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NURS 302/ Med-Surg 2 > test 1; Eye/Ear/Neuro > Flashcards

test 1; Eye/Ear/Neuro Flashcards

1
Q

The eye is the sensory organ of _______

A

vision

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2
Q

What is the elliptical open space between the upper and lower lid?

A

Palpebral fissue

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3
Q

What is the part of the eye that provides constant irrigation through tears?

A

Lacrimal apparatus

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4
Q

How are tears drained?

A

Puncta

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5
Q

When we see an object, the image is _______ on the retina

A

Upside down

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6
Q

What is the area between the cornea and the lens?

A

Aqueous humor

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7
Q

What is the gelatin like substance that is behind the eye ball that serves as a cusion?

A

Vitrous humor

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8
Q

What is the normal IOP?

A

10-21

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9
Q

What is the most frequent method to measure IOP?

A

Tono-pen tonometry

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10
Q

Myopia is _______________

A

nearsightedness

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11
Q

In myopia, the light rays are falling _________ the retina

A

in front of

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12
Q

What are causes for Myopia

A

Excessive light refraction
Abnormally long eye
Lens swelling causes by hyperglycemia
Happens during growth spurts

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13
Q

Hyperopia is ______________

A

farsightedness

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14
Q

Hyperopia is caused when light rays are focusing _______ the retina

A

behind

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15
Q

What are the causes of hyperopia?

A

Inadequate focusing power
Eyeball is too short

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16
Q

________ is a form of hyperopia that is normal when you get older

A

Presbyopia

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17
Q

What are some things to try if a patient has presbyopia?

A

Hold the objects farther away
Bifocals or Trifocals

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18
Q

What is the irregular or unequal corneal curvature causing the parallel light rays to be bent unequally?

A

Astigmatism

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19
Q

What is the difference between LASIK and PRK

A

In lasik, there is a flap of the cornea and PRK there is not!

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20
Q

LASIK is better for severe _______

A

Myoptics and severe myopia

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21
Q

PRK is the ______ of the cornea with laser

A

reshaping

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22
Q

PRK is geared toward correcting what three disorders

A

myopia
hyperopia
Astigmatism

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23
Q

A hordeolum is what?

A

An infection of the sebaceous gland in the lid margin and it is normally caused by S. Aureus

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24
Q

What eye condition is characterized by a red, swollen, circumscribed and tender area on the eyelid (normally lower)

A

Hordeolum (sty)

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25
Q

What are the three treatment considerations for a sty

A

Warm compress
No makeup
Lid scrub (with baby shampoo)
IF IT PERSISTS FOR MORE THAN 72 HOURS MAY NEED ABX

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26
Q

What is the infection of the conjunctiva?

A

Conjunctivitis

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27
Q

What are the two kinds of conjunctivitis?

A

Bacterial and Viral

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28
Q

Bacterial conjunctivitis is highly __________

A

Highly contagious; needs ABX

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29
Q

What are two causes of bacterial pink eye?

A

Staph A. and Strep P.

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30
Q

What are s/sx of pink eye (conjunctivitis)

A

discomfort
Pruritus
Redness
Mucopurulent drainage

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31
Q

What surgery is removing layers of the cornea?

A

LASIK
*(Layers in Lasik)

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32
Q

What eye surgery shaves and reshapes the cornea?

A

PRK
Reshapes in PRK

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33
Q

what surgical procedure can give you almost perfect vision in almost 24 hours?

A

LASIK

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34
Q

MonoVision therapy is uses in what surgery?

A

LASIK

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35
Q

PRK is used for a patient that has a very ____ cornea

A

THIN

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36
Q

What are the 4 treatment considerations for bacterial pink eye?

A

ABX drops
Strict hand washing
Careful handling of drainage
Warm compress

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37
Q

The signs and symptoms of viral pink eye are what?
feels like something is in their eye

A

Itching
Burning
Redness
Mild photophobia

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38
Q

pink eye may happen after what two events?

A

A URI
Swimming

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39
Q

Usually viral pink eye is ___-__________ but if it lasts longer than 3 days you may need ______ drops

A

steroid

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40
Q

What is the inflammation and infection of the cornea?

A

Bacterial Keratitis

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41
Q

Bacterial Keratitis is normally caused by

A

CONTACT LENSES

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42
Q

Treatment considerations for Bacterial Keratitis?

A

Topical ABX
(MAY NEED 2; PO, sub-conjunctival or IV ABX)

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43
Q

What is the viral infection of the cornea?

A

Viral Keratitis

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44
Q

What are the two most common forms of viral Keratitis?

