Test 6 Flashcards
- Client education conjunctivitis (Slide 16)
If contagious remain away from people separate lines/towels.
Apply Ung in conjunctival sac, instruct to close eye but not squeeze, if need to wipe do from inner to outer canthus
(Most common)
- Retinal detachment client education (Slide 23)
Instruct patient to remain upright preop and restrict movement, eyepatch over affected eye.
Postop: eyepatch when sleeping to avoid injury; avoid bending, coughing, straining
- Most common cause of visual loss and normal aging changes in older adults (Slide 2)
Macular Degeneration
Normal Aging Changes:
Crystalline lenses harden.
Loss of accommodation
Macular degeneration
Presbycusis
Calcification of the ossicles
- Macular degeneration assessment
Loss of central vision
No detail in images
Lack of depth perception
- Macular degeneration diagnostic tests
Amsler grid for peripheral vision test
- Macular degeneration client education/nursing management(Slide 24)
Arrange community resources.
The nurse will assist with ambulation by letting the client follow their lead and encourage client to turn head side to side.
- Nursing interactions for visually impaired clients (Slide 11)
Lead the client, walk a bit ahead during ambulation.
Introduce yourself each time you enter the room because many voices sound similar.
Call the client by name during group conversations because the blind client cannot see to whom questions or comments as directed.
Speak before touching the client.
Tell the client when you are leaving the room.
- Glaucoma manifestations
o Affects people of all ages and all race
o Characterized by increased ocular pressure (IOP) in the eye brought on by an excessive amount of aqueous humor. Tonometry will measure the pressure.
Manifestations:
Open angle: mild eye discomfort, temporary blurred vision, reduced peripheral vision, halos around lights.
Acute angle-closure: hard, painful, sightless eyes; N/V; red conjunctive; headache, color halos around lights
- Glaucoma Nursing/Surgical Management
Medication
Laser surgery
- Glaucoma Diagnostic Findings
Optic disc visualization
Anterior chamber inspection
Tonometry
Visual field exam
- Glaucoma Client Education
Drop taken for life.
Stress importance of drop regimen
Call with OTC med
Keep yearly appointments.
Surgery post-op; avoid lifting, bending, coughing or straining.
- Stapedectomy client education
Refrain from blowing the nose because this action can dislodge the prosthesis.
Avoid high altitudes or flying.
Refrain from lifting heavy objects, straining when defecating, or bending over at the waist; these activities increase pressure in the middle ear.
Prevent water from getting in the ear. Avoid swimming, showering, and washing the hair until approved by the primary provider.
Follow the primary provider’s instructions for keeping the ear clean.
Stay away from people with respiratory infections. If a head cold occurs, contact the primary provider immediately.
Notify the primary provider immediately if severe pain, excessive drainage, a sudden loss of hearing, or fever occurs.
Adhere to the above restriction of activities recommended by the surgeon until told otherwise. Normal activities can usually be resumed within 2 to 4 weeks.
- Cataract manifestations (Slide 22)
Halos
Difficulty in reading
Color vision changes
Reduced, distorted vision.
- Cataract surgery client education/nursing management
Eye shield 24 hrs.
Sunglasses x1 week
Eyedrops
Blurring for days to a week
Expected white drainage, call if yellow or green.
Might feel mild itching and bloodshot.
No heavy lifting, straining, coughing, or bending could indicate increases LOC.
Eye patch changed qd.
Unexpected findings:
- Flashes of light
- Yellow or green drainage
- Sudden increases in pain
- Diagnostic tests for hearing loss
-Audiometry: Non-invasive preliminary test for hearing loss
Tympanogram: Measures the mobility of the TM to detect middle ear disease
Weber~ Test bone conduction hearing loss, client will hear on affected side
Rinne: Tuning forks to determine if hearing loss-hears through air conduction
Otoscopy: To examine external auditory canal, TM, and malleus bone
History and assessment: Trauma, medications, chemotherapy
- Paroxysmal positional vertigo nursing interventions
Sensation of Motion: positional vertigo occurs in response to change in position. Safety in nurse priority- major fall risk
Bed rest
Watch for sedation.
Antiemetics as needed.
Meclizine: antihistamine and anticholinergic effects
- Tonometry education
Glaucoma Test; will measure the intraocular pressure (IOP).
- Timolol K,H,K
Glaucoma Medication
Side effects:
Burning/ Stinging
Discomfort
Dry eyes
Eyelid erythema
Nursing Action/CE:
Avoid canthus duct to limit systemic effect like bradycardia.
Apple pressure to innercaunts for systemic medication
Use caution when hypertensive beta-blocker drugs are used.
- Impacted Cerum Assessment/manifestation
Blocked or Muffled hearing
Plugged feeling in the ear.
Otalgia
- Cerumen removal nursing interventions
Softening wax with mineral oil or Debrox
Let sit overnight then flushing with a syringe.
If left untreated, impacted cerumen leads to tinnitus.
- LASIK complications (Slide 9)
Flap issues: move or doesn’t stay put or inflammation, displace, infective, and can get berede under the flap.
- Brimonidine K,H,K
Glaucoma Medication
Side Effects:
Burning/ stinging
Discomfort
Dry eyes
Safety:
Do not take with MAOI antidepressants.
Confusion noted in frail elderly when used.
- Pilocarpine K,H,K
Glaucoma Medication
Side Effects
Periorbital pain
Blurry vision
Safety:
Warning regarding difficulty with vision in evening or dark area
- Uveitis risk factors
Specific Disease and autoimmune disease
Ankylosing Spondylitis
Tuberculosis
Juvenile rheumatoid arthritis
Toxoplasmosis
Histoplasmosis
Herpes Zoster Infection
- Quinine K,H,K
Use: for leg cramps
Long term use can cause hearing loss
- Weber test nursing considerations
- Performed by striking the tuning fork and placing its stem in the midline of the client skull or center if the forehead.
-A person with normal hearing perceives the sound equally well in both ears (if the sound seems lateralized to on ear, it suggested a conduction hearing loss in that ear or a sensorineural loss in the opposite ear.
- Ear drops instillation client education/nursing management
Assist with drop instillation-always point toward roof of canal not directly at eardrum.
Warm drops prior to instillation
Clean external ear with warm cloth
- Otosclerosis client education
Unknown cause but can be accelerate in pregnancy.
Causes bilateral hearing loss*
- Nursing consideration post op stapedectomy
Place client on opposite side and monitor for dizziness, assist with ambulation.
Avoid coughing, vomiting and monitor for prosthesis dislodgement.
Assess facial nerve function.
Monitor for infection, use aseptic technique when cleaning wound.
- Otitis externa client education/ nursing management
(swimmer’s ear)
After swimming instill alcohol drops to dry
Wear earplugs/ swim cap
Do not use cotton swabs inside.
Use a low heat hairdryer.
- Otitis Media contributing factors
Contributing Factors:
Viral or bacterial infections
Allergens like smoke
