Nervous system Flashcards
(186 cards)
1
Q
Brain
controls
generates
CNS
A
controls center of nervous system-
generates thoughts, emotions and speech
2
Q
Hemispheres-
what kinds/lobes
each hemisphere
ie
CNS
A
Left & Right & 4 lobes-
each hemisphere receives sensory and motor impulse from opposite side of body
(Ie right hemisphere receivers impulse from left side of body
3
Q
Left hemisphere controls what
CNS
A
Left side controls language
4
Q
Right hemisphere controls what
CNS
A
non verbal perceptual function
5
Q
Brainstem consists of:
CNS
A
midbrain
pons
medulla oblongata
6
Q
Midbrain function
CNS
A
center for auditory and visual reflexes
7
Q
Pons function
CNS
A
controls respirations
8
Q
Medulla oblongata-
important role in
CNS
A
important role in cardiac rate, blood pressure, respirations and swallowing
9
Q
CSF
liquid/derived from where
forms
helps
CNS
A
- CSF is a clear colorless liquid derived from blood plasma
, forms a cushion for brain tissue and protects the brain and spinal cord from trauma.
Helps nourish brain and remove waste products
10
Q
Spinal Cord-
protected by
serves as
CNS
A
protected by vertebrae,
serves as center for conducting messages to and from brain
11
Q
Meninges-
protective
covers
CNS
A
protective tissue membrane
covers the brain and spinal cord
12
Q
Peripheral nervous system
links
consists. of
A
Links the central nervous system with rest of body
Consists of Nerves, sensory receptors, motor receptors
13
Q
Spinal nerves
contain
31 pairs-
C
T
L
S
C
A
contain both sensory and motor fibers
31 pairs- named by locations-
cervical (8)
, thoracic (12)
lumbar (5),
sacral (5)
, coccygeal 1
14
Q
Reflexes-what are they
A
rapid, involuntary motor responses to a stimulus
15
Q
Olfactory nerve #
function
A
1
sense of smell
16
Q
Optic nerve #
function
A
2
vision
17
Q
Oculomotor nerve #
function
A
3
eyeball movement
raining of upper eyelid
contraction of pupil
proprioception
18
Q
trochlear nerve #
function
A
4
eyeball movement
19
Q
Trigeminal nerve #
function
A
5
sensation of upper scalp, upper eyelid, nose, nasal cavity, cornea and lacrimal galena
sensation of palate, upper teeth, check, top lip, lower eyelid
chewing
20
Q
Abducens nerve #
function
A
6
lateral movement of eyeball
21
Q
Facial nerve #
function
A
7
movement of facial muscles
secretions of lacrimal,, nasal, submandibual and sublingual glands
sensation of taste
22
Q
acoustic nerve #
function
A
8
sensation of equilibrium
sensation of taste
23
Q
glossopharngyleal nerve #
function
A
9
swallowing
gagreflex
sensation of taste
24
Q
vagus nerve #
function
A
10
swallowing
regulation of cardiac rate
regulation of respirations
digestion
sense of taste
25
accessory nerve #
function
11
movement of head and neck
26
hypoglossal nerve #
function
12
movement of tongue for speech and swallowing
27
autonomic nervous system regulates what
internal environment of the body
28
sympathetic division
what is primary trasnmitter
prepares for what
autonomic nervous system
norepinephrine is primary neurotransmitter of sympathetic division-
prepares the body to handle harmful or stressful situations
29
sympathetic division
how will body present
autonomic nervous system
dilated pupils,
increased heart rate/force of heart contraction,
increased glucose release
diaphoresis
30
Parasympathetic Division-
what is primary trasmitter
operates when
autonomic nervous system
acetylcholine is primary transmitter,
operates during non stressful situations,
31
Parasympathetic Division-
what happens when stimulated
autonomic nervous system
constriction of pupils,
decreased heart rate
vasoconstriction of coronary arteries
32
What do diagnostic tests of nervous system used for
nurse is responsible for-(explain/ assess/ signed/ sup)
Help to support diagnosis of specific disease or injury
Nurse is responsible for :
Explaining procedure & special considerations
Assessing medications
Signed consent
Supporting patient
33
Diagnostic Tests of the Neurologic System
Carotid Duplex
CT Scan –used for suspected stroke or looking for blockage/ hemorrhage
EEG
Lumbar Puncture –regularly address dressing site, encourage inc of oral fluids, encourage acetaminophen for back/headaches
MRI
Myelogram
PET scan
34
Health Assessment Interview
consider what-
interview-questions?
