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Chronic Rehab > Sensory Pt 3 > Flashcards

Sensory Pt 3 Flashcards

1
Q

Member of the herpes group of viruses
Direct viral invasion of retinal cells
naturally occurring virus

A

Cyotomegalvirus (CMV) Retinitis

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2
Q

who is CMV most common in

A

pts with HIV or that are immunocompromised

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3
Q

what can CMV cause

A

blindness

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4
Q

symptoms of CMV

A

Blurred vision
Decreased vision
Floaters
Blindness

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5
Q

an exudative inflammatory process that involves retinal vessels

A

chorioretinitis

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6
Q

managment of CMV

A

Gancyclovir (IV or PO)

Foscarnet (IV)

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7
Q

carcinoma of the eye types

A

Choroidal melanoma
Iris melanoma
Retinoblastoma

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8
Q

nursing diagnoses for eye problems

A

Disturbed sensory perception r/t visual deficit
Risk for injury r/t visual impairment
Self-care deficit r/t visual impairment
Anticipatory grieving r/t loss of functional vision loss
Acute pain r/t pathophysiologic process and/or surgical correction
Noncompliance r/t inconvenience of lifelong meds

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9
Q

med for Acute closed-angle glaucoma

A

Osmotic (draws fluid into intravascular space to lower IOP)

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10
Q

med for Corneal abrasion

A

Anti-inflammatory

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11
Q

med for Ophthalmoscopy

A

Midriatic (pupil dilates, example is Atropine)

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12
Q

med for Chronic closed-angle glaucoma

A

Miotic (constricts pupil and contracts the ciliary muscle allowing for enhanced circulation of aqueous humor)

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13
Q

what percent of people with Down syndrome develop hearing loss in adulthood

A

70%

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14
Q

what is important piece to ask during ear assessment

A

do you have dizziness or vertigo

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15
Q

what does audiometry test

A 
Pure tone (tests hearing threshold levels) 
Speech
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16
Q

Artificial stimulation of the vestibular apparatus
Involves induced nystagmus (rapid involuntary movement of the eye)
Can suggest etiology of vertigo

A

Electronystagmography

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17
Q

purpose of electronystagmography

A

determining if there is something wrong with the vestibular portion of the inner ear.

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18
Q

If dizziness is not caused by the inner ear

A

it might be caused by disorders of the brain, or by medical disorders (low blood pressure)

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19
Q

difficulty in the external ear or the middle ear);
i.e., problem conducting sound waves
Obstruction
Otosclerosis

A

conductive hearing loss

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20
Q

overgrowth of bone in the inner ear

A

otosclerosis

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21
Q

Root cause sometimes found in CN VIII, (Vestibulocochlear nerve)
Resulting from exposure to loud noises
Diabetes
Damage to inner ear
Meniere’s Disease
difficulty in the inner ear or the acoustic nerve

A

Sensorineural hearing loss

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22
Q

Combination of conductive hearing loss and sensorineural hearing loss

A

mixed hearing loss

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23
Q

PAIN
Itching or ear canal
Inflammation

A

external otitis

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24
Q

why do kids often get outer ear infections

A

their ear canal is not sloped like in adults

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25
Q

aka middle ear infection, is a common cause of hearing loss; trauma

A

Chronic otitis media

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26
Q

types of otitis media

A

Acute
Chronic
Serous

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27
Q

Performed if the perforation if only the membrane with no other accompanying damage

A

Myringoplasty

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28
Q

Performed if the middle ear is involved

A

tympanoplasty

29
Q

post op considerations of ear surgery

A 
Do not blow nose; sneeze or cough with mouth open
Avoid physical activity for one week
Keep ear dry for six weeks
Do not shampoo hair for one week
Avoid airplane travel for one week
30
Q

Throbbing pain, drainage, fever, bulging tympanic membrane with possible perforation

A

otitis media

31
Q

Hardening of the ear (stapes); normal canal and ear drum; progressive conductive hearing loss

