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NCLEX-RN (5) Adult Health > Eye & Ear > Flashcards

Flashcards in Eye & Ear Deck (38)
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1

Name the parts of the eye on the diagram:

  • bottom lid, cornea, iris, pupil, sclera, tear duct, top lid

2

What is tonometry?

Tonometry is a diagnostic test to assess for an increase in the intraocular pressure, which could indicate glaucoma.

3

What is normal intraocular pressure (IOP)?

IOP = 10 to 21 mm Hg

It is higher in the mornings, so document what time it was measured.

4

What are the risk factors for eye and ear problems?

  • aging
  • infections
  • medications - some meds cause blurry vision or ototoxicity
  • trauma and tumors
  • diabetes mellitus increases risk for blindness - due to sugar destroying the small vessels

5

What are the safety precautions for a client with a vision problem or eye injury?

Safety precautions for vision problems or eye injury:

  • no straining
  • don't rub the eye
  • fall precautions

6
Define:

Myopia

Myopia is nearsightedness: the client has trouble seeing objects far away.

7
Define:

Hyperopia

Hyperopia is farsightedness: the client has trouble seeing objects close up.

 

8

What is considered perfect vision?

20/20 vision

9

How should the nurse speak to a client who can't see well or is legally blind?

When interacting with clients that can't see well:

  • orient client to the environment by explaining where things are
  • use the "clock method" of describing where foods are on the plate
  • let client hold onto the nurse's arm when ambulating
  • provide equipment that gives the time orally

10
Describe:

Cataracts

Cataracts are an opacity of the lens that distorts what the client sees that can progress to blindness.

 

 

11

How do clients with cataracts see?

Clients with cataracts have blurry vision and have a harder time seeing color.

12
Treatment:

Cataracts

Cataracts are surgically removed (one at a time) when the vision interferes with the client's ability to function normally.

13
Describe:

Glaucoma

Glaucoma is an increase in intraocular pressure of the eye, which can damage the ocular nerve causing blindness

It occurs later in life and is hereditary.

 

14
Describe:

Acute angle-closure glaucoma

Immediate complication

Acute angle-closure glaucoma is sudden eye pain and possible nausea and vomiting, resulting in blindness.

The client will receive antiglaucoma meds to lower the pressure. 

15

What is the most common type of glaucoma?

Open-angle glaucoma

16
Interventions:

Glaucoma

Interventions for glaucoma focus on lowering the pressure in the eye:

  • give eye drops
    • latanoprost
    • timolol
    • dorzolamide

If meds don't work, possible surgery to drain fluid.

17
Describe:

Retinal detachment

Retinal detachment is the separation of layers in the eye due to too much fluid or a tumor.

If untreated, blindness can occur.

18

What are the characteristic signs and symptoms of retinal detachment?

Signs and symptoms of retinal detachment:

  • flashes of light
  • floaters
  • blurry vision
  • a sense that curtain is being drawn over the eye
  • painless loss of vision

19
Interventions:

Retinal detachment

Interventions for retinal detachment:

  • avoid additional pressure on eyes
  • surgery to drain fluid or remove tumor

20
Describe:

Macular degeneration

Macular degeneration is the loss of central vision more common in the elderly caused by leaking blood vessels.

21
Treatment:

Macular degeneration

Treatment for macular degeneration is possible surgery to seal leaking blood vessels.

22

What are the post-op interventions for eye surgery?

Post-op interventions for eye surgery:

  • keep bed elevated to 30 - 45 degrees
  • maintain an eye patch
  • position belongings on non-operative side
  • fall precautions

23
Teaching:

Eye surgery

Teaching after eye surgery:

  • avoid straining (bending over, constipation, heavy lifting)
  • don't rub the eye
  • administer eye drops
  • contact HCP for signs of infection

24

What are the interventions if a client has a penetrating object in the eye such as sharp metal?

Immediate complication

Interventions for a penetrating object in eye:

  • DO NOT remove the object
  • cover the eye with a cup and tape in place
  • no bending, no straining
  • surgery to remove object

25

What is the intervention if a client gets chemicals splashed in the eye?

The intervention for chemical eye burns is to flush eyes with water for at least 15 to 20 minutes.

26

What is an eye contusion?

An eye contusion is a "black eye" from the result of an injury.

27
Interventions:

Eye contusion

Interventions for an eye contusion:

  • apply an ice pack immediately
  • assess vision and refer to an eye doctor

28

Name the parts of the ear on the diagram:

  • outer ear, inner ear, middle ear and pinna.

29

What are the 2 functions of the ear?

hearing and maintaining balance

30

Which cranial nerve is responsible for hearing and balance?

The 8th cranial nerve

31

What are signs of hearing loss?

  • frequently asking others to repeat statements
  • turning or leaning forward to favor one ear
  • shouting
  • raising the volume on the TV

32

What can occur socially with a client that can't see or hear well?

The client may become isolated due to unable to communicate well, causing depression and anxiety.

33

How does the nurse communicate with a client that can't hear well?

  • use a firm volume, calm and low-pitched voice
  • speak slowly with simple words
  • don't yell or speak in a loud voice
  • stand in front of client and maintain eye contact
  • repeat questions, don't rephrase questions

34

What should never be placed in the ear?

Never put cotton-tipped applicators in the ears such as Q-tips.

It can puncture the eardrum.

35
Teaching:

Hearing aids

Teaching for hearing aids:

  • put volume at minimum and then adjust the volume up to avoid feedback squealing
  • keep hearing aid dry and don't get lotions or sprays on it
  • remove battery when not using
  • don't place on food tray due to risk of getting thrown out

 

36
Describe:

Otitis media

Otitis media is an ear infection typically in the middle ear caused by a blocked eustachian tube.

It is a common complication of a respiratory infection. The treatment is to give antibiotics.

37
Describe:

Meniere's syndrome

Meniere's syndrome is an inner ear disorder that can cause vertigo (dizziness), hearing loss and tinnitus (ringing in the ears).

38

What is the priority intervention for a client with Meniere's syndrome?

Prevent risk of falling due to vertigo.