WEEK 1-Sensory Preception Flashcards
1
Q
define tinnitus
A
Hearing sounds when no actual outside sound is occurring, such as ringing, buzzing, roaring, clicking, hissing, or humming noises.
2
Q
define Meniere’s disease
A
A hearing disorder caused from excessive buildup of fluid in the ear that leads to vertigo, tinnitus, and hearing loss.
3
Q
define cataracts
A
A clouding of the lens of the eye that causes vision to be blurry, hazy, or less colorful.
4
Q
define macular degeneration
A
An irreversible degeneration of the macula that leads to loss of central vision as clients age.
5
Q
define glaucoma
A
An increase in intraocular pressure due to the buildup of fluid, or aqueous humor, that causes compression of the optic nerve.
6
Q
define retinal detachment
A
A visual disorder that occurs when the retinal tissue detaches from the blood vessels in the posterior eye.
7
Q
external structures of the eye
A
extrinsic eye muscles, upper and lower eyelids, sclera, conjunctiva, and lacrimal structures.
8
Q
three layers of the eye
A
fibrous, vascular, and neural
9
Q
three fluid filled chambers
A
(anterior, posterior, and vitreous
10
Q
fibrous layer of the eye
A
the outermost layer and contains the sclera and transparent cornea.
11
Q
vascular layer of the eye
A
middle layer is the vascular layer that consists of the iris, choroid, and ciliary body.
12
Q
neural layer of the eye
A
The innermost neural layer holds the retina, optic nerve, and visual pathway.
13
Q
what is the anterior and posterior chambers filled with
A
clear fluid called aqueous humor
14
Q
aqueous humor
A
Aqueous humor is secreted from the choroid and is necessary to maintain intraocular pressure within the eye.
15
Q
vitreous chamber
A
the biggest of the three chambers and contains a gel-like liquid that is found between the lens and retina.
This vitreous liquid maintains the shape of the eye and is needed for the transmission of light.
16
Q
photoreceptors
A
also known as rods and cones, are located within the retina and are responsible for receiving signals, processing them, and transmitting them to the brain through the optic nerve.
Rods are useful for vision in low light and assist in the detection of images in peripheral vision. Cones allow the eye to differentiate changes in color.
17
Q
macular degeneration aka AMD
A
occurs when the component of the retina responsible for central vision is not able to function.
18
Q
age-related macular degeneration (AMD)
A
AMD leads to blurred vision that is noticed most often while reading and progresses to distorted vision in the center of the eye field.
This condition occurs when there is a buildup of photoreceptor waste products, called drusen, that accumulate beneath the retina.
19
Q
dry AMD vs. wet AMD
A
Dry AMD is more commonly diagnosed and causes the outer portion of the retina to break down and develop areas with increased accumulation of drusen.
Wet AMD is triggered by the abnormal growth of blood vessels underneath the retina. The vessels leak blood and fluid under the center portion of the retina (macula), causing distorted vision.
20
Q
how is AMD a risk to older people?
A
Globally, AMD is the most common cause of irreversible blindness and vision loss in people over the age of 65.
21
Q
risk factors for developing AMD
A
smoking, hypertension, elevated cholesterol levels, obesity, and a family history of AMD. People who have light skin pigment or light-colored eyes are also at an increased risk for developing AMD
22
Q
Co-morbidities with AMD
A
people who are at a higher risk for stroke, myocardial infarction, hypertension, hyperlipidemia, or renal disease should complete regularly scheduled eye examinations.
23
Q
what is there a correlation diesase with AMD?
A
renal and AMD correlate
24
Q
A nurse is teaching a client who has macular degeneration about ADLs that may become more difficult to perform as the condition progresses. Which of the following will the nurse include in the teaching?
A
showering, driving, reading a book
25
what can people with dry AMD experience?
People who have dry AMD will notice gradual blurring of their vision, which can impair night vision, diminish central vision, and make reading progressively more difficult
26
what can people with wet AMD experience?
Wet AMD progresses more rapidly and causes sudden blurred vision or blind spots in the center of the visual field.
