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Med Surg E&E
flashcards to study for eyes and ears med surg exam
| Question | Answer |
|---|---|
| What do eyelids, eyelashes, and tears do? | Protect the eye |
| Why do we blink? | To clear dust and particles from the surface of the eye |
| What do Eyelids help do? | Help adjust the amt of light entering the eyes and spread tears |
| What is the conjunctiva? | sensitive, transparent mucous membranes |
| What is the canthus? | where eyelids meet; usually horizontal |
| How is the canthus positioned in someone with down syndrome? | angled |
| People of Asian desent have what? | An epicanthal fold, which is a fold of skin that covers the inner canthus |
| What is the punctum and where is it located? | A small opening in the corner of the eye near the nose, through which tears drain |
| What is the pupil and what does it do? | An opening that dilates and constricts in response to light |
| What is the limbus and where is it located? | The limbus is the thin area that connects the cornea and the sclera. |
| What are the three layers of the eye? | Sclera (white part), uvea-choroid (middle layer), and retina (inside part) |
| What is the iris? | The colored part of the eye. |
| What is the Aqueous humor? | a nutrient-rich liquid that nourishes eye structures |
| What is the Vitreous humor? | thick, gelatinous material that maintains the spherical shape of the eyeball. It also maintains the placement of the retina. |
| What is the macula? | "yellow spot" Composed entirely of cones and allows for detailed vision. Lies in the center of the retina. |
| What is the retina? | the innermost layer of the eye, composed of a pigmented outer layer and an inner neurosensory layer. |
| What are rods and cones for? | Rods function in night or dim light and assist in distinguishing black and white. Cones function in bright light and are sensitive to color. |
| What do Ciliary muscles do? | helps change the shape of the lens when adjusting to near or far vision |
| where is the lens located? | lies behind the the pupil and iris |
| What is the difference between the aqueous and vitrious humor? | The vitrious is more permanent, the aqueous is constantly being made. |
| Where does light transform into nerve signals? | cerebral cortex |
| What do cones and rods sense? | light |
| What is refraction? | when light rays bend |
| How is an image viewed on the retina? | upside-down and reversed image |
| What happens with accommodation? | lens changes shape |
| What is the near point? | The closest point a person can focus on. |
| What is a cataract and how do images appear? | Opaque lens, blurred, and cloudy images. |
| How is the Snellen eye chart used? | determines visual acuity, the ability to see far images clearly. The chart is placed 20 feet away. Client is asked to cover one eye and identify letters of decreasing size. |
| What are Jaeger charts and what are they used for? | evaluate near vision. Contain words, numbers, and letters in various print sizes. Client is asked to cover one eye and hold chart @ 14 inches away and read the smallest print they can see comfortably. |
| What is the Ishihara chart used for? | used to assess color vision. A pattern of a number is embedded in a circle of colored dots. |
| What tests can you do to check the extraocular muscle function? | Corneal light reflex test (with pen light, evaluates eye alignment); Cover-uncover test (extraocular muscle strength); and Positions test (tests eye muscle strength and cranial nerve function) |
| What do you assess for when taking a clients history? | Allergy, vision changes, discomfort, use of glasses or contacts, eye meds, Hx of eye trauma, disease, or surgery; family hx of eye disease |
| What do you observe for when performing a physical assessment r/t extraocular muscle function? | observe for normal and abnormal findings |
| What is ophthalmoscopy used for? | Examination of fundus (interior of the eye) |
| What is retinoscopy used for? | evaluates focusing power of each eye |
| What is tonometry used for? | measures intraocular pressure (puff of air into eye) |
| What is the normal IOP range? | 10 to 21 mm Hg |
| what are causes of an abnormal visual field exam? | Glaucoma, stroke, brain tumor, and retinal detachment |
| What does an Amsler grid detect? | Macular problems (grid with a dot in the middle) |
| What is a slit-lamp exam used for? | magnifies eye surface, helps identify corneal abrasions, iritis, conujunctivitis, and cataracts |
| What is a retinal angiography used for? | detects vascular changes and blood flow through retinal vessels. |
| What disorders can retinal angiography identify? | DM, AIDS, hypertension, drug toxicity, and tumors |
| When is ultrasonography used for the eyes? | Used when pathologic changes make it difficult to look directly at the posterior of the eye. |
