Test 6

Question 1

1. Client education conjunctivitis (Slide 16)

Answer 1

 If contagious remain away from people separate lines/towels.
 Apply Ung in conjunctival sac, instruct to close eye but not squeeze, if need to wipe do from inner to outer canthus
(Most common)

Question 2

2. Retinal detachment client education (Slide 23)

Answer 2

 Instruct patient to remain upright preop and restrict movement, eyepatch over affected eye.
 Postop: eyepatch when sleeping to avoid injury; avoid bending, coughing, straining

Question 3

3. Most common cause of visual loss and normal aging changes in older adults (Slide 2)

Answer 3

 Macular Degeneration

Normal Aging Changes:
 Crystalline lenses harden.
 Loss of accommodation
 Macular degeneration
 Presbycusis
 Calcification of the ossicles

Question 4

4. Macular degeneration assessment

Answer 4

 Loss of central vision
 No detail in images
 Lack of depth perception

Question 5

4. Macular degeneration diagnostic tests

Answer 5

 Amsler grid for peripheral vision test

Question 6

4. Macular degeneration client education/nursing management(Slide 24)

Answer 6

 Arrange community resources.
 The nurse will assist with ambulation by letting the client follow their lead and encourage client to turn head side to side.

Question 7

5. Nursing interactions for visually impaired clients (Slide 11)

Answer 7

 Lead the client, walk a bit ahead during ambulation.
 Introduce yourself each time you enter the room because many voices sound similar.
 Call the client by name during group conversations because the blind client cannot see to whom questions or comments as directed.
 Speak before touching the client.
 Tell the client when you are leaving the room.

Question 8

6. Glaucoma manifestations

Answer 8

o Affects people of all ages and all race
o Characterized by increased ocular pressure (IOP) in the eye brought on by an excessive amount of aqueous humor. Tonometry will measure the pressure.

Manifestations:
 Open angle: mild eye discomfort, temporary blurred vision, reduced peripheral vision, halos around lights.
 Acute angle-closure: hard, painful, sightless eyes; N/V; red conjunctive; headache, color halos around lights

Question 9

6. Glaucoma Nursing/Surgical Management

Answer 9

 Medication
 Laser surgery

Question 10

6. Glaucoma Diagnostic Findings

Answer 10

 Optic disc visualization
 Anterior chamber inspection
 Tonometry
 Visual field exam

Question 11

6. Glaucoma Client Education

Answer 11

 Drop taken for life.
 Stress importance of drop regimen
 Call with OTC med
 Keep yearly appointments.
 Surgery post-op; avoid lifting, bending, coughing or straining.

Question 12

7. Stapedectomy client education

Answer 12

 Refrain from blowing the nose because this action can dislodge the prosthesis.
 Avoid high altitudes or flying.
 Refrain from lifting heavy objects, straining when defecating, or bending over at the waist; these activities increase pressure in the middle ear.
 Prevent water from getting in the ear. Avoid swimming, showering, and washing the hair until approved by the primary provider.
 Follow the primary provider’s instructions for keeping the ear clean.
 Stay away from people with respiratory infections. If a head cold occurs, contact the primary provider immediately.
 Notify the primary provider immediately if severe pain, excessive drainage, a sudden loss of hearing, or fever occurs.
 Adhere to the above restriction of activities recommended by the surgeon until told otherwise. Normal activities can usually be resumed within 2 to 4 weeks.

Question 13

8. Cataract manifestations (Slide 22)

Answer 13

 Halos
 Difficulty in reading
 Color vision changes
 Reduced, distorted vision.

