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Fundamentals SEM2 > WEEK 1-Sensory Preception > Flashcards

WEEK 1-Sensory Preception Flashcards

1
Q

define tinnitus

A

Hearing sounds when no actual outside sound is occurring, such as ringing, buzzing, roaring, clicking, hissing, or humming noises.

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2
Q

define Meniere’s disease

A

A hearing disorder caused from excessive buildup of fluid in the ear that leads to vertigo, tinnitus, and hearing loss.

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3
Q

define cataracts

A

A clouding of the lens of the eye that causes vision to be blurry, hazy, or less colorful.

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4
Q

define macular degeneration

A

An irreversible degeneration of the macula that leads to loss of central vision as clients age.

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5
Q

define glaucoma

A

An increase in intraocular pressure due to the buildup of fluid, or aqueous humor, that causes compression of the optic nerve.

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6
Q

define retinal detachment

A

A visual disorder that occurs when the retinal tissue detaches from the blood vessels in the posterior eye.

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7
Q

external structures of the eye

A

extrinsic eye muscles, upper and lower eyelids, sclera, conjunctiva, and lacrimal structures.

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8
Q

three layers of the eye

A

fibrous, vascular, and neural

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9
Q

three fluid filled chambers

A

(anterior, posterior, and vitreous

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10
Q

fibrous layer of the eye

A

the outermost layer and contains the sclera and transparent cornea.

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11
Q

vascular layer of the eye

A

middle layer is the vascular layer that consists of the iris, choroid, and ciliary body.

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12
Q

neural layer of the eye

A

The innermost neural layer holds the retina, optic nerve, and visual pathway.

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13
Q

what is the anterior and posterior chambers filled with

A

clear fluid called aqueous humor

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14
Q

aqueous humor

A

Aqueous humor is secreted from the choroid and is necessary to maintain intraocular pressure within the eye.

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15
Q

vitreous chamber

A

the biggest of the three chambers and contains a gel-like liquid that is found between the lens and retina.

This vitreous liquid maintains the shape of the eye and is needed for the transmission of light.

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16
Q

photoreceptors

A

also known as rods and cones, are located within the retina and are responsible for receiving signals, processing them, and transmitting them to the brain through the optic nerve.

Rods are useful for vision in low light and assist in the detection of images in peripheral vision. Cones allow the eye to differentiate changes in color.

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17
Q

macular degeneration aka AMD

A

occurs when the component of the retina responsible for central vision is not able to function.

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18
Q

age-related macular degeneration (AMD)

A

AMD leads to blurred vision that is noticed most often while reading and progresses to distorted vision in the center of the eye field.

This condition occurs when there is a buildup of photoreceptor waste products, called drusen, that accumulate beneath the retina.

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19
Q

dry AMD vs. wet AMD

A

Dry AMD is more commonly diagnosed and causes the outer portion of the retina to break down and develop areas with increased accumulation of drusen.

Wet AMD is triggered by the abnormal growth of blood vessels underneath the retina. The vessels leak blood and fluid under the center portion of the retina (macula), causing distorted vision.

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20
Q

how is AMD a risk to older people?

A

Globally, AMD is the most common cause of irreversible blindness and vision loss in people over the age of 65.

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21
Q

risk factors for developing AMD

A

smoking, hypertension, elevated cholesterol levels, obesity, and a family history of AMD. People who have light skin pigment or light-colored eyes are also at an increased risk for developing AMD

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22
Q

Co-morbidities with AMD

A

people who are at a higher risk for stroke, myocardial infarction, hypertension, hyperlipidemia, or renal disease should complete regularly scheduled eye examinations.

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23
Q

what is there a correlation diesase with AMD?

A

renal and AMD correlate

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24
Q

A nurse is teaching a client who has macular degeneration about ADLs that may become more difficult to perform as the condition progresses. Which of the following will the nurse include in the teaching?

A

showering, driving, reading a book

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25
Q

what can people with dry AMD experience?

A

People who have dry AMD will notice gradual blurring of their vision, which can impair night vision, diminish central vision, and make reading progressively more difficult

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26
Q

what can people with wet AMD experience?

A

Wet AMD progresses more rapidly and causes sudden blurred vision or blind spots in the center of the visual field.

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27
Q

diagnostic tests for AMD

A

This examination will identify changes in the macula, the presence of drusen deposits, and bleeding. A fundoscopy or ophthalmoscopic examination will be performed with the client’s pupils dilated, with medicated eye drops to enable the provider to visualize the rear of the eye.

