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335 Cards in this Set
- Front
- Back
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Young old
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65-74
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middle old
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75-84
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old old
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85-99
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elite old
used to be called frail old GROWING |
100+
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Geriatrics
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diagnosis and tx of diseases that affect older adults
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Gerontology
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study of different aspects of aging and the consequences of aging
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Gerontological nursing
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growing need
assessing the health stauts and functional status of the older adult |
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Health Promotion:
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Autonomy
Risk factors that can neg. impact aging - smoking and alcohol Chronic Illness |
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Self-Management
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increase in losses-- loss of control
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Self- Esteem
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contain control
give them tasks do as much as possible SET UP FOR SUCCESS |
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Self-Care
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admission and discharge
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Nutrition
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Poor nutrition
Meal assistnace Mood- boredom Physical changes dietary requirements |
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Dietary requirements for elderly
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Calcium ( vitamin D)
Vitamin c Vit A |
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Complications r/t decreased motility in elderly
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skin impairement, bone loss, contractures, constipation, muscle atrophy, decreased respiratory effort, weight gain
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Benefits if active
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less likely for falls
live longer ENCOURAGE WALKING AND AMBULATION |
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Stress factors in elderly
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change in:
role environment in health losses |
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Fall Risks
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*Upon admission
hx of falls multiple illness weakness/decreased motility confusion >80 Medications Incontinence Visual Impairments |
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Reducing Falls
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close to nurses station
check every 30- 60 minutes toileting sched. bed in low position clutter-free adequate lighting |
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Chemical restrains
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medication or device that keeps people from moving freely
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Alternative to restraints
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keep lines out of field of vision
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Drugs in the elderly
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Adverse rxns increase with number of drugs used!
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Poly-Pharmacy
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more than 1 drug used OTC
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Absorption issues in elderly
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increase in gastric pH
slowing of gastric motility |
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Metabolism in elderly
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Liver- decreased size and enzymes- more in the plasma
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Excretion in elderly
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decreased renal blood flow and filtration rate
decreased creatinine clearance |
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Decrease medication side effects
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reduce # of drugs taken
appropriate amounts of meds |
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S and S of drug reactions because of slow metabolism
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RR, NV, constipation, weakness, dizziness, diarrhea, confusion
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Errors in meds in the elderly
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decreased sensory input
- larger print - child-proof? ( arthritis) - decreased eye sight = pill boxes, increase lighting, assistance? |
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Mental Health in Elderly
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depression = most common health issue
** suicide is highest ( males >70) NOT JUST A PART OF AGING |
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Tx of Depression in Elderly
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SSRI-- 2-4 weeks--more likely to suicide after it starts working-- more energy!
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Dementia
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slow, progressive decline in cognition--degenerative
Alzheimers- expensive, no cure |
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Delirium
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Acute state of confusion, short term, reversible
unfamiliar environment TREAT THE CAUSE! |
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Neglect
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not being cared for their needs: fed, clothing, hygience
--> pressure ulcers, dehydration, weight loss |
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Physical Neglect
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Torso area
--> bruises clusters of bruises--various stages of healing will deny |
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Financial Abuse
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property and resources mishandled
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Emotional Abuse
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in order to control behavior
NURSES ARE MADATORY REPORTERS--> social services and physicians |
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Caregivers ( are under stress as well)
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Knowledge level?
