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NUR 155 med surg > Sensory > Flashcards

Sensory Flashcards

(46 cards)

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1
Q

What is Cataracts

A

opacity in lens

age-related (senile cataracts)
•May be in one or both eyes

altered metabolic processes in lens cause water accumulation and changes in lens fiber structure altering transparency resulting in vision changes

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2
Q

Cataracts signs and diagnosis

A

decreased vision, abnormal color perception, and glare

  • Diagnosis: Ophthalmoscope or slit lamp examination
  • Nonsurgical therapy (temporary); prescription eyewear; visual aids; increased light; change lifestyle
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3
Q

Cataracts nursing care post op

A

Topical antibiotics
Topical corticosteroids
Mild analgesia
Eye patch or shield and activity as prescribed

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4
Q

Cataracts Surgical therapy (outpatient)

A
  • Preoperative: H and P; give anti-inflammatory and pupillary dilating drops
  • Mydriatic—alpha-adrenergic agonist dilation
  • Cycloplegic -Anticholinergic—paralysis of accommodation and dilation
  • Drug Alert: Patients wear dark glasses to reduce photophobia; monitor for systemic toxicity (tachycardia and CNS effects)
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5
Q

Cataracts surgery’s

A
  • Phacoemulsification— dissolve lens ; fragments are removed
  • Extracapsular cataract extraction procedure—remove lens in one piece; requires sutures
  • Intraocular lens (IOL) implantation
  • Administration of antibiotics and corticosteroids
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6
Q

Cataracts post op phase

A

Discharged after sedation wears off
•Postoperative medications: antibiotic and corticosteroids drops

  • Activity restrictions: avoid IOP such as bending, stooping, coughing, or lifting
  • Nighttime shielding
  • Follow-up for visual acuity; may or may not need glasses/lenses
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7
Q

Cataracts nursing assessment

A 
Assess:
•Visual acuity; near and distant
•Psychosocial impact
•Need for teaching
•Planning: Goals
  • Preoperative: make informed decisions, minimal anxiety
  • Postoperative: understand and adhere to therapy, physical and emotional comfort, no complications
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8
Q

Cataracts preventative care and acute care

A
  • No specific preventative measures
  • Wear sunglasses, avoid unnecessary radiation
  • Antioxidant vitamins (C and E); adequate nutrition
  • Acute care:
  • Preoperative care and education
  • Intraoperative: decrease lighting for photophobia
  • Postoperative: Mild analgesia, monitor for complications
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9
Q

Cataracts ambulatory care

A
  • Review instructions with patient and caregiver
  • Most have little visual impairment
  • If significant visual impairment—activity and environmental modifications
  • Use of eye patch: altered depth perception; fall precautions
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10
Q

Cataracts evaluation of outcomes

A
  • Improved vision and self-care
  • Minimal or no pain
  • Optimistic expectations
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11
Q

Retinopathy

A

Microvascular damage to the retina; blurred vision; progressive loss of vision

•Most common with HTN or diabetes mellitus
(Diabetic retinopathy)

  • Nonproliferative—loss of central vision
  • Proliferative—advanced disease; severe vision loss

•Treatment: laser photocoagulation

  • Hypertensive retinopathy
  • Treatment: lower BP to restore vision
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12
Q

Retinal Detachment

A

•Separation of retina and underlying epithelium; fluid accumulation between layers

Breaks—holes (spontaneous) or tears (aging)

photopsia (light flashes), floaters, and cobweb/hairnet or ring in field of vision

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13
Q

Retinal detachment risk factors

A 
Age
Cataracts surgery
Eye trauma
Family or personal history of retinal detachment 
Severe myopia (nearsightedness)
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14
Q

Retinal detachment diagnostic studies

A
  • Visual acuity measurements
  • ophthalmoscope or slit lamp
  • ultrasound
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15
Q

Retinal detachment surgery

A

Surgical therapy—seal retinal breaks by inflammation/adhesion or scar

  • Laser photocoagulation—inflammation
  • Cryopexy—freezing scar
  • Scleral Buckling—band placed around globe
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16
Q

Retinal detachment intraOCULAR procedures

A
  • Pneumatic retinopexy—intravitreal injection of gas to form bubble to close retinal break
  • Vitrectomy—removal of vitreous
  • Postoperative considerations:
  • Bedrest/Activity restrictions
  • Medications: analgesia and topical
  • Patient education
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17
Q

macular degeneration signs and test

A

acute vision loss; blurred or darkened vision, scotomas (blind spots) and metamorphopsia (visual distortion)

•Diagnostic studies: visual acuity measurements; *ophthalmoscopy; Amsler grid test

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18
Q

macular degeneration medication and care

A
  • Medications injected every 4 to 6 weeks into vitreous cavity to stop new vessel formation and slow vision loss
  • Photodynamic therapy (PDT) uses dye and laser to damage abnormal blood vessels
  • Patients must avoid sunlight and intense light for 5 days
  • Nutrition: vitamin C and E; beta-carotene, zinc, lutein
  • Smoking cessation
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19
Q

Glaucoma

Study These Flashcards
A

characterized by increased IOP and subsequent optic nerve atrophy and peripheral visual field loss.

