Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Med-Surg 48
| Question | Answer |
|---|---|
| T or F | T: education is a vital strategy for preventing conjunctivitis |
| Single most important measure to prevent transmission of infection to the eye | Hand washing |
| Health history fo conjunctivitis | presence of redness, discomfort, tearing, photophobia, and draingage; sympton onset; care measures; use of contact lenses; exposure to "pink eye" or recent travel; allergies; previous history of conjunctivitis; presence of any chronic diseases |
| Physical assessment for conjunctivitis | viscual acuity (clearness of vision); inspect eyelids, conjunctiva, sclera, and cornea; vital signs including temperature |
| conjunctivitis | inflammation of the conjunctiva; most common eye disease; usually caused by bacterial or viral infection |
| medications for glaucoma | the primary pharmacologic agents are topical beta-adrenergic blocking agents, adrenergics (mydriatics), prostaglandin analogs, or carbonic anydrase inhibitors. An oral carbonic anhydrase inhibitor may be used |
| additional information on medications for glaucoma | medications cannot cure glaucoma! However, many clients with open-angle glaucoma can control intraocular pressure and preserve vision indefinitely with meds. |
| Xalatan | prostaglandin anaglo that is a new class of ophthalmics prescribed to increase aqueous outflow. Similar to beta-blockers in their onger duration of action. |
| Xalatan (latanoprost) | Although fewer systemic effects, these drugs may cause conjunctival hyperemia and permanent changes in colour of iris and eyebrows |
| Adrenergic agonist brimonidine | may be prescribed along with a beta-blocker or if a beta blocker is contraindicated (ie., in a client with heart failure, asthma, or COPD) |
| Apraclonidine | another adrenergic agonist; may be prescribed when other drugs do not sufficiently reduce intraocular pressure, but adverse effects make it inappropriate for long-term use |
| Dorzolamide (Trusopt) | carbonic anhydrase inhibitor; decreases production of aqueous humor and reduces intraocular pressure. Used with other drugs to control pressures and in clients for whom beta-blockers are contraindicated due to heart failure or reactive airway disease |
| Is surgery recommended for patients with acute angle-closure glaucoma? | Yes. It is also recommended for clients with chronic open-angle glaucoma that is not effectively controlled by medication |
| What does surgery do for chronic open-angle glaucoma? | involves improving the drainage of aqueous humor from the anterior chamber of the eye. |
| Most commonly used surgical procedures for open-angle glaucoma | trabeculoplasty and trabeculectomy filtration |
| surgical procedures used in the treatment of acute angle-closure glaucoma | gonioplasty, laser iridotomy, and peripheral iridectomy |
| interesting fact about glaucoma and the hospitalized client | In the hospitalized client, glaucoma is typically a concurrent diagnosis rather than the primary reason for seeking care; UNLESS the diagnosis is acute angle-closure glaucoma |
| disturbed sensory perception in client with glaucoma and cataracts (nursing diagnosis) | visual related to myopia and lens extraction |
| Clients with glaucoma require teaching about lifetime strategies for managing the disease at home | they need to understand the importance of lifetime therapy to control the disease and prevent blindness |
| physical indicators of anxiety (pg. 1713) | tachycardia, dilated pupils, cool and clammy skin, tremors |
| laser photocoagulation (pg. 1716) | used to treat both the nonproliferative and proliferative forms of diabetic retinopathy. |
| laser photocoagulation, con't | leaking microaneurysms are sealed and proliferating vessels destroyed, reducing risk of hemorrhage, retinal edema, and retinal detachment. Tx slows progress of aneurysms and new vessel formation; however, does NOT cure disorder |
| valsalva maneuver and the diabetic client with retinopathy | although conclusive research is lacking, diabetic client with retinopathy may be advised to avoid physical activity associated with Valsalva maneuver (ie., weight training) |
| retinal detachment | separation of the retina or sensory portion of the eye from the choroi (pigmented vascular layer) |
| Can retinal detachment occur spontaneously? | Yes, although it is usually precipitated by trauma |
| Aging and retinal detachment | a common risk factor; so are myopia and aphakia |
| myopia | nearsightedness |
| aphakia | absence of the lens of the eye, due to surgical removal, a perforating wound or ulcer, or congenital anomaly. It causes a loss of accommodation, hyperopia, and a deep anterior chamber. |
| complications of aphakia | Complications include detachment of the vitreous or retina, and glaucoma |
| floaters | AKA spots; often seen when the retina detaches; client describes the sensation of having curtains drawn across the vision |
| retinal detachment (pg. 1716) | it is a medical emergency and prompt treatment is necessary to preserve vision |
| manifestations of retinal detachment | floaters: irregular, dark lines or spots in FOV; flashes of light; blurred vision; progressive deterioration of vision; curtain sensation; if macula is involved, loss of central vision |
| otitis media (pg. 1721) | inflammation or infection of the middle ear; primarily affects infants and young children, but may also occur in adults |
| two primary forms of otitis media | serous and acute or suppurative |