what testing
Consider genetic influences-many neurologic diseases have a genetic component due to inheritance of a gene or gene mutation,
Interview- questions to ask?--- ask about family history, health problems related to neurological disorders, history of disorders like- seizures, ALS,MS, Parkinson, tremors, past history of dizziness, headaches, trauma, or injury
Genetic testing, counseling if data collected indicates risk factors or alterations
35
Neurological Physical Assessment
Mental Status,
cranial nerve assessment,
sensory assessment,
motor function,
reflexes
Vitals,
assesses level of consciousness,
pupillary response,
strength,
sense
pain/touch
36
Glasgow Coma Scale
what is it
assessment of what
score of 15 is what
–objective tool used to describe extend of impaired consciousness,
Assessment of eyes open, best motor response, best verbal response
Score of 15 indicates patient is alert and oriented; highest level of functioning
37
Decorticate
manifestations
arms
wrists
legs
feet
you will see upper arms are close to sides,
wrists and fingers are flexed,
legs internally rotated
feet plantar flexed
38
Decorticate
cause
posture that occurs with lesions of cortical spinal tract
39
Decerebrate manifestaitons
arms
wrists
feet
arms pronated and extended,
wrists that are flexed
feet plantar flexed,
40
Decerebrate cause
posture that occurs with lesions/injures to brain stem-midbrain or pons
41
Aphasia-
defective/ absent language function
42
Dysphonia –
change in tone of voice
43
Dysarthria
–difficulty speaking
44
Dysphagia
–difficulty swallowing
45
Anosmia
– inability to smell
46
Nystagmus
involuntary eye movement
47
Ataxia
lack of coordination/ clumsiness
48
Flaccidity
muscle tone is decreased or absent causing extremities to drift in strokes or loss of tone d/t consequences of stroke
49
Spasticity
–muscle tone increased- tightening of muscles-seen in MS and cerebral palsy
50
Consciousness
individual is aware of self/environment and they respond appropriately
51
altered level of consciousness
looking at
Level of consciousness
Pupillary response
Oculomotor response
Motor response
Breathing
52
AEIOU
altered loc
alcohol,
epilepsy,
insulin,
opium,
uremia(high levels of urate in blood)
53
T-I-P-S-S
what causes altered loc
tumor,
injury,
psych,
stroke,
sepsis
54
Full consciousness-
Decreased LOC
alert and orientated, can comprehend
55
Confusion-
Decreased LOC
patients are unable to think rapidly or quickly
56
Disorientation-
Decreased LOC
not aware, nor orientated to time place or person,
57
Obtunded
Decreased LOC
- lethargic but react to stimuli and drift back to sleep
58
Stupor-
Decreased LOC
briefly affected by painful stimuli
59
Semicomtatose-
Decreased LOC
do not move spontaneously, stimuli may cause moaning, but withdrawal right away
60
Coma
Decreased LOC
- unarousable, make no attempt to withdrawal
61
Deep coma
Decreased LOC
- absence of reflexes
62
what is a seizure
abnormal
may result
Its an Abnormal electrical activity
may result in abrupt altered stated of function
63
epilepsy
partial seizure
generalized seizure
Epilepsy- seizure disorder, chronic
Partial Seizure may affect only part of brain
Generalized Seizure affects all of brain
64
MRI & CT-
Seizures- Diagnosis
Abnormalities in brain
65
EEG-
Seizures- Diagnosis
helps to localize any brain lesions and confirm diagnosis
66
Lumbar Puncture-
nursing considerations
assess
encourage
backpain/headahce
Seizures- Diagnosis
assess spinal fluid for CNS infections
Nursing Considerations??