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28
Q

CNS relations to AMD

A

Clients who have AMD are more likely to also develop narrowing and thickening of the carotid arteries, hypercholesterolemia, hyperlipidemia, and increased buildup of blood vessel plaque, which places them at a higher risk for developing central nervous system health conditions, such as stroke.

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29
Q

what is priority for people with AMD

A

fall risk-make sure things aren’t in the way on the floor

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30
Q

what is a lifestyle change that can help with AMD

A

lowering smoking

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31
Q

define cartaracts

A

cloudy or opaque areas around on the eye lens

These areas alter the passage of light through the eye lens, which may cause painless blurred vision or glare. Cataracts develop as the lens becomes denser and less transparent due to proteins and fibers in the lens breaking down ​​​​​​​.

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32
Q

what is the most common risk factor for developing cataracts

A

age, as cataracts typically affect adults over the age of 65

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33
Q

risk factors for developing cataracts

A

Advanced age
Diabetes mellitus
Hypertension
History of eye inflammation
Previous traumatic eye injury
Use of steroids
Previous eye surgery
Family history
Overexposure to sun or ultraviolet (UV) rays
Smoking
Alcohol use disorder
Obesity

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34
Q

correlation with cataracts

A

There is a correlation between the development of cataracts and chronic hypertension and diabetes mellitus.

Poorly controlled blood pressure and blood glucose levels decrease adequate blood flow causing damage to the lens of the eye.

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35
Q

cataracts safety considerations

A

same as AMD-fall risk

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36
Q

client education with cataracts

A

Provide instruction on lifestyle modifications that should be implemented, including smoking cessation, alcohol reduction, and dietary changes that include an increase in leafy green vegetables. Information will be provided on the importance of medication compliance and its impact on the recovery process.

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37
Q

A nurse is teaching a client who is an older adult about eye health. Which of the following instructions should the nurse include?

A

Increase the amount of fruits and green leafy vegetables in their diet.

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38
Q

surgery for cataracts

A

Cataract extraction surgery involves removing the cloudy opaque lens and implanting an artificial intraocular lens (IOL).

The technique most often used is phacoemulsification, a mechanically assisted extracapsular procedure.

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39
Q

A nurse is providing preoperative teaching to a client who is scheduled for bilateral eye cataract extraction surgery. Which of the following instructions should the nurse include in the teaching?

A

“You will need to stop taking aspirin one week before the surgery.”

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40
Q

A nurse is providing postoperative medication teaching to a client who had bilateral eye cataract extraction surgery. Which medications should the nurse include in the teaching?

A

Antibiotics eye drops

b
Steroid eye drops

c
Anti-inflammatory eye drops

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41
Q

define glaucoma

A

Glaucoma develops slowly over time but progressively causes increased ocular pressure against the optic nerve.

This is due to a change in the volume or a decrease in absorption of the aqueous humor

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42
Q

types of glaucpma

A

common form is open wide or wide angle glaucoma ( It develops slowly as the outflow of aqueous humor is reduced, and changes in vision are gradual. contacts don’t help)

other one is angle-closure or narrow-angle glaucoma (has a sudden onset of vision loss and is considered an urgent situation requiring emergent treatment. This form of glaucoma is due to the complete obstruction of aqueous humor outflow.)

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43
Q

risk factors for glaucoma

A

age over 60 has greater risk but it can come at any age

Other factors that contribute to glaucoma include previous eye trauma or injury, chronic health conditions, and family history.

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44
Q

correlations with glaucoma

A

There are several chronic medical conditions that are associated with the development of glaucoma, including high blood pressure, diabetes, and hyperlipidemia

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45
Q

normal intraocular pressure (tonometry)

A

11-21 mmHg

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46
Q

safety considerations for glaucoma

A

same as AMD and cataracts (fall risk)

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47
Q

A nurse is caring for a client who has glaucoma. Which of the following manifestations should the nurse expect?

A

Client reports seeing halos around lights.

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48
Q

define retinal detachment

A

Retinal detachment occurs when retinal tissue in the posterior of the eye pulls away or detaches from the blood vessels that provide oxygen and nourishment to the retina.

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49
Q

what does retinal detachment usually bring

A

Retinal detachment often creates dark floaters or a sensation of a curtain being placed in the field of vision.

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50
Q

diabetic retinopathy

A

An eye disorder that may occur in individuals who have diabetes and results in a deficit in vision acuity and possible permanent loss of vision caused by diminished blood flow to the rear of the eye.

