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223 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the eye danger signals to report? x7
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"COVERUP"
Crossed-eyes Outgrowth of eye or lid Visual problems Effluent (d/c, crust, tearing) Redness Unequal or misshapen pupils Pain in or around eye |
COVERUP
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What are two general nursing care guidelines for pt w/ eye problems and their daily care?
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1. wash hands before touching eyes
2. let pt do AMAP |
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What's OD mean?
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right eye
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What's OS mean?
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left eye
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What's OU mean?
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both eyes
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When do you change eye dressing?
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only when ordered
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When and how do you apply pressure to eye dressing?
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Only when ordered,
use 2-3 pads |
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How do you remove eye dressing?
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pull all tape toward eye, then lift straight up
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What is it called when mearuing intraocular pressure?
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tonometry
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What do you do before tonometry?
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use topical anesthetic drop first
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What is tonometry?
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measure of intraocular pressure
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What's the first aide for chemical eye burns?
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BEFORE MOVING PT, flush with water for 15 min
(can use IV tubing) |
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What is it called when you inject dye into ac vein to be seen in retinal vessels?
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fluorescein angiography
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What odd s/e may happen after fluorescein angiography?
And for how long? |
skin and urine may turn yellow,
disappears in 24 hours |
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What is the process of fluorescein angiography? 2 steps
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1. dye injected in ac vein
2. pictures taken of retinal vessels |
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What v refractory power?
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relaxing ciliary muscles
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At what age doe the ability of the eye to accommodate begin to decrease?
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40 y/o
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What is presbyopia?
(type of what? what happens?) |
type of farsightedness,
when lens loses elasticity |
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What's another word for farsightedness?
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Hyperopia
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What's another name for nearsightedness?
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myopia
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With myopia, what's the refractory power like?
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excessive refractory power
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With myopia, what happends to light rays?
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light rays from distant objects focus in front of retina
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What is myopia defined r/t near and distance vision?
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normal near vision,
poor distance vision |
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What is hyperopia defined r/t near and distance vision?
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poor near vision,
good distance vision |
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With hyperopia, what's the refractory power like?
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insufficient
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Where do light rays focus with hyperopia?
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behind retina
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What is the most common refractory error?
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hyperopia
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What do the eye meds for glaucoma do?
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v IOP
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What are four examples of meds that v IOP?
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents |
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What type of drugs are: pilocarpine & carbachol?
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cholinergic (miotic) agents
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What are two examples of cholinergic (miotic) agents?
hint |
pilocarpine,
carbachol |
atropine
betaxolol carbachol cyclogyl Diamox homatropine Mydriacyl pilocarpine scopolamine timolol Trusopt |
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What are two examples of beta blockers for glaucoma?
hint |
betaxolol,
timolol |
atropine
betaxolol carbachol cyclogyl Diamox homatropine Mydriacyl pilocarpine scopolamine timolol Trusopt |
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What are two examples of carbonic anhydrase inhibitors for glaucoma? And what route?
hint |
Trusopt (drops)
Diamox (po) |
atropine
betaxolol carbachol cyclogyl Diamox homatropine Mydriacyl pilocarpine scopolamine timolol Trusopt |
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What are five examples of mydriatic/cycloplegic drops?
hint |
atropine, scopolamine, homatropine, Mydriacyl, cycogyl
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atropine
betaxolol carbachol cyclogyl Diamox homatropine Mydriacyl pilocarpine scopolamine timolol Trusopt |
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What are two examples of anti-infectives for the eyes?
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gentamicin, erythromycin
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What type of drug is pilocarpine?
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cholinergic (miotic) agent
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is carbachol?
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cholinergic (miotic) agent
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is betaxolol?
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beta blocker
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is timolol?
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beta blocker
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is Trusopt?
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carbonic anhydrase inhibitor
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is Diamox?
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carbonic anhydrase inhibitor
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is atropine drops?
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mydriatic/cycloplegic agent
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is scopolamine drops?
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mydriatic/cycloplegic agent
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is homatropine drops?
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mydriatic/cycloplegic agent
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is cyclogyl
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mydriatic/cycloplegic agent
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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What type of drug is mydriacyl drops?