| Why is retinal imaging done? | It produces a high-resolution image of almost the entire retina without having to dilate the pupil. Can detect retinal disorders like diabetic retinopathy, and provides an excellent baseline screening test. |
| What would we teach clients about eye maintenance? | importance of eye care to preserve and maintain function; regular eye exams; balanced diet |
| What is Occuvit? | vitamins for the eyes |
| What does the outer ear consist of? | (also called the auricle); Made up of the Pinna, external acoustic meatus(opening), and the tympanic membrane (ear drum) |
| What makes up the middle ear? | The 3 small bones: malleus, incus, and stapes |
| What does the inner ear consist of? | The cochlea, vestibulocochlear nerve, and organ of corti |
| What is the cochlea (semicircular canals) for? | (sensory organ); balance. (Cochlea are snail shaped) |
| What does the vestibulocochlear nerve help with? | hearing and balance |
| What is the organ of corti? | (located inside the cochlea) the sensitive element in the inner ear, can be thought of as the body's microphone. |
| What bone does the meatus go through? | the mastoid bone |
| What type of test is the whisper test, and what does it test for? | Is a basic auditory acuity test that tests gross auditory acuity |
| What happens with an otoscopic exam? | inspection of external acoustic canal and tympanic membrane |
| Where does the eustachian tube run? | From the middle ear to the nasopharynx |
| What does the tuning fork test for? | conductive or sensorineural hearing loss |
| How is the Rinne test performed? | the tuning fork is struck, placed on the mastoid process behind the ear and held there until sound is no longer heard. Then, the still vibrating tuning fork is held beside the ear until sound is no longer heard. |
| How is the Weber test performed? | tuning fork is struck and its stem is placed in the midline of client's skull or center of forehead. A person with normal hearing perceives the sound equally well in both ears. |
| What does the Romberg test, test for? | Ability to sustain balance. Tests for problems with the vestibular part of the nerve (balance) |
| What is audiometry? | precise measurement of hearing acuity |
| What is the dB level of the softest sound we can perceive? | 20 dB |
| At what dB level are sounds painful? | 120 dB |
| What does electronystagmography test for? | vestibular function |
| How is the caloric stimulation test performed? | Ice water is shot against the tympanic nerve, eyes should move in response to it |
| What is the purpose of the caloric stimulation test? | To determine if someone is brain dead or not |
| A good rule of thumb for ear hygiene is? | Never put anything smaller than the elbow into the ear |
| Why are nonprescription meds used for the ears? | used to soften hardened cerumen |
| What meds can cause ototoxicity? | ASA, Lasix, Gentamycin, and Cisplatin |
| What are the best colors to use for someone with vision impairment? | Black or red on yellow background |
| What is emmetropia? | Normal vision |
| What is myopia | Near sighted, long eyeball |
| What is hyperopia? | Far sighted, short eyeball |
| What is presbyopia? | normal age related change, bifocals or reading glasses help to correct |
| What is astigmatism? | An irregular curve of the cornea (can accompany any of the other conditions or can occur on its own) |
| What is the pathophysiology and etiology of refractive vision errors? | inherited or result of surgical treatment (presbyopia: age related changes) |
| What assessment findings would there be for refractive errors in vision? | Blurred vision -> recurrent headaches, snellen and jaeger charts |
| What is surgical management for refractive errors in vision? | RK; LASIK; PRK |
| What is nursing management for common eye problems? | Perform screening exams (esp school nurses and office settings); refer clients to eye specialists; provide preop and postop care; client teaching (care of contacts, postop care at home) |
| What vision would someone who is legally blind have? | BCVA of 20/200 or less even with corrective lenses (best corrected visual acuity) |
| What are some causes of blindness? | Can be congenital, from injury, damage to the optic nerve, visual disorders, tumors (on the nerve) |
| What is management for blindness? | Corrective lenses, rehab center, skills for independent living |
| What would we assess for someone who is blind? | degree of impairment, ability to cope, response to disability |
| What interventions would we use for a blind client? | Introduce self each time entering room, tell when leaving and location of signal cord; call by name; speak b4 touching; items in same place at all times; ask pt to hold your elbow and walk behind you during amb; describe where food is on plate/ clock face |
| What is the pathophysiology and etiology of impaired vision due to eye trauma? | Sun, wind, sprays, blows, lacerations, and penetrating objects. |
