Card Set Information

2012-08-13 11:21:59
AMS1T4 Sensory

Sensory Disorders, Eyes, Ears
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  1. Gloucoma
    • Increased intraocular pressure
    • Optic nerve atrophy
    • Visual field loss
  2. Primary open angle vs angle closure gloucoma
    • Primary open-angle glaucoma
    • --Most common (90%)
    • --Genetic component
    • --Bilateral
    • --Insidious in onset
    • --Slow to progress

    • Angle-closure glaucoma
    • --acute attack develops in an eye in which the anterior chamber angle is anatomically narrow
    • --attack occurs because of a sudden blockage of the anterior angle by the base of the iris
  3. POA vs AC Gloucoma SnSs
    • Primary open-angle glaucoma
    • --Symptoms appear late in the disease
    • --Mild aching in the eyes
    • --Loss of peripheral vision
    • --Seeing halos around lights

    • Acute angle-closure glaucoma
    • --Ophthalmic emergency due to rapid onset
    • --Unilateral inflammation and pain
    • --Pressure over the eye
    • --Moderate pupil dilation that’s nonreactive to light
  4. Diagnostics for Gloucoma
    • Triad of signs: loss of visual field, cupping of optic disc, ^ intraocular pressure.
    • Tonometry (air puff). (Good to know for test). Eye will be more firm than person w/out gloucoma. 
    • Slit-lamp examination
    • Gonioscopy
    • Ophthalmoscopy
    • Perimetry or visual field tests
    • Fundus photography
  5. Tx for Gloucoma
    • Drug therapy to decrease aqueous humor production and to lower IOP
    • --beta blockers 
    • --alpha agonists
    • --miotic eyedrops
    • ----facilitate outflow of AH
    • Argon laser trabeculoplasty
    • --thermal burn increases the outflow of aqueous humor
    • Trabeculectomy
    • --flap of sclera is dissected free and removed, followed by peripheral iridectomy
  6. Nursing considerations for pt/Gloucoma
    • Dilating agents are contraindicated in narrow-angle glaucoma
    • --Mydriatic agents dilate the pupil
    • --Cycloplegic agents paralyze the ciliary muscle and the dilator muscle of the iris

    • Desired outcomes
    • --Patient will report no further loss of vision, adapt to any visual loss, be able to perform ADLs, and recognize clinical manifestations of complications
  7. Cataracts
    A condition which develops when the crystalline lens of the eye begins to develop barriers stopping light from getting through it.
  8. Cataracts SnSs
    • Blurred vision
    • Monocular diplopia
    • Photophobia
    • Glare
    • See better in low light
    • No complaint of pain
    • Cloudy lens
    • Red reflex seen with the direct ophthalmoscope is distorted or absent
    • Accurate determination of type and extent of lens change requires slit-lamp examination
  9. Tx for Cataracts
    • Surgery to remove the opacified lens
    • ICCE
    • --removing lens and lens capsule
    • ECCE
    • --removing lens and anterior portion of lens capsule
    • most common
  10. Patient education for pt w/gloucoma
    • Leave eye patch until f/u visit next day
    • Limit activity 24 hrs
    • Do not lift more than 5 pounds (gal of milk)
    • Do not strain
    • Take eye drops
    • Take Tylenol for pain or itching (common)
  11. Diabetic retinopathy
    • Progressive disorder
    • --Caused by microscopic damage to the retinal vessels, resulting in occlusion of the vessels
    • --Inadequate blood supply causes sections of the retina to deteriorate
    • --Vision is permanently lost
    • A leading cause of blindness worldwide
    • Two types: nonproliferative and proliferative
  12. Retinal detachment
    (Secondary to a tear in the retinaretinal hole)
    • liquid in the vitreous body with access to the hole
    • subsequent fluid accumulation between the retina and the retinal pigment epithelium
    • liquid seeps through the hole and separates the retina from its blood supply
  13. SnSs of retinal detachment
    • Described as shadow or curtain falling across the field of vision
    • No pain
    • Usually sudden onset
    • Burst of black spots or floaters indicate that bleeding has occurred
  14. Surgical repair (scleral buckling)
    • Places retina back in contact with the choroid
    • Vision may improve over weeks and months as healing takes place
  15. Floaters
    Floaters are tissue remnants located in the vitreous body. They will often move after a vigorous blink. Patients view.
  16. Hearing loss
    • Conductive
    • --otosclerosis
    • --trauma
    • Sensorineural 
    • --presbycusis
    • --noise-induced
    • --sudden 
    • Mixed hearing loss
  17. Presbycusis
    • Progressive hearing loss, predominantly in the elderly (age related.)
