306 Exam 2 Flashcards
(117 cards)
1
Q
What is Achromatopsia
A
is a rare form of color blindness in which the individual cannot distinguish any color at all and sees only shades of gray.
2
Q
What is Osteoarthritis
A
Progressive Degeneration of cartilage and bone in a joint. Over time.
Bone on bone friction in the joint.
(Risks; Obesity
Age
Smoking
Repetitive stress on joints)
3
Q
How frequently should adults get eye exams (what about those with comorbidities?)
A
W/o comorbidities
age 20-30s every 5-10 year
Age 40-54 every 2-4 year
Age 55-64 every 1-3 year
Age 65 and above every 1-2 year
With high risk or comorbidites (like diabetes)
Annually
4
Q
Contraindications to MRI
A
Anything that can be attracted to the magnet. Anything that has any metal in it. Including implants.
5
Q
MRI with contrast contraindications
A
Same as standard MRI contraindications as well as:
Patients on dialysis
Patients with kidney or renal impairment
Patients who are being administered medication for diabetes mellitus or hypertension.
Breastfeeding or pregnant patients
6
Q
What is Photophobia
A
Sensitivity to light
7
Q
What are the components of the sensory process?
A
Reception and perception
Reception = The process of receiving external stimuli or data.
Perception = Awareness and interpretation of stimuli; the ability of the individual to interpret the environment.
8
Q
Left brain stroke symptoms and signs
(Think - Left brain = Language and logic)
A
Dysphasia
Reading or writing problems
Right sided hemiparesis (weakness)
Right sided neglect
9
Q
Right sided stroke signs and symptoms
(Think right brain = reckless and really creative )
A
Lack of impulse control
Behavioral changes
Left hemparesis (weakness)
Left sided neglect
10
Q
A client manifests with visual and spatial deficits, left homonymous hemianopsia and one sided neglect.
What is the suspected cause?
A
Right sided hemispheric stroke
11
Q
What two cranial nerves are located in the anterior brain, and sensory only?
A
Cranial nerves 1 & 2,
Sense of smell (1) sight (2)
12
Q
A negative Romberg test means what?
A
The patients balance is normal.
And the motor component of cranial nerve 8 is intact.
13
Q
When assessing cranial nerves 9 & 10, what would the nurse consider a normal finding?
A
Uvula and soft palate rising bilaterally on phonation.
14
Q
What do ligaments do?
A
Connect bones with eachother
15
Q
What do tendons do?
A
Connect muscles to bones
16
Q
What regions do herniated discs usually occur in patients spine?
A
C5-C6; C6-C7; L4-L5; and L5-S1
(Cervical). And (lumbar, sacral)
17
Q
What is a herniated intervertebral disc?
A
A rupture of the cartilage surrounding the disc with a protrusion of the nucleus pulposus.
18
Q
What is vertigo
A
A feeling of rotation or imbalance
19
Q
Nystagmus
A
Rapid involuntary eye movements
20
Q
A common type of vertigo that is caused by a disruption of the orientation of ear otoliths with changes in head position is called what?
A
Benign paroxysmal positional vertigo (BPPV)
21
Q
What is Ménière’s disease?
A
Disorder of endolymph accumulation in the ear.
Symptoms are tinnitus, vertigo, imbalance, aural pressure and hearing loss
22
Q
Blindness affect Black Americans more than other races. T/F
A
True
23
Q
Uncontrolled hypertension, artherosclerosis, CVA (stroke), and uncontrolled diabetes mellitus can all contribute to vision loss T/F
A
True
24
Q
What is the leading cause of blindness in the US
A
Uncontrolled diabetes mellitus
25
What is cranial nerve 1?
Olfactory- sense of smell
26
what is cranial nerve 5?
Trigeminal nerve-
motor and sensory nerve
motor is temporal and masseter.
sensory has 3 divisions of face ( ophthalmic, maxillary, and mandibular)
27
What is cranial nerve 11?