A

Herpes SImplex Virus
Herpes Zoster Opthalmicus

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45
Q

For HSV Keratitis, you would use what medication

A

Antiviral Eye drops (CORTICOSTEROIDS ARE CONTRAINDICATED)

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46
Q

HSV Keratitis can lead to corneal ________

A

blindness

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47
Q

VSV Keratitis, there is a ______ break-out in the mucous tissue areas like the eye tissue

A

Virulent

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48
Q

What is the treatment considerations for VSV Keratitis?

A

Analgesics
topical corticosteroids
Antiviral
Mydriatic agents
Topical ABX- Secondary infections

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49
Q

What is the opacitiy within the lens which presents with a glare?

A

Cataracts

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50
Q

Treatment for cataracts?

A

Surgery

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51
Q

After cataract surgery what things do you want to consider?

A

Decrease IOP
Infection prevention
Pain control

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52
Q

What are the signs and symptoms of a retinal detaching (the process of it actually detaching)? FFR

A

Flashes
Floaters
Ring in the field of vision

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53
Q

Once the retina is detaches what are the s/sx?

A

Painless loss of vision in the area of detachment

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54
Q

Macular degeneration is the degeneration in the macula that results in what?

A

central vision loss

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55
Q

What is the difference between dry and wet MD

A

Dry MD- slow progression and painless vision loss
Wet Md- this is a more severe rapid vision loss with abnormal blood vessels forming around the macula

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56
Q

What is a condition that is characterized by increased IOP which can result in optic nerve atrophy and peripheral visual loss?

A

Glaucoma

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57
Q

What are the meds given for POAG treatment?

A

Beta adrenergic blockers- decreases aqueous humor production
Alpha adrenergic blockers- decrease aqueous humor production and increase outflow
Mitotic- constrict the iris to increase outflow

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58
Q

What is the inflammation or infection of the epithelium of the auticle of the ear canal

A

external otitis
(Swimmers ear)

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59
Q

What are the s/sx of external otitis?

A

Ear pain is first symptom
Swelling of the ear canal
Muffled hearing
Discharge
Fever occurs with infection

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60
Q

Treatment for Swimmers Ear?

A

ABX drops for Infection
Corticosteroid drops for Inflammation
Good hygiene when giving ear drops
Keep ear dry (May use OTC drying drops)
Warm moist external compresses

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61
Q

What is the inflammation of the middle ossicles and space in the middle of the ear?

A

Otitis Media

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62
Q

What are the symptoms of Otitis Media?

A

History of nasal congestion (allergies)
Muffled hearing
Pain in ear and /or down neck
Sore throat
Fever

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63
Q

What is the presentation of otitis media?

A

Redness, swelling & bulging of tympanic membrane
Fluid and or pus trapped under eardrum

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64
Q

Treatment for Otitis Media?

A

PO ABX for 10 days (may need 2nd ABX)
Monitor meds for ototoxicity
Antihistamines if allergies are root cause
Adult myringotomy

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65
Q

what is the autosomal dominant disease where the
footplate of the stapes is immobilized from spongy
one being developed

A

Otosclerosis

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66
Q

What is used for Otosclerosis?

A

Rinne test

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67
Q

What is the education for a patient with otosclerosis?

A

After surgery they will hear good, and then it will decrease with the swelling but then will get better again, but education about this so they do not get freaked out

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68
Q

What is the Unknown etiology, abnormal accumulation of endolymph/fluid in the inner ear. Usually between ages 30-60…

A

Meniere’s Disease

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69
Q

Presentation of Meniere’s Disease?

A

Sudden attacks of Vertigo
Nausea & Vomiting
Sweating & Pallor
Tinnitus
Fluctuating sensorineural hearing loss
Aural fullness

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70
Q

Treatment considerations for Meniere’s Disease

A

Ongoing (ambulatory) Care- because they are dizzy
Diuretics, sedatives, antihistamines, calcium channel blockers
Avoid nicotine, caffeine, ETOH, foods with MSG and do not go on a low sodium diet
Avoid flickering lights & television during attacks

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71
Q

What are some reasons for conduction hearing loss?

A

Impacted cerumen
Foreign body
Perf. of tympanic membrane
Otitis media with effusion
Otosclerosis

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72
Q

What is the hearing loss that is due to impairment of CN 8

A

Sensorineural

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73
Q

Steps for easing into hearing aids

A

First – restrict to quit areas of home
Second – expand use to outdoors
Finally – incorporate into other environments based on the individuals desire and need

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74
Q

What is the part of the brain that is in charge of production of speech?

A

Broca’s Area

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75
Q

What is the inability to express
written of spoken language?