27
diagnostic tests for AMD
This examination will identify changes in the macula, the presence of drusen deposits, and bleeding. A fundoscopy or ophthalmoscopic examination will be performed with the client’s pupils dilated, with medicated eye drops to enable the provider to visualize the rear of the eye.
28
CNS relations to AMD
Clients who have AMD are more likely to also develop narrowing and thickening of the carotid arteries, hypercholesterolemia, hyperlipidemia, and increased buildup of blood vessel plaque, which places them at a higher risk for developing central nervous system health conditions, such as stroke.
29
what is priority for people with AMD
fall risk-make sure things aren't in the way on the floor
30
what is a lifestyle change that can help with AMD
lowering smoking
31
define cartaracts
cloudy or opaque areas around on the eye lens
These areas alter the passage of light through the eye lens, which may cause painless blurred vision or glare. Cataracts develop as the lens becomes denser and less transparent due to proteins and fibers in the lens breaking down .
32
what is the most common risk factor for developing cataracts
age, as cataracts typically affect adults over the age of 65
33
risk factors for developing cataracts
Advanced age
Diabetes mellitus
Hypertension
History of eye inflammation
Previous traumatic eye injury
Use of steroids
Previous eye surgery
Family history
Overexposure to sun or ultraviolet (UV) rays
Smoking
Alcohol use disorder
Obesity
34
correlation with cataracts
There is a correlation between the development of cataracts and chronic hypertension and diabetes mellitus.
Poorly controlled blood pressure and blood glucose levels decrease adequate blood flow causing damage to the lens of the eye.
35
cataracts safety considerations
same as AMD-fall risk
36
client education with cataracts
Provide instruction on lifestyle modifications that should be implemented, including smoking cessation, alcohol reduction, and dietary changes that include an increase in leafy green vegetables. Information will be provided on the importance of medication compliance and its impact on the recovery process.
37
A nurse is teaching a client who is an older adult about eye health. Which of the following instructions should the nurse include?
Increase the amount of fruits and green leafy vegetables in their diet.
38
surgery for cataracts
Cataract extraction surgery involves removing the cloudy opaque lens and implanting an artificial intraocular lens (IOL).
The technique most often used is phacoemulsification, a mechanically assisted extracapsular procedure.
39
A nurse is providing preoperative teaching to a client who is scheduled for bilateral eye cataract extraction surgery. Which of the following instructions should the nurse include in the teaching?
“You will need to stop taking aspirin one week before the surgery.”
40
A nurse is providing postoperative medication teaching to a client who had bilateral eye cataract extraction surgery. Which medications should the nurse include in the teaching?
Antibiotics eye drops
b
Steroid eye drops
c
Anti-inflammatory eye drops
41
define glaucoma
Glaucoma develops slowly over time but progressively causes increased ocular pressure against the optic nerve.
This is due to a change in the volume or a decrease in absorption of the aqueous humor
42
types of glaucpma
common form is open wide or wide angle glaucoma ( It develops slowly as the outflow of aqueous humor is reduced, and changes in vision are gradual. contacts don't help)
other one is angle-closure or narrow-angle glaucoma (has a sudden onset of vision loss and is considered an urgent situation requiring emergent treatment. This form of glaucoma is due to the complete obstruction of aqueous humor outflow.)
43
risk factors for glaucoma
age over 60 has greater risk but it can come at any age
Other factors that contribute to glaucoma include previous eye trauma or injury, chronic health conditions, and family history.
44
correlations with glaucoma
There are several chronic medical conditions that are associated with the development of glaucoma, including high blood pressure, diabetes, and hyperlipidemia
45
normal intraocular pressure (tonometry)
11-21 mmHg
46
safety considerations for glaucoma
same as AMD and cataracts (fall risk)
47
A nurse is caring for a client who has glaucoma. Which of the following manifestations should the nurse expect?
Client reports seeing halos around lights.
48
define retinal detachment
Retinal detachment occurs when retinal tissue in the posterior of the eye pulls away or detaches from the blood vessels that provide oxygen and nourishment to the retina.
49
what does retinal detachment usually bring
Retinal detachment often creates dark floaters or a sensation of a curtain being placed in the field of vision.