A

otosclerosis

32
Q

Most common blockage due to enlarged adenoid tissue

A

Eustachian tube disorders

33
Q

inner ear infection

can be viral or bacterial

A

Labyrinthitis

34
Q

a triad of symptoms – vertigo, dizziness, tinnitus, and hearing loss. Affects CN VIII

A

Meniere’s disease

35
Q

Ringing noise

A

tinnitus

36
Q

When eyes are open, world seems to be spinning

A

vertigo

37
Q

Meniere’s Disease:Diagnosis

A

MRI and Audiometric testing

38
Q

meniere’s disease treatment

A

Bed rest during attack

Avoid sudden movement

39
Q

meniere’s disease meds

A

Dimenhydrinate (Dramamine)
Cyclizine hydrochloride (Marezine)
Meclizine (Bonine; Antivert; sedatives and hypnotics)

40
Q

what is important to know about meniere’s meds

A

make pt sleepy so watch for falls

41
Q

how can you improve noise induced hearing loss

A

Tympanoplasty

42
Q

Hearing loss related to aging
More common after age 50
Hearing loss of higher frequencies
Accompanied by tinnitis

A

presbycus

43
Q

occurs suddenly usually in association with known trauma. signs of acute pain: sweating, pallor, perhaps nausea.

A

acute pain

44
Q

develops over several days, often increasing in intensity with a pattern of progessive pain symptomatology. Typical cancer pain.

A

subacute pain

45
Q

occurs over shorter periods of time at regular or irregular intervals. Arthritic pain that comes and goes is an example.

A

episodic pain

46
Q

Pain that has persisted for more than 3 months.

A

chronic pain

47
Q

example of things that cause chronic pain

A

Cancer, arthritis, fibermialga

48
Q

Is the pain reported as an average pain intensity for 12 hours or more out of 24hrs.

A

baseline pain

49
Q

pain more severe than the the baseline pain

A

breakthrough pain

50
Q

pain occurring before the next dose of analgesics is due

A

end of dose pain

51
Q

will decrease sensations in GI tract

A

narcotics

52
Q

well-localized, sharp, aching, throbbing, pressure
Inflammatory
Muscular

A

somatic

53
Q

Originates in internal organs
diffuse, gnawing, aching, sharp, cramping, throbbing
Referred pain

A

visceral

54
Q

Nociceptive pain is receptive to what

A

opioids

55
Q

Caused by an injury to the peripheral or central nervous system and causes a pain that is in excess of the initial injury

A

neuropathic pain

56
Q

what fibers transmit pain

A

c fibers and A delta fibers-

57
Q

morphine like substances are released from large diameter nerve fibers and close the gate

A

endorphins

58
Q

gating mechanism occurs in the spinal cord, nerve fibers (A &C) transmit pain impulses to the dorsal horn of the spinal cord (substantia gelatinosa), where gating mechanism is, if gate is open, impulses go through, if not, no painful stimuli

A

gate control

59
Q

what does chronic pain lead to

A

fatigue and sleep disturbances.

difficulty performing ADLs

60
Q

what is the key to acute pain

A

when client unable to report
unable to take deep breath, ambulate, sleep, perform ADLs
Guarding, muscle tension or rigidity
Autonomic changes with sudden and severe pain

61
Q

how do you assess pain

A 
PQRST
Precipitating
Quality
Radiating
Severity
Timing
62
Q

what is the WHO pain scale

A

1-4 scale

1 is bottom (NSAIDS)

63
Q

what is the bottom rung of ladder

A

(mild pain): Non opioid +/- adjuvant

ie/Aspirin, Ibuprofen (motrin), Naproxen (naprosyn)

64
Q

second rung of ladder

A

worse pain): Weaker opioid +/- non opioid +/- adjuvant

ie/Codeine, Darvocet

65
Q

highest rung of ladder

A

worst pain): Strong opioid +/- non opioid +/- adjuvant

ie/Morphine, Fentanyl, Oxy

66
Q

why should you never take more than 4 g of tylenol a day

A

can cause severe liver failure and death

67
Q

what causes severe constipation

A

morphine

68
Q

describe Darvocet

A

very addictive-banned in US

Chronic Rehab (18 decks)

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