Ch 41-43 Eye & Ear Notes

Front 1

Nursing Assessment for the eyes

Back 1

Assess for:
Symmetry
Inflammation or drainage
Loss of eyelashes Nystagmus
Pupil size and response Eye movements

Front 2

Ptosis

Back 2

Drooping of upper eyelid

Front 3

Proptosis

Back 3

Extended or protruded upper eyelid that prevents lids from closing

Front 4

Nystagmus

Back 4

Uncontrolled movement of the eye

Front 5

measures peripheral vision and detects gaps in the visual field.

Back 5

Visual field examination

Front 6

Visual field examination is used for what type of disorders of the eye?

Back 6

Disorders such as glaucoma, stroke, brain tumor or retinal detachment are associated with loss of visual fields

Front 7

what should the nurse tell the patient when getting the retinal aniograph test done?

Back 7

Tints skin yellow for 6-8 hours and urine for 24-36 hours

Front 8

Positions test

Back 8

Object 12 inches away

Object moved in all directions

Eye movements should be smooth

Front 9

The medical term for nearsightedness.
Objects held closer to see
Pathophysiology
Elongated eyeballs
Light focuses on the vitreous body before they reach the retina

Back 9

Myopia

Front 10

Hyperopia

Back 10

The medical term for farsightedness
Objects held at a distance to see
Pathophysiology
Shorter eyeball
Light focuses on a spot after the retina

Front 11

Presbyopia

Back 11

Poor accommodation that is due to loss of elasticity of the ciliary muscles.
R/T aging and deals with near vision
Pathophysiology
Degenerative changes and loss of elasticity of the lens

Front 12

Astigmatism

Back 12

An irregularity in the cornea or lens.

Pathophysiology

Unequal curves in the shape of the cornea

Front 13

NURSING MANAGEMENT

Back 13

Eye exams
Referrals to eye specialist
Eye protection
Medication administration
Proper care of contacts

Front 14

Endophtalmitis

Back 14

All 3 layers of the eye and vitreous are inflamed

Front 15

An inflammation of the conjunctiva caused by microorganisms, allergy or chemical irritants.

Back 15

CONJUNCTIVITIS

Front 16

Bacterial conjunctivitis is commonly called

Back 16

“pink eye”.

Front 17

The infection can be passed from one person to another. Antibiotics may be prescribed.

It is characterized by redness of the conjunctiva, mild irritation and drainage.

Back 17

pink eye”.

Front 18

An inflammation of the hair follicles along the eyelid margin.

Back 18

BLEPHARITIS

Front 19

if a patient has BLEPHARITIS
what are the S/S?

Back 19

Symptoms include itching, burning, and photophobia.

Scales or crusts may be seen on the eye lid margins.

Front 20

if a patient has BLEPHARITIS
how should it be cleaned and what could it lead to if not cleaned?

Back 20

This should be cleaned with baby shampoo and water.

Can lead to hordeolum or chalazion

Front 21

How is BLEPHARITIS treated?

Back 21

Treated with topical antibiotic

Front 22

HORDEOLUM

Back 22

Commonly called a stye.

Inflammation and infection of the oil gland at the edge of the eyelid

Staphylococcus aureus

Front 23

how woulod you treat HORDEOLUM?

Back 23

Warm, moist compresses several times a day is the primary treatment.

Severe cases require incision and drainage

Front 24

Commonly called a cyst

Inflammation of the glands of the eyelids

Swelling prevents fluid from leaving the glands, causing them to become enlarged, hardened and tender.

Back 24

CHALAZION

Front 25

how would you treat CHALAZION known as a cyst?

Back 25

Warm compresses may bring some relief in producing spontaneous drainage.

Not treated unless it interferes with vision

Front 26

A condition in which the lower lid turns inward.

Requires surgical correction

Back 26

ENTROPION

Front 27

ECTROPION

Back 27

A condition where the lower lid turns outward.

Require surgical correction

Front 28

When the lens becomes opaque so that it is no longer transparent.

Vision decreased R/T decreased light getting to the retina

Back 28

Cataracts

Front 29

ASSESSMENT
for Cataracts is what?

Back 29

Assess for s/s
***halos around lights***
Difficulty reading
Distortion of objects
Cloudy lens upon inspection

Front 30

Cataracts
MEDICAL TREATMENT

Back 30

***surgery***

Front 31

NURSING MANAGEMENT

Cataracts is what?

Back 31

Client will continue to wear glasses or contacts or have intraocular lens implant
Vision will be blurred for ~1 week
Verbal and written discharge instructions
N/V, Coughing, sneezing, Avoid lying client on operative side
Pain in eye or near brow

Front 32

occurs most often caused by some interference with the outflow and production of aqueous humor.

Back 32

Glaucoma

Front 33

Patients complain of tired eyes or discomfort, occasional blurred vision and halos around lights. Another clue is frequent changes of eye glass prescriptions.

Decrease in peripheral vision

Back 33

Open angle glaucoma

Front 34

Angle-closure Glaucoma

Back 34

The flow of the aqueous humor is blocked through the pupil, causing the iris to push forward and blocking the trabecular meshwork.

Considered a medical emergency.

Vision can be lost in 1-2 days

It causes sudden acute pain.

Front 35

NURSING MANAGEMENT

for gluacoma?