50
diabetic retinopathy
An eye disorder that may occur in individuals who have diabetes and results in a deficit in vision acuity and possible permanent loss of vision caused by diminished blood flow to the rear of the eye.
51
match vision change with correct eye condition
blurry or hazy vision: cataracts
diminished peripheral vision: glaucoma
blind spots in the center of the vision field: macular degeneration
Seeing floating dark spots moving through all vison fields: retinal detachment
52
safety considerations for retinal detachment
To promote a safe home environment, clients and caregivers should always be instructed to keep rooms well-lit, keep floors free of clutter, and remove all area rugs.
53
A nurse is caring for a client who reports a loss of peripheral vision. Which of the following assessments will the nurse perform to assess peripheral vision?
Confrontational visual field test
54
A nurse is caring a client who reports a sudden onset of blurry vision with blind visual spots. Which of the following medications should the nurse anticipate the provider prescribing?
Dilating eye drops
55
three structures of the ear
external
middle
inner
56
external ear
pinna
auditory canal
57
middle ear
tympanic membrane
three ossicle bones (malleus, incus, and stapes)
58
inner ear
holds the organs for hearing and balance: the spiral-shaped cochlea and the fluid-filled semicircular canals. The cochlea, which is pea-sized, is separated into the scala vestibuli, which is filled with plasma-like fluid called perilymph, and the scala media, which is filled with a thicker fluid called endolymph.
59
cochlea function
Transduces physical vibrations into electrical impulses
60
malleus, incus, and stapes function
Transfers and amplifies sound waves into physical vibrations
61
external ear function
collect and transmits sound waves from the outside enviroment
62
tympanic membrane function
Transfers and amplifies air vibration from external ear to the ossicles
63
Vestibulocochlear nerve function
transmits electrical impulses to the auditory cortex of the brain
64
A nurse is assessing a client’s hearing. Which of the following tests should the nurse perform to screen for hearing loss?
Finger rub test
Whispered voice test
Audiometry
65
define tinnitus
perception of sound when no actual external noise in present
frequently described as ringing, roaring, or constant sound in the ears.
66
lifestyle modifications for tinnitus
Lifestyle modifications may help control the intensity of tinnitus. Instruct the client to wear headphones when in noisy or loud environments, turn down music, reduce salt intake, and decrease the use of nicotine, caffeine, and alcohol
67
A nurse is planning care for a client who is experiencing tinnitus. Which of the following should the nurse recommend to include in the plan?
Monitor blood pressure
c
Monitor blood glucose levels
d
Remove cerumen from external ear canal
e
Wear hearing protection
68
meniere's disease
Meniere’s disease is a progressive disorder that develops from an excessive buildup of endolymphatic fluid in the inner ear and leads to debilitating vertigo, tinnitus, and hearing loss.
69
Common Manifestations of Meniere’s Disease
Vomiting
Nausea
Blurry vision
Cold sweats
Trembling
Hearing loss
Headaches
Imbalance
Congestion in the ear
Ear fullness
70
A nurse is caring for a client who has Meniere’s disease. Which of the following manifestations should the nurse expect?
Extreme dizziness
Hearing ringing
Hearing loss
Feeling of fullness in the ears
71
healthy food recommendations to client who has AMD
fruits and vegetables high in antioxidants (bluberries, grapes, kale, spinach)
foods high in zinc (red meats, dairy, eggs, grains)
foods high in omega-3 fatty acids (salmon, soybeans, flax seeds, chia seeds)
72
treatment for AMD
there is no cure for dry AMD but there is modifications
increasing the client’s daily intake of carotenoids lutein and zeaxanthin may slow the disease’s progression.
also smoking cessation will help treat the symtpoms
73
why are hypertension and DM related to cataracts?
poorly managed blood glucose and poorly managed blood pressure can lead to diminished blood flow to the lens of the eye
74
what can cataracts be mistaken for
mudged eyeglasses or ill-fitting contact lenses.
condition is typically pain-free
75
levels of intraocular pressure that considered elevation
21-32 mmHg
76
medications for glaucoma
alpha agonists
beta-blockers
carbonic anhydrase inhibitors
Prostaglandin analogs
77
Describe the pathophysiology associated with the development of a detached retina.
retinal tissue in the posterior of the eye pulls away or detaches from the blood vessels that provide oxygen and nourishment to the retina
vitreous humor can become more serous or liquid consistency (thins out), causing it to collapse and pull away from the retina
78
vitreous humor vs aqueous humor
Aqueous humor is a water-like fluid that lies in front of the lens.