Acceptance of role ( burden)? Stress Manag. technique respite care indicators of stress |
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INterventions for the caregiver
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stress management
support groups respite care resources community |
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Biggest Risk Factor of Skin
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SUN EXPOSURE
- damage is cumulative - tanning is result of skin injury |
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Skin Risk Factors
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Environmental Hazards
Sun Exposure Drugs that increase sensitivity Irritants and allergens Radiation |
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Sunscreen
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SPF 15 everyday- 19% of AVA rays
20-30 minutes before reapply every 2-3 hours |
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Drugs that increase sun sensitivity
(PHotosensitivity) |
Antidepressants, antihistamines, antifungal, antibiotics, NSAIDS
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Irritants dermatisis
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chemical irritates skin
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allergic dermatitis
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specific hypersensitivity- topical solution, frangrances
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Help with skin problems
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Rest and Sleep
Exercise Hygiene ( skin is acidic) Nutrition |
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Vitamin A
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wound healing
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Vitamin B
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deficiency- erythema
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Vitamin C
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connective tissue and wound healing
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Vitamin K
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clotting factors--> bruising
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Protein
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help with cell growth and wound healing
If it has big wound- high protein diet |
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Risk Factors of SKin Neoplasm
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Fair Skinned
Blondes/Red heads Blue or green eyes family history chronic sun exposure |
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Non-Melanoma Skin CAncers
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most common
found on exposed areas will not die from Actinic, Basal, Squamous |
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Actinic Keratosis
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PRE-MALIGNANT squamous cell
older, white adults lesions have irregula shape red papule with indistinct borders TX- cryosurgery |
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Basal Cell
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most common/ least deadly
pearly nodules--> ulcerate |
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Squamous Cell
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leads to death if untreated
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Malignant melanoma is dark brown or black
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assess using ABDCE
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NEVER SHAVE A BIOPSY
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has to be excised
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Staging of cancer
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0= confined to one place on epidermis
1-2 stage= depth and involved layers determines 3= Lymphnode involvement 4- metastisis |
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Fungal Infections
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Candidiasis, Tinea Corporis, Pedis, Unguim
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Drug Reactions
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Severe = EMERGENCY= swelling around the face
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Phototherapy
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MAKE SURE THEY HAVE SUNGLASSES or EYEWARE
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Excision
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removing malignancy of the skin-- thin layers-- each layer analyzed--looking for clean margins
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Pre-operative stage
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ends with patient on table
starts when they make the decision to have surgery |
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Intraoperative Phase
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brought into OR-- transfer to PACU
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Post-OP
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Admission to PACU--discharge
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CNOR
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Certification of Nurse of OR-- practiced 2 years
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Diagnostic Surgery
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determine diagnosis
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Curative
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repaire the cause of illness
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Resotrative
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improves functional ability
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palliative
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alleviate symptoms
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cosmetic
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alter appearance
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Elective
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planned- not in a rush
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Ugent
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within 24-48 hours
BAD bone fracture |
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Emergent
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life-threatening-- immediately!
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Minor risk
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no risk- under ocal anesthesia
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Major risk
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longer in lenght
more extensive anesthesia |
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INpatient
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in the hospital when surgery is planned
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Outpatient
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come to hospital- have surgery- discharged
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Ambulatory
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come in day of--check in and admitted--surgery-- go to floor or room
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Age
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how body responds to durgery and affected by pain
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Drugs/ Substance Abuse
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affects wound healing
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Current Medications
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Coumadin, Apspirine- blood thinners
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UTI
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lots of cancelled surgeries
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Cardiac History
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MI will make them harder to manage on table for anesthesia
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Pulmonary history
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reduce tissue ox
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Previous Surgery
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increased anxiety
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Family Members
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Malignant Hyperthermia risk
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Allergies
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Bananas- latex
Eggs- anesthesia base Shellfish- betadine |
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Abnormal Physical Assessment prior to surgery
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report to anesthesia
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Clubbin
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long term hypoxia- COPD
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Renal Function
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drugs excreted through kidneys
- electrolyte inbalance |
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Oliguria
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not a lot of urine
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Dysuria
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pain with urination
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Neurological System
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LOC
orientation follow demands? Fall risk? Confused? |
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Musculoskeleltal System
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Position during surgery
Neck- inutbation Chest shape- interferes with positioning Abnormalities- make it difficult to position and maky need different equipment |
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Malnutrition
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delayed wound healing
higher instance of dehiscience |
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Obese
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fatty deposits can impact wound healing
more stress on lungs and heart may need higher quanitty of drugs- longer to be eliminated |
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Preoperative pain assessment
( baseline) |
in order to treat post-po
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Psychosocial
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Anxiety
- increase recovery time -impacts amount of anesthesia Coping Ability |
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Signs of Fear/ Anxiety
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crying
increased pulse sleepless diarrhea, urinary frequency |
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Lab ( baseline)
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NOT ON DAY OF- delays surgery
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Urinalysis
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signs of UTI
blood in urine glucose |
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Blood-type and cross-match
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delivery of blood products
** must sign consent for this |
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CBC
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signs of infection- WBC
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Clotting studies
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PTT - bleeding issues
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Electrolytes
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Hyperkalemia- dysrhythmias
Hypokalemia- toxicity |
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Creatinine
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clear anesthesia?
