Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Ear, eye&Mouth Revie
Ear,Eye&Mouth review
| Question | Answer |
|---|---|
| . | |
| Spaces inside the eye Anterior cavity | Anterior chamber from the cornea to iris |
| Spaces inside the eye Posterior chamber | between the iris and the lens |
| Ciliary body produces | aqueous humor |
| Aqueous humor | helps to give shape to the eye and circulates nutrients and removes waste, flows through pupil into anterior chamber |
| Trabecular meshwork at edges of anterior chamber | canal of Schlemm connects with venous system |
| Production of aqueous humor is | normally in balance with outlfow of aqueous humor |
| Glaucoma is | blockage of outflow of aqueous humor; IOP above 21 mm Hg; Optic nerve destroyed over time |
| With Glaucoma you loose | peripheral visual field and central visual acuity |
| With Glaucoma you are somewhat blind, kinda blind or totally blind? | Totally blind |
| What is one of the leading causes of blindness? | Gluacoma |
| Primary glaucoma you have | impaired canal of Schlemm, no precipitating cause |
| Can Glaucoma be genetic? | Yes |
| Can Glaucoma be congenital? | Yess |
| When does Glaucoma occur? | In clients over 60 years of age |
| In Secondary glaucoma it is caused by | eye trauma or disease and certain medications |
| What type of trauma or disease can cause Secondary glaucoma? | Infection, hemorrhage, tumor and cataracts |
| In Secondary glaucome it is also caused by medications. What type of meds can cause this? | Topical glucocorticoids, Antihistamines, Antidepressants and some antihypertensives |
| What are some risk factors for Glaucoma? | HNT, Migraine HA, Nearsightedness, Farsightedness |
| What is Tonometry? | Measures intraocular pressure |
| In glaucoma how do pressures build? | gradually |
| There are three "gradual" symptoms with glaucoma what are they? | Gradual destruction of optic nerve; gradual change in visual field; gradual increase in pressure |
| What is normal range of intraocular pressure? | 12-21 mm Hg |
| What are the two types of Glaucoma? | closed angle glaucoma and Open angle glaucoma |
| Closed angle glaucoma has two other names which are? | Acute glaucoma and Narrow angle glaucoma |
| Open angle glaucoma is | chronic, simple glaucoma and is 90% of the cases |
| closed angle glaucoma | has other names, Acute and Narrow; is the uncommon form of glaucoma and is unilateral (can occur in one eye) |
| In the two types of glaucoma, closed angle and open angle which one affects older adults and ppl of Asian descent? | Closed-angle glaucoma |
| What are the signs and symptoms of closed/narrow angle glaucoma? | Caused by sudden inc in IOP, stress, impact injury, medications and is an emergent situation |
| What are the signs and symptoms of closed/narrow angle glaucoma? | intense eye pain or HA, bloodshot eyes, blurred vision |
| What are the signs and symptoms of Open angle glaucoma? | iris does not cover the trabecular meshwork; is the most common type; usually bilateral; IOP increases slowly and often asymptomatic |
| What are the goals of Glaucoma? | improve circulation of aqueous humor; adjust the circulation of aqueous humor, improve aqueous humor outflow; medications or surgical alternatives |
| When do they use surgery in glaucoma? | Acute cases |
| What is the name of the surgical procedure performed? | Gonioplasty; Laser iridotomy; peripheral iridectomy |
| What is Gonioplasty? | Laser burns holes in periphery of iris, causing the iris to contract thus opening the angle |
| What is laser iridotomy? | Small hole in iris allows fluid to drain better |
| What is Peripheral iridectomy? | Section of iris is removed |
| What are the goals for open angle glaucoma | Increase outflow of aqueous humor at the canal of Schlemm and decrease formation of aqueous humor of ciliary body |
| What are the administration alerts of the medication? | Remove contact lens before instillation and keep out for 15 min; Avoid touching the eye or eyelashes with any part of the dropper to avoid contamination; wait 5 min before instillation of additional |
| What are the groups of meds for glaucoma? | Cholinergic agonists, Sympathomimetics, Prostaglandins, Beta-adrenergic blockers, Alpha2 - adrenergic agonists, Carbonic anhydrase inhibitors, Osmotic diuretics |