| What is Endophthalmitis? | a condition in which all three layers of the eye and the vitreous are inflamed, removal of the eye may be necessary. |
| What are S&S of eye trauma? | Pain, "gritty" feeling, tearing, blurred vision, asymmetric eyes, diplopia (dbl vision), swelling, bleeding, chng in size or shape, foreign object, purulent drainage |
| What do you use to diagnose eye trauma? | Fluorescein dye, slit-lamp exam, radiography, CT |
| What is the medical and surgical management of eye trauma? | Emergency 1st aid, antibiotic ointment or drops, eye patch, hospitalization, surgery if internal dmg |
| What do you do if a client has something protruding from the eye? | Leave it, stabilize them, and let ophthalmologist take care of the item |
| What are the general interventions for eye trauma? | Wash hands and don gloves, wipe debris away from nose with moist pad, dim lights, flush from inner to outer aspect for 10-15 mins, in 1st aid situation… patch both eyes to prevent ocular movement |
| What is conjunctivitis? | an inflammation of the conjunctiva. Commonly called pink eye because of hemorrhage of the subconjunctival blood vessels, which cause pink appearance. Some forms are highly contagious. |
| What is Uveitis? | an inflammation of the uveal tract which consists of the iris, ciliary body, and choroid |
| What is keratitis and corneal ulcer? | Keratitis is an inflammation of the cornea. A corneal ulcer is an erosion in the corneal tissue |
| What is blepharitis? | an inflammation of the lid margins. |
| What is Hordeolum (a Sty)? | an inflammation and infection of the Zeis or Moll glands, types of oil glands at the edge of the eyelid. |
| What is a chalazion? | a cyst of one or more meibomian glands, a type of sebaceous gland in the inner surface of the eyelid at the junction of the conjunctiva and the lid margin |
| What is the pathophysiology and etiology of conjunctivitis? | (pink eye) Bacterial, viral, Rickettsial infection; can lead to blindness; transmission |
| What are the assessment findings with conjunctivitis? | Redness, tearing, burning, itching, purulent drainage, enlarged lymph nodes |
| What is the medical management for conjunctivitis? | Antibiotic or antiviral meds, warm soaks and irrigations, antihistamines, decongestants |
| What can nurses do for a client with conjunctivitis? | provide eye care, administer meds, client and family teaching (r/t treatments, meds, and prevention of infection and its spread) |
| How do you administer eye medications? | The container for the medication should not touch the eye, and drops are introduced into the inner canthus or corner of the eye. |
| What is the pathophysiology and etiology of Uveitis? | inflammatory changes, identified with specific diseases or autoimmune disorders (Ex: Lupus) |
| What are the assessment findings with uveitis? | Blurred vision, photophobia, eye pain, red, congested eye, pupil reacts poorly to light, slit-lamp exam |
| What is the medical management for uveitis? | oral and topical corticosteroids, mydriatic and antibiotic eyedrops, analgesics, sunglasses |
| What is the nursing management for uveitis? | Client teaching: medication regimen, drug admin technique, compliance with therapy, complications, close follow-up |
| What is the pathophysiology and etiology of keratitis and corneal ulcer? | Trauma to the cornea, infectious agents |
| What are the assessment findings for keratitis and corneal ulcers? | pain, photophobia, blurred vision, tearing, purulent discharge, redness |
| What is the medical and surgical management for keratitis and corneal ulcers? | Topical anesthetics, mydriatics, antibiotics, keratoplasty (removal of excess keratin) |
| What is the nursing management for keratitis and corneal ulcers? | eye care, medication, aseptic technique, teaching r/t contact lenses |
| What is the pathophysiology and etiology of blepharitis? | Hypersecretion, infectious agents |
| What are the assessment findings for blepharitis? | inflamed lid margins (where you would put eyeliner), patchy flakes, missing eyelashes, purulent drainage |
| What is the medical management for blepharitis? | topical antibiotics, cleansing the eye, face and hair |
| What is the nursing management for blepharitis? | Teaching r/t hygiene, effects of noncompliance |
| What is the pathophysiology and etiology of hordeolum (sty)? | Staphylococcus aureus |
| What are the assessment findings for hordeolum (sty)? | tender, swollen, red pustule |
| What is the medical and surgical management for hordeolum (sty)? | warm soaks, topical antibiotics, incision, drainage (Note: warm soaks done only with physician order) |
| What is the nursing management for hordeolum (sty)? | eye care, hygiene, techniques to decrease transmission |
| What is the pathophysiology and etiology of chalazion? | blocking of sebaceous secretions |