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Pregnancy
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CHANGES THE GAME
IMPORTANT! done the same day |
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Radiographic
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Chest Xray:
- signs of pneumonia/ heart CT: - depends MRI: - depends |
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OTHER DIAGNOSTIC
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ECG- over 40 with history
Pulmonary function tests- hx of COPD, asthsma, lung disease |
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Surgical Risks
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Age- bodies ability to maintain stasis
- over 65 - infants |
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Medications
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Antihypertensives- alter respose to muscle relaxants- cause hypertension
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Trycyclic Antidepressants
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alters BP
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Anticoagulants
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increase risk for hemmorrhage
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NSAIDs
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inhibit platelets- post-op bleeding
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ASK ABOUT HOME REMEDIES
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some don't consider this meds!
ask specifically! |
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Diabetes
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harder time healing postop
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Anemia
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impact wound healing and overall postop health
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Hpertension
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impairs ability to withstand hemodynamic changes that occur during anesthesia
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Cardiac Disease
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increased risk of MI during procedure
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Malignant Hyperthermia
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reaction to inhaled anesthetics--> rabdomyaliysis--cells go crazy--lyse--K level and cardiac problems--body temp UP--
Cool down body... |
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INformed Consent
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responsibiloty of who is performing procedure
nurses are witnesses CHECK BEFORE GIVING MEDS 30 days in advance |
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Emergency consent
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call family ( 2 witnesses)
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Life-threatening consent
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a note will be written in the chart doc. the medical necessity
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COnsent Form
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WHAT procedure is
WHERE it is MARK THE SITE! |
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Advanced Directives
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Living Will
Power of Attorney NOT SUSPENDED DURING OR |
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NPO Guidelines
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6-8 hours:general anesthesia
3 hours: local |
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Anesthesia Guidelines
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Small infants, Older Adults, Diabetics:shortened time--get sick
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Daily surgery Schedule
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based on age
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REgularly Scheduled Medications
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Aspirine is stopped
Hypetension allowed not with lots of water insulin dose changed -dictated by surgeon and anesthesiologist |
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Intestinal Preparation
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undergoing GENERAL surgery
- enema - laxatives- decrese intestinal bacteria |
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Skin Prep
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Hepicleanse- take shower night before
prevents wound infection |
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Shaving
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prior to surgery outside OR
head- while intubated NOT WITH STRAIGHT RAZOR |
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Patient Prep
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Education: process( see), procedural ( happens)
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IVs started
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in holding area- cuts down OR time
Children- after gasses |
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Foley's
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after gas
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Beathing exercises
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High fowler's
thru mouth in breath out through mouth then, in from nose out mouth hold for count of 5, exhale Helps expand lungs - post-op teaching |
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Deep breathing
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loosens secretions
maintains adequate air exchange decreases NV |
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Incentives Spirometer
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lung expansion, prevents pulmonary problems, set goals...
