Nur112 Test 4 Eyes

Front 1

What is amblyopia, what is its causes and what should be done about it?

Back 1

amblyopia: loss of visual acuity because of disuse.
- baby brain must have equally focused images from both eyes. if not: amblyopia.
- MUST CORRECT EARLY (before age 6) or PERMANENT BLINDNESS!!!
- most common cause: cross-eyes (heterotrophia)
TO DO: screen babies.

Front 2

What are the four most common causes of preventable vision loss?

Back 2

1. amblyopia
2. age related maculopathy
3. glaucoma
4. diabetic retinopathy

Front 3

Macular degeneration is the age related loss of (CENTRAL OR PERIPHERAL) vision. pick one.,

Back 3

central vision
S/S
- blurry vision
- center blind spot

Front 4

Glaucoma
gradual loss of (CENTRAL OR PERIPHERAL) vision. pick one.

Back 4

slow loss of peripheral vision - don't notice it happening - get tunnel vision

Front 5

What causes glaucoma?

Back 5

Damage to the optic nerve because of increased interocular pressure IOP

Front 6

What is normal IOP (intra ocular pressure) and how is it measured?

Back 6

Normal IOP is 12 - 20 mmHg
- it is measured by finger pressure or tonometry.
FYI: IOP varies during the day. Normally higher in the morning.

Front 7

IF both eyes go glaucoma... is this chronic or acute?

Back 7

Chronic - open angle - 90% of cases

Front 8

Doctor: "you have glaucoma."
Patient: "nonsense. I have no pain!"
Chronic or Acute?

Back 8

Chronic - painless - slow "insipid" onset.

Front 9

A diabetic, over 40 who has severe myopia is more at risk for chronic or acute glaucoma?

Back 9

chronic glaucoma
The acute kind is more dependent on problems with physical structures: small chamber, large lens, small cornea.

Front 10

Name that Eye Disease!
severe, sudden pain
halos around lights
blurred vision & headaches
red eye - pupil dilated
nausea, vomiting, abdominal pain

Back 10

Acute Glaucoma
Medical Emergency

Front 11

Which glaucoma is caused by an obstruction of aqueous humor flow?

Back 11

chronic - open angle - simple.
- trabecular network blocks flow of humor through the canal of Schlemm (my favorite canal ever!)

Front 12

Which glaucoma is caused by a block of aqueous humor flow or an over production of aqueous humor?

Back 12

acute - congestive - closed angle
- lens/pupil dilation causes this from meds or sympathetic stimulation.

Front 13

So we all know :) that the trabecular network drains the aqueous humor... an channels it through the canal of Schlemm... but where does it go from there?

Back 13

to the general circulation.
I guess that's why you have to be careful giving beta blocker eyedrops. They can get into the bloodstream and do what beta blockers do to the whole body.

Front 14

She mentioned cranial nerves, so lets just take a guess. Which ones are involved with the eye?

Back 14

2, 3, 4, 6
II = optic
III = oculomotor
IV = troclear
VI = abducens

Front 15

Which class of meds will slow the rate of fluid production (aqueous humor)? there are four.

Back 15

1. carbonic anhydrase inhibitors - CAI's for short. These are sulfonamides so be careful about allergies. drops or pills.
2. beta blockers. block epi & norepi - careful they make pulmonary disease worse, decrease HR & BP (and let's not forget cause impotence!)
3. Alpha Agonists -aka adrenergics aka sympathomimetics - vasoconstriction, also decrease production of aqueous humor. and
4. combination durgs (beta blockers and alpha agonists or beta blocker and carbonic anhydrase inhibitors

Front 16

What classes of medications increase drainage of aqueous humor? there are 4

Back 16

1. Cholinergic drugs - stimulate eye muscles to work; open drainage channels. include Miotics: opens drainage angle
2. Prostaglandin Analogs: side effects - change eye color, grow eye lashes!
3. alpha agonists aka adrenergics -
4. Combination drugs - do both. beta blocker + alpha agonist or beta blocker + carbonic anhydrase inhibitor CAI

Front 17

What do most people call these three conditions?
conjunctivitis
blepharitis
hardoleum

Back 17

conjunctivitis = pink eye
blepharitis = inflammation of eyelid
hardoleum = stye (infection of sebaceous gland/hair follicle)

Front 18

What is chalazion and what would you do about it?

Back 18

chalazion = inflammation of the meibomian gland in the upper or lower lid due to obstruction. Need I&D surgery (incision & drainage)

Front 19

What is keratitis, how do you know you have it and what are ya gonna do about it?