•Early detection and treatment important to prevent blindness

20
Q

Glaucoma Etiology and pathophysiology

Study These Flashcards
A

Aqueous production (inflow) and aqueous reabsorption (outflow) must be balanced to maintain IOP.
•Outflow occurs at angle where iris meets cornea
•Inflow > outflow increased IOP
•Increased IOP permanent loss of vision

21
Q

Glaucoma types

Study These Flashcards
A
  • Primary open-angle glaucoma (POAG)
  • Outflow of aqueous decreased; drainage channels clogged optic nerve damage
  • Angle-closure glaucoma (ACG)
  • Reduced outflow from angle closure
22
Q

Glaucoma signs

Study These Flashcards
A
  • POAG
  • Initially asymptomatic
  • Gradual loss of peripheral vision
  • Late or untreated: tunnel vision
  • ACG—acute
  • Severe, sudden pain in or around eye
  • Nausea/vomiting
  • Colored halos, blurred vision, ocular redness
23
Q

Glaucoma normal IOP and test

Study These Flashcards
A

Normal IOP = 10 to 21 mm Hg

  • Diagnostic studies:
  • IOP measurement
    * POAG—IOP 22 to 32 mm Hg
    * AACG —IOP > 50 mm Hg
  • Slit lamp microscopy
  • Visual acuity measurements
  • Ophthalmoscope: optic disc cupping
24
Q

Glaucoma professional care / surgery’s

Study These Flashcards
A

POAG:
•Argon laser trabeculoplasty- opens outflow

AACG—
•Miotics and hyperosmotic agents
•Laser peripheral or surgical iridotomy

25
Glaucoma nursing assessment
* Ability to understand and adhere to therapy plan * Psychological reaction to sight-threatening disorder * Family support
26
Glaucoma goals
* No progression of visual impairment * Comply with therapy * No postop complications
27
Glaucoma nursing interventions to prevent
•Early detection and treatment •Eye examination: Age 40 to 64 every 2 to 4 years Age 65+ every 1 to 2 years Blacks—more frequent Acute care: •Medication to lower IOP as prescribed •Surgery and postop instructions
28
Glaucoma evaluation of outcomes
No further loss of vision; Adhere to therapy * Safely function in environment * Pain relief
29
Glaucoma Patient education
Occlude puncta to limit systemic absorption of glaucoma medications
30
Corneal Ulcer
infection of cornea resulting in tissue loss •Causes: bacteria, viruses, or fungi *pain and foreign body sensation, tearing, purulent or watery discharge, redness, photophobia * Treatment to avoid permanent vision loss; eye drops every hour for 24 hours * Untreated—scarring and perforation or hole. May require corneal transplant
31
Inner Ear Problems
Manifestations of inner ear disease * Vestibular labyrinth * Vertigo * Auditory labyrinth * Sensorineural hearing loss * Tinnitus
32
Ménière’s Disease
Accumulation of endolymph in membranous labyrinth; progressive genetic and environmental factors
33
Ménière’s Disease signs and symptoms
Excess fluid and pressure hearing and balance problems * sudden, severe attacks of vertigo, nausea, vomiting, sweating; unpredictable * Prior to attack: fullness in ear, tinnitus, and muffled hearing * Some experience feelings of: being pulled to the ground “drop attacks” or whirling in space * Last hours, days; several times/year; variable
34
Ménière’s Disease test
* Audiogram—low frequency sensorineural hearing loss * Spontaneous vertigo on two occasions * Abnormal vestibular tests * Glycerol test
35
Ménière’s Disease care between attacks
diuretics corticosteroids low-sodium diet stress reduction
36
Treatment for vertigo
* Dark, quiet room * Avoid sudden movements * Close eyes during vertigo * Avoid fluorescent, flickering lights, and TV * Emesis basin
37
Patient safety for Ménière’s Disease
* Fall precautions: side rails up, bed low position; call for help for OOB; assist with ambulation * Monitor intake and output; parenteral medication; and fluid administration * Patient education: Protect from injury/falls * Safety measures at home * Exercises for balance
38
Benign Paroxysmal Positional Vertigo (BPPV)
* Vertigo caused by free-floating debris (“ear rocks”) in semicircular canal with head movements * Symptoms: nystagmus, loss of balance, nausea * Diagnosis: auditory and vestibular tests * Treatment: Epley maneuver
39
Labyrinthitis
Inflammation of the labyrinth in the inner ear * vertigo, nausea, vomiting, and possible hearing loss and tinnitus * Treated with bedrest, darkened environment * Meclizine or dimenhydrinate prescribed for nausea and vomiting * Systemic antibiotic therapy may be prescribed
40
Meneires disease treatment
No cure; treatments to reduce frequency and severity of vertigo attacks * Acute attack (decrease abnormal sensations, nausea, and vomiting): corticosteroids, antihistmaines, anticholinergics, and benzodiazepines * Vertigo: bed rest, sedation, antiemetics, or antivertigo
41
Ménière’s Disease surgery
Decompression * Vestibular nerve section * Ablation of labyrinth (unilateral disease) * Gentamicin injections
42
Sensorineural hearing loss
Hearing loss caused by damage to the inner ear or the nerve from the ear to the brain. Sensorineural hearing loss is permanent
43
Tinnitus
Ringing or buzzing noise in one or both ears that may be constant or come and go, often associated with hearing loss.
44
Teaching after eye surgery
- proper hygiene and I care to ensure medication and dressing is not contaminated - signs and symptoms of infection( increase purulent drainage, increased redness, decrease vision) - importance of following restrictions on her position, bending, coughing - How to instill eye medication’s using anti-septic techniques - how to take pain medication Importance of continued follow up
45
Ménière’s disease drug therapy
``` Antichilinergics Antihistamine Antiemetic Bensodiazepines Corticosteroids ```
46
Retinal detachment continuous care
* Monitoring and Education | * Retinal Specialist

NUR 155 med surg (15 decks)

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