assess dressing site
encourage increase of oral fluids
acetaminophen for back pain/ headache
67
labs
Seizures- Diagnosis
Look at
Blood count,
electrolytes,
blood urea,
glucose
68
Antiepileptic drugs
dont cure-rather they
limits
Seizures- Medications
- don’t cure; rather they: reduce/ control activity- it will raise the seizure threshold,
which limits the spread of abnormal activity in the brain
69
Goal->seizure meds
protect
reduce
allow
focus
need
protect from harm,
reduce/prevent activity-will be lethargic
, allow pt to rest,
focus on safety and positioning if another seizure,
need to lay on side
70
Seizures- Medications
Phenytoin
phenobarbital,
valproic acid
lamotrigine
gabapentin
71
Seizures- Medications
considerations:
minimum
dosing
not always
frequent
Pt will be on for minimum of three years – if Seizure free, withdrawal may be considered by reducing one drug at a time over several weeks/months
Dosing-need to take exact dose
Not always well tolerated-ca cause decreased alertness, headache, dizziness,
Frequent blood monitoring-make sure they have decreased blood levels, need to do liver function test
72
health promotion seizures
what care
stress importance of
vehicles
family teaching
Follow up care,
Stress importance of taking, scheduling, considering and continuing medications even if no seizure activity
Vehicles –may be prohibited and reinstated after prover has cleared them
Family teaching-first aid
73
positioning during episode
positioning after episode
Positioning during episode cushion- head if seizure, loosen anything tight around neck, turn head and body to side and call for assistance
Positioning after episode –let them rest, but lay on side in case of another seizure
74
ineffective airway clearence-seizures
what happens
what pools
pt airway interventions-clothing/ turn/ dont put/ may need
Tongue falls back, obstruct airway –Gag reflex depressed
Secretions pool
Patent airway interventions: risk for aspiration- loosen clothing, turn to side, do not put anything in mouth and may need oxygen
75
anxiety/knowledge-seizures
provide support
identify
medical identification
watching
avoiding
Provide support –emotional, mental, physical
Identify safe activities –identify safe activities when shower or bathing
Medical identification-bracelet or card
watching Triggers/aura
Avoiding alcohol/coffee
76
heachace
pain where
results from
Pain within the cranial area
Result from ->benign or pathologic conditions such as stress, tension or disease process
77
Migraine
what is it
ignited by
accompanied by
- recurring primary headache,
initiated by trigger,
accompanied by neurologic dysfunction
78
Cluster Headache s/s
severe or burning,
poking sensation in or directly around the eye causing the eye to water
79
headache
based on->
diagnostic tests to rule out structural disease processes->
Based of history & physical, symptoms, precipitating events
Diagnostic tests to r/o structural disease processes mri, xray, eeg, lumbar puncture
80
Sumatriptan
binds
rapidly effective
medication headache
binds with serotonin receptors
rapidly effective when given in onset of migraine
81
Once migraines are in progress
meds
narcotics/antiemetics may be prescribed
82
what helps to decrease incidence of headaches
when wake up
no
avoid
when wake up, eat meals, get regular exercise,,
no artificial sweeteners or msg
Avoid stimulates & food high in tyramine avoid smoked meats, beers, alcohol, chocolate or caffeine
83
Alzheimer's- Overview
Form of dementia-
progressive, irreversible deterioration of intellectual functioning
84
stages 1-7 alzheimers
Stage 1- no cognitive impairment
Stage 2- Very mild decline
Stage 3-Mild cognitive decline
Stage 4- Moderate cognitive decline
Stage 5- Moderately severe cognitive decline
Stage 6- Severe cognitive decline
Stage 7- Very severe cognitive decline
85
diagnosis of Alzheimers
No specific diagnostic test- can have postmortem examination of brain tissue
History and physical, identifying if reversible or treatable
86
Alzheimer medications-> use
what meds
Medications slow the progression of cognitive decline
Donepezil (), memantine ()
87
Priorities in care alzheimers
top priority
risk for injury
con
daily
caregiver
Top Priority: optimize environment to patients functional level
Risk for injury- SAFETY!!- need protective measure to keep them safe as they decline
Continuity of care
Daily routines
Caregiver, role strain
88
Multiple Sclerosis- what is it
What is it? A chronic disease of the CNS (Brain, nerves, spinal cord)
89
Multiple Sclerosis- patho
response
destroyed