| What are the assessment findings for chalazion? | Swelling, hardness, affects visual acuity |
| What is the medical and surgical management for chalazion? | warm soaks, massage, surgical excision |
| What is the nursing management for chalazion? | client prep for exam, teaching r/t treatment and meds, prevention of infection measures, precautions, follow-up care |
| What is the pathophysiology of macular degeneration? | Dry (gradual onset), and wet (abrupt onset) |
| What assessment findings would you find with macular degeneration? | Dry (blurred vision), Wet (diminished color perception and central vision affected |
| What is the medical management for macular degeneration? | Photocoagulation, PDT |
| What is the nursing management for macular degeneration? | assist client to maintain independence, cope with loss of vision |
| What is the pathophysiology for glaucoma? | imbalance between production and drainage of aqueous fluid; Intraocular pressure increases |
| What S&S would you find with assessment of glaucoma? | open-angle: (begins slowly) eye discomfort, temporary blurred vision, halos, reduced peripheral vision. Acute angle-closure: (sudden onset) hard, painful sightless eyes, N, V, red conjunctiva |
| What diagnostic findings would you find upon assessment of someone with glaucoma? | Optic disc visualization, inspection of anterior chamber of the eye, Tonometry, visual field examination |
| What is the medical management for glaucoma? | Meds, miotics, analgesics, complete rest |
| What is the surgical management for glaucoma? | Laser or surgical iridectomy, laser trabeculoplasty, corneal trephine |
| What is the difference between miotics and mydriatics? | Miotics are drugs that constrict the pupil. Mydriatics are dilating drops used to enlarge the pupil for eye examinations |
| What is the nursing management for glaucoma? | client hx, symptoms, meds. Nx interventions for acute angle-closure glaucoma in case of emergency: immediate medical tx, admin analgesics, limit sensory stim, assist w/ADLs. Teaching: medical regimen, follow-up, med admin, med alert jewelry |
| What is the pathophysiology for cataracts? | aging process, congenitally acquired, lens injury, secondary to other disease |
| What assessment findings would be present with cataracts? | halo around lights, diff in reading, changes in color vision, reduced visual acuity, glaring of objects in bright light, distortion of objects, snellen chart, opthalmoscopic and slit-lamp exam, tonometry |
| What is the surgical management for cataracts? | intracapsular or extracapsular extraction, phacoemulsificaion, postsurgery vision restoration, corrective eyeglasses, contacts, intraocular lens implant |
| What is the pathophysiology and etiology for retinal detachment? | stretching, degenerative changes, injury, eye surgery, loss of blood and visual stimuli, vision lost |
| What assessment findings would be present with retinal detachment? | blind spots, flashes of light, floaters, complete loss of vision |
| What is the medical management for retinal detachment? | pneumatic retinopexy |
| What is the surgical management for retinal detachment? | cryosurgery, electrodiathermy, laser reattachment, scleral buckling |
| what is the nursing management for retinal detachment? | immediate exam, postop care, bed rest, head immobilized, client teaching r/t postop care (floaters) |
| Why would enucleation be necessary? | (enucleation is the removal of the eye) related to trauma or cancer of the eye |
| What is the medical and surgical management of enucleation? | metal or plastic ball in capsule of connective tissue, pressure dressing, shell-shaped prosthesis |
| What is the nursing management for enucleation? | assess for bleeding or infection, client teaching r/t care of prosthetic shell |
| What types of material are eye prosthetics made of? | Glass or acrylic |
| What can carotenoids protect against? | macular degeneration |
| What eye disorder can vitamins A and C help prevent? | cataracts |
| What types of food should be eaten after cataract surgery? | soft, easily chewed foods |
| When should eye ointment meds be administered? | at night. Do not administer during the daytime or when driving. Can make vision blurry. |
| What are the gerontologic considerations for eyes? | assist to cope with visual impairment, advise use of glasses or contacts, use teaching aids with lg-sized letters, assist with ADLs, keep room dimly lit at night, assess for depression and withdrawal |
| What are the levels of hearing impairment? | Mild, moderate, severe, or profound |
| What do hearing impairments result from? | excessive noise, conductive loss or sensorineural loss |
| What would be the most common symptom of hearing impairment? | Tinnitus (from sensory nerve loss or damage) |
| What can be the consequences of hearing impairment? | depends on age and severity. <3 years: affects language development. Also effects communication and safety. |