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mydriatic/cycloplegic agent
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cholinergic (miotic) agents
beta blockers carbonic anhydrase inhibitors osmotic (hyperosmotic) agents mydriatic/cycloplegic agents |
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How do miotic-cholinergic agents work?
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^ aqueous fluid outflow by causing miosis (pupil constriction)
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What are the side effects of miotic-cholinergic agents?
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blurred vision,
pain, difficulty seeing in the dark |
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What should pt expect immediately following admin of miotic-cholinergic drops?
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stinging
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How do beta blockers work as eye med?
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v aqueous humor production
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How do carbonic anhydrase inhibitors work as eye med?
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v aqueous humor production
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What type of eye meds v aqueous humor production?
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beta blockers, and
carbonic anhydrase inhibitors |
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What do mydriatic drops do?
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dilate pupil
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What do cycloplegic drops do?
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paralyze iris sphincter to keep pupil dilated
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How long does dilation last after admin of mydriatic-cycloplegic drops?
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3 hours - several days
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What meds do you most use for eye exams and surgery?
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mydriatic/cycloplegic agents
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What are the s/e of mydriatic/cycloplegic drops? x5
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^ BP
^ P dizziness confusion photosensitivity |
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What should pt use after using mydriatic/cycloplegic agents?
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sunglasses
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What's the goal of osmotic agents for the eye?
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v IOP
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How do osmotic agents v IOP?
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draw aqueous humor from eyes by making plasma hypertonic
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When do you often use osmotic agents?
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pre-op
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What are the s/s of conjuctivitus?
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redness, swelling, pain, lacrimation, d/c, foreign body sensation
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What do the following symptoms indicate?
redness, swelling, pain, lacrimation, d/c, foreign body sensation |
conjunctivitis
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Three ex of Rx for conjunctivitis?
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warm compresses, antibiotics, maybe steroid drops
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What's the name of inflammation of the iris, ciliary body, or choroid?
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Uveitis
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What do the following s/s indicate?
pain, photophobia, blurred vision, redness |
uveitis
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What meds might you use for uveitis?
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mydriatics, analgesics, antibiotic or steroid drops
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What is an infection of superficial lid gland called?
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Hordeolum (sty)
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What is a hordeolum?
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infection of superficial lid gland (sty)
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What do the following s/s indicate?
pain, swelling, redness, then an abscess |
hordeolum (sty)
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Chalazia is what?
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painless cyst of lid gland
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What's the main two differences between chalazion and hordeolum?
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chalazion: painless, long-term
hordeolum (sty): painful, acute usu. |
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What is the Rx for a hordeolum (Sty)? x3
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warm compresses; maybe I&D or antibiotic drops
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What is the Rx for a chalazion?
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warm compresses; maybe I&D for cosmetics or vision interference
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What's a difference for Rx of hordeolum vs. chalazia?
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hordeolum might get antibiotic drops
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What is indicated with these s/s?
burning, itching; lid margins red & crusty |
Blepharitis
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What is Blepharitis?
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inflammation of lid margins
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What is the Rx for Blepharitis?
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warm compresses (to soften and remove crusts), antibiotic ointment
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Can you reverse blindness from Glaucoma?
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no
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What is the condition resulting from IOP?
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glaucoma
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What kind of glaucoma is an emergency?
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closed angle glaucoma
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What happens if closed angle glaucoma goes untreated?
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blindness in 2-5 days
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How are the aqueous drainage channels in closed angle glaucoma?
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normal
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What is the sudden kind of glaucoma?
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closed-angle
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Why does IOP ^ in closed angel glaucoma?
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root of iris blocks the angle of the anterior chamber
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What are the s/s of closed angle glaucoma?
hint |
N/V, pupils dilated & not RESPONSIVE to light, SUDDEN severe pain goes from eye to other parts of head, eyes RED, BLURRED vision, HALOS or rainbows around lights
"Not Very RESPONSIVE SUDDEN RED BLURRY HALOS" |
"Not Very RESPONSIVE SUDDEN RED BLURRY HALOS"
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Immediate Rx for closed angle glaucoma? x3
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v IOP
v pain v nausea |
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What meds may be used v IOP in closed angle glaucoma?
