of forced expiration against a closed glottis.

MEDICAL-SURGICAL (5 decks)

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