| What is the medical management of hearing impairment? | lip reading, hearing aids, sign language, technologic devices (TDDs), use of products to perceive sound: light-activated alarms, hearing dogs |
| What is the surgical management of hearing impairment? | cochlear implant, bone conduction device, semi-implantable hearing aid |
| How does a cochlear implant work? | Sound is passed from the external transmitter to the inner coil by magnetic conduction and is then carried over an electrode to the cochlea. |
| What would nursing management be for a client who's hard of hearing? | Observe for signs of hearing loss, assess speech & comm skills, teach client & family: use of hearing aids, communication aids, & support services; help to promote self-esteem, evaluate and follow-up. |
| What is the pathophysiology and etiolgy of impacted cerumen? | Interferes with sound carried on airwaves (people can have either wet or dry cerumen, cotton tip swabs can push cerumen back against tympanic membrane) |
| What are the assessment findings for impacted cerumen? | Otalgia (ear pain), diminished hearing, orange-brown accumulation of cerumen. |
| What is the medical management of impacted cerumen? | Hydration, irrigation or removal with cerumen spoon. |
| What is the nursing management for impacted cerumen? | inspect ear and implement measures to remove excessive cerumen, ear drops, irrigation (avoid putting syringe in too deep, direct the flow toward roof of ear canal, position pt on affected side post procedure) |
| What is the pathophysiology and etiology of foreign objects in the ear? | scratched skin, blunt penetration of eardrum, local inflammation of tissue. |
| What are the assessment findings for foreign objects in the ear? | discomfort, diminished hearing, feeling movement, buzzing sound, inspection with penlight or otoscope. |
| What is the medical management for a foreign object in the ear? | mineral oil instillation for insects, removal of solid object with small forceps. |
| What is the nursing management for a foreign object in the ear? | client teaching r/t care of the ear (wash external ear with facecloth, DO NOT insert anything in the ear smaller than the elbow) |
| What is the pathophysiology and etiology of otitis externa? | (swimmer's ear) overgrowth of pathogens, infected hair follicle |
| What are the assessment findings for otitis externa? | red tissue, swelling, reduced hearing, fever, enlarged lymph nodes behind ear, otoscope exam, Culture & Sensitivy (if normal ABX don't work). |
| What is the medical management for otitis externa? | warm soaks, analgesics, ABX |
| What is the nursing management for otitis externa? | Client teaching r/t treatment if symptoms are not relieved, preventing recurrence, avoid use of nonprescription remedies, follow up with physician |
| What is the pathophysiology and etiology of otitis media (OM)? | Respiratory allergies, enlarged adenoids, pressure on the eardrum. |
| What are the assessment findings with otitis media (OM)? | History of recent upper resp infection & seasonal allergies, fever, tinnitus, malaise, earache, diminished hearing, mastoiditis (infection of mastoid bone), eardrum: red & bulging, N, V, dizziness, fluid from ear. |
| What is the medical and surgical management for otitis media? | prevention of rupture of the eardrum, fld aspiration by needle, ABX, myringotomy, tympanotomy, myringoplasty, mastoidectomy. |
| What is the nursing management for otitis media (OM)? | postop care: remove drainage from external ear, wipe with dry, sterile cotton applicator, insert loose cotton pledget |
| What is the pathophysiology and etiology of otosclerosis? | (hardening of little bones in the ear) interference of vibration of stapes (bone) reduces transmission of sound to inner ear, possibly genetic, in females more than males |
| What are ossicles? | The three small bones in the ear (smallest bones in the body) |
| What are the assessment findings with otosclerosis? | S&S: progressive, bilateral hearing loss, Tinnitus (at night), pinkish-orange eardrum). Diagnostic findings: audiometric tests, CT scan |
| What is the medical and surgical management for otosclerosis? | hearing aid, stapedectomy (all or part of stapes is removed) & prosthesis (to vibrate the oval window) |
| What is the nursing management for otosclerosis? | use of comm alternatives, pre and postop teaching r/t care of prosthesis, and postop care: positioning on non-operative side, monitor for N and dizziness, prevent V, coughing, and sneezing; and assess facial nerve function (have ct smile or frown) |
| What is done for otosclerosis? | a wire prosthetic stapes is positioned in the middle ear |
| What would you assess for a client recovering from a stapedectomy? | VS, monitor for complications, drainage from affected ear, lvl of discomfort, reprt elevation in temp |