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Incentive Spirometer use
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in sitting position
mouth around mouthpiece inhale slowly --flow rate 600-900 hold it for 5 seconds exhale through pursed lips |
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Coughing and Splinting
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1-2 hours post-op
put pillow over insertion- splinting prevents pneumonia and atelectasis |
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Leg Procedures
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Promotes venous return- ted hose
Pneumatic suppresion- prevents clots decreased pulmonary embolus |
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Early Ambulation
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enhances lung expansion
promotes venous retunr prevents joint rigidity relieves pressure |
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ROM exercises
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3-5 times a day
passive/ active |
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Communication
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trusting relationship
concerns? |
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Distraction
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intervention for anxiety
music = reduction in pain, vital signs stabilize faster, recover quicker |
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Family Education
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active part in client's care
reduces anxiety in patients |
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Pre-operative Patient
Clothing |
Gown-
long surgeries- take underwear off |
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Jewelry
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remove ALL jewelry
electric coddery |
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ID band
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MUST HAVE--emergent situations-- ER--emergency surgery--blood products
allergies, fall risk |
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Dentures
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don't take out until in OR
breaking ro cracking of teeth with intubation ** assess prior to account for |
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Prosthetics
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artificial limbs, contacts ( corneal abrasions), hearing devices, fingernail polish, empty bladder
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Preoperative Chart Review
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Orders
COnsent Marking operative site allergy id patient id blood consent ( separate) |
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Preoperative Meds
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reduce anxiety
promote relaxation reduce pharyngeal secretions prevent laryngospasm inhibit gastric secretions decrease amount of anesthesia |
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Preoperative Meds
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Sedatives, Opioids, Anticholinergic( dries things up)
Antibiotic |
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Evaluations and Outcomes
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states understanding
demostrates post-op exercises reduced anxiety |
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Transfer to OR
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stretcher
children may ambulate |
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Children:
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Metabolism is higher
Fluid overload Temp- minimize heat loss |
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Cardiopulmonary status
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infection risk- cause for cancelling procedure
* respiratory infection |
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PAIN- Children
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Flacc scale
( facial expression, legs, activity, crying, consolibility |
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Nursing INterventions- children
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custody? requires both parents
up to 18- must have parents ( unless reproductive) |
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Children NPO guidelines
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6 hours
clear liquids allowed up until 2 hours |
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Normal blood pH
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7.35-7.45
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Fatal BLood pH
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lower than 6.8
higher than 7.8 |
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Ability to maintain blood pH is important in...
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Electrolyte imbalance
Enzyme activity muscle contraction cellular function |
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Buffers
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Protein
Phophate BICARB |
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Kidneys
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Chemical buffers
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Phosphte buffer
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interacts with acids or bases to form compounds that slightly alter pH
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Protein BUffer
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hemoglobin and proteins binds with acids and bases to neutralize them
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Repiratory System
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2nd line of defense ( 2 x effective as chemical)
QUICK RESPONSE |
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CO2
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CO2 combines with water - carbonic acid
pH drops |
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If acidic ( respiratory)
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breath deeper--pH gets higher
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if shallow breathing
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pH lowers
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Chemoreceptors
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vary the rate and depth of breathing to compensate for pH changes
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PaCO2 normal
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35-45 mmHg
reflects concentration of CO2 in the blood |
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CO2 increases...
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pH drops
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Kidneys
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reabsorb and excrete acids and bases into the urine
produce and regulare bicarb takes awhile... |
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Bicarb Norm
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22-26 mEq/L
metabolic component to acid/base balance |
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low pH ( kidneys will..)
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increase in H or decrease bicarb
will start to reabsorb bicarb and dump H into urine |
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high pH ( kidneys will...)
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kidneys hold on to H ( reabsrob) and dump Bicarb in urine
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Compensation
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body responds to imbalances by compensating ( repiratoy or metabolic)
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Partial Compensation
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the pH will still be out of the normal range
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COmplete of Full Compensation
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pH goes back to normal
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No compensation
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** causes determine compensation**
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Metabolic disturbance
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lungs compensate ( respiratory compensation)
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Respiratory Disturbance
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kidneys compensate ( metabolic compensation)
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paO2
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80-100
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saO2
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95-100%
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paCo2
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repiratory acidosis- >45
respiratory alkalosis- <35 |
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HCO3
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metabolic acidosis <22
metabolic alkalosis >26 |
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Absent Compensation
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values within normal range
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Partial Compensation
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value is abnormal and the pH is abnormal
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Complete Compensation
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value is abnormal
pH is normal |
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Respiratory Acidosis
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a compromise in 1 essential part of breathing
Ventilation, prefusion, hypoventilation |
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Causes of Respiratory Acidosis
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Neuromuscular Problems
Depression of the respiratoy center in brain Lung Disease Airway obstruction |
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@ risk respiratory acidosis
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children
mechanical ventilation post-op patients ( pain) analgesics or sedatives |
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SS of Respiratory Acidosis
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Apprehension, RESTLESS, headaches, confusion depresseed DTR, NV, warm skin, dyspnea
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Compensation of RAcidosis
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rr and depth increase
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TX of Racidosis
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patent airway
bronchodialators 02 as needed drug therapy- HYPERKALEMIA anitbiotics if infection chest PT |
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Repiratory Alk
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too much CO2 being eliminated
decrese in paCO2 and increased pH |
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CAuses of Resp Alk
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hyperventilation
hypermetabolic state liver failure brains respiratory control center hypoxia |
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SS of Resp Alk
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repirations are rapid and deep
anxious, restless headache/ lightheadedness muscle weakness ECG changes Hyperreflexia EXTREME: confusion/ alternating apnea and hyperventialtion/seizures/coma |
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TX of resp alk
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correct the underlying disorder
relaxation watch VS if hypoxic- give o2 if anxiety- give sedative |
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Metabolic Acidosis
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loss of HCO3 from ECF or accumulation of metabolic acids or combo of both
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CAuses of Met Ac
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ketone body overproduction ( diabetes)
impaired kidney function GI losses- diarhea( losing alkalinity) poisoning |
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SS of Met Ac
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Kussmauls
hypotension shock-- cool clammy skin weakness decreased DTR ANV headache LOC deterioration |
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TX of MEt Ac
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NaCO3 Iv
abx if infection antidiarrheal rapid acting insulin ventilation dialysis safety and seizure |
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Flush when?