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miotics, osmotics, carbonic anhydrase inhibitors
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What med v pain and nausea in closed angle glaucoma?
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demerol
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What does Demerol do for closed angle glaucoma?
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causes miosis and v pain
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What are the NI for post-op closed angle glaucoma pt? x7
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1. eye patch
2. antibiotics 3. steroids 4. operated side up 5. progressive ambulation 6. no reading 7. no driving |
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How long is eye patch on post-op for closed angle glaucoma?
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at least 24 hrs
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How long are antibiotic gtts given post-op for closed angle glaucoma?
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4-5 days
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How long and WHY give steroids post-op for closed angle glaucoma?
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weeks,
to prevent inflammation & scarring |
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When can you read post-op for closed angle glaucoma?
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when MD says so
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How long can't you drive post-op for closed angle glaucoma?
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1 week
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How long is Rx for closed angle glaucoma?
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lifelong (even if no sym)
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What condition is most imp to avoid after having closed angle glaucoma?
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IOP ^
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What can ^ IOP? x8
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sneezing, vomiting, coughing;
bending from waste; straining (Valsava or lifting >5 lbs); emotional stress; excessive fluid intake; tight clothing (ex collars) |
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What are two thing you CANNOT take with glaucoma?
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mydriatics and antihistamines
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What difficulty do miotics cause?
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difficulty seeing at night
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What can't you do after recovering from closed angle glaucoma and taking miotics? x2
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1. can't read for extended periods
2. can't play games with fast moving objects |
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What are two common causes/risk factors for cataracts?
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long term steroid use,
excessive sun exposure |
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What condition does the following describe?
blurred/hazy vision, objects distorted, diplopia, poor night vision, glare in bright light, no pain, gradual vision loss |
cataracts
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How might you slow progression of cataracts?
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protection for sunlight
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What four things to you give pre-op for cataract surgery?
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1. sedation
2. mydriatic-cycloplegic 3. osmotic 4. antiemetic |
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How long post-op is cataract pt d/c?
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usu. a few hours
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How do you sleep after cataract surgery?
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operated side up,
HOB 45 degrees |
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How long do you apply dsg. to eye after cataract surgery?
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1 day
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What do you give to prevent ^ IOP post-op cataract surgery?
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antiemetic PRN for nausea (prior to vomiting)
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What eyes meds do you give post-op cataract surgery?
w/ lens implant? w/ no lens implant? |
antibiotic & steroid
implant: miotic no implant: mydriatic or myd-cycloplegic |
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How often must you wear replacement lens after cataract surgery?
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all the time
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How is focusing power with replacement lens post-op cataract surgery?
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1/3 focusing power
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What type of lens is most common?
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IO implant
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Where is an IO lens placed?
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posterior chamber
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What are your chances for good vision is IO lens in place?
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excellent
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How problematic is magnification with IO implant?
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no problem
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How problematic is magnification with contact lens?
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slight problem
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How much is magnification with cataract glasses?
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25%
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What might you need with IO implant if single focus lens used?
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glasses needed for distant or close vision
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With what lens replacement must you learn to rejudge distances?
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cataract glasses
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What vision is best for cataract glasses?
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central vision
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What images are distorted when wearing cataract glasses?
So what must you do? |
peripheral images,
you gotta turn head & look thru glasses' center |
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What is the rarest replacement lens post cataract surgery?
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glasses
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What do you received first if getting cataract glasses after surgery?
For how long? |
temporary glasses,
for 2-3 months |
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What is dangerous that can occur from congenital cataracts?
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if monocular can cause blindness in affected eye
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What's amblyopia?
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lazy eye, where unaffected eye is used for vision
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What is retinoblastoma?
where's is arise? how many eyes affected? |
congenital malignancy,
starts in retina, usu. unilateral |
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When does retinoblastoma arise?
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maybe present at birth, or
arise before 2 y/o |
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What is strabismus?
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eyes not straight or aligned bilaterally
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What condition presents with white glow in pupil (cats eye reflex)?
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retinoblastoma
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What are four usual sym of retinoblastoma?
What is often present? What is a late sign? |
whitish glow in pupil, strabismus, pain, redness;
often glaucoma, Blindness is a late sign. |
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What is most common cause of strabismus?