slows/distorts
autoimmune response,
the myeline sheath that protects nerve fibers are destroyed,
demyelination slows and distorts impulse transmission
90
manifestations for MS
vary->
manifestations
Manifestations vary- depending on area of nervous system involved
Sensory loss, visual deficits, weakness, paresthesia, ataxia, vertigo
91
Multiple sclerosis
exacerbations
remission
end result
Exacerbations- manifestations present,
remission- manifestations not obvious
end result- total loss of function
92
Diagnostic Test MS
MRI –may show lesions
Cerebral spinal fluid analysis –lymphocytes indicating an immune response or increased igg
CT Scan-may reveal atrophy in white matter lesion
93
One of the following criteria has to be met
MS
two
history
slowly
Two or more exacerbations separated by 1 month or more and lasting more than 24 hours, followed by recovery
A history of repeated exacerbations and remissions with out without complete recovery; progression of symptom severity
Slowly increasing manifestations for at least 6 months
94
multiple sclerosis medications are used for
treat
modify
interrupy
surgery ->
1. treat manifestations
2._modify course of disease
3-interrupt progression of disease
surgery ->indicated for severe spasticity and deformity
95
Immunomodulators-
meds
given for
monitor
assess/ rotate
report
Multiple sclerosis
interferon,
given to prolong onset of disability,
monitor liver function tests, cbc
assess / rotate injection sites
report any feelings of suicide/self harm
96
Adrenocorticosteroid-
type of meds
given to treat
avoid
doses
labs
take when
Multiple sclerosis
"prednisone”-
given to treat exacerbations of ms, suppress immune system,
avoid crowds
taper doses
labs- inc glucose
take in morning
97
Muscle Relaxants-
meds
receives/supress
can have
change
maintain
Multiple sclerosis
“baclofen, diazepam,
-relieves muscle spasms, suppress cans reflexes
can have sedative effects-monitor fall precautions,
change positions slowly
maintain safety-fall precautions
98
Immunosuppressant-
meds
what does
assess
watch for
protect against
increase
labs
Multiple sclerosis
imuran, methotrexate,
suppress immune system
assess anemia/fatigue
watch for bleeding,
protect against infection
increase fluids
labs- CBC and urine
99
Multiple sclerosis
watch what
fatigue->
components
Nursing Care: Health Promotion
watch Nutrition, Dietary needs, Weight
Fatigue ->low blood counts, medications that cause sedative effect, poor nutrition, overall muscle weakness
Psychosocial components
100
Multiple sclerosis fatigue rehab
assess
arrange
ask
perform
avoid
releive
refer
assess fatigue
arrange daily activites to promote rest
ask patents for priotites
perform taks in morning
avoid extreme temps
receive pain
refer to apporpatite professionals
101
Parkinson Disease-
degenerative
characterized by
Degenerative neurologic disorder- progressive
Characterized by tremors, muscle rigidity, bradykinesia (slow movement), postural instability
102
Tremor
manifestations parkinsons
at rest, starts on one side and progresses to both, affects dexterity and fine muscle control
103
Rigidity & Bradykinesia
manifestations parkinsons
slow movements, making passive and active movements difficulty, difficulty starting, continuing and coordinating movements –shuffling gait
104
Abnormal posture
manifestations parkinsons
flexion of head makes It difficulty to maintain upright position
105
Autonomic & Neuroendocrine
manifestations parkinsons
elimination problems, blood pressure issues and skin changes
106
Mood & Cognition
manifestations parkinsons
high incidence of depression rt dimension
107
Sleep disturbances->
manifestations parkinsons
difficulties falling asleep and staying asleep
108
diagnosis of Parkinson's
cardinal signs
H&P,
having 2/3 cardinal signs-
tremor at rest, bradykinesia, rigidity
109
is there cure
meds do what
Pt/ot/st
Parkinson's
No cure; medications improve debilitating manifestations
PT/OT/ST-focusing on strength, tremor control and activities that strengthen and control muscles on affected side
110
Dopamine Precursors- Carbidopa- Levodopa-
how does it work
makes what
improves /decreases
Parkinson's meds
carbidopa makes more levodopa for the brain
–which improves mobility and decreased muscle rigidity and tremors
111
Dopamine Precursors-Carbidopa-Levodopa
nursing repsosiblites -s/e
Psychological reactions
Parkinson's meds
s/e- nausea vomiting, orthostatic hypotension
Psychological reactions- hallucinations and vivid dreams
112
Dopamine Agonists-Ropinirole//Pramipexole
mimics/increases
equals
How does it work??