A

Broca’s aphasia

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76
Q

Broca’s area is in which area of the brain?

A

Frontal Lobe

77
Q

Werkicke’s area is in the _______ lobe?

A

Temporal

78
Q

Wernickes area is in charge of what?

A

understanding language

79
Q

What is the inability to understand written or spoken language?

A

Wenickes Aphasia

80
Q

If you have both brocas and wernickes aphasia it is called?

A

Global aphasia

81
Q

What lobe is in charge of judgement, motor function ,memory, concentraction and personality?

A

Frontal

82
Q

What is a uncontrolled electrical impulse in the brain?

A

Seizure

83
Q

A seizure is a _______; Epilepsy is a ______

A

Sympton; Disorder

84
Q

Tonic/Clonic seizure of a Grand Mal is a full seizure that looks like what?

A

Stiffening and jerking phase

85
Q

A patient is consciois and alert but may have unusual sensations, this is like what kind of seizure?

A

Focal/Partial

86
Q

What are staring spells that are actually seizures noticed in kids?

A

Absent seizures

87
Q

What is a constant seizure for more than 5 minutes and or back to back seizures without a return of consciousness?

A

Status Epilepticus; NEURO EMERGENCY

88
Q

What is the immediate treatment for status epilepticus?

A

IV BENZO

89
Q

Nursing care for seizures?

A

Ensure safety
Document all the details
TIME CAREFULLY and if it is longer than 5 minutes it is a code blue

90
Q

What are some other seizure considerations?

A

No suction in mouth
Pad the bed
Do not hold them down

91
Q

What is an autoimmune desctruction of the myelin sheath?

A

Multiple Sclerosis (MS)

92
Q

In the late stage of MS, ______ degenrate so there are no nerve impulses?

A

Axons

93
Q

What is the clear pattern of relapsing and remitting in MS?

A

Relapsing and remitting

94
Q

What is the stage in MS where there is a progressive decline with a temp. improvement?

A

Primary Progressive

95
Q

What stage of MS is characterized like relapsing remitting but keeps getting worse?

A

Secondary Progressive

96
Q

What is a common sign for MS?

A

L’hermittes sign; they flex the neck and there is a shocking sensation down the spine

97
Q

Nursing care for MS

A

Promote independence
Journal to figure out triggers
Maintain nutrition
Manage complication with mobility

98
Q

What is a decrease in dopamine in the substantia region of the brain?

A

Parkinsons Disease (PD)

99
Q

TRAP of PD?

A

Tremon
rigidity
Akinesia
Bradykinea

100
Q

Treatment for PD?

A

Levodopa/Carbidopa

101
Q

What is the nursing care for PD?

A

Promote optimal function
Self Care
Independence
Aspiration risk
Maintain diet and weight
Falls Risk
Drooling (give 1% atropine)

102
Q

Early signs of PD?

A

slight limp, tremor, etc.

103
Q

What is an autoimmune disease at the neuromuscular junction that leads to weakness of the skeletal muscles; low ACH receptors?

A

Myasthenia Gravis (MG)

104
Q

________ of MG patients have anti ACH receptor antibodies

A

85-90%

105
Q

What is the main s/sx of MG

A

muscle fatigue that gets better with test

106
Q

COmplication of MG?

A

Resp. insufficiency, infection
Aspiration

107
Q

3 tests for MG

A

Tensillion Test
Eye droop test

108
Q

Drugs that can be used to treat MG?

A

Anticholinesterase Drugs
Corticosteroids
Immunosuppressants- body is attacking itself; calms the immune system down
Plasmapheresis and removal of thymus can also be done

109
Q

Nursing care for MG?

A

Perform tasks in the AM; this is when they have the most energy
Monitor eating- choking risk
Allow for alternate communication (it can be hard to speak)
Do not encourage hot showers

110
Q

What is the most common form of dementia that is multifactorial with both genetics and environmental risk factors?

A

Alzheimer’s Disease (AD)

111
Q

What are some characteristics of AD?

A

Many beta amyloid plaques
Neurofibrillary tangles
(seen at autopsy)

112
Q

Nursing care of AD?

A

Risk of injury and wandering
Coping for the patient
Family burnout?
Self esteem issues

113
Q

What are treatment options for AD?

A

Cholinesterase Inhibitors
SSRIs
Antipsychotics
Sleeping Aids

114
Q

You cannot stop ___ but you can slow it down

A

AD

115
Q

KNOW THE GLASGLOW COMA SCALE

A

!!!

