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Med-Surge 2 Exam 2 > Sensory > Flashcards

Sensory Flashcards

1
Q

refraction

A

Bends light rays from the outside into the eye through curved surfaces and refractive media and finally to the retina

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2
Q

pupillary constriction

A

Constriction and dilation control the amount of light that enters the eye

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3
Q

Accommodation

A

Allows the healthy eye to focus images sharply on the retina whether the image is close to the eye or distant

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4
Q

Convergence

A

The ability to turn both eyes inward toward the nose at the same time

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5
Q

Coordinated eye movements ensure that both eyes…

A

eyes receive an image at the same time so only a single image is seen

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6
Q

The muscles around the eye are innervated by cranial nerves

A

III oculomotor
IV trochlear
VI abducens

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7
Q

the optic nerve II is

A

the nerve of sight, connecting the optic disc to the brain

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8
Q

the trigeminal nerve V stimulates

A

the blink reflex when the cornea is touched

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9
Q

the facial nerve VII innervates

A

the lacrimal glands and muscles for lid closure

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10
Q

Vision testing:

A

visual acuity tests to measure both distance (using the Snellen eye chart) and near vision (using the Rosenbaum Pocket Vision Screener)

Record findings as a comparison between what the patient can read at 20 feet and the distance that a person with normal vision can read the same line

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11
Q

Arcus senilis

A

an opaque, bluish white ring within the outer edge of the cornea, is caused by fat deposits

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12
Q

presbyopia

A

near objects, especially reading material must be placed farther from the eye to be seen clearly

age-related problem which the lens loses its elasticity and is less able to change shape to focus the eye for close work

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13
Q

ectropion

A

the lower eyelid may relax and fall away from the eye, leading to dry eye manifestations

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14
Q

structural changes occur with aging including…

A

decreased eye muscle tone that reduces the ability to keep the gaze focused on a single object

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15
Q

how does the clarity and shape of the cornea change with age

A

The cornea flattens, and the curve of its surface becomes irregular. This change causes or worsens astigmatism and blurs vision

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16
Q

with age, the iris has less ability to dilate which…

A

which leads to difficulty in adapting to dark environments

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17
Q

emmetropia

A

is the perfect refraction of the eye in which light rays from a distant source are focused into a sharp image on the retina

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18
Q

Hyperopia (farsightedness)

A

occurs when the eye does not refract light enough; as a result, images actually converge behind the retina

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19
Q

hyperopia signs and symptoms

A

Distant vision is normal
Near vision is poor

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20
Q

hyperopia treatment

A

Corrected with a convex lens in eyeglasses or contact lenses

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21
Q

Myopia (nearsightedness)

A

occurs when the eye overbends the light and images converge in front of the retina

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22
Q

myopia signs and symptoms

A

Near vision is normal
Distance vision is poor

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23
Q

myopia treatment

A

Corrected with a biconcave lens in eyeglasses or contact lenses

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24
Q

Astigmatism

A

is a refractive error caused by unevenly curved surfaces on or in the eye, especially of the cornea. These uneven surfaces distort vision
Because light rays are not refracted equally in all directions, the image does not focus on the retina

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25
Q

Astigmatism nursing interventions

A

Eyeglasses
Contact lenses
Laser in-situ keratomileusis (LASIK) surgery or photorefractive keratectomy (PRK)
Both procedures can correct nearsightedness, farsightedness, and astigmatism
Powerful laser pulses reshape the deeper corneal layers

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26
Q

blindness

A

is having best corrected visual acuity that can range from 20/400 to no light perception. Legally defined by visual acuity with corrective lenses is 20/200 or less in the better eye or if the visual field is 20 degrees or less

can occur in one or both eyes

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27
Q

blindness nursing interventions

A

Communication
Safety
Ambulation
Self-care
Support

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28
Q

glaucoma is

A

a group of eye disorders resulting in increased IOP (intraocular pressure)

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29
Q

a normal IOP requires a…

A

balance between production and outflow of aqueous humor

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30
Q

if the iop becomes too high…

A

the extra pressure compresses retinal blood vessels and photoreceptors and their synapsing nerve fibers

This compression results in poorly oxygenated photoreceptors and nerve fibers

These sensitive nerve tissues become ischemic and die. When too many have died, vision is lost permanently

