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Patient Centered Care 2 > Sensory Perception: Visual Impairment > Flashcards

Sensory Perception: Visual Impairment Flashcards

1
Q

What questions should a nurse ask a patient to assess for visual impairment?

A
  1. How would you rate your vision (excellent, good, fair, or poor)? Describe any recent changes in your vision
  2. Do you wear eyeglasses or contact lenses?
  3. Do you have any difficulty seeing near or far objects or difficulty seeing at night?
  4. When did you last visit an eye doctor?
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2
Q

What comorbidities put someone at risk for vision impairment?

A

DM, Heart problems, breathing problems, hypertension, joint problems, and stroke

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3
Q

How would a pt’s visual acuity be assessed?

A

Use a Snellen chart or other reading material such as a newspaper, and visual fields, using picture charts for those with limited reading or language proficiency.

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4
Q

What resources should be available to a person with a visual deficit?

A
  1. eyeglasses of the right prescription, clean and in good repair
  2. Adequate room lighting, including night-lights
  3. Sunglasses or shades on windows to reduce glare
  4. Bright contrasting colors in the environment
  5. magnifying glass
  6. Phone dialer with large numbers
  7. Clock with large numbers or auditory device
  8. Color code or texture code on stoves, washer, medicine containers, and so on.
  9. Colored or raised rims on dishes
  10. Reading material with large print
  11. Braille or recorded books; podcasts
  12. seeing-eye dog
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5
Q

What is important to remember when communicating with someone who has a visual deficit?

A
  1. Always announce your presence when entering the patient’s room and identify yourself by name
  2. Stay in the patient’s field of vision if the patient has a partial vision loss
  3. speak in a warm and pleasant tone of voice. Some people tend to speak louder than necessary when talking to someone who is blind.
  4. Always explain what you are about to do before touching the individual
  5. Explain the sounds in the environment
  6. Indicate when the conversation has ended and when you are leaving the room
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6
Q

How would a nurse educate on having a safe environment for someone with visual impairment?

A
  1. keep an uncluttered environment with plenty of lighting
  2. clear pathways (chairs pushed under tables, things put away); furniture should not be rearranged without orienting the patient
  3. Organized self-care articles within reach
  4. call lights and assistive devices within easy reach
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7
Q

What surgeries can be done to help with visual impairments?

A
  1. cataract surgery
  2. glaucoma surgery
  3. laser eye surgery to correct myopia, hyperopia, astigmatism, and other disorders
  4. corneal transplant surgery
  5. surgery to repair detached retinas
  6. eye muscle surgery to correct strabismus
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8
Q

What are the risk factors for cataracts?

A
  1. Age
  2. genetics
  3. environmental factors: sunlight
  4. Cigarette smoking and heavy alcohol consumption
  5. Eye trauma
  6. DM
  7. Drugs (corticosteroids, lovastatin, phenytoin, chlorpromazine, busulfan)
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9
Q

What medications can cause problems with vision?

A
  1. antihistamines
  2. antihypertensives
  3. miotic eye drops
  4. Antiseizure meds (eye pain)
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10
Q

What is the difference between open-angle and closed-angle glaucoma?

A

open-angle glaucoma: the anterior chamber angle between the iris and cornea is normal
Closed-angle glaucoma: narrowing of the anterior chamber angle occurs because of corneal flattening or bulging of the iris into the anterior chamber.

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11
Q

What are the types of otitis?

A
  1. Otitis externa: Inflammation of the ear canal
  2. Otitis interna (labyrinthitis): Inflammation of the inner ear
  3. Otitis media: Inflammation of the middle ear
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12
Q

What is otitis externa most likely referred to?

A

Swimmer’s ear

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13
Q

What is otitis media most commonly referred to?

A

An ear infection

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14
Q

What most often precedes the development of otitis media?

A

An upper respiratory infection or allergies

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15
Q

What are the three types of otitis media?

A
  1. serous otitis media
  2. Acute otitis media
  3. Chronic otitis media
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16
Q

What is serous otitis media?

A

Occurs when obstruction of the eustachian tube is prolonged, impairing equalization of air pressure in the middle ear. The resulting negative pressure in the middle ear causes sterile serous fluid to move from the capillaries into space, a process that is known as middle ear effusion

17
Q

What is acute otitis media?

A

Acute otitis media typically follows an upper respiratory infection. Edema of the eustachian tube impairs drainage of the middle ear, causing mucus and serous fluid to accumulate. This fluid is an excellent environment for the growth of bacteria, which may enter from the oronasopharynx via the eustachian tube.

18
Q

What is chronic otitis media?

A

Involves permanent perforation of the tympanic membrane, with or without recurrent pus formation. It usually is the result of recurrent acute otitis media and eustachian tube dysfunction, but it may also result from trauma or other diseases.

19
Q

What are the clinical manifestations of serous otitis media?

A

In adults typically includes decreased hearing in the affected ear and complaints of “snapping” or “popping” in the ear.
The tympanic membrane demonstrates decreased mobility and may appear retracted or bulging.

20
Q

What are the clinical manifestations of acute otitis media?

A

Mild to severe pain in the affected ear, elevated temperature, diminished hearing, dizziness, vertigo, and tinnitus.
Pus within the mastoid air cells often causes mastoid tenderness.
tympanic membrane often appears red and inflamed or dull and bulging.

21
Q

What are the treatments for acute otitis media?

A
  1. ear pain: local anesthetic, local herbal pain products, or systemic acetaminophen or ibuprofen
  2. If the patient’s condition for 48-72 hours, treatment with a course of antibiotics
22
Q

What are the diagnostic tests for otitis media

A
  1. impendence audiometry
  2. CBC
  3. Tympanocentesis or myringotomy
  4. Spectral gradient acoustic reflectometry
  5. Culture and sensitivity tests
  6. Audiologic testing
23
Q

What type of drugs are used for pharmacologic therapy for otitis media?

A
  1. antibiotics

2. Analgesics, antipyretics, antihistamines, and the local application of heat may relieve symptoms

24
Q

What type of surgery could be done to relieve otitis media?

A

myringotomy or tympanocentesis to relieve excess pressure in the middle ear and prevent spontaneous rupture of the eardrum.

25
Q

What is a tympanocentesis?

A

The healthcare provider inserts a 20-gauge spinal needle through the inferior portion of the tympanic membrane, allowing aspiration of fluid and pus from the middle ear to relieve pressure and, if necessary, to obtain a specimen for culture.

26
Q

What should nurses teach parents to help reduce the risk of otitis media?

A
  1. infants in an upright position and not to put children to bed with a bottle
  2. breastfeeding appears to be protective against otitis media
  3. Pacifier use can alter the dental structure and promote eustachian tube dysfunction, and it also allows reflux of nasopharyngeal secretions into the middle ear from sucking
  4. recurrent otitis media is common with children of parents who smoke and children who attend child care centers.
27
Q

What type of vaccination beginning at 2 months of age has proved to reduce the incidence of diseases like otitis media?

A

Haemophilus influenzae type B vaccine

28
Q

What are the interventions for Otitis media?

A
  1. assess the severity, quality, and location of the pain
  2. encourage the patient to use mild analgesics like ibuprofen or acetaminophen for pain and fever
  3. advise the patient to apply heat to the affected side unless contraindicated.
  4. Instruct the patient to promptly report to the primary care provider
  5. Instruct the patient to avoid air travel, rapid changes in elevation, or driving
  6. Instruct the patient to promptly report to the primary care provider
  7. Elevate the head of the bed to decrease pressure on the middle ear when the patient is in bed

Patient Centered Care 2 (26 decks)

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