116
Q

Eye opening response in glasgow coma scale

A

4- opens spontaneously
3- opens to command
2-open to pain
1- none

117
Q

Verbal response in glasglow coma scale

A

5- orientated and answers well
4-confused but able to answer
3- Odd words
2- Incoherent Sounds
1- None

118
Q

What is the hydrostatic force measured in the brain compartment?

A

ICP

119
Q

Normal ICP is?

A

5-15

120
Q

ICP of over 20 means

A

Needs treatmetn

121
Q

ICP of over 30 or 40

A

Brainstem herniation

122
Q

ACIDOSIS LEADS TO what?

A

cerebral vasodilation and increased ICP- fix the acidosis

123
Q

What is the first sign of increased ICP?

A

change in LOC

124
Q

What are other signs of ICP

A

Projectile vomiting
Cushing’s Triad- bradycardia with bounding pulse, irregular RR and widening PP (normal is 40-60)
Fixed unilateral dilated pupil (shows brainstem herniation)

125
Q

Nursing care for increased ICP

A

HOB at 30 degrees
Maintain O2
Avoid things that increase ICP- sneezing coughing etc.
Cluster care to minimize stimulation
Have a dark environment
Do not suction
Check ABG to check for acidosis

126
Q

What is the top pritority for neuro?

A

perfusion

127
Q

How do you calculate CPP?

A

MAP-ICP = CPP

128
Q

What is the normal CCP?

A

60-100 mmHg

129
Q

What is the big concern for a scalp laceration?

A

Risk for infection

130
Q

Signs of a skull fracture

A

Battle sign- bruising by ear
Racoon Eyes- exactly what is sounds likes
Basal skull fracture- DO NOT PLACE A NG TUBE BLINDLY
CSF leak? (from nose or ear)

131
Q

If you suspect a CSF leak what would show you that it is CSF?

A

Halos sign (will see a yellow ring or halo)

132
Q

If you use a glucometer to check CSF, the glucose level will be

A

40-70

133
Q

What is a sudden change in LOC w/ or w/o loss of consciousness

A

Concussion

134
Q

What can happen 2 weeks-months after an injury (concussion)

A

Post concussion syndrome

135
Q

S/Sx of Post Concussion Syndrome?

A

HA, lethargy, change in personality behavior, attention span etc.

136
Q

What is the bruising of the brian due to closed head injury?

A

Contusion

137
Q

Ipsilateral Pupillary changes show

A

Contusions

138
Q

What med can change outcomes of head traumas?

A

ANTICOAGS.
It changes the bleeding and can lead to much worse outcomes

139
Q

What is the bleeding between the dura matter and the inner surface of the skull?

A

Epidural Hematoma
Arterial in nature

140
Q

What is the hallmark sign of an epidural hematoma?

A

They hit their head, pass out, wake up, and pass out agian

141
Q

What is the bleeding the dura mater and the arachnoid layer?

A

Subdural hemaotma

142
Q

A subdural hematoma is ______ in nature and occurs a few hours or days after the trauma

A

VENOUS
Wrote a patho about a man who fell and hit his head, days later he had a subdural hematoma!

143
Q

What is the gold standard for D/x in head trauma?

A

Head CT

144
Q

Nursing care for head trauma

A

Pain-
Fever- due to trauma in the hypothalamus not infection
Neuro checks
Manage ICP

145
Q

What is the consideration for brain tumors

A

Operability is perhaps more important on whether it is malignant or benign. (If it is benign, but is an inoperable place it can be more deadly than a cancerous one in a “good” place)

146
Q

What is a stroke that happens because a clot forms from a vessle wall injury?

A

Thrombotic Ischemic Stroke

147
Q

What is the biggest factor for an ischemic stroke?

A

HTN

148
Q

T/x for Ischemic Stroke?

A

ASA
TPA
Cerebral angiography

149
Q

What is bleeding within the brain?

A

Intracerebral hemorrhage (stroke)

150
Q

What kind of stroke that is bleeding into the subarachnoid space and they say it is the worst headache of their life?

A

Subarachnoid hemorrhage

151
Q

For a subarachnoid hemorrhage they will then go to neuro ICU for 14 days bc we are worried about

A

Cerebral vasospasm

152
Q

In the neuro world, they allow for _____________ ____ because it allows for better blood flow

A

Permissive HTN (for 24-72 hours)

153
Q

Treatment for Subarachnoid hemorrhage?

A

Surgery
ICU
HHH therapy
Calcium blocker therapy

154
Q

What are the clinical manifestations of stroke?