Tissue damage starts in the periphery and moves inward toward the fovea centralis
When aqueous fluid production and drainage are in balance, the IOP is between 10 and 21 mmHg

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31
Q

Primary open-angle glaucoma (POAG)

A

also known as wide angle glaucoma; is the most common form of primary glaucoma; outflow of aqueous humor through the chamber angle is reduced

Usually affects both eyes and has no manifestations in the early stages

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32
Q

Primary angle-closure glaucoma (PACG)

A

also known as acute glaucoma or narrow angle glaucoma; is a forward displacement of the iris, which presses against the cornea and closes the chamber angle, suddenly preventing outflow of aqueous humor
Has a sudden onset and is an emergency

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33
Q

angle-closure glaucoma signs and symptoms

A

Severe pain in the eye or forehead
Redness
Decreased or blurred vision
Seeing halos or rainbows
Headache
N/V

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34
Q

open-angle glaucoma signs and symptoms

A

Early manifestations:
None
Painless
Loss of peripheral vision
Halos

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35
Q

glaucoma nursing interventions

A

Pharmacological
Prostaglandins agonists drugs reduce IOP by increasing aqueous humor outflow
Adrenergic agonists and beta-adrenergic blockers reduce IOP by limiting the production of aqueous humor and by dilating the pupil
Cholinergic agonists reduce IOP by increasing the outflow of the aqueous humor
Carbonic anhydrase inhibitors directly and strongly inhibit production of aqueous humor
Systemic osmotic drugs may be given for angle-closure glaucoma to rapidly reduce IOP
Oral glycerin and IV mannitol
Surgery

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36
Q

cataracts

A

is a lens opacity that distorts the image
Both eyes may have cataracts, but the rate of progression in each eye is different

37
Q

cataracts signs and symptoms

A

Early manifestations
Slightly blurred vision
Decreased color perception
Blurred vision
Double vision
Opacity

38
Q

cataracts nursing interventions

A

Prevention through smoking cessation, weight reduction, optimal blood sugar control, wearing sunglasses, etc.
Promote safety and independence
Surgery when symptoms interfere with ADLs
Post-surgery
Educate on the importance of close adherence to the eye drop regimen after surgery
Wear a light eye patch at night to prevent accidental rubbing
Assess for signs of infection
Remind the patient to avoid activities that might increase IOP

39
Q

macular degeneration

A

is the deterioration of the macula (the area of central vision); with the most common type being the age-related macular degeneration (AMD)

40
Q

Dry AMD

A

most common, caused by gradual blockage of retinal capillaries, allowing retinal cells in the macula to become ischemic and necrotic

41
Q

Wet AMD

A

is the growth of new blood vessels in the macula, which have thin walls and leak blood and fluid

42
Q

macular degeneration signs and symptoms

A

Central vision declines
Mild blurring
Distortion
Eventual loss of all central vision

43
Q

macular degeneration nursing interventions

A

Prevention is key or slow the progression of vision loss
Dietary intake of antioxidants, vitamin B12, vitamin E, and the carotenoids
Control hypertension
Stop smoking
Supportive care
Wet AMD
Laser therapy to seal the leaking blood vessels can limit the extent of the damage
Ocular injections with the vascular endothelial growth factor inhibitors (VEGFIs), such as bevacizumab (Avastin) or ranibizumab (Lucentis)

44
Q

retinal tear

A

is a more jagged and irregularly shaped break in the retina

45
Q

retinal detachment

A

is the separation of the retina from the epithelium; classified by the type and cause of their development

46
Q

retinal tear/detachment
signs and symptoms

A

Sudden onset
Painless
Bright flashes of light (photopsia)
Floating dark spots (floaters)
Shade or curtain coming across the vision

47
Q

retinal tear/detachment nursing interventions

A

Education
Supportive care
Retinal hole or tear:
The defect may be closed or sealed with surgery
Retinal detachment:
Surgical repair via scleral buckling, to place the retina in contact with the underlying structures

48
Q

conjunctivitis

A

is an inflammation with or without infection of the conjunctiva. Inflammation occurs from exposure to allergens or irritants
Often called “pink eye,” it is a common eye disease, especially in children

49
Q

conjunctivitis signs and symptoms

A

A gritty feeling in one or both eyes
Itching or burning sensation in one or both eyes
Excessive tearing
Discharge from one or both eyes
Swollen eyelids
Pink discoloration to the whites of one or both eyes
Increased sensitivity to light