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Before and AFTER bicarb is given
No interactions- can innactivate other meds and cause precipitation |
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Metabolic Alkalosis
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loss of acid or increase/gain of bicarb or both
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Causes of Met Alk
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Hypokalemia- kidneys conserve K and excrete
Hypochloremia Acid loss from GI tract Diuretic therapy Kidney disease transfusions/ drugs |
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SS of Met Alk
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repirations will be slow and shallow
cyanosis muscle twitching, tetany hyperactive DTR Apathy, confusion ANV Polyuria Arrythmias/death |
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TX of Met Alk
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stop diuretics and NG suctioning
antiemetics Acetazolamide- helps kidney retain bicarb 02 if hypoxic seizure precaution |
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Irrigate NG with?
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NS ( helps with retention of electrolytes)
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Otitis Externa
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irritating or infective agents come into contat with the skin of the external ear
SWimmer's ear |
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Tx of OE
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reducing inflammation
PAIN with heat bedrest, limited motion |
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ABX instillation in OE
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feed wick into ear cancal and ut drops on end of wick--> deliver abx
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NO SWIMMING
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Otits Externa- should not submerge head until resolved
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Furuncle
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STAPH- pimple in ear
localized external otitis cause by bacterial infection of hair follicle intense LOCAL pain |
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TX of furuncle
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local and systemic ABX, heat application, ear wick, incision and drainage
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Cerumen or foreign bodies
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MOST COMMON
Insects- kill with mineral oil first irrigate with BODY TEMP |
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Otitis Media
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painless- fluid accumulates behinf tympanic membrane
eustachian tube is blocked Day cares, smokers in house, other repiratory problems, bottle-fed |
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Acute Otitis Media
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3 weeks or less, sudden onset
Children 3 mos- 3 years Babies have short eust. tubes--fluid trapped--bacteria builds |
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SS of Acture OM
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sense of fullness
reduced hearing poppping when eating fever vertigo TM will be BEEFY RED, no landmarks |
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Non_surgical Management of OM
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Quite environment
Bedrest w/ limited head motion heat and cold application Systemic ABX |
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Analgesic in OM
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only topical if the tm is intact--damage to inner ear if it ruptures
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Surigcal Management of OM
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Myringotomy
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Myringotomy
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surigcal opening of the pars tensa of the ear drum
tubes drain fluid abx before and after surgery ear will drain for a day or so |
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Mastoiditis
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infection of the mastoid air cells caused by untreated or inadequately treated OM
- cellulitis over mastoid process enlarged postauricular lymph surigcal removal of infected material |
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Surgical management of MAstoiditis
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mastoidectomy or tympanoplasty
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Complications of Mastoid Surgery
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damage to cranial nerves, vertigo, meningitis, vomiting, brain absess, chronic purulaent OM and wound infection
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Trauma eardrum and ossicles
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infection, direct damage, rapid changes in middle ear cavity pressure
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Eardrum perforations heals within
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24 hours
totaly within a week-2 weeks |
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Tinnitus
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constant ringing ro noise perception
COMMON can't be observed mask the background noise |
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Vertigo and Dizziness
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COmmon manifestation of ear disorders
- restrict head movement adequate hydration antivertiginous drugs SAFETY concerns |
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Labyrinthitis
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infection of labyrinth- acute OM complication
* monitor for signs of meningitis |
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TX of Labyrinthitis
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systemic abx
bedrest in dark room antiemetics balance problems--- SAFETY! |
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Meniere's Disease
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Overproduction or increased reabsorption of endolymphatic fluid
--tinnitus and vertigo |
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Assessment of Menier's
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feeling of fullness
TInntitus hearing loss is worse during attack hold on to sheets even when lying down |
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Non-Surgical Management of Menier's
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slow head movement
salt and fuid restriction/sugar cessation of smoking mild diuretics |
