Glaucoma - Hesi Nclex Rn Review

Front 1

What is Glaucoma?

Back 1

Characterized by increased intraocular pressure (IOP)

Usually happens in the elderly, increase incident in elderly.

Usually occurs bilaterally

Front 2

How fast does glaucoma happen?

Back 2

Gradual

Front 3

Is glaucoma painful?

Back 3

No. It is painless

Front 4

If glaucoma is not treated, what happens?

Back 4

It can lead to blindness. (2nd leading cause of blindness in the USA)

Front 5

Glaucoma has issues with the aqueous fluid. Describe.

Back 5

It is not adequately drained from the eye.

Front 6

When do most patients know they have glaucoma?

Back 6

When they are having a routine visit. Glaucoma is asymptomatic in the early stages.

Front 7

Can you cure glaucoma?

Back 7

No, but you can treat it phamacologically and surgically.

Front 8

Early nursing assessment of glaucoma

Back 8

Early signs include >22 mmHg in intraocular pressure

Decreased accommodation or ability to focus

Front 9

HESI HINT: Glaucoma

Back 9

Glaucoma is often painless and symptom-free. It is usually picked up as part of a regular eye exam.

Front 10

Late nursing assessment of glaucoma

Back 10

Loss of peripheral vision

Halos around lights

Decreased visual acuity, not correctable with glasses

Headache or eye pain which may be so severe as to cause n/v. (Acute closed-angle glaucoma)

Front 11

What are diagnostic tests for glaucoma?

Back 11

Tonometer used to measure intraocular pressure

Electronic tonometer used to detect drainage of aqueous humor

Gonioscopy used to obtain or direct visualization of the lens

Front 12

What are risk factors of glaucoma?

Back 12

Family history
Family history of diabetes
History of previous ocular problems
Medication use (antihistamines, anticholinergics)

Front 13

Nursing Interventions of glaucoma.

Back 13

Administer eye drops as prescribed

Orient client to surroundings

Avoid nonverbal communication which requires visual acuity.

Front 14

HESI HINT: Eye Drops

Back 14

Eye drops are used to cause pupil constriction since movement of the muscles to constrict the pupil also allow aqueous humor to flow out, thereby decreasing the pressure in the eye.

Front 15

HESI HINT: Pilocarpine

Back 15

Often used to enhance papillary constriction. Caution client that vision may be blurred 1 to 2 hours after administration of pilocarpine and adaptation to dark environments is difficulty because of pupillary constriction of the drug.

Front 16

Nursing interventions of glaucoma. Teaching.

Back 16

Careful adherence to eye drop regime can prevent blindness

Vision already lost cannot be restored

Eye drops are needed the rest of life.

Proper eye drop instillation technique. Obtain a return demonstration!

Safety measures to prevent injuries (remove rugs, adjust lighting to meet needs)

Avoid activities that may increase intraocular pressure?

Front 17

How can you avoid activities that may increase intraocular pressure?

Back 17

Avoid emotional upsets

Exertion: pushing, heavy lifting, shoveling

Coughing severely, sneezing (Get help for URI!)

Constrictive clothing (belt, tie, scarf)

Straining stool, constipation

Front 18

Describe pilocarpine

Back 18

Para-sympathomimetics.

Enhances papillary constriction

(Adv reaction: bronchospasm, n/v/d/, blurred vision, twitching eye lids, eye pain with focusing)

Implications:

Use caution with pregnancy, asthma, HTN.

Teach proper drop instillation

Need for ongoing use of drug at prescribed intervals

Blurred vision tends to decrease with regular use of this drug

Front 19

Describe timolol

Back 19

Beta-Adrenergic Receptor-Blocking Agent

Inhibits formation of aqueous humor

(Adv. Rxn: Side effects are insignificant. Hypotension.)

Use cautiously: Hypersensitive, asthmatic clients, 2nd or 3rd degree heart block, CHF, congenital glaucoma, pregnancy)

each proper drop instillation

Need for ongoing use of drug at prescribed intervals

Blurred vision tends to decrease with regular use of this drug