50
Q

allergic conjunctivitis

A

occurs more commonly among people who already have seasonal allergies; they develop these symptoms when they come into contact with a substance that triggers an allergic reaction in their eyes

51
Q

allergic conjunctivitis signs and symptoms

A

Edema, a sensation of burning, a “bloodshot” eye appearance, excessive tears / watery drainage, extreme itching, severe photophobia

52
Q

allergic conjunctivitis treatment

A

Cool compresses and artificial tears sometimes relieve discomfort in mild cases
NSAIDs and antihistamines
Vasoconstrictor and corticosteroid eye drops
Instruct patients to avoid using makeup near the eye until all symptoms are gone

53
Q

viral conjunctivitis

A

is most commonly caused by contagious viruses associated with the common cold

54
Q

viral conjunctivitis signs and symptoms

A

Tearing / drainage, itchiness, redness, and light sensitivity
Recent or current upper respiratory infection
Possibly preauricular lymphadenopathy

55
Q

viral conjunctivitis treatment

A

Symptoms can often be relieved with cool compresses and artificial tear solutions
Topical steroid drops may be prescribed to reduce the discomfort from inflammation in severe cases

56
Q

bacterial conjunctivitis

A

an infection most often caused by staphylococcal or streptococcal bacteria from your own skin or respiratory system

57
Q

bacterial conjunctivitis signs and symptoms

A

Blood vessel dilation, redness, edema, burning, and discharge
The discharge is watery at first and then becomes thicker, with shreds of mucus
Crusting in the morning

58
Q

bacterial conjunctivitis treatment

A

Cultures of the drainage may be obtained to identify the organism
Ophthalmic antibiotics are prescribed to eliminate the infection
Teach the patient the importance of preventing the spread of the infection to the other eye or to other people

59
Q

eye trauma

A

Foreign bodies, lacerations or penetrating trauma

60
Q

eye trauma signs and symptoms

A

Feeling of something being in the eye
Blurred vision
Pain
Tearing
Photophobia

61
Q

eye trauma treatment

A

Immobilize; DO NOT apply a pressure patch to the affected eye
Antibiotics
Surgery?

62
Q

auditory sensory perception is the main function of the ear and occurs when…

A

sound is delivered through the air to the external ear canal
sound waves strike the movable eardrum, creating vibrations
The eardrum is connected to the first bony ossicle, which allows the sound wave vibrations to be transferred from the eardrum to the malleus, the incus, and the stapes
Receptors at the cochlea transduce (change) the vibrations into action potentials. The action potentials are conducted to the brain as nerve impulses by the cochlear portion of the eighth cranial (auditory) nerve
The nerve impulses are processed and interpreted as sound by the brain in the auditory cortex of the temporal lobe

63
Q

age related changes to the ear

A

Pinna becomes elongated because of loss of subcutaneous tissues and decreased elasticity
Hair in the canal becomes coarser and longer, especially in men
Cerumen is drier and impacts more easily, reducing hearing function
Tympanic membrane loses elasticity and may appear dull and retracted
Hearing acuity decreases
The ability to hear high-frequency sounds is lost first
Older adults may have particular problems hearing the f, s, sh, and pa sounds
Presbycusis:is hearingloss that occurs with aging; caused by degeneration of cochlear nerve cells, loss of elasticity of the basilar membrane, or a decreased blood supply to the inner ear

64
Q

ear assessment

A

Ask about any vertigo
Ask about any tinnitus
Ask about any medications

65
Q

ear exam

A

Inspection and palpation
Otoscope
Hold the otoscope in your dominant hand, and gently pull the pinna up and back with your other hand to straighten the canal

66
Q

Cerumen(earwax)

A

the most common cause of an impacted canal
A canal can also become impacted as a result of foreign bodies that can enter or be placed in the external ear canal, such as vegetables, beads, pencil erasers, and insects

67
Q

cerumen impaction signs and symptoms

A

Otalgia
Hearing loss
Itching
Dizziness

68
Q

cerumen impaction nursing interventions

A

Watchful waiting
Manual irrigation
Manual removal
Ceruminolytics

69
Q

external otitis

A

to an inflammation of the external auditory canal andis a painful condition caused when irritating or infective agents come into contact with the skin of the external ear