Parkinson's meds
Mimics role of dopamine in brain and increases effects of levodopa,
which equals a reduction of symptom fluctuation
113
Dopamine Agonists-Ropinirole//Pramipexole
nursing repsobilites
Parkinson's meds
Can cause compulsive behaviors
114
Anticholinergics-Benztropine
blocks
used to ease
how does it work
Parkinson's meds
Blocks excitatory action of acetylcholine ,
used to ease side effects like drooling, tremors and rigiity
115
Anticholinergics-Benztropine
nursing responsibilities
mouth
can have
changes
assess for
increase
check
Parkinson's meds
Dry mouth,
can have. Urinary retention
mentation changes
assess for other meds that have anticholinergic effect
inc fluids
check I and o
116
Parkinson's preventative measure of complications
Malnutrition,
falls,
skin breakdown,
constipation,
safety
117
parkinsons education
how to
take
incrase
slow
limit
increase
how to improve sleep
take meds
increase protein
slow positional changes
limit alcohohol
increase fluids
118
Amyotrophic lateral sclerosis (ALS)
what is->rapid
muscle
aka
incidence
Rapid progressive and fatal degenerative neurologic disease
Muscle weakness and wasting, fatigue
AKA lou Gehrigs disease
Incidence high in men vs women, middle to late age
119
survival after onset
ALS
2-5 years dt repository failure and decreased repository function
120
complications of ALS
communication dysfunction
, muscle dysfunction needed for respiratory support
swallowing issues
121
ALS- Musculoskeletal Manifestations
fatigue,
progressive muscle weakness,
twitching of muscles
122
ALS- Respiratory Manifestations
difficultly clearing airway,
complications such as pneumonia, respiratory failure and often death is due to decreased function
123
ALS- Nutritional Manifestations
difficulty chewing,
aphasia
ultimately malnutrition
124
ALS-
emotional
Manifestations
loss of control can lead to depression
125
goals for als
r/t decreasing complications r/t respiratory status & mobility
126
Risk for disuse syndrome ALS
at risk for
altered
cannot move
At risk for developing problems associated with bedrest
Altered nutrition and hydration status
Cannot move and reposition self, at risk for risk for breakdown, reposition every 2 hours
127
Stroke/CVA
Emergency condition->results from
neurologic deficits result from sudden decrease in blood flow to area of brain
128
risk factors for stroke/cva
Hypertension,
a fib,
hyperlipidemia,
sleep apnea,
smoking,
family history,
obesity
129
Ischemic stroke
thrombotic
stenosis
embolic
Thrombotic-blockage dt blood clot fat,
stenosis dt plaque
embolic stroke dt a fib
130
Hemorrhagic stroke
blood vessel ruptures,
spilling blood into surrounding area
131
what is used for stroke when looking for blocking/ hemorrhage
ct scan
132
Manifestations stroke
onset
left hemisphere
right hemisphere
FAST
glucose->
Sudden in onset, focal and usually one-sided
Left hemisphere– right sided deficits, drifts
Right hemisphere- left sided deficits , drifts
FAST- Face, Arm, Speech (aphasia), Time-quick assessment, monitor repository status, pulse ox and treat as needed
Low glucose can mimic sign of stroke
133
Visual Complications:
Hemianopia
Homonymous Hemianopia
Complications Related to Stroke
Hemianopia- Loss of half of visual field of one or both eyes
Homonymous Hemianopia- visual loss in the same half of the visual field of each eye
134
Cognitive & behavioral Complications:
agnosia->
Consciousness:
loss
decreased
poor
Complications Related to Stroke
Agnosia-> inability to identify objects or people
Memory loss,
decreased attention,
poor judgemen
135
behavior changes->
Consciousness->
Complications Related to Stroke
Inability to control emotions
Consciousness-> ranging from mild – coma
136
Aphasia-
inability
common
Communication Disorders
Complications Related to Stroke
inability to use or understand language;
common with CVA
137
Expressive
can
can only
Communication Disorders
Complications Related to Stroke
- can understand what is being said,
can only respond verbally in short phrases and can be garbled
138
Receptive
