Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
80 Cards in this Set
- Front
- Back
|
NORMAL VISUAL FINDINGS
|
acuity 20/20, no diplopia
symmetrical eyes, no deformity nontender lacrimal, no drainage clear conjunctiva, sclera white PERRLA Lens clear retina normal, no hemorrhage/ spots |
|
|
droopy eyelid, decreased muscle tone
|
ptosis
|
|
|
NORMAL AUDITORY FINDINGS
|
symm location & shape
auricles non-tender canal clear, tympanic membrane intact able to hear low whisper @ 30 cm (1 foot) |
|
|
age related changes to eyes
|
loss of orbital fat
lipid deposits in sclera decr water content decr tear secretion dilator muscle atrophy chgs in color perception (blue & violet) decr visual acuity macular degeneration (central vision loss) c/o floaters |
|
|
meds that can affect vision
|
antihistamines - ocular dryness
corticosteroids-contribute to glaucoma/cataracts WHY ARE THEY TAKING MEDS ESP IF HX DOESN'T INDICATE A NEED |
|
|
subjective data Q's
|
any vision changes
contacts? family hx cataracts, glaucoma, macular degen |
|
|
small superficial white nodule along lid margin (S Aureus of sebaceous gland)
|
hordeolum (sty)
|
|
|
red, edematous area of eyelid (from sty or rupture of sebaceous gland)
|
chalazion
|
|
|
chronic redness, crusting of lid
|
blephartis
|
|
|
visual objective data to gather
|
subconjunctival hemorrhage from coughing, sneezing
jaundice - liver dysfunction corneal abrasions or opacity exophthalmos of globe PERLA |
|
|
dilation due to drugs, head injury
|
mydriasis
|
|
|
constriction due to Morphine, drugs, miotic agents
|
miosis
|
|
|
unequal & constricted pupils - CNS problem but can be normal in some people
|
anisocoria
|
|
|
irregularly shaped pupil due to trauma, lens implant; abnormal response to light or accomodation
|
dyscoria
|
|
|
deviation of eye position in 1 or more directions "lazy eye"
|
strabismus
|
|
|
hearing loss due to aging, noise exposure, vascular or systemic disease, ototoxic drugs
|
presbycusis
|
|
|
ringing in ears can accompany hearing loss
|
tinnitus
|
|
|
age related changes in hearing
|
hearing loss causes social isolation - tx early
incr production & drier cerumen incr hair growth degeneration & atrophy of inner ear |
|
|
subjective data re: hearing
|
childhood illness, otitis media, myringotomy, MMR, syphillis
ototoxic meds - ASA, antibiotics, antimalarials, chemo, diuretics, NSAIDs work & exercise hx |
|
|
objective data re: hearing
|
cyst, cerumen, discharge, swelling of pinna, scaling/lesions
tympanic membrane should be pearly gray - bulging red or perforation is abnormal |
|
|
disproportionate loudness of sound
|
recruitment
|
|
|
means nearsighted -- most common refractive error
|
myopia
|
|
|
farsighted
|
hyperopia
|
|
|
loss of accommodation associated with aging
|
presbyopia
|
|
|
irregular shape of eye
|
astigmatism
|
|
|
normal vision 20/20
|
emmetropia
|
|
|
surgery to reshape the central corneal surface with a laser
|
PRK - photorefractive keratectomy - for myopia, hyperopia & astigmatism
|
|
|
pre-op care for eye surgery
|
check vision of non-surgical eye
ADL help support system no eye make-up or contacts |
|
|
post-op care for eye surgery
|
no vomiting
no straining for BM no coughing/sneezing no bending over nothing over 5 lbs call for sharp, sudden pain= hemorrhage sunglasses |
|
|
blindness with no light perception & no usable vision
|
total blindness
|
|
|
blindness with some light perception but no usuable vision
|
functional blindness
|
|
|
blindness that has some usuable vision, criteria set by federal government
|
legally blind
|
|
|
blindness that has corrected visual acuity greater than 20/200 in the better eye & greater than 20 degrees visual field
|
partially sighted
|
|
|
NSG MGMT FOR HEARING/VISION LOSS
|
address patient-look at them
introduce self & others explain noise & activity orient to environment use sighted-guided technique |
|
|
types of eye trauma
|
blunt - fist
penetrating-glass, stick, etc. chemical thermal foreign bodies |
|
|
s/s eye trauma
|
pain
photophobia edema redness tearing ecchymosis absent eye movement fluid drainage visible foreign body prolapsed globe abnormal or decr vision |
|
|
care for eye trauma
|
determine how injury occurred
ABC's ocular irrigation immed after chemical exposure w/NSS or water-flush inner to outer no pressure to eye patch unaffected eye to decr occular movement stabilize foreign object no food or drink, HOB 45 deg cover w dry, sterile patches check vision each eye remove any loose foreign bodies |
|
|
opacity within crystalline lens
|
cataract
|
|
|
cataract info
|
between ages 65-74
congenital cataracts 1:250 newborns caused by senile cataracts, trauma, maternal rubella, UV exposure |
|
|
s/s cataract
|
c/o decr vision
abnormal color perception - blue/purple pupils cloudy to gray white glare |
|
|
PRE-OP CATARACT SURGERY
|
NPO
eyedrops - used for pupil dilation mydriatic - Neo-Synephrine - may cause tachycardia, HTN cycloplegics - Isopto, Atropine pts with dark irises need larger doses |