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imbalanced IO muscles
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How many with strabismus have family hx?
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half
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What's a bad long term effect of strabismus?
What can that then cause? |
amblyopia;
permanent blindness |
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What are sym of strabismus? x5
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malalignment of eyes, head tilt or squint, maybe h/a or uncoordination
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What might a head tilt or squint indicate?
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strabismus
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What are four Rx for strabismus?
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patch on good eye, eye exercises, glasses, surgery
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What is the most common cause of visual loss after age 60?
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Macular degeneration
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What is used to dx macular degeneration?
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amlser grid
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What appears in retina with macular degeneration?
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Drusen (yellow spots)
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What are four sym of retinal detachments?
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1. floaters
2. flashes of light 3. blurred or 'sooty' vision (veil feeling) 4. blindness if unRx |
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What might flashes of light in vision indicate?
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retinal detachment
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Immediate Rx for retinal detachment? x3
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bedrest,
OU bandages keep detachment dependent |
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How do you keep area of retinal detachment dependent?
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flat, sitting, etc.
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What dsg do you see after retinal re-attachment surgery?
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OU bandages
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What activity is typically ordered post-op retinal re-attachment?
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bedrest with assisted BRP
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If gas bubble, what position do you avoid post-op retinal re-attachment?
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flat
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How ofter deep breath post-op retinal re-attachment?
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Q2 hours
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What feeling should pt expect post-op retinal re-attachment?
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scratchy feeling
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What two things would be normal to note near the surgical site in pt post-op retinal re-attachment?
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small amount serosanguineous drainage, and
edema of lid |
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What sign do you report post-op retinal re-attachment?
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^ IOP
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When do you resume usual activities post-op retinal re-attachment?
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5-6 weeks
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What do you want to be sure to avoid post-op retinal re-attachment?
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activities that ^ IOP:
head movement, reading, strenuous activity, contact sports |
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If gas bubble used during retinal reattachment surgery, when can you fly?
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when gas bubble gone
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What can you never do again post-op retinal re-attachment?
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contact sports
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What are the two eye situations where you apply pressure post-op?
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enucleation and
recipient of donor eye |
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What do you do post-op enucleation?
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1. pressure dressing for 1 week
2. antibiotic ointment TID |
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After enucleation, what may ^ drainage signify?
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infection
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How much and how long do you see drainage post enucleation?
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some drainage in first weeks
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How often to you remove and clean prosthetic eye?
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as per MD
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What two things do you do pre-op for recipient of eye donation?
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1. check for eye infection
2. admin antibiotic gtts |
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What are the signs of eye graft rejection?
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"RSVP"
Redness Swelling Visual acuity v Pain |
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Post-op eye recipient, what do you apply to eyes and for how long?
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pressure dressing and eye shield for 1 day
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Post-op eye recipient, what position should they be in ?
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Elevate HOB,
operated side up |
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What do you monitor for post-op for eye recipient? x3
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bleeding,
infection, graft rejection |
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What's another name for hearing loss?
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paracusis
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what is paracusis?
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hearing loss
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What are three important causes of paracusis?
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1. constant loud noise
2. ototoxic drugs 3. aging |
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What are 6 ex of ototoxic drugs?
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streptomycin, gentamycin, neomycin, other aminoglycosides;
ASA, loop diuretics |
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What are sym of infant paracusis? x3
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no babbling, v response to loud noise, delayed speech
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What are 6 sym of adult paracusis?
hint |
speech deterioration (flat), fatigue, social withdrawal, false pride (pretends to hear), "hogs" conversation, disinterest
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1. r/t speech
2. r/t energy level 3. r/t relationships 4-6. r/t conversing w/ others |
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What are the two classifications of hearing loss?
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conduction and
sensorineural |
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What causes conductive hearing loss?
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impairment of outer or middle ear
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What is sensorineural hearing loss also called?
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perceptive loss
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What are damaged which result in sensorineural hearing loss?
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damage of inner ear or nerve pathways
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What are four causes of sensorineural hearing loss?
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ototoxic drugs, syphilis in utero, blow to head, loud noise
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How do you speak to something with hearing impairment?