| Acetylcholine (Ach) | -Nicotinic receptor works on skeletal muscle; smooth -Muscarinic receptor works on Smooth muscle, glands, decreases heart rate, decreases strength of heart contraction |
| What is the Physiology of acetylcholine | synthesized in the presynaptic neuron, then stored in vesicles; Acetylcholinesterase (AchE) destroys/erases Ach; agonist encourage something to happen |
| What do Miotics (cholinergic agonists) do? | Change the tradbecular meshwork to allow greater outflow of fluid which decreases IOP; |
| What are Miotics direct acting cholinergic agonists drugs? | carbochol (Isopto Carbachol) pilocarpine HCL (Isopto Carpine) |
| What does Miotics indirect-acting cholinergic agonist do? | inhibit cholinesterase activity demecarium bromide (Humorsol |
| Side effects of Cholinergic agonists are | stinging, burning, eye pain; altered vision, HA; sweating, muscle weakness, v |
| When do they use these medications in glaucoma patients? (cholinergic agonists) | In open agnle glaucoma not responding to other drug ther |
| What is the antidote for toxicity in choliergic agaonist? | pralidoxime chloride, (Z-PAM) |
| What effect will a cholinergic agonist have on the size of the pupil? | Miotic, constriction |
| Sympathomimetic drugs for glaucoma are | nonselective and activate the sympathetic nervous system (fight or flight) |
| Prototype drug is? | dipivefrin (Propine) |
| dipivefrin (Propine)does? | converts to epinephrine in the eye; produces dilation of the eye (mydriasis); inc outflow of aqueous humor; reduces IOP |
| if epinephrine reaches system circulation what also happens? | increases blood pressure and pressure |
| Adverse effections of Prostaglandin-inhibiting agents actions are? | increases blood pressure and pressure |
| Prostaglandin-inhibiting agents actions are? | decreasing aqueous humor production and increase outflow |
| Adverse effections of Prostaglandin-inhibiting agents actions are? | May change the pigmentation of the eye; ppl w light color eyes may becomes more brown |
| Prototype: latanoprost (Xalatan)actions are? | increased outflow of aqueous humor; reaches peak effect in |
| latanoprost (Xalatan)actions side effects are? | Tearing; conjuctival edema; dryness, burning, itching; sensation of foreign body in the eye; photophobia; orther visual disturbances |
| When do you administer latanoprost (Xalatan)? | HS |
| Beta blocking drugs are | drug of choice for open angle glaucoma, chronic/simple |
| What are the actions of beta blocking drugs on glaucoma? | decrease production of aqueous humor thus decreasing IOP; rare ocular side effects; rare systemic effects - bronchospasm, bradycardia, hypotension |
| What are some examples of beta blockers? | betaxolol (Betaoptic), carteolol (Ocupres), levobunolol (Betagen), metipranolol (OptePranolol), timolol (Timoptic) |
| What type of side effects do Alpha2-adrenergic agonist have? | minimal cardiovascular and pumonary side effects |
| How are carbonic anhydrase inhibitors taken? | topical or po |
| carbonic anhydrase inhibitors ... | reduce production of aqueous humor |
| When do you use carbonic anhydrase inhibitors ? | when beta blockers are not effective |
| What type of glaucoma is carbonic anhydrase most effective? | acetazolamide (Diamox) taken po is a diuretic that works on HTN as well; brinzolamide (Azopt); dorzolamide (Trusopt) |
| What are the precautions of carbonic anhydrase inhibitor? | contains sulfur, may cause severe allergic reaction; may cause electrolyte imbalance |
| Osmotic diuretics are used during? | eye surgery to decrease production of aqueous humor and is administered topical or po; & emergent treatment of acute/ closed angle glaucoma |
| Side effects of Osmotic diuretics ? | HA, tremor, dizziness, dry mouth, electrolyte imbalance |
| Example of osmotic diuretic? | glycerin anhydrous (Ophthalgan)and Manitol (IVP |
| Which of the following increase the outflow of aqueous humor? Sympathomimetics, beta blockers, osmotic diurects, carbonic anhydrase inhibitors? | Sumpathomimetics |
| What are the nursing considerations for glaucoma? | monitor pts condition; |
| Prior to giving meds for glaucoma what should the nurse do? | general health history; drug history for interactions; cardiovascular and respiratory system - heart block, CHF, COPD may not be able to take drug that act in the ANS; baseline blood pressure and pulse |