A

Facial Droop
Arm
Speech changes
Terrible HA
Can also have damage for Broca’s area, Wernicke’s area, or global aphasia

155
Q

What is the first thing you do before even thinking about treatment of a stroke

A

Get a head CT, because it changes the treatment

156
Q

Review when you can or cannot give tPA

A

must be administers within 3-4.5 hours of symptom onset
Do not give if they have had a hemorrhagic stroke, coagulation disorders GI bleed, head trauma, or major surgery within the last two weeks

157
Q

What is the acute inflammation of the lining of the brain?

A

Meningitis

158
Q

Hallmark sign of meningitis?

A

Nuchal Rigidity

159
Q

What are two other signs for meningitis

A

Kernig’s sign
Brudzinski’s sign

160
Q

If a patient has cloudy CSF after a Lumbar puncture you would suspect what kind of meningitis?

A

Bacterial (BAD)

161
Q

If a patient has clear CSF after a lumbar puncture you would suspect what kind of meningitis?

A

Viral (Better outcomes)

162
Q

Trigeminal Neuralgia affects what CN?

A

5

163
Q

S/Sx of Trigeminal Neuralgia?

A

Sudden pain
Twitching and tic like movements

164
Q

What meds can be used for Trigeminal Neuralgia?

A

Carbamazepine

165
Q

Bells Palsy resembles a stroke but is not a stroke and it affects CN ____

A

7

166
Q

The clinical manifestations for Bells Palsy are very similar to stoke but also show

A

Inability to close one eye
Unilateral loss of taste
decreased ability to chew- aspiration!!

167
Q

Nursing Management for Bells Palsy

A

Gentle massage
moist heat
Patch the eye if they cannot close it
Self Esteem

168
Q

What is the rare neurological illness noted by ascending symmetrical paralysis?

A

Guillian Barre

169
Q

GB normally happens after what?

A

URI or GI infection
After vaccination

170
Q

Basically, GB affects all muscles and nerves so it is important to pay attention to

A

ALL THINGS BREATHING! It affects diaphragm

171
Q

If a patient had a spinal cord injury to C3 (cervical injury) they will have

A

Tetraplegia and on a vent for life

172
Q

If a patient had a spinal cord injury to the thoracic or lumbar spine (above T6), they will likely be a

A

Paraplegic

173
Q

What is caused by damage to half of the spinal cord and there is a loss of motor function on the side of the injury(ipsilateral) and a loss of pain and temp. on the other side (contralateral)

A

Brown-Sequard Syndrome

174
Q

What are clinical manifestations for Brown Sequard?

A

Resp- need mechanical ventilation
Hypotension and low BP
Need a cath

175
Q

Nursing Care for Spinal Injuries

A

Pain
Prevent UTIS and Pneumonia
ROM
Watch for infection
Monitor cardiac status and nutrition
Need OT and PT
Support the patient and the family.

176
Q

When you have a patient that has a HA and high BP they may have

A

Autonomic Dysreflexia

177
Q

What are the locations used for a lumbar puncture

A

L3-L4
L5-L6

178
Q

What is the glaucoma that is characterized by the outflow of aqueous humor is decreased in the trabecular meshwork the drainage becomes clogged this results in increased IOP… GRADUALONSET

A

Primary Open Angle Glaucoma (Gradual)

179
Q

What is the glaucoma that is characterized by the angle between the iris and the cornea closes (happens rapidly)

A

Acute Angle Closure Glaucoma (Opthalamic Emergency)

180
Q

What are the signs and symptoms of Acute angle closure glaucoma?

A

Sudden Pain
N/V
Blurred vision
Ocular Redness
Colored halos around lights

181
Q

Motor response for Glasgow coma scale

A

6- Obeys commands
5- Moves to localized pain
4- Withdraws from pain
3- Abnormal Flexion
2- Abnormal Extension
1- None

182
Q

What part of the brain is in charge of perception of space, and can cause safety issues if it is impaired

A

Parietal
parietal think proprioception

183
Q

What lobe of the brain is in charge of perception and memory

A

Occipital

184
Q

What part of the brain is in charge of memory, sound, understanding and language

A

Temporal

185
Q

What is the stage of of MS that starts like relapse/remitting and then declines?

A

Secondary Progressive

186
Q

What is the stage of MS that declines from the start with acute relapses that may or may not have remission?

A

Progressive Relapsing

187
Q

What are some common MS triggers

A

Stress
Infection
Cold

188
Q

Pharmacological considerations for MS?

A

Immunosuppression
Immunomodulator
Monoclonal antibodies
Muscle relaxants

189
Q

Late signs of Parkinson’s Disease?

A

Pill rolling that gets worse with stress and concentration. This is worse at rest, rigidity, and bradykinesia

NURS 302/ Med-Surg 2 (5 decks)

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