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Surgical Management of Meniere's
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LAST RESORT
Labyrinthectomy? Endolymphatic Decompression with drainage and shunt Reset vestibular nerve Hearing in affected ear is sacrificed |
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Causes of Heaing Loss
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Conductive- inflammation or obstruction of external or middle ear by cerumen or objects
(soft spoken, otosclerosis, scar tissue, inflammatory, tumors) |
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Causes of Hearing Loss ( Sensorineural)
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loud noise, drugs, persbycusis, atherosclerosis, hypertension, prolonged fever, Meniere's, diabetes mellitis, ear surgery
PERMANENT |
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Sensorineural Loss SS
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can hear SOUNDS but can't make out words-- hard to hear hig-pitched sounds
--lower your voice DO NOT SHOUT |
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Mixed Hearing Loss
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aka Conductive- Senosrineural
has both losses... |
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Signs of Hearing Loss
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repeate statements
straining to hear turning head or leaning shouting ringing in ears failing to respond avoid crowded areas |
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TX of hearing loss
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Hearing aids
- amplifies background as well Cochlear Implants |
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Hearing Aid Education
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adjust slowly
prevent feedback squeeking turn off when not in avoid wetness remove batt when not in use extra set of batteries |
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Impaired Verbal Communication
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lip reading, sign language
well lit rooms do not shout repeat things back for understanding |
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Blepharitis
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inflammation of the eyelid edges
control with warm compress, scrub, avoid rubbing |
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Blepharitis SS
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itchy
red burning eyes scaling around lids matted lashes |
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Entropion
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turning inward of the eyelid causing lashes to rub against the eye
- ey lid spasm, trauma |
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SS ENtropion
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red conjunctiva ( eyelid inward)
changes in skin elasticity untreated-- ulcers |
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Surgical Removal of Entropion
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Patch it until eye doc visit- report pain or drainage
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Ectropion
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outward sagging of the eyelid
relaxation of the orbicular muscle- older --> corneal drying and ulceration |
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Ectropion surgery
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restory proper lid alignment
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Hordeolum
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STYE- internal or external
Staph/strep only 1 eye purulent drainage |
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TX of Hordeolum
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warm compress 4x a day
antibacterial ointment -- to remove ointment: close eye, gently wipe from nasal side outward |
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Chalazion- further down than a stye
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inflammation of sebaceous gland in eyelid
protrude on inside of lid not as painful as stye |
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SS of Chalazion
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eye fatigue
light sensitivity excessive tearing |
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TX of Chalazion
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warm compress 15 min 4 x a day--> opthalamic ointment
surgery is option **RE-occuring |
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Conjuctival Hemorrhage
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thin mucous membrane cover eye
vessels are fragile if pressure- burst heals itself in a few days |
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Conjunctivitis
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PINK EYE- viral and bacterial
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Viral COnjunctivitis
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watery drainage
Corticosteroid for inflammation NO ABX |
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Bacterial Conjunctivitis
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thicker, purulent drainage-yellow/green
eyelashes matted = staph TEACH HANDWASHING |
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Trachoma
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Chlamydia Trachomas= PREVENTABLE BLINDNESS
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TRachoma
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scarring of conjunctival bilateral
5-14 days incubation warm slimates--poor sanitation lashes damage cornea ABX |
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Keratoplasty ( Corneal Disorders)
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surgical removal of diseased corneal tissue and replacement with tissue from a human donor cornea
*cookie cutter |
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POST OP care of Keratoplasty
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abx injection, pressure patch, protective shield
HOB raised patch removed within 24 hours |
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Eye Patch education
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changing
@ night for a month around children/pets watch for infection, bleeding, rejection corticosteroids |
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EYe Donor procedure
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elevate HOB 30
instill abx drops close eyes ice packs |
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Cataract
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Clousing, blurring of the lens--opacity makes it difficult to see retina
= result of some other disease process ( 2ndary condition) SAFETY? |