External otitis occurs more often in hot, humid environments, especially in the summer, and is known asswimmer’s earbecause it occurs most often in people involved in water sports

70
Q

external otitis signs and symptoms

A

Redness and tender to touch or movement
Mild itching
Swelling of the ear canal canlead to temporary hearing loss from obstruction

71
Q

external otitis nursing interventions

A

Applying heat to the ear for 20 minutes 3 times a day
Teach the patient that minimizing head movements reduces pain
Avoid any water sport activity for approximately 7-10 days to allow the canal to heal
Pharmacological
Topical antibiotic drops
Steroid therapies
Oral or IV antibiotics are used in severe cases
Analgesics

72
Q

applying ear drops

A

Remove and discard any ear packing
Irrigate the ear if the eardrum is intact
Place the bottle of eardrops in a bowl of warm water for 5 minutes
Tilt the patient’s head and place the drops in the ear
More the head back and forth 5 times
Insert a cotton ball into the opening of the ear to act as packing

73
Q

otitis media

A

an infecting agent in the middle ear causes inflammation of the mucosa, leading to swelling and irritation of the ossicles within the middle ear, followed by purulent inflammatory exudate
Pathogens enter the middle ear after eustachian tube dysfunction - caused by obstruction related to upper respiratory infections, inflammation of surrounding structures, or allergic reactions

74
Q

otitis media signs and symptoms

A

Fever, ear pain, otalgia
Reduced hearing
Tinnitus, dizziness
Headache
Nausea/vomiting

75
Q

otitis media nursing interventions

A

Supportive care
Quiet environment
Low heat application
Reduce head movements
Pharmacological
Antibiotics PO
Analgesics
Antipyretic
Surgery

76
Q

tinnitus

A

continuous ringing or noise perception in the ear; is a common ear problem that can occur in one or both ears

77
Q

tinnitus signs and symtoms

A

Mild ringing to loud roaring

78
Q

tinnitus contributing factors

A

Age
Sclerosis of the ossicles
Underlying disorders
Drugs
Exposure to loud noise

79
Q

tinnitus nursing interventions

A

Supportive care
Decrease background noise
Ear mold hearing aids
Support groups
Pharmacological
Mirapex

80
Q

vertigo and dizziness

A

is a sense of whirling or turning in space, whether it be the person or the surroundings

aka lightheadedness, is a disturbed sense of a person’s relationship to space

81
Q

vertigo and dizziness S/S

A

Nausea/vomiting
Falling
Nystagmus
Hearing loss
Tinnitus

82
Q

vertigo and dizziness nursing interventions

A

Supportive care
Restrict head motion and change position slowly
Pharmacological
Dimenhydrinate OTC
Meclizine
Scopolamine
Diazepam

83
Q

meniere’s disease

A

is an abnormality in inner ear fluid balance caused by a malabsorption in the endolymphatic sac or a blockage in the endolymphatic duct

84
Q

meniere’s disease has three features…

A

Tinnitus
One-sided sensorineural auditorysensory perceptionloss
Vertigo, occurring in attacks that can last for several days

85
Q

meniere’s disease nursing interventions

A

Supportive care
Move the head slowly to prevent worsening of the vertigo
Nutrition and lifestyle changes can reduce the amount of endolymphatic fluid
Pharmacological
Mild diuretics to relieve symptoms by lowering the pressure of the ear
Antihistamines to shorten attacks
Benzodiazepines in acute instances to help control vertigo
Antiemetics to control N/V
Surgery

86
Q

deafness

A

partial or complete loss of the ability to hear

87
Q

deafness S/S

A

Tinnitus
Increasing inability to hear when in a group
A need to turn up the volume of the television
Can trigger changes in attitude
Inability to communicate
Unawareness of surroundings
The ability to hear high-frequency consonants—especiallys, sh, f, th,andchsounds—is lost first

88
Q

deafness diagnostic test

A

Weber test
Rinne test
Audiometry
X-ray
CT
MRI

89
Q

deafness nursing interventions

A

Protective measures
Ear muffler, avoiding ototoxic medications
Correct the underlying problem
Assistive devices
Portable amplifiers
Hearing aids
Learning lip reading / sign language/brail
Surgery

Med-Surge 2 Exam 2 (4 decks)

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