exam 7 alterations
Quiz yourself by thinking what should be in
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| what is cataracts | Opacity of the lens that distorts the image projected onto the retina and can progress to blindness
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| what causes cataracts | aging process, inherited, injury or other eye diseases
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| what is secondary cataracts | caused by DM, maternal rubella, severe myopia, UV light exposure and steroids
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| interventions for cataracts | Removal of lens
Lens implant one eye at a time
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| cataract manifestations | Blurred vision
Decreased color vision
White pupil
Diplopia
Reduced visual acuity
Reduced red reflex
Pain or redness
LOSS OF VISION IS GRADUAL
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| pre op care for cataracts | Administer eye drops mydriatics and cycloplegics as prescribed (they dilate the pupil)
Atropine, cyclogyl, isopto and opticyl
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| post op care for cataracts | Elevate head of bed 30-45 degrees
Turn client to back or non-operative side
Wear a patch at night to avoid scratching
No bending at waist
Position clients’ belongings on non-operative side
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| post op care for cataracts | Use side rails for safety
Assist with ambulation
Avoid rapid movements – straining, sneezing, coughing, bending, vomiting or lifting heavy object over 5lbs
Take measures to prevent constipation
Wear dark glasses
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| post op care for cataracts | It may take several months to get vision back to normal
Depth perception will be off so maintain caution with stairs
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| what is glaucoma | increased intraocular pressure, normal pressure is 10-21mmHg, damages optic nerve and can cause blindness, gradual loss of vision, LOSS OF PERIPHERAL VISION
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| does open angle glaucoma affect both eyes | yes
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| does closed angle glaucoma affect both eyes | no
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| which glaucoma is a medical emergency | closed angle
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| what are the manifestations of closed angle glaucoma | painful, sudden vision changes, blurred vision, halos around light, ocular erythema
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| what are the manifestations of open angle glaucoma | painless, vision changes slow, “tunnel” vision
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| interventions for glaucoma | Importance of taking lifelong meds, miotics (constrict pupils), carbonic anhydrase inhibitors (decrease production of aqueous humor), beta blockers (decrease production of aqueous humor and decrease intraocular pressure)
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| interventions for glaucoma | Wear medic-alert bracelet
Avoid anticholinergic meds
Report halos, changes in vision to MD
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| indications for glaucoma | Surgery may be needed if meds to not help
Contact MD before taking OTC meds
Client may need trabeculoplasty (draining of aqueous humor)
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| medications for glaucoma | Beta blockers (Ocupress, -olols)
Alpha agonists (-idine)
Prostaglandin (-prost)
Cholinergic (-ide)
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| medications for glaucoma | Carbonic anhydrase inhibitors (-mides)
Nonselective adrenergic agonist (propine)
AVOID ATROPINE it increases intraocular pressure
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| what is a retinal detachment | detachment of the retina from the epithelium
When detachment becomes complete, blindness occurs
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| manifestations of retinal detachment | Flashes of light
Floaters (signs of bleeding)
Increased blurry vision
Sense of curtain being drawn over eye
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| manifestations of retinal detachment | Loss of portion of field, painless loss of central or peripheral vision
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| interventions for retinal detachment | Provide bed rest
Cover both eyes to prevent further detachment
Speak to client before approaching
Position clients head as prescribed (if right eye affected turn head to right, left to left)
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| interventions for retinal detachment | Protect client avoid jerky movements
Minimize eye stress
Prepare client for surgery
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| what is macular degeneration | CENTRAL VISION GONE, leading cause of legal blindness
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| what are the two types of macular degeneration | Age related (dry) – ischemia and necrotic macula, rods and cones die most common, slow progression
Exudative (wet) – scar formation and visual distortion, fast progression
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| what are the manifestations for macular degeneration | Decline in central vision
Blurred vision and distortion
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| what are the interventions for macular degeneration | Aimed at maximizing remaining vision
Laser therapy
Photodynamic therapy-wet
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| what are medications for macular degeneration | Macugen, Avastin, Lucentis
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| what is conjunctivitis | most common eye disease, bacterial or viral, acute or chronic
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| what is the most common conjunctivitis, acute | pink eye
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| what are signs and symptoms of pink eye | redness, itching, burning and light sensitivity
Highly contagious
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| manifestations of conjunctivitis | visual disturbances
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| how is conjunctivitis diagnosed | culture and sensitivity
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| what meds are used for conjunctivitis | Anti-inflammatory – restasis, ocufen, optivar, opticrom, emadine
Anti-infective – antibacterial, antifungal, antiviral
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| what is trachoma | due to chlamydia in southwest native American culture
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| what is external otitis | (swimmer’s ear) – infective inflammatory or allergic response
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| what are the manifestations for external otitis | Pain
Itching
Plugged feeling in ear
Redness/edema
Exudate
Hearing loss
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| interventions for external otitis | Apply heat for 20 minutes 3x daily
Encourage rest
Administer antibiotics or steroids as prescribed
Administer analgesics as prescribed
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| interventions for external otitis | Instruct client to keep ears clean and dry
Use earplugs for swimming
Do not use cotton tipped swabs as damage can result
Hair products and headphones should not be used
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| medications for external otitis | Antibiotics – amoxicillin, penicillin, erythromycin
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| what is mastoiditis | acute or chronic, resulting from untreated ear infection
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| manifestations of mastoiditis | Reddened dull thick immobile tympanic membrane
Tender enlarged lymph nodes
Low grade fever
Malaise
Anorexia
Swelling behind ear and pain with minimal movement of head
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| interventions for mastoiditis | Prepare client for surgical intervention
Monitor for complications – increased risk for spreading into brain
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| what is meniere's disease | over production of fluid in the ear, caused by viral and bacterial infections, biochemical disturbances, vascular disturbances, long-term stress
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| manifestations of meniere's disease | Feeling of fullness in ear
Tinnitus
Hearing loss
Vertigo
Nausea/vomiting
Nystagmus (rapid involuntary movement of the eye)
Severe headaches
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| interventions for menieres disease | Client safety is most important
Prevent injury
Bed rest
Salt and fluid restriction
Smoking cessation
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| medications for meniere's disease | Valium
Meclizine
Diuretics
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