Back 35

Mydriatics contraindicated in gluacoma**
Decreased sensory stimulation
Quiet room Dim lights Preventing activities that increase IOP:
Laughing Sneezing N/V Straining Lifting > 5 lbs

Front 36

A separation of the sensory layer of the eyeball from the pigmented layer.

Back 36

Retinal Detachment

Front 37

affects both eyes and is progressive, causing central vision to get gradually worse.

Regular glasses do not improve vision but special telescopic lenses may be helpful.

Back 37

Senile Macular Degeneration

Front 38

ASSESSMENT
Senile Macular Degeneration

Back 38

Blurred or distorted vision

Absence of central vision

Diminished color perception

Front 39

NURSING MANAGEMENT

Senile Macular Degeneration

Back 39

Assist with ADL’s

Glasses or other visual aids

Brighter lighting

Front 40

BASIC TESTS

Back 40

Whisper test

Stand 1-2 feet away from client and whisper

Ask client to repeat words that are whispered

Front 41

Tuning fork tests conductive and sensorineural hearing loss

Back 41

Rinne’s

Front 42

Tuning fork to top of head, sound should be heard equally

Back 42

Weber’s

Front 43

Evaluates balance

Feet together and eyes closed

Arms out at side

If swaying, loss of balance or arm drifting occurs, test is abnormal

Back 43

Romberg test

Front 44

Otosclerosis

Back 44

Bony overgrowth of the stapes

Interferes with vibration and transmission of sound

No cure

Front 45

Meniere’s Disease

Back 45

A disorder of the labyrinth.

The cause is unknown, but symptoms are related to an accumulation of fluid in the inner ear.

***Classic symptoms are hearing loss, tinnitus and vertigo. The hearing loss is unilateral (one ear).***

Front 46

Assessment for Meniere’s Disease

Back 46

**vertigo, tinnitus, hearing loss**

Nystagmus

“ora”

HA, fullness in affected ear

Attacks may last from minutes to weeks

Front 47

Ototoxicity

Back 47

Damage to the ear or eighth cranial nerve caused by specific chemicals, including some drugs.

Front 48

Acoustic Neuroma

Back 48

Benign Schwann cell tumor that progressively enlarges and adversely affects cranial nerve VIII (the vestibular and cochlear nerve).

Front 49

Danger Signs of Eye Disease

Back 49

Persistent redness of the eye
Continuing pain or discomfort
Visual disturbance
Light flashes, loss of vision in certain areas
Crossing of the eyes
Growths on the eye or eyelids
Opaque lenses Discharge
Pupil irregularities

Front 50

The Snellen

Back 50

eye chart for distance vision

Front 51

The Jaeger chart

Back 51

for near vision

Front 52

Ishihara

Back 52

color perception test for red-green color deficiencies
plates for color blindness

Front 53

Blindness

Back 53

Legal term for best corrected visual acuity of 20/200 or less even with corrective lenses
BCVA ≤20/200, even with corrective lenses

Visual Impairment: BCVA between 20/70 and 20/200 (in better eye with glasses)

BCVA ≤20/200, even with corrective lenses

Visual Impairment: BCVA between 20/70 and 20/200 (in better eye with glasses)

BCVA ≤20/200, even with corrective lenses

Visual Impairment: BCVA between 20/70 and 20/200 (in better eye with glasses)

Front 54

Visually Impaired

Back 54

Visual acuity between 20/70 and 20/200 with the use of glasses.

Front 55

S/S of

Otosclerosis

Back 55

Progressive bilateral hearing loss Tinnitus
Pinkish orange ear drum
Rinne test, Webber test
Sound goes to affected ear

Front 56

Treatment of Otosclerosis

Back 56

Hearing aid
Stapedectomy
Prosthetic stapes inserted
Complications
Dislocation of prosthesis
Infection Dizziness
Facial nerve damage

Front 57

Nursing Management of Otosclerosis

Back 57

VS
Drainage from ear
Fever
Bedrest for 24 hours
Positioned on nonoperative side
Methods to prevent dislodgement

Front 58

S/S Meniere’s Disease

Back 58

**vertigo, tinnitus, hearing loss**
Nystagmus
“ora”
HA, fullness in affected ear
Attacks may last from minutes to weeks

Front 59

Drug Therapy Meniere’s Disease

Back 59

Meclizine (Antivert)

Front 60

Treatment Meniere’s Disease

Back 60

Decreasing fluid production in inner ear
Facilitating drainage from inner ear
Treating symptoms
Low Na diet
Cessation of smoking
Antihistamines
BR during attacks

Front 61

Ototoxicity

Back 61

Damage to the ear or eighth cranial nerve caused by specific chemicals, including some drugs.

Front 62

S/S of Ototoxicity

Back 62

Tinnitus and hearing loss

Front 63

Acoustic Neuroma of

S/S

Back 63

Hearing loss (usually gradually)
Impaired facial movement or sensation
Tinnitus-in affected ear
Vertigo-with or without balance distrubance

Front 64

Acoustic Neuroma of
Treatment

Back 64

Removal of tumor without damaging facial nerve
Complications:
Facial nerve paralysis
CSF leak Meningitis
Cerebral edema (IICP)
Assess for pupillary changes, bradycardia, HTN, and respiratory distress