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51
Q

match vision change with correct eye condition

A

blurry or hazy vision: cataracts

diminished peripheral vision: glaucoma

blind spots in the center of the vision field: macular degeneration

Seeing floating dark spots moving through all vison fields: retinal detachment

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52
Q

safety considerations for retinal detachment

A

To promote a safe home environment, clients and caregivers should always be instructed to keep rooms well-lit, keep floors free of clutter, and remove all area rugs.

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53
Q

A nurse is caring for a client who reports a loss of peripheral vision. Which of the following assessments will the nurse perform to assess peripheral vision?

A

Confrontational visual field test

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54
Q

A nurse is caring a client who reports a sudden onset of blurry vision with blind visual spots. Which of the following medications should the nurse anticipate the provider prescribing?

A

Dilating eye drops

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55
Q

three structures of the ear

A

external
middle
inner

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56
Q

external ear

A

pinna
auditory canal

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57
Q

middle ear

A

tympanic membrane
three ossicle bones (malleus, incus, and stapes)

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58
Q

inner ear

A

holds the organs for hearing and balance: the spiral-shaped cochlea and the fluid-filled semicircular canals. The cochlea, which is pea-sized, is separated into the scala vestibuli, which is filled with plasma-like fluid called perilymph, and the scala media, which is filled with a thicker fluid called endolymph.

59
Q

cochlea function

A

Transduces physical vibrations into electrical impulses

60
Q

malleus, incus, and stapes function

A

Transfers and amplifies sound waves into physical vibrations

61
Q

external ear function

A

collect and transmits sound waves from the outside enviroment

62
Q

tympanic membrane function

A

Transfers and amplifies air vibration from external ear to the ossicles

63
Q

Vestibulocochlear nerve function

A

transmits electrical impulses to the auditory cortex of the brain

64
Q

A nurse is assessing a client’s hearing. Which of the following tests should the nurse perform to screen for hearing loss?

A

Finger rub test
Whispered voice test
Audiometry

65
Q

define tinnitus

A

perception of sound when no actual external noise in present

frequently described as ringing, roaring, or constant sound in the ears.

66
Q

lifestyle modifications for tinnitus

A

Lifestyle modifications may help control the intensity of tinnitus. Instruct the client to wear headphones when in noisy or loud environments, turn down music, reduce salt intake, and decrease the use of nicotine, caffeine, and alcohol

67
Q

A nurse is planning care for a client who is experiencing tinnitus. Which of the following should the nurse recommend to include in the plan?

A

Monitor blood pressure

c
Monitor blood glucose levels

d
Remove cerumen from external ear canal

e
Wear hearing protection

68
Q

meniere’s disease

A

Meniere’s disease is a progressive disorder that develops from an excessive buildup of endolymphatic fluid in the inner ear and leads to debilitating vertigo, tinnitus, and hearing loss.

69
Q

Common Manifestations of Meniere’s Disease

A

Vomiting
Nausea
Blurry vision
Cold sweats
Trembling
Hearing loss
Headaches
Imbalance
Congestion in the ear
Ear fullness

70
Q

A nurse is caring for a client who has Meniere’s disease. Which of the following manifestations should the nurse expect?

A

Extreme dizziness
Hearing ringing
Hearing loss
Feeling of fullness in the ears

71
Q

healthy food recommendations to client who has AMD

A

fruits and vegetables high in antioxidants (bluberries, grapes, kale, spinach)
foods high in zinc (red meats, dairy, eggs, grains)
foods high in omega-3 fatty acids (salmon, soybeans, flax seeds, chia seeds)

72
Q

treatment for AMD

A

there is no cure for dry AMD but there is modifications

increasing the client’s daily intake of carotenoids lutein and zeaxanthin may slow the disease’s progression.

also smoking cessation will help treat the symtpoms

73
Q

why are hypertension and DM related to cataracts?

A

poorly managed blood glucose and poorly managed blood pressure can lead to diminished blood flow to the lens of the eye

74
Q

what can cataracts be mistaken for

A

mudged eyeglasses or ill-fitting contact lenses.

condition is typically pain-free

75
Q

levels of intraocular pressure that considered elevation

A

21-32 mmHg

76
Q

medications for glaucoma

A

alpha agonists
beta-blockers
carbonic anhydrase inhibitors
Prostaglandin analogs

77
Q

Describe the pathophysiology associated with the development of a detached retina.