cant
speech
Communication Disorders
Complications Related to Stroke
- can not understand spoken world or written word,
speech is fluent but inappropriate in content
139
Mixed/global-
dysfunction
Communication Disorders
Complications Related to Stroke
dysfunction in both understanding and expression
140
stroke may cause
change in
Elimination Disorders
Complications Related to Stroke
Stroke may cause loss of sensation that trigger elimination
Change in bowel elimination –watch bowel regimen and if they need anything
141
Urinary frequency, urgency or incontinence –
offer
how often/why
offer means of urinary elimination via urinal, commode
– do this every 2 hrs to make urinary schedule and prevent skin breakdown
142
Stroke interrupts
produces
Motor Deficits
Complications related to Stoke
Stroke interrupts component of relay system
produce effects to opposite side in which structure/condition occurs
143
Hemiplegia
Hemiparesis
Complications related to Stoke
Hemiplegia- paralysis of left or right side of body
Hemiparesis- weakness of left or right side of body
144
Assistive device safety
Complications related to Stoke
how to move walker,
how to move weak/affected side first followed by strong side
145
Neglect syndrome- cannot
interventions-utilize/ promote/ dressing
Complications related to Stoke
cannot integrate and use perceptions from affected side of body
Interventions:
utilize and encourage unaffected side use
Promote use of assistive devices
Dressing-dress affected side first
146
Diagnosis stroke
Complete history and physical- neuro exam
ct scan
147
Medications stroke
used to treat
gabapentin
used to treat during acute phase, to prevent further thrombosis, increase cerebral blood flow
gabapentin can be given to prevent seuizures
148
Fibrinolytic therapy- TPA (tissue plasminogen activator)
converts
given
need
contraindicated
Converts plasmogin to plasmin resulting in breaking of the clot
Given within.3 hrs of onset
Need a ct scan to confirm its not hemorrhagic
Contraindicated in recent head injury
149
surgery for stroke
helps
repair
removal
help restore blood flow,
repair vascular damage,
removal of clot
150
Medication management & Prevention
what drugs
drugs do what
Nursing considerations????
daily
prevent seizures w/
stroke
Clopidogrel //ticlopidine
Drugs to prevent clot formation/vessel occlusion
Nursing considerations???? Look for bleeding, epistaxis,
Daily low dose aspirin
Prevent Seizures- Gabapentin
151
Stroke nursing education
exercises
use what adl
check
bladder
sit eating
keep
ROM exercises
use unaffected arms for aDL
check for pocketing of food
bladder training with kegels
sit upright when eaating
keep objects on unaffected side
152
Conjunctivitis-
what is it
Eye Conditions/Disorders
inflammation of conjunctiva
153
Conjunctivitis-
diagnosis
Eye Conditions/Disorders
culture and sensitivity
Fluorescein stain
Conjunctival scraping
154
Conjunctivitis-why is accurate diagnosis important
Eye Conditions/Disorders
important be use other potentially vision threatening conditions can cause red eyes
155
Conjunctivitis-health promotion
wash
do nont
avoid
contact
when inflamed
Eye Conditions/Disorders
wash hands before administering meds
do not share towels or makeup
avoid rubbing/scrathing
contact lens care
reduce lighting and wear sunglasses and dont use contact when onflammed
156
Cataracts-what is it
Eye Conditions/Disorders
clouding of lens of eye
157
Cataracts manifestations
color
visual
difficulty
Eye Conditions/Disorders
color discrimination is impaired
visual acuity down, affecting close and distance
difficulty adjusting to dark/light
158
Cataracts
c
a
t
a
r
a
c
Eye Conditions/Disorders
Congenital
Aging
Toxicity
Accidents
Radiation
Altered metabolism
Cigarette smoking
159
cataracts post surgery
eye
do not
place in
avoid
eye patches/sheilds
do not touch/ scratch/ squeeze
place in semi/ fowlers
avoid coughing, sneezing, straining
160
Glaucoma-what is it
Eye Conditions/Disorders
optic neuropathy
increase intraocular pressure
161
Glaucoma-open angle manifestaitons