| What would be the expected outcomes for a client recovering from a stapedectomy? | minimal pain, N, and vertigo, no infection, safety maintained, medical regimen and restrictions discussed |
| What is the pathophysiology and etiolgy of meniere's disease? | malabsorption of fld in the endolymphatic sac |
| What assessment findings would you find with a ct with meniere's disease? | vertigo, tinnitus, hearing loss, N, V, nystagmus, pre-attack HA |
| What is the medical and surgical management for a ct with Meniere's disease? | low-sodium diet, no smoking, bed rest, drug therapy [meclizine (Antivert)], surgical procedures |
| What is the nursing management for a ct with Meniere's disease? | history of symptoms, medical, drug, allergy; assess gross hearing, Weber and Rinne tests; provide emotional support, admin prescribed drugs, limit movement, promote safety, ct teaching r/t treatments |
| Treatment for Meniere's disease includes: (Select all that apply) A. Low sodium diet B. meclizine (antivert) C. smoking cessation D. emotional support | All of the above |
| What are S&S of ototoxicity? | tinnitus, sensorineural hearing loss, vestibular toxicity, lightheadedness, vertigo, N, V |
| What is the nursing management of ototoxicity? | ct teaching: ototoxic effects of certain meds; monitor dosage and frequency of drug admin; assess changes in hearing |
| What is the pathophysiology and etiology of acoustic neuroma? | cochlear nerve compression, interference with bld supply to the nerve and cochlea |
| What are the assessment findings with acoustic neuroma? | gradual hearing loss, tinnitus, altered facial sensation & movement, vertigo with or w/o balance disturbance, MRI, CSF studies |
| What is the medical and surgical management for a ct with acoustic neuroma? | surgical removal of tumor, retain cranial nerve VIII function |
| What is the nursing management for a ct with acoustic neuroma? | (tumor on the nerve) assessment: eval hearing function; observe facial movements, test for facial sensation, postop care: continue assessment, monitor for IICP; maintain strict asepsis |
| T/F Nonprescription preps are available for softening hardened cerumen? | TRUE |
| What are gerontologic considerations for hearing impairment? | drier cerumen-> experience inc incidence of impaction in external meatus; experience disorientation & confusion in strange surroundings, hearing loss common with age, assess ability to care for & maintain hearing aid or other treatments |
| Client has a history of hearing loss and is returning for his annual hearing exam. During your client education session, you explain to him that hearing involves which areas of the ear? | All sections of the ear |
| An 87 year old is receiving her first hearing test due to a perceived change in her hearing. During your client education session, you indicate the lowest level of sound that individuals may normally hear. What is that level? | 20dB |
| From where do the nerve cells of the retina extend? | Optic nerve |
| Which of the following are functions of the eyelids? Select all that apply: eliminates dust, spreads tears, produces tears, impacts ocular light | Spreads tears, impacts ocular light |
| Which structure within the middle ear is instrumental in equalizing middle ear pressure? | Eustachian tubes |
| Which of the following are conditions which interfere with the wearing of contact lenses? Select all that apply: Recurrent upper respiratory infection, clumsiness, recurrent eye infections, low tear production | Recurrent eye infections and low tear production |
| Ct education, you are speaking w/ a ct about the best places to buy hearing aids. In your discussion, which places should they AVOID buying her aids? Select all that apply: mail-order catalog, audiology clinic, ENT clinic, hearing aid co. salesperson | Mail-order catalogue and hearing aid company salesperson |
| Which kind of hearing loss can be caused by frequent ear infections? | Sensorineural |
| Which of the following should be recommended for a patient with blepharitis? Incision and drainage, frequent washing of face and hair, warm soaks of the area, sleeping with the face parallel to the floor | Frequent washing of the face and hair |
| What are the pre-attack symptoms that a client with Meniere’s disease may report? Select all that apply: Low blood pressure, nystagmus, headache, photosensitivity, full feeling in the ear | Headache and full feeling in the ear |
| A patient has suffered a blunt facial trauma to the orbit of his skull. Which of the following bones are in danger of fracture in this type of injury? Select all that apply: mastoid, ethmoid, lacrimal, stapes | Ethmoid and lacrimal |