Spinal accessory nerve.
motor movement of sternocleidomastoid (SCM) and Trap muscles.
28
What is cranial nerve 7?
Facial nerve- motor and sensory
facial expression eyes closing and mouth closing.
taste on anterior 2/3 of tongue.
29
what is cranial nerve 12
hypoglossal- motor
tongue movement
30
What is cranial nerve 9?
Glossopharyngeal.
motor- pharynx
sensory-TASTE!
pharynx, posterior eardrums and posterior tongue
31
what is cranial nerve 10?
Vagus nerve. sensory and motor
motor- palate, pharynx, larynx
sensory- pharynx and larynx
SWALLOWING
32
What is cranial nerve 8?
vestibucochlear nerve.
HEARING AND BALANCE
33
What is cranial nerve 3?
Oculomotor nerve.
raises upper eyelid,
PUPIL CONSTRICTION
34
What is cranial nerve 2?
Optic nerve.
only sensory
VISION
35
What is cranial nerve 6?
Abducens nerve. -motor-
lateral deviation of eyes.
36
What is cranial nerve 4?
Trochlear nerve. -motor-
downward, internal rotation of the eye.
37
Does cartilage contain blood vessels?
No
38
What are interventions for fractures?
Ice packs; pharmacological therapy to reduce swelling, pain and prevent infection; immobilization with splint, brace, cast or traction; surgery to stabilize bone or replace fractured bone.
39
What is multiple sclerosis?
Autoimmune disease that causes damage to the myelin sheath around nerve.
Symptoms :
Loss of balance, muscle spasms, numbness/ tingling, tremor/weakness in arms/legs, bowel/bladder problems, eye/hearing/speech problems, cognitive defects.
40
What is bradykinesia
Slowness of movement due to muscle rigidity
41
Parkinson’s disease
Motor system disorder caused by the lack of dopamine in brain and imbalance with a normal amount of acetylcholine.
42
What are the 5 Ps of neurovascluar assessment?
Pain
Pallor
Pulses
Paresthesia
Paralysis/ paresis(weakness)
43
With Axillary crutches, the body weight is supported by ?
Wrists.
44
Stereognosis is?
The ability to perceive and understand an object through touch.
45
What is impulse conduction
The transmission of an impulse along the nerve pathways to the spinal cord and directly to the brain.
46
Which cranial nerve is responsible for chewing?
Cranial nerve 5- trigeminal.
47
If a patient cannot feel any sensation of their upper or lower eyelid, cheek and scalp or tongue. What nerve would be affected?
Cranial nerve 5- trigeminal.
48
Which sensory perceptions are associated with internal stimuli ?
Gustatory, visceral, stereognosis
49
When testing the 6 cardinal fields of vision, what nerves are being assessed
Nerves 3,4,&6
Occulomotor, trochlear, and abducens
50
What neurosensory assessments are included when testing a patients sensory function?
Distinguishing sharp from dull
Hot and cold sensation
Identifying vibration
Testing kinesthesia
51
What visual problem is most commonly diagnosed in school-age children
When they have difficulty reading.
Convergence
52
A patient has hyperlipidemia, what assessment is most associated with this that you would find when observing the eyes?
Xanthelasma
(Yellow plaques on or near lid margins)
53
A hordeolum is what?
A sty. Commonly cause by a staph infection
54
Treatment for glaucoma includes medications to relieve pressure t/f
True
55
A nurse is admitting a client for the treatment of closed-angle glaucoma. What procedure should the nurse anticipate will be performed?
Laser iridotomy to treat closed angle glaucoma.
gonioplasty (iridoplasty)
or peripheral iridoplasty.
56
What is used to treat age-related wet macular degeneration?
Laser surgery and photodynamic therapy
57
What is the major cause of sensorineural hearing deficit?
Noise exposure
58
What equipment should be used to assess an infant client with symptoms related to the ear?
Tympanogram, otoscope, thermometer
59
A tympanogram measure what?
Pressure inside the middle ear.
60
What medication can cause hearing impairment?