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clearly and slowly (don't shout)
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What do you avoid when answering a pt w/ hearing loss?
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avoid one-word answers
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How should the room be for person with hearing impairment?
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well-lit and quiet
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What should you remember to do when entering a room of blind pt.?
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Speak to pt.
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What should you do r/t arrangement of room for blind pt? x4
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orient to room,
don't rearrange furniture, don't leave door 1/2 open, call bell in reach |
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What do you do when walking walking with blind pt.?
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1. let them touch your elbow
2. walk one step ahead |
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What's an example of allowing independence for blind pt?
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let feed self
(ex. "meat at 3 o'clock") |
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What are two common inner ear disorders?
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motion sickness,
Meniere's disease |
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What are sym of motion sickness?
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n/v, pallor, sweating
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What is a common inner ear disorder often with family hx?
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Meniere's disease
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What's the duration of Meniere's disease?
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chronic
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What is affected in Meniere's disease?
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inner ear (labyrinth)
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What is the pathophysiology of Meniere's disease?
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-fluid imbalance in inner ear
-caused by malabsorption in endolymphatic sace |
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What are four sym of Meniere's disease?
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feeling of fullness in ear,
paraxysmal whirling vertigo, tinnitus, sensorineural hearing loss |
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How many sym of Meniere's disease occur at a time?
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May occur 1 at a time or together
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What is the medical Rx and nursing care for Meniere's disease? x10
hint |
No MSG, No ASA;
Low Na diet, limit alcohol & caffeine; Often diuretics, antihistamines, Antivert or Valium, antiemetics, vasodilators |
-avoid 2 things
-limit 3 things -admin 5 things |
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What two things might ^ sym of Meniere's?
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MSG or ASA
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What might you give to v vertigo in Meniere's?
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Antivert or Valium
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What do you use to suppress the vestibular system in Meniere's?
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antihistamines
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What antiemetic might you give for Meniere's?
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Phenergen
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What are two vasodilators given for Meniere's?
What are they used for? What is particular about that? |
Pavabid, Banthine;
to v tinnitus; not scientificaly proven |
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What organism often causes acute otitis media?
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strep
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What is acute otitis media?
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infection of middle ear
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Who usu. gets acute otitis media?
Why? |
children;
r/t short, straight eustachian tubes |
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What is a secondary risk factor for acute otitis media?
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2nd hand smoke
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How does eardrum look with acute otitis media?
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bright red or yellow
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What does it mean if purulent drainage from ear?
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rupture of tympanic membrane
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Are sym mild or severe with acute otitis media?
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either mild or severe
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What are the sym of acute otitis media? x7
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pain, ear tugging, ^ temp, irritable, n/v, v hearing, h/a
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What happens to pain if ear drum ruptures in otitis media?
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pain stops
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What are 2 meds to Rx acute otitis media
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antibiotics, maybe decongestants
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What are 5 NI post-op myringotomy?
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1. affected ear dependent
2. report severe earache 3. report COCA of drainage 4. report hearing loss 5. keep water out of ears |
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How long does it take ventilating tubes to fall out of ear?
What do you do when it happens? |
6-18 mos.
Call MD |
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What are 3 NI post-op for middle ear or mastoid surgery?
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prevent infection,
sleep w/ operative ear up, blow nose, sneeze, and cough gently |
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How long do you keep water out of ear post-op middle ear surgery?
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up to 6 wks
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What might go in ear post-op middle ear surgery? 2x
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antibiotic soaked packing or cotton ball w/ petroleum jelly
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What do you do for postaural incision? x2
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keep dry for 2 days,
report infection |
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What are 2 signs of infection post-op middle ear surgery?
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temp or purulent drainage
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How do you blow nose post-op middle ear surgery?
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1 nostril at a time
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How do you sneeze or cough post-op middle ear surgery?
For how long? |
with mouth open for weeks
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What can happen with prolonged acute otitis media?
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chronic otitis media
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What is main symptom of external otitis media?
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pain that ^ when auricle moved (unique from middle ear infection)
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What may you see with external otitis media?
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yellow-green, foul-smelling d/c
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What does AU mean?
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both ears
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What does AD mean?
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right ear
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What does AS mean?
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left ear
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