A

retinal tissue in the posterior of the eye pulls away or detaches from the blood vessels that provide oxygen and nourishment to the retina

vitreous humor can become more serous or liquid consistency (thins out), causing it to collapse and pull away from the retina

78
Q

vitreous humor vs aqueous humor

A

Aqueous humor is a water-like fluid that lies in front of the lens.

Vitreous humor is a gel-like substance that lies behind the lens and in front of the retina

79
Q

what would be a correlation with retinal detachment

A

age-related changes in consistency with vitreous humor
inflammatory disorders like lupus
diabetic retinopathy
macular degeneration
eye tumors
traumatic eye incidents
family history
nearsightedness

80
Q

what can increase the risk of detachment of the retina

A

diabetes and hypertension
previous eye surgery

81
Q

psychosocial aspects related to retinal detachment

A

clients feel

depressed
anxious
fearful
and that there life has been reduced in quality

82
Q

tonometer is associated with what sensory disorder

A

glaucoma

it reads the intraocular pressure in your eyes

83
Q

confrontational visual field test

A

to assess client’s peripheral vision

84
Q

what can contacts prevent

A

oxygen from getting to your eyes so therefore can build up extra blood vessels in your eyes to make up for that

85
Q

what can diabetics loose

A

eyes, feet, kidneys

86
Q

what is average blood glucose level

A

fasting is 70-100 mg/dL
random one is usually about 125 mg/dL

87
Q

prediabetic blood glucose

A

100-125 mg/dL

88
Q

diabetic blood glucose

A

above 125 mg/dL

89
Q

ototoxic medications

A

ototoxic means bad for the ears

examples would be Lasix’s because it can lead to tinnitus
gentamycin

90
Q

conditions correlating with AMD

A

cardio (poor blood flow to eyes) and renal (not enough RBCs and protein)

91
Q

eye ointments

A

from inner canthus to outer canthus (TEST Q)

92
Q

clinical judgement for AMD

A

assess: diminished central vision
analysis: indications of AMD and risk for falls
planning: home safety plan
implementation: take meds, no smoking, healthy diet (education)
eval: safe home environment

93
Q

conditions correlating with cataracts

A

diabetes and hypertension

94
Q

what does DOUBLE VISION go with?

A

cataracts

95
Q

clinical judgement for cataracts

A

Assessment: blurred vision/DOUBLE VISION
Analysis: indication of cataracts and risk of injury
Hypothesis: safety and daily living
Planning: address safety and treatment needs
Implementation: ensure safety (preop and postop)
Evaluation: progressive improvement of vision

96
Q

surgical treatment for cataracts

A

IOL and extraction of cloudy lens

97
Q

pre-op nursing considerations for cataract surgery

A

relax because we don’t want to give high blood pressure, education about procedure, prepare

98
Q

post-op nursing considerations for cataract surgery

A

don’t lift above 10 lbs, no super strenuous activity, education about safety considerations, don’t lay flat

99
Q

open angle vs closed angle glaucoma

A

open-angle: little drainage (which means increased pressure) of aqueous humor (mild pain)

closed-angle: NO drainage of aqueous humor (intense pain) (worse because there is no drainage at all)

100
Q

conditions that correlate with glaucoma

A

HTN
diabetes
hyperlipidemia

101
Q

clinical manifestations of glaucoma

A

EARLY: halos around lights/blurry vision
LATER: worsening peripheral vision

102
Q

conditions that correlate with retinal detachment

A

IMPORTANT

hypertension and diabetes

103
Q

clinical presentation of retinal detachment

A

blurred vision
floaters or photopsia

104
Q

what eye condition has the curtain-like shadow?

A

retinal detachment

IMPORTANT: TEST Q

105
Q

what is the most common sensory disorder

A

hearing loss

106
Q

hearing loss

A

conductive vs sensorineural

107
Q

conductive hearing loss

A

treatable
result of EXTERNAL ear condition

108
Q

sensorineural hearing loss

A

often permanent
result of damage to INNER ear
cochlear hair follicle or auditory nerve

109
Q

Lasixs

A

cause tinnitus so they are considered ototoxic

IV push LOW and SLOW

110
Q

what can ototoxic drugs cause?

A

tinnitus

important: TEST Q

111
Q

tinnitus testing

A

test for…
anemia
thyroid function
heart disease

112
Q

conditons that correlate with tinnitus

A

Meniere’s and thyroid disease

113
Q

Meniere’s disease

A

excessive endolymphatic fluid

114
Q

is Meniere’s disease genetic?