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Cataract Assessment
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Opague, cloudy white pupil
gradual loss of vision blurred vision decreased color preception vision better in dim light with pupil dilation photophobia absence of red relex |
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Disturbed Sensory Perception
Interventions |
SURGERY to remove cataract and implant lens
enhanced social iteraction safety issues 1 EYE AT A TIME |
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Cataract Surgery Post- OP
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Abx subconjunctivally
eye is UNPATCHED- discharge occurs withing 1 hour with dark glasses (creamy normal, green no) instill anx steroid drops mild itching is normal |
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Pain with cataract
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EMERGENCY!!! IOC
- reduce IOP - prevent infection _ assess for bleeding |
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weeks for best vision after cataracts
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4-6 weeks
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CLient Education- Cataracts
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avoid straining
eye shield at night avoid rubbing or pressure on eyes avoid RAPID MOVEMENTS, straining lifting objects ovre 5 pounds no bend at waist |
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REPORT TO SURGEON- Cataracts
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Sharp, sudden pain in the eye
bleeding or increased discharge lid swelling, decreased vision flashes of light or floaters |
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Glaucoma
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COMMON, increases with age
Optic nerve damage- IOC so high -- optic disc damadge--disrupts visual field |
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Primary/ Acute/ Closed/ Narrow Angle
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EMERGENCY
obstruction to outflow of acqueous humor sharp pain |
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Chronic Closed Angle Glaucoma
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more common
overproduction or obstruction to the outflow of acqueous humor |
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CLinical Manifestations of Glaucoma
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optic disc atrophy--white/grey
visual field impairemtn headache, brow pain, NV, HALOS, decreased light pereption |
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Drug Therapy of Glaucoma
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pupillary constriction- miotics
inhibition of acqueous humor osmotic drugs ER for rapid decresae in IOP |
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TX of Glaucoma
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constrict the pupil
Surgical: = lifelong--sop further loss from happening medic alert bracelet! |
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Hypertensive Retinopathy
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bp increases- retinal arterioles narrow and "COPPER WIRE" appearance
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DIabetic retinopathy
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poor glucose control
cells in retinal vessel will die and fluid leaks capillaries wont be transferring th way they are supposed to--> tiny hemorrhages= decreased visual acuity |
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TX of Diabetic Retinopathy
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depends on severity
use lasers to stop growth and breakage |
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Vitrectomy
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remove fibrous bands so they don't detach the retina
scar tissue will detach the retina |
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DIabetic retinopathy
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poor glucose control
cells in retinal vessel will die and fluid leaks capillaries wont be transferring th way they are supposed to--> tiny hemorrhages= decreased visual acuity |
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DIabetic retinopathy
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poor glucose control
cells in retinal vessel will die and fluid leaks capillaries wont be transferring th way they are supposed to--> tiny hemorrhages= decreased visual acuity |
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Macular Degeneration
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still have good peripheral vision
= layers of retina separate because of hole or tear in the retina, accumulation of fluid , or when both layers elevates away from the choroid ( tumor) |
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TX of Diabetic Retinopathy
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depends on severity
use lasers to stop growth and breakage |
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Vitrectomy
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remove fibrous bands so they don't detach the retina
scar tissue will detach the retina |
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TX of Diabetic Retinopathy
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depends on severity
use lasers to stop growth and breakage |
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Macular Degeneration
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still have good peripheral vision
= layers of retina separate because of hole or tear in the retina, accumulation of fluid , or when both layers elevates away from the choroid ( tumor) |
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Macular Degeneration
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SMOKERS
maximize remaining vision--adaptive equipment sow this down and max what they have left |
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Macular Degeneration
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SMOKERS
maximize remaining vision--adaptive equipment sow this down and max what they have left |
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Vitrectomy
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remove fibrous bands so they don't detach the retina
scar tissue will detach the retina |
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Retinal Detachment
EMERGENCY |
complete separation= blindness
"curtain being drawn" |
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REtinal Detachment Assessemtn
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flashes of light, floaters, blurred vision, curtain
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Retinal Detachment
EMERGENCY |
complete separation= blindness
"curtain being drawn" |