| serous otitis media (AKA otitis media with effusion_ | occurs when the eustachian tube is obstructed for a prolonged time, impairing equalization of air pressure in the middle ear |
| causes of otitis media | upper respiratory infection or allergies such as hay fever. The middle ear can't adapt to rapid changes in barometric pressure |
| what happens when ear canal becomes occluded with either cerumen or a foreign body | client will experience a conductive hearing loss in the affected ear. Manifestations include sensation of fullness, along with tinnitus and coughing due to stimulation of vagal nerve |
| vertigo | a sensation of whirling or rotation |
| nystagmus | rapid involuntary eye movements |
| Meniere's disease | aka endolymphatic hydrops; a chronic disorder characterized by recurrent attacks of vertigo with tinnitus and progressive unilateral hearing loss |
| Meniere's disease, con't (pg. 1726) | affects men and women equally, with adults between 35-60 at highest risk. Cause is unclear, although most common form is thought to result from viral injury to fluid transport system of the inner ear |
| low-sodium diet | helps reduce labyrinthine pressure |
| Furstenberg diet | a salt-free neutral ash diet (alkaline diet); may be prescribed if moderate sodium restriction is ineffective in controlling attacks of Meniere's disease |
| medications that help with Meniere's disease | scopolamine patch, although adverse effects such as dry mouth, blurred vision, and urinary retention may limit use; a diuretic such as hydrochlorothiazide may help reduce endolymphatic pressure |
| additional medications that help with Meniere's disease | CNS depressant such as diazepam (Valim) or lorazepam (Ativan) may halt an attack of vertigo; parenteral droperidol (Inapsin) provides both sedative and antiemetic effect, making it a useful drug for acute attacks |
| More medications that help with Meniere's disease | antivertigo-antiemetic medications such as medlizine (Antivert), prochlorperazine (Compazine), or hydroxyzine hydrochloride (Vistaril) are prescribed to reduce the whirling sensation and nausea. |
| options for masking tinnitus to promote concentration and sleep (Pg. 1728) | ambient noise from radio or sound system; masking device or white-noise machine; hearing aid that produces a tone to mask tinnitus; hearing aid that amplifies ambient sound |
| discuss possible risks and benefits of medications to treat tinnitus (pg. 1728) | many medications have been used to treat tinnitus; oral antidepressants such as nortriptyline (Aventyl, Pamelor) taken at bedtime have been shown to be most effective |
| acoustic neuroma | aka schwannoma; a benign tumor of cranial nerve VIII. Typically occurs in adults between 40-50. Acoustic neuromas are common and account for 7-8% of intracranial tumors |
| common location of acoustic neruoma tumors | internal auditory meatus; compresses auditory neve where it exits skull to the inner ear. |
| early manifestations of an acoustic neuroma | tinnitus; unilateral hearing loss; nystagmus. Dizziness or vergito may occur; as tumor expans and occupies more space in the closed cranium, neurologic signs related to the area of the brain are affected |
| % of adults in US with hearing loss | 10% |
| hearing loss impairs the ability to communicated in a world filled with sound and hearing individuals | a hearing deficit can be partial or total, congenital or acquired, affect one ear or both ears; may affect ability to perceive all sounds or specific frequencies |
| conductive hearing loss | anything that disrupts the transmission of sound from the external auditory meatus to the inner ear resultings in a conductive hearing loss |
| Most common cause of conductive hearing loss | is obstruction of the external ear canal; impacted cerumen, edeman of canal lining, stenosis, and neoplasms may all lead to canal obstruction |
| other causes of conductive hearing loss | perforated tympanic membrane, disruption or fixation of ossicles of middle ear, fluid, scarring, or tumors of middle ear |
| classification of hearing loss | conductive, sensorineural, or mixed, depending on what portion of the auditory system is affected. Profound deafness is often a congenital condition |
| presbycusis (pg. 1730) | gradual hearing loss associated with aging; hearing acuity begins to decrease in early adulthood and progresses as long as the individual lives |
| Rinne and Weber tests | compare air and bone sound conduction; if both air and bone conduction are impaired, a sensorineural loss is indicated |
| audiometry | identifies the type and pattern of hearing loss; specific sound frequencies are presented to each ear by either air or bone conduction |
| speech audiometry | identifies the intensity at which speech can be recognized and interpreted |
| speech discrimination | evaluates the ability to discriminate among various speech sounds |
| tympanometry | an indirect measurement of the compliance and impedance of the middle ear to sound transmission; external auditory meatus is subjected to neutral, positive, and negative air pressure while resultant sound energy flow is monitored |
| acousitc reflex testing | uses a tone presented at various intensisites to evaluate movement of the structures of the middle ear |
| tinnitus | the perception of sound or noise in the ears without stimulus from the environment; sound may be steady, intermittent, or pulsatile and is often described as a buzzin, roaring, or rining |
| tinnitus, con't (pg. 1730) | usually associated with hearing loss (conductive or sensorineural); most tinnitus is chronic and has no pathologic importance |
Created by:
biojoule
Popular Nursing sets