| What are the contraindications? | Pregnancy and lactation; factors that may affect compliance such as financial resources; dexterity, dosing schedule |
| Patient education administration technique is | wash hands; avoid touching tip of container w hands, eye and lashes; admin into conjuctival sac, apply pressure over lacrimal sac for one min to prevent systemic absorption |
| Patient education in glaucoma | inc risk for falls r/t reduced visual fields & following admin of meds; visual diff may worsen or be blurry just after installation; removed contacts and wait 15 min b4 reinserting; report poss of pregnancy |
| What side effects should the patient report? | eye irritation, burning, stinging; itching, sensation of foreign body in eye; photophobia, visual disturbances |
| Drugs used for eye exams | provide relief for minor eye conditions |
| Examples of drugs used for eye exams are | Cycloplegic drugs Mydriactic drugs Fluorescein sodium |
| Cycloplegic drugs actions are | paralyze the ciliary muscles prevent lens from moving during |
| Example of cycloplegic drug is | atropine (Isopto Atropine) |
| Side effects from cycloplegic drug is | severely blurred vision loss of near vision |
| Mydriatic drugs actions are | dilate the pupil to allow examination of the retina |
| Example of a mydriatic drug is | tropicamide (Mydriacyl) |
| Side effects of mydriatic drugs are | intense photophobia |
| Fluorescein sodium is used for | diagnosing lesion on the surface of the eye temporarily stains the tears yellow so that lesions are easier to observe during slit lamp exam |
| Minor irritation and injury there are broad range of classes of drugs used such as | antimicrobials; glucocorticoids; local anesthetics; Nsaids |
| Admin of eye ointment | pull lower lid down to form a pouch apply oint from inner to outer part of eye have pt blink to distribute instruct pt 2 avoid taks requiring clear vision |
| Otic preparations treat | infections inflammation ear wax buildup |
| External otitis is aka | swimmer's ear |
| External otitis is associated with | water exposure and can be very painful |
| How do you treat external otitis? | otic drops - ABX, STEROIDS, PAIN MEDS sometimes may need systemic ABX |
| eXAMPLES OF OTIC PREPARATIONS ARE | acetic acid & hydrocortisone benzocaine & antipyrine ciprofloxacin hydrochloride & hydrocortisone polymixin B, neomycin & hydrocortisone |
| Otitis media is | inflammation of middle ear |
| Otitis media is associated with ? | upper respiratory infections |
| What location of an ear infection is the most difficult to treat? | Inner ear (Otitis media) |
| How do you treat Otis media? | systemic ANB comfort meds for pain |
| Treatment for otitis | Amoxicillin first line of defense - assess pt for allergy to penicillin; Trimethoprim/sulfamethoxazole (TMP-SMZ), Bactrim is next choice - assess for sulfa allergy, maintain adequate U.O. to prevent crystalluria |
| Mark has an inf of the external ear. Treated w polymixin B, neomycin and hydrocortisone(Cortisporin)The steroid should relieve all his symptoms EXCEPT? | Pain |
| Why was the polymixinB prescribed? | This is an ABX and used to treat the infection |
| Mastoiditis is | inflammation of the mastoid sinus |
| if mastoiditis goes untreated | client could have hearing loss brain abscess |
| Surgery for mastoiditis is called | mastoidectomy or meatoplasty |
| What types of ear wax are there? | wet and dry |
| What could change the nature of the wax? | Age |
| Can ear wax cause problems with hearing? | Yes, narrows ear canal and interferes with hearing and can cause pain in some people |
| What is another term for ear wax? | cerumen |
| How do you manage wax buildup? | mineral oil and cerumen softeners (Debrox (OTC brand) Lavage/irrigation w tepid water and asepto syringe |
| What are your nursing considerations? | monitor patient's condition before admin otic preparations assess - baseline hearing/auditory status; symptoms and current medical conditions; hypersensitivities |
| Patient drug education | warm ear drops to body temperature Lie down while instilling ear drops to avoid dizziness - remain lying on side w affected ear up for 5 min after admin, massage area around ear gently after admin |
| Patient drug education | do not touch dropper to ear > age 3 hold pinna up and back during instillation < age 3 years hold pinna down and back |
Created by:
lgultom1
Popular Nursing sets