|
|
mydriatic eyedrops do what
|
dilation of pupils
|
|
|
cycloplegic eyedrops do what
|
paralysis of accomodation, causing pupils to dilate
|
|
|
POST-OP CARE CATARACT SURGERY
|
no bending, coughing, lifting
eye shield @ hs sunglasses teach eyedrops teach s/s infection |
|
|
separation of sensory retina & underlying pigment epithelium w/fluid build-up between the 2 layers
|
detached retina
|
|
|
2 types of retinal breaks
|
retinal holes
retinal tears |
|
|
atrophic retinal breaks occuring spontaneously
|
retinal holes
|
|
|
vitreous humor shrinks due to aging & pulls on the retina
|
retinal tear
|
|
|
r/f for detached retina
|
proliferative diabetic retinopathy
ocular trauma |
|
|
s/so detached retina
|
photopsia (light flashes)
floaters cobwebs in field of vision painless loss of peripheral or central vision "like a curtain" |
|
|
2 types of surgery for retina detachment
|
photocoagulation (heat laser) and cryopexy (cold)
|
|
|
group of eye disorders with incr intraocular pressure (IOP), optic nerve atrophy, peripheral visual field loss, related to balance or imbalance of aqueous humor fluid
|
glaucoma
|
|
|
inflow of aqueous humor greater than outflow giving pressures > 21 mm Hg
normal is 10-21 |
glaucoma
|
|
|
2 types of glaucoma
|
primary open angle glaucoma (POAG)
primary angle closure glaucoma (PACG) |
|
|
PRIMARY OPEN ANGLE GLAUCOMA
|
common 90%
R/F - >35, genetic, Afr Amer frequent change in glasses impaired dark adaptation halos around eyes gradual decr in visual field w/central vision late |
|
|
TX FOR POAG
|
beta blockers-decr aqueous humor production
mitotics-facilitate aqueous outflow laser trabeculectomy laser trabeculoplasty |
|
|
PLANNING FOR POAG
|
no progression of visual impairment<BR>comply w/therapy<BR>understand the disease-regular eye exams
|
|
|
DIAGNOSIS OF POAG
|
IOP 22-32 mm Hg - normal is 10-21
tonometry - puff of air to measure IOP fundoscopy - check optic fundus gonioscopy - check depth of anterior chamber |
|
|
R/F primary angle closure glaucoma (PACG) - rare
|
narrow anterior chamber
aging asian |
|
|
PACG s/s<BR>Primary Angle Closure Glaucoma
|
IOP > 50<BR>c/o sudden excruciating pain in or around eye<BR>h/a, n/v<BR>red conjunctiva, cloudy cornea, fixed pupil, unilateral
|
|
|
tx for PACG
|
topical miotics or beta blockers
laser iridotomy |
|
|
meds for glaucoma
|
beta blockers (Betoptic, Timoptic) - decr aqueous humor -- will incr effects of systemic beta blockers
alpha agonists (Propine, Lopidine) - enhance outflow facility cholinergic agents (Miotics) - Isopto Pilocar |
|
|
problems caused by cerumen
|
decr hearing
otalgia tinnitus vertigo cough cardiac depression |
|
|
inner ear disease w/episodic vertigo, tinnitus, sensorineural hearing loss, aural fullness
|
MENIERE'S DISEASE
|
|
|
S/S MENIERE'S DISEASE
|
c/o whirling in space, roaring or ocean in ears, accompanied by n/v, pallor, sweating
|
|
|
R/F MENIERE'S DISEASE
|
viral injury to fluid transport sys
trauma bacterial infection (syphillis) family hx |
|
|
DX MENIERE'S DISEASE
|
glycerol test - oral dose glycerol given w/serial audiograms if hearing or speech discrimination improves, positive test
|
|
|
NSG INTERVENTIONS MENIERE'S DISEASE
|
quiet dark room
no sudden head movements no TV or flickering lights medicate for n/v, dizziness |
|
|
TX MENIERE'S DISEASE
|
Valium
Atropine (dries secretions) Benadryl Meclizine (antivert) low salt diet no caffeine no smoking |
|
|
known as the "unseen handicap"
|
hearing loss
|
|
|
2 types of hearing loss
|
conductive & sensoneural
|
|
|
hearing loss in outer & middle ear, impairs sound being conducted from outer to inner ear
|
conductive hearing loss
|
|
|
hearing impairment of inner ear or its central connection
|
sensoneural hearing loss
|
|
|
most common? conductive or sensoneural
|
conductive hearing loss
|
|
|
causes of conductive hearing loss
|
impacted cerumen
foreign bodies middle ear disease otosclerosis stenosis of external auditory canal otitis media |
|
|
manifestations of conductive hearing loss
|
speak softly because they hear their own voice
hear better in noisy environment hearing aids useful |
|
|
causes of sensoneural hearing loss
|
congenital
Menier's disease noise trauma presbycusis ototoxicity TB syphillis HIV Lyme's disease |
|
|
manifestations of sensoneural hearing loss
|
gradual loss
think person is confused hear sounds but unable to understand speech (muffled) give inappropriate answers "speak up" cupping ear |
|
|
protect against hearing loss
|
wear ear protection
control noise in environment immunizations |
|
|
ways to communicate with someone with hearing loss
|
use hand movements
have speaker face in good light avoid covering mouth or face w/hands no gum, smoking, eating avoid distracting environment move close to "good ear" speak normally & slowly do not over-exaggerate facial expressions no shouting |