Vitreous humor is a gel-like substance that lies behind the lens and in front of the retina
79
what would be a correlation with retinal detachment
age-related changes in consistency with vitreous humor
inflammatory disorders like lupus
diabetic retinopathy
macular degeneration
eye tumors
traumatic eye incidents
family history
nearsightedness
80
what can increase the risk of detachment of the retina
diabetes and hypertension
previous eye surgery
81
psychosocial aspects related to retinal detachment
clients feel
depressed
anxious
fearful
and that there life has been reduced in quality
82
tonometer is associated with what sensory disorder
glaucoma
it reads the intraocular pressure in your eyes
83
confrontational visual field test
to assess client's peripheral vision
84
what can contacts prevent
oxygen from getting to your eyes so therefore can build up extra blood vessels in your eyes to make up for that
85
what can diabetics loose
eyes, feet, kidneys
86
what is average blood glucose level
fasting is 70-100 mg/dL
random one is usually about 125 mg/dL
87
prediabetic blood glucose
100-125 mg/dL
88
diabetic blood glucose
above 125 mg/dL
89
ototoxic medications
ototoxic means bad for the ears
examples would be Lasix's because it can lead to tinnitus
gentamycin
90
conditions correlating with AMD
cardio (poor blood flow to eyes) and renal (not enough RBCs and protein)
91
eye ointments
from inner canthus to outer canthus (TEST Q)
92
clinical judgement for AMD
assess: diminished central vision
analysis: indications of AMD and risk for falls
planning: home safety plan
implementation: take meds, no smoking, healthy diet (education)
eval: safe home environment
93
conditions correlating with cataracts
diabetes and hypertension
94
what does DOUBLE VISION go with?
cataracts
95
clinical judgement for cataracts
Assessment: blurred vision/DOUBLE VISION
Analysis: indication of cataracts and risk of injury
Hypothesis: safety and daily living
Planning: address safety and treatment needs
Implementation: ensure safety (preop and postop)
Evaluation: progressive improvement of vision
96
surgical treatment for cataracts
IOL and extraction of cloudy lens
97
pre-op nursing considerations for cataract surgery
relax because we don’t want to give high blood pressure, education about procedure, prepare
98
post-op nursing considerations for cataract surgery
don’t lift above 10 lbs, no super strenuous activity, education about safety considerations, don’t lay flat
99
open angle vs closed angle glaucoma
open-angle: little drainage (which means increased pressure) of aqueous humor (mild pain)
closed-angle: NO drainage of aqueous humor (intense pain) (worse because there is no drainage at all)
100
conditions that correlate with glaucoma
HTN
diabetes
hyperlipidemia
101
clinical manifestations of glaucoma
EARLY: halos around lights/blurry vision
LATER: worsening peripheral vision
102
conditions that correlate with retinal detachment
IMPORTANT
hypertension and diabetes
103
clinical presentation of retinal detachment
blurred vision
floaters or photopsia
104
what eye condition has the curtain-like shadow?
retinal detachment
IMPORTANT: TEST Q
105
what is the most common sensory disorder
hearing loss
106
hearing loss
conductive vs sensorineural
107
conductive hearing loss
treatable
result of EXTERNAL ear condition
108
sensorineural hearing loss
often permanent
result of damage to INNER ear
cochlear hair follicle or auditory nerve
109
Lasixs
cause tinnitus so they are considered ototoxic
IV push LOW and SLOW
110
what can ototoxic drugs cause?
tinnitus
important: TEST Q
111
tinnitus testing
test for...
anemia
thyroid function
heart disease
112
conditons that correlate with tinnitus
Meniere's and thyroid disease
113
Meniere's disease
excessive endolymphatic fluid
114
is Meniere's disease genetic?