Aminoglycosides, alkylating agents, loop diuretics, and salicylicates
61
What client would benefit from a hearing aid?
A client with stenosis in the ear canal.
(Conductive hearing loss)
62
What is conductive hearing loss?
Conductive = obstruction of ear canal; impacted cerulean, perforated tympanic membrane, fluid, scarring, edema or stenosis of the canal
63
What is sensorineural hearing loss?
Disorders that affect inner ear, auditory nerve, or auditory pathways. The receptors aren’t picking up the stimuli correctly.
64
A family is learning to communicate with a member who has hearing loss. Which technique uses hand shapes to represent sounds?
Cued speech.
8 hand shapes represent consonant sounds and 4 positions about the face that represent vowels.
65
What communication technique for hearing impairment uses speech and sign, finger spelling, lip reading, and residual hearing simultaneously.
Total communication
66
Longer phrases are easier to understand than short ones for hearing impaired. T/f?
True
67
A hearing screening is done on an infant prior to discharge after delivery. T/f?
True
68
How far away can a newborn visually focus on objects?
8-10 inches away from them
69
What is myringotomy?
Common procedure of inserting ear tubes in young children with recurrent otitis media.
70
Who is otoacoustic emissions hearing testing performed on?
Almost exclusively on infants
71
What is audiometry?
Testing that evaluates hearing loss
72
If a patient has abnormal test results for a kinesthesia test what would be the most likely causative factor associated?
Lesion on the posterior column of the spinal cord.
73
What is tonometry measure?
Intraocular pressure
74
What is a fundoscopy?
visual inspection of the optic fundus using an ophthalmoscope.
75
What is Gonioscopy differentiate?
open-angle from closed angle glaucoma.
76
What is the Amsler grid used for?
as a diagnostic tool for AMD.
77
Are there medications available for treating cataracts?
No
78
What optic conditions can surgery treat?
cataracts, glaucoma, and wet AMD.
79
What are the most common surgical procedures used for glaucoma management?
Trabeculoplasty and trabeculectomy filtration surgery.
80
What is the most common form of glaucoma?
Open Angle. it is due to the decreased outflow of the aqueous humor.
it is gradual.
81
extreme eye pain, accompanied by headaches, blurred vision and nausea could indicate what?
closed-angle glaucoma. It is a medical emergency. notify HCP.
82
What is the normal Intraocular pressure reading range?
10-21 mmHg
83
What does a patient want to avoid post optical surgery?
Anything that increases pressure:
coughing, sneezing, bending down at waist, lifting heavy objects, nausea and vomiting, valsalva maneuver (bearing down), anticholinergics (dries body out) -includes benedryl (drying).
avoiding constipation is a priority.
84
explain laser trabeculoplasty to a client.
"It improves the flow of the fluid in your eye and decreases the pressure within your eye."
85
what the worst that can happen from macular degeneration?
"Scar tissue may result from repeated bleeding episodes, leading to permanent loss of central vision."
86
what are some manifestations of a detached retina?
Floaters: irregular spots or dark lines in the field of vision
Blurred vision
Flashes of light
Progressive deterioration of vision
Sensation of a curtain or veil being drawn across the field of vision.
"hairnet like vision"
If the macula is involved, loss of central vision
87
what are risk factors for glaucoma?
long term steroid use
age
heredity
race
myopia
HTN
diabetes
thin corneas
88
What are 3 key signs for Menieres Disease?
tinnitus
unilateral hearing loss
vertigo.
89
what is Menieres disease?
Buildup of endolymph fluid interferes with the normal signals between the inner ear and the brain, causing the symptoms of Ménière disease.
90
Are there daily medications that can be used to treat macular degeneration?
no.
91
The nurse is instructing a client newly diagnosed with glaucoma on self-administration of eye medication. With which type of medication should the nurse teach the client to apply pressure over the lacrimal sac?
topical beta-adrenergic blocking agents. This is important to prevent systemic absorption of the medication.