A

YES! it is autoimmune
test Q!

115
Q

safety for Meniere’s disease

A

consistent spinning so at risk for falls

116
Q

Meniere’s disease: diet

A

reduce sodium

where salt goes, water goes. so decrease sodium to reduce fluid in ears

117
Q

medications for Meniere’s disease

A

diuretics to reduce fluids
corticosteroids
motion sickness pills for the vertigo

118
Q

three main medication classes for glaucoma

A

cholinergic agonists
cholinesterase inhibitors
beta-adrenergic blockers

others wound include:
alpha-adrenergic agonists
carbonic anhydrase inhibitors

119
Q

beta-adrenergic blockers

A

eye drops provide topical therapy for lowering IOP for clients with OPEN-ANGLE GLAUCOMA

they can also help provide emergency treatment for acute closed-angle glaucoma

120
Q

prototype and other drugs for beta-adrenergic blockers

A

eye drops for lowering IOP for open-angle glaucoma (and emergency treatment for closed-angle glaucoma)

the prototype drugs are:
betaxolol (Betaoptic)
timolol (Timoptic)

121
Q

expected pharm action for beta-adrenergic blockers

A

decrease production of aqueous humor, thereby decreasing intraocular pressure

122
Q

adverse drug reactions to beta-adrengenic blockers

A

aka betaxolol (Betaoptic) and timolol (Timoptic)

topically: stinging, burning, eye discomfort
absorb them systematically through admin: bradycardia, hypotension, bronchospasm

contraindicated in clients with AV heart block, bradycardia, asthma, COPD

123
Q

interventions for administering beta-adrenergic blockers

A

take HR first and measure vital signs on reg basis after admin

124
Q

admin of beta-adrenergic blocker

A

aka betaxolol or timolol

clean hands
after instillation, hold pressure on the eye dropper to sac for 60 SECONDS

125
Q

cholinergic agonists

A

provide topical therapy to lower IOP in glaucoma
aka muscarinic agonists

126
Q

prototype for cholinergic agonists

A

pilocarpine
aka Isopto Carpine
solution or gel

127
Q

expected pharm action for cholinergic agonists

A

aka Isopto Carpine or pilocarpine
increase availability of acetylcholine at muscarinic receptor sites
pupil constricts, allows the drainage of aqueous humor

128
Q

adverse effects of cholinergic agonists

A

most common: decreased visual acuity
risk for retinal detachment

129
Q

interventions for cholinergic agonists

A

after admin, admin a mild analgesic for a headache that does not resolve shortly after admin
hold pressure over puncta and sac for at least a minute

130
Q

safety concern for cholinergic agonists eye drops

A

constrict pupil
so vision at night is bad and vision in low lit places
keep lights on and assist to bathroom
keep night light on at home to minimize risk of falls

131
Q

admin of cholinergic agonists

A

same as other eye drops

132
Q

contraindications and precautions of cholinergic agonists

A

do not admin to people with acute inflammatory eye disorders or retinal detachment!
use cautiously with clients who have chronic respiratory disorders or hypertension

133
Q

cholinesterase inhibitors

A

topical therapy that helps lower IOP in glaucoma

134
Q

prototype and other drugs for cholinesterase inhibitors

A

echothiophate
aka Phospholine Iodide

135
Q

pharm action for cholinesterase inhibitors

A

breakdown of acetycholine, allowing more acetycholine to be available for use of muscarinic receptors in the body

similar action of cholinergic agonists!!!

136
Q

adverse reactions for cholinesterase inhibitors

A

primary: decreased visual acuity or myopia (nearsightedness)

137
Q

interventions for cholinesterase inhibitors

A

same as cholinergic agonists (fall risk, poor vision, dark out is bad)

observe pupil and lack of red reflex (could indicate CATARACT)

138
Q

admin of cholinesterase inhibitor

A

instill in the evening and at least 5 MINUTES before or after instilling any other eye drops

139
Q

worsening vision with cholinesterase inhibitors?

A

could be ineffective with controlling IOP and could mean the client is developing cataracts

140
Q

contraindications for cholinesterase inhibitors

A

history of retinal detachment
cardiac or respiratory disease
hyperthyroidism
urinary tract blockage
Parkinson’s disease

141
Q

interactions with cholinesterase inhibitors

A

insects and herbacides that contain organophosophates

142
Q

drug class is the first line of therapy for treatment of open-angle glaucoma?

A

beta blockers

143
Q
A

Fundamentals SEM2 (7 decks)

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