Back 19

Keratitis = cornea inflammation
S/S SEVERE eye pain
photophobia
blepharospasms
opacity of cornea with loss of vision.
TX:steroids to lessen inflammation, antibiotics, antiviral, anticholinergics to rest eye.

Front 20

Do you know the Uveal Tract?
Then what is uveitis?
Would you be upset if you got it?

Back 20

Uveal Tract = iris, ciliary body, choroid - provides blood supply to retina.
Hell yea, I'd be upset. - can cause blindness.
- secondary to acute/chronic diseases such as rheumatoid arthritis.
- TX: steroids to lessen inflammation, anticholinergics to rest eye, dark glasses.

Front 21

What do mydriatic medications do to the eye?
What class of drug does the opposite?

Back 21

mydriatics - dilate pupils.
by contracting the radial muscle.
opposite
miotics - contract the pupil

Front 22

What do the cycloplegic drugs do to the eye?

Back 22

cycloplegics - also dilate pupils (like mydriatics) but also paralyze the ciliary body. Lens will not be able to adjust = blurry vision

Front 23

What should the nurse do if someone is getting an IV with Fluorescein?

Back 23

Fluorescein is a dye that outlines damaged issue. it can be given by drops or IV.
- for IV, ask about dye allergies; get informed consent. After; give fluids to get rid of dye. The urine may be bright green! I want some of that - Christmasy!

Front 24

What are characteristics of legally blind?

Back 24

worse than 20/200 vision and less than 20 degree visual field.

Front 25

If you can't read the Snellen chart, what are some other ways to test vision?

Back 25

E chart: children or illiterates
CF: counts fingers at 3 feet
HM: sees hand movements
LP: light perception

Front 26

Define strabismus

Back 26

strabismus aka heterotropia
- muscles not balanced
- hold object 12 inches away, cover one eye, observe movement of other eye

Front 27

What's the test for color blindness called?

Back 27

Ishihara plates. by the way, the first plate is just for practice- all people should be able to read it.. Diagnoses red/green color blindness. mostly men.

Front 28

What a pupil's normal diameter?

Back 28

3 - 5 mm

Front 29

Why are cataracts yellow?

Back 29

- reduction in oxygen uptake
- initial increase in water content, then dehydration
- protein turns yellow

Front 30

What eye problem is this?
- gradual vision loss
- blurry
- decreased color perception ** unique
- halos, photophobia
- maybe diplopia
- vision better in low light (late sign)
- opaque lens (late sign)

Back 30

YES!!! CATARACTS!!!
- must remove lens. remember the video?? ew!

Front 31

Name some Post Op concerns with cataract removal
(5)

Back 31

1. secondary glaucoma
2. infections
3. hemorrhage
4. retinal detachment
5. TASS: toxic anterior segment syndrome. an acute postoperative inflammatory reaction in which a noninfectious substance enters the anterior segment and induces toxic damage to the intraocular tissues. Almost all cases occurred after uneventful cataract surgery

Front 32

What diseases can cause cataracts?
(there are 5 listed here)

Back 32

diabetes mellitus
maternal rubella
severe myopia
UV light exposure (wear your sunglasses!)
meds (eg steroids)

Front 33

Client education/nursing actions after cataract surgery includes...

Back 33

1. avoid eye strain
2. don't rub
3. don't raise intraocular pressure (straining, vomiting, sneezing, coughing)
4. EYE SHIELD at bed
5. eye drops 2-4 weeks
6. turn to good side, elevate HOB 30-45 degrees, use side rails.

Front 34

What the heck is aphakia? What do you do about it - three things.

Back 34

Aphakia - is absence of a lens in an eye.
Can correct by
1. glasses - heavy/thick. distort distance (objects appear closer). only give you central vision.
2. contact lenses
3. lens implants (still need glasses because lens will not accommodate)

Front 35

Diagnose me!
- sudden, painless
- floating spots, recurrent flashes
- shadow or curtain like *** unique

Back 35

Retinal Detachment because of fluid accumulation, tumor or trauma. retina pulls away, layers separate; loses blood supply... avascular necrosis develops. can take hours or years.

Front 36

What are some risk factors for Retinal Detachment?

Back 36

- chronic illness such as diabetes mellitus
- cataract extraction
- trauma
- aging

Front 37

Nursing actions for retinal detachment?

Back 37

- positioning (how depends on location of detachment.
- cover both eyes
- prep for surgery

Front 38

Post op, Retinal Repair

Back 38

- eye patch
- monitor for hemorrhage
- prevent N/V
- report sudden, sharp eye pain
- NO coughing, sudden head movements, NO increase IOP by lifting, squinting, constipation
- limit reading for 3-5 weeks.