Question 14

8. Cataract surgery client education/nursing management

Answer 14

 Eye shield 24 hrs.
 Sunglasses x1 week
 Eyedrops
 Blurring for days to a week
 Expected white drainage, call if yellow or green.
 Might feel mild itching and bloodshot.
 No heavy lifting, straining, coughing, or bending could indicate increases LOC.
 Eye patch changed qd.
 Unexpected findings:
- Flashes of light
- Yellow or green drainage
- Sudden increases in pain

Question 15

9. Diagnostic tests for hearing loss

Answer 15

-Audiometry: Non-invasive preliminary test for hearing loss

Tympanogram: Measures the mobility of the TM to detect middle ear disease

Weber~ Test bone conduction hearing loss, client will hear on affected side

Rinne: Tuning forks to determine if hearing loss-hears through air conduction

Otoscopy: To examine external auditory canal, TM, and malleus bone

History and assessment: Trauma, medications, chemotherapy

Question 16

10. Paroxysmal positional vertigo nursing interventions

Answer 16

Sensation of Motion: positional vertigo occurs in response to change in position. Safety in nurse priority- major fall risk
 Bed rest
 Watch for sedation.
 Antiemetics as needed.
 Meclizine: antihistamine and anticholinergic effects

Question 17

11. Tonometry education

Answer 17

Glaucoma Test; will measure the intraocular pressure (IOP).

Question 18

12. Timolol K,H,K

Answer 18

Glaucoma Medication
Side effects:
 Burning/ Stinging
 Discomfort
 Dry eyes
 Eyelid erythema

Nursing Action/CE:
 Avoid canthus duct to limit systemic effect like bradycardia.
 Apple pressure to innercaunts for systemic medication
 Use caution when hypertensive beta-blocker drugs are used.

Question 19

13. Impacted Cerum Assessment/manifestation

Answer 19

 Blocked or Muffled hearing
 Plugged feeling in the ear.
 Otalgia

Question 20

13. Cerumen removal nursing interventions

Answer 20

 Softening wax with mineral oil or Debrox
 Let sit overnight then flushing with a syringe.
 If left untreated, impacted cerumen leads to tinnitus.

Question 21

14. LASIK complications (Slide 9)

Answer 21

 Flap issues: move or doesn’t stay put or inflammation, displace, infective, and can get berede under the flap.

Question 22

15. Brimonidine K,H,K

Answer 22

Glaucoma Medication
Side Effects:
 Burning/ stinging
 Discomfort
 Dry eyes

Safety:
 Do not take with MAOI antidepressants.
 Confusion noted in frail elderly when used.

Question 23

16. Pilocarpine K,H,K

Answer 23

Glaucoma Medication
Side Effects
 Periorbital pain
 Blurry vision

Safety:
 Warning regarding difficulty with vision in evening or dark area

Question 24

17. Uveitis risk factors

Answer 24

Specific Disease and autoimmune disease
 Ankylosing Spondylitis
 Tuberculosis
 Juvenile rheumatoid arthritis
 Toxoplasmosis
 Histoplasmosis
 Herpes Zoster Infection

Question 25

18. Quinine K,H,K

Answer 25

Use: for leg cramps
Long term use can cause hearing loss

Question 26

19. Weber test nursing considerations

Answer 26

• Performed by striking the tuning fork and placing its stem in the midline of the client skull or center if the forehead.

-A person with normal hearing perceives the sound equally well in both ears (if the sound seems lateralized to on ear, it suggested a conduction hearing loss in that ear or a sensorineural loss in the opposite ear.

Question 27

20. Ear drops instillation client education/nursing management

Answer 27

 Assist with drop instillation-always point toward roof of canal not directly at eardrum.
 Warm drops prior to instillation
 Clean external ear with warm cloth

Question 28

21. Otosclerosis client education

Answer 28

 Unknown cause but can be accelerate in pregnancy.
Causes bilateral hearing loss*

Question 29

21. Nursing consideration post op stapedectomy

Answer 29

 Place client on opposite side and monitor for dizziness, assist with ambulation.
 Avoid coughing, vomiting and monitor for prosthesis dislodgement.
 Assess facial nerve function.
 Monitor for infection, use aseptic technique when cleaning wound.

Question 30

22. Otitis externa client education/ nursing management

Answer 30

(swimmer’s ear)
 After swimming instill alcohol drops to dry
 Wear earplugs/ swim cap
 Do not use cotton swabs inside.
 Use a low heat hairdryer.

Question 31

22. Otitis Media contributing factors

Answer 31

Contributing Factors:
 Viral or bacterial infections
 Allergens like smoke