Eye Conditions/Disorders
Open-angle glaucoma is painless, with gradual loss of visual fields
162
Glaucoma-closed angle manifestaitons
pain
/
colored
abrupt
Eye Conditions/Disorders
eye pain
nausea vomiting
colored halos
abrupt decrease in visual acuity
163
Glaucoma-diangoses
Eye Conditions/Disorders
tonometry
Fundoscopy
Gonioscopy
Visual field testing
164
Macular Degeneration-what is it
Eye Conditions/Disorders
degeneration of retina
165
Macular Degeneration-manfiestations
central
straight
initially
Eye Conditions/Disorders
central vision is blurry
straight lines appear wavy/ distorted
initially is one eye
166
Macular Degeneration-nursing care
large
increase
magnify
visual
Eye Conditions/Disorders
large print
increase lighting
magnifying glass
visual aids
167
Macular Degeneration-health promotion
reduce risk w
quit
vitamins
Eye Conditions/Disorders
reduce risk w/ omega 3
quit smoking
vitamins c and e slow progression
168
Retinal Detachment-
seperation
_or_
Separation of the retina of the eye from the pigmented vascular layer
Trauma or spontaneously
169
Retinal Detachment
Manifestations
floaters,
spots,
curtain is drawn across visual fields
170
Early intervention
vital
will need
Retinal Detachment- overview
vital to preserve sight,
will need surgery
171
Positioning the patient-eyedissorder
important
lateral
position so
important until intervention can take place!
Lateral positioning on affected side
Position so affected eye is inferior- this allows posterior portion of eye to place pressure on detached area; bringing retina closer in
172
Otitis externa
inflammation
most prevelant
inflammation of the ear canal, “swimmer’s ear”
_most prevalent in people who spent a lot of time in water
173
Otitis externa
etiology
Bacterial infection
, fungal infection,
local hypersensitivity reaction,
trauma
174
Otitis externa
Manifestations:
Feeling of fullness in ear,
pain,
drainage,
inflamed and edematous ear canal
175
Otitis externa
Treatment:
cleansing
anti
meds
Cleansing ear canal,
local or systemic antibiotics,
meds for pain/itching may have topical steriod__
176
Otitis media:
middle ear
commonly
infection
dysfunction
inflammation or infection of middle ear,
most commonly in infants and children
Upper respiratory infection
eustachian tube dysfunction
177
Serous otitis media
auditory tube
impairing
auditory tube is obstructed for prolonged time,
impairing pressure equalization(popping in ear)
178
Acute otitis media-
edema
prevents
causing
edema of auditory tube
prevents drainage of middle ear
causing mucus and fluids to accumulate
179
Otitis media- manifestations
Mild to severe pain
Elevated temperature
Diminished hearing, dizziness, vertigo, tinnitus
Tympanic membrane red and inflamed or dull and bulging
180
Otitis media- treatment
Short course of steroids
Antibiotics- finish course
Symptomatic treatment: analgesics, antipyretics
Surgery
181
Mastoiditis-
Mastoid process
portion of the temporal bone that lies adjacent to the middle ear. Contains the mastoid sinuses.
182
Mastoiditis-
infection
effective
if treatment is ineffective
Infection of acute otitis media generally extends into the mastoid sinuses.
Effective treatment of otitis media usually eliminates infection of the mastoid sinuses.
If treatment is ineffective = acute mastoiditis
183
Mastoiditis- Manifestations
develop when
recurrent
tenderness
possible
others
usually develop 2-3 weeks after an episode of acute otitis media
Recurrent earache and loss of hearing
Tenderness over mastoid process,
possible redness and inflammation
Fever, tinnitus, headache, profuse ear drainage
184
mastoiditis treatment
Aggressive antibiotic therapy
Mastoidectomy if at high risk for spread of infection to the brain
185
Meniere’s Disease-
manifestations
; vertigo,
unilateral hearing loss,
tinnitus
186
Meniere’s Disease-
Treatment/Medications-
rest
diet
meds
surgery
Bedrest during vertigo attacks, safety/help
Low sodium diet to reduce pressure
Medications- diuretics, depressant, antivertigo/antiemetic
Surgery- shunt to eliminate pressure