92
why are Clients with nonexudative macular degeneration are not candidates for surgery or use of prescribed eyedrops.
Vision loss is typically not significant, and the disorder progresses slowly. However, there is a risk that the disorder will progress to an exudative stage of the disease.
93
what conditions are contraindicated for beta adrenergic blockers?
asthma, chronic obstructive pulmonary disease, heart block, or heart failure).
94
What are some risk factors for macular degeneration?
Modifiable risk factors include smoking, obesity, poor cardiovascular health, and excessive UV exposure. High alcohol consumption is also associated with a higher risk of developing AMD.
nonmodifiable risk factors include age, race, eye color (lighter eyes), and family history. AMD is seen more frequently in women, likely because they tend to live longer.
95
The physical examination of a client with glaucoma includes...
distant and near vision,
peripheral fields,
and optic nerve cupping on the retina.
96
While assessing a client with eye pain, the nurse finds red, cloudy conjunctiva and swollen eyelids. The nurse should suspect which eye injury?
Chemical burn of the eye.
97
A detached retina is a medical emergency. T/F?
True. - will need surgery
98
Clients with a corneal abrasion usually present with...
intense pain and redness, photophobia, and tearing.
99
what is the difference between penetrating injury and perforating injury?
A penetrating injury has an entrance wound but no exit wound. A perforating injury has both entrance and exit wounds.
100
what nursing interventions are appropriate for a patient who sustained blunt force trauma to their eye?
Place patient in semi-Fowler position.
Protect the injured eye with an eye shield; patch the unaffected eye to minimize eye movement.
Administer carbonic anhydrase inhibitor as prescribed.
101
what diagnostic tests would be expected for a patient who sustained an eye injury?
Fluorescein stain
Facial x-ray
Visual acuity
Computerized tomography (CT) scan
102
Charcot-Marie-Tooth disease
an inherited disease causing peripheral neuropathy through the progressive degeneration of muscles.
103
what are expected diagnostic laboratory tests to investigate the etiology of peripheral neuropathy.
Serum thiamine,
a metabolic panel,
thyroid function tests,
and a complete blood count
104
what are surgical interventions indicated for a client with osteoarthritis?
Arthroplasty, osteotomy, and joint fusion
105
Isometric exercises do what?
low impact strength training that can be safely adapted for people who are mobility impaired.
-yoga, wall sits.
106
what is used instead of joint replacement surgery if the client is young, healthy, and damage is limited to only one side of the joint?
An osteotomy is performed to realign the joint or shift the joint load toward areas of less cartilage damage.
107
what is synovial joint fluid analysis is used to detect?
inflammation, bacteria, and uric acid crystals to rule out inflammatory arthritis and gout.
108
What is a priority for a nurse to address with a client who has osteoarthritis?
chronic pain management
109
What age-related changes to the musculoskeletal system can be expected?
Muscle fiber atrophy
Ligament tears
Flexed position of hips
Decreased joint fluid
110
Prevention strategies for musculoskeletal disorders include
good nutrition, adequate calcium intake, and regular exercise.
111
Which diagnostic test should the nurse expect the client's healthcare provider to order for a patient who is suspected of having nerve problems?
Nerve conduction studies
Electromyography
112
What is an open (compound) fracture?
Skin surface is broken and bones protrude through
113
What are the healing stages of a fractured bone?
Inflammatory stage
Reparative stage
Remodeling stage
114
What is rheumatoid arthritis?
An systemic autoimmune disorder that effects the joints.
115
What diagnostic tests would be performed to confirm Rheumatoid arthritis and rule out other diseases?
Synovial fluid aspiration
Rheumatoid Factor
Erythrocyte sedimentation
116
If a patient comes in with knee pain and the X-ray and MRI were inconclusive. What procedure would you anticipate to occur next?
Arthroscopy.
117
Rheumatoid arthritis signs and symptoms
Joint pain that increases at rest (relief with activity)
Contractures of small joints of hands (fingers)
Symmetrical pain and swelling in the small joints of hands.