YES! it is autoimmune
test Q!
115
safety for Meniere's disease
consistent spinning so at risk for falls
116
Meniere's disease: diet
reduce sodium
where salt goes, water goes. so decrease sodium to reduce fluid in ears
117
medications for Meniere's disease
diuretics to reduce fluids
corticosteroids
motion sickness pills for the vertigo
118
three main medication classes for glaucoma
cholinergic agonists
cholinesterase inhibitors
beta-adrenergic blockers
others wound include:
alpha-adrenergic agonists
carbonic anhydrase inhibitors
119
beta-adrenergic blockers
eye drops provide topical therapy for lowering IOP for clients with OPEN-ANGLE GLAUCOMA
they can also help provide emergency treatment for acute closed-angle glaucoma
120
prototype and other drugs for beta-adrenergic blockers
eye drops for lowering IOP for open-angle glaucoma (and emergency treatment for closed-angle glaucoma)
the prototype drugs are:
betaxolol (Betaoptic)
timolol (Timoptic)
121
expected pharm action for beta-adrenergic blockers
decrease production of aqueous humor, thereby decreasing intraocular pressure
122
adverse drug reactions to beta-adrengenic blockers
aka betaxolol (Betaoptic) and timolol (Timoptic)
topically: stinging, burning, eye discomfort
absorb them systematically through admin: bradycardia, hypotension, bronchospasm
contraindicated in clients with AV heart block, bradycardia, asthma, COPD
123
interventions for administering beta-adrenergic blockers
take HR first and measure vital signs on reg basis after admin
124
admin of beta-adrenergic blocker
aka betaxolol or timolol
clean hands
after instillation, hold pressure on the eye dropper to sac for 60 SECONDS
125
cholinergic agonists
provide topical therapy to lower IOP in glaucoma
aka muscarinic agonists
126
prototype for cholinergic agonists
pilocarpine
aka Isopto Carpine
solution or gel
127
expected pharm action for cholinergic agonists
aka Isopto Carpine or pilocarpine
increase availability of acetylcholine at muscarinic receptor sites
pupil constricts, allows the drainage of aqueous humor
128
adverse effects of cholinergic agonists
most common: decreased visual acuity
risk for retinal detachment
129
interventions for cholinergic agonists
after admin, admin a mild analgesic for a headache that does not resolve shortly after admin
hold pressure over puncta and sac for at least a minute
130
safety concern for cholinergic agonists eye drops
constrict pupil
so vision at night is bad and vision in low lit places
keep lights on and assist to bathroom
keep night light on at home to minimize risk of falls
131
admin of cholinergic agonists
same as other eye drops
132
contraindications and precautions of cholinergic agonists
do not admin to people with acute inflammatory eye disorders or retinal detachment!
use cautiously with clients who have chronic respiratory disorders or hypertension
133
cholinesterase inhibitors
topical therapy that helps lower IOP in glaucoma
134
prototype and other drugs for cholinesterase inhibitors
echothiophate
aka Phospholine Iodide
135
pharm action for cholinesterase inhibitors
breakdown of acetycholine, allowing more acetycholine to be available for use of muscarinic receptors in the body
similar action of cholinergic agonists!!!
136
adverse reactions for cholinesterase inhibitors
primary: decreased visual acuity or myopia (nearsightedness)
137
interventions for cholinesterase inhibitors
same as cholinergic agonists (fall risk, poor vision, dark out is bad)
observe pupil and lack of red reflex (could indicate CATARACT)
138
admin of cholinesterase inhibitor
instill in the evening and at least 5 MINUTES before or after instilling any other eye drops
139
worsening vision with cholinesterase inhibitors?
could be ineffective with controlling IOP and could mean the client is developing cataracts
140
contraindications for cholinesterase inhibitors
history of retinal detachment
cardiac or respiratory disease
hyperthyroidism
urinary tract blockage
Parkinson's disease
141
interactions with cholinesterase inhibitors
insects and herbacides that contain organophosophates
142
drug class is the first line of therapy for treatment of open-angle glaucoma?
beta blockers
143