| Role of nx for ct who will undergo eye exams and tests? (all that apply): assure ct gets eye care to preserve fx & prevent more vision loss determine if further action is warranted obtain baseline fx & structure of eyes advise on diet & excer | Assuring that the client receives eye care to preserve eye function and prevent further vision loss and obtaining an accurate baseline of the function and the structure of the eyes |
| What steps do you take to effectively communicate with a blind client? Select all that apply: notify the patient before you touch her, let the patient know when you leave the room, announce your entrance into the patient’s room | All options |
| Which of the following features should a nurse observe during an ophthalmic assessment? Select all that apply: pupil responses, external eye appearance, intraocular pressure, visual acuity | Pupil responses and external eye appearance |
| Which procedure to repair myopia includes low discomfort, no sutures, and quick healing? | LASIK |
| What advice would you give to a patient regarding swimming who is recovering from otitis externa? | Wear soft plastic ear plugs |
| What precaution should the nurse take when a client is at risk of injury secondary to vertigo and probable imbalance? | Have the client sit in a wheelchair when moving |
| Which of the following are effective communication strategies are appropriate for a patient with hearing loss: speech reading, signing, writing, one he will use | One he will use |
| Which type of hearing loss benefits most from hearing aid use? | Conductive |
| Which visual condition would be indicated in a patient who has noticed an inability to see reading material unless they hold it at arm’s length? | Presbyopia |
| What would be an appropriate nursing intervention for a client who plans to use a hearing aid? | Describe the various types of hearing aids that are available to the client |
| A patient is concerned about his vision changes because he sees distance more clearly than nearby sights. What is the term used to describe his visual condition? | Hyperopia |
| Which of the following is a possible complication of LASIK: corneal microscarring, flap difficulties, discomfort, increased glare | Flap difficulties |
| A patient is diagnosed with myopia. What is the cause of the vision change? | Elongated eyeballs |
| Which cranial nerve alteration causes a patient to begin falling to one side while their eyes are closed during his neuro assessment? | Vestibulocochlear nerve and VIII cranial nerve |
| Which of the following structures is NOT attached to the sclera: cornea, eyelids, iris, pupil | Eyelids |
| Before pneumatic retinopexy is performed, the client should recline for about ___ hours. | 16 |
| Which type of hearing loss is usually irreversible? | Sensorineural |
| Why should the nurse encourage a client with otitis externa to eat soft foods? | Chewing may cause discomfort |
| An MVA victim suffered blunt facial trauma, especially to the orbit of his skull. Which of the cranial nerves are in danger of damage as a result of ocular injuries? Select all that apply: abducens, facial, vestibulocochlear, olfactory | Abducens and facial |
| Which of the following daily functions which typically move cerumen to the external acoustic meatus? Select all that apply: breathing, chewing, clearing one’s throat, talking | Chewing and talking |
| What would you do to promote a blind client’s control over their hospitalized environment? | Ask the patient where to store their self-care items |
| Which glands, contained in the eyelids, produce tears? | Lacrimal |
| A patient has severe sensorineural hearing loss. The patient wants to know if there is a device that could restore her hearing. What is your response? | The hearing is not restorable |
| What would be the correct advice regarding food for a client who underwent a cataract surgery? | Eat soft, easily chewed foods |
| Which of the following are signs of diminished hearing? Select all that apply: leaning back during conversation, clear speech, turning the head, asking for words to be repeated | Turning the head (to hear out of the better ear) and asking for words to be repeated |
| What would be a negative result in a cover-uncover test? | Movement in the uncovered eye |
| A patient has been diagnosed with hyperopia. What is the cause of the vision change? | Eyeballs are shorter than normal |
| During an assessment using the positions test, what does an asymmetrical movement indicate? Select all that apply: cataract, weakness in the extraocular muscles, glaucoma, dysfunction of the cranial nerve | Weakness in the extraocular muscles and dysfunction of the cranial nerve |
| A patient has been diagnosed with myopia. What type of lenses will improve the patient’s vision? | Concave lenses |
| What can you, as a nurse do, to maintain hearing in your pediatric client base? | Reduce frequency and severity of ear infections |
| What is the description of hearing loss based upon? | Intensity of first sound heard |
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