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Macular Degeneration
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still have good peripheral vision
= layers of retina separate because of hole or tear in the retina, accumulation of fluid , or when both layers elevates away from the choroid ( tumor) |
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REtinal Detachment Assessemtn
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flashes of light, floaters, blurred vision, curtain
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Macular Degeneration
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SMOKERS
maximize remaining vision--adaptive equipment sow this down and max what they have left |
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retinal detachment
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EMERGENCY
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retinal detachment
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EMERGENCY
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Retinal Detachment IMplementation
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SURGICAL- LAser therapy ( seals small tears)
Scleral buccaling ( hold together until scar tissue forms) draining fluid |
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Retinal Detachment IMplementation
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SURGICAL- LAser therapy ( seals small tears)
Scleral buccaling ( hold together until scar tissue forms) draining fluid |
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Retinal Detach post-op
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maintan eye patches bilaterally
monitor for hemmorhage SUDDEN SHARP EYE PAIN- notify physician encourage deep breathing bed rest 1-2 days ENCOURAGE FOLLOW-UP |
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Retinal Detach post-op
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maintan eye patches bilaterally
monitor for hemmorhage SUDDEN SHARP EYE PAIN- notify physician encourage deep breathing bed rest 1-2 days ENCOURAGE FOLLOW-UP |
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Diathermy
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Retinal detachment-
= use of an electrode needle and heat through sclera to stimulate and inflammatory response |
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Retinal Detachment
EMERGENCY |
complete separation= blindness
"curtain being drawn" |
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Scleral Buccaling
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POSTOP- retinal detachment repair
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Diathermy
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Retinal detachment-
= use of an electrode needle and heat through sclera to stimulate and inflammatory response |
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REtinal Detachment Assessemtn
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flashes of light, floaters, blurred vision, curtain
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Scleral Buccaling
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POSTOP- retinal detachment repair
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Myopia
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nearsightedness
refraction is too strong in front of the retina can see cose up |
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Myopia
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nearsightedness
refraction is too strong in front of the retina can see cose up |
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Retinal Detachment IMplementation
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SURGICAL- LAser therapy ( seals small tears)
Scleral buccaling ( hold together until scar tissue forms) draining fluid |
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Hyperopia
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far sightedness
focused behind retina see better at a distance |
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Diathermy
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Retinal detachment-
= use of an electrode needle and heat through sclera to stimulate and inflammatory response |
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Hyperopia
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far sightedness
focused behind retina see better at a distance |
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Scleral Buccaling
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POSTOP- retinal detachment repair
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Presbyopia
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loss of lens elascticy
30s-40s imaged focused BEHIND retina can't do close work |
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Presbyopia
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loss of lens elascticy
30s-40s imaged focused BEHIND retina can't do close work |
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Astigmatism
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curve of cornea is uneven
image doesn't focus well on retina |
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Astigmatism
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curve of cornea is uneven
image doesn't focus well on retina |
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Photorefractive Keratotomy
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PRK
when cornea is not think enough for lasik |
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Photorefractive Keratotomy
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PRK
when cornea is not think enough for lasik |
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Laser In- Situ Ketatomileusis
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LASIK
make small flap in cornea and re-shape it *astigmatism as well |
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Intact Corneal Ring
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Myopia
plastic betwwen layers of cornea to treat mild myopia |
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Laser In- Situ Ketatomileusis
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LASIK
make small flap in cornea and re-shape it *astigmatism as well |
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Hyphema
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presense of blood in the anterior chamber of the eye
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Intact Corneal Ring
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Myopia
plastic betwwen layers of cornea to treat mild myopia |
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Hyphema
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presense of blood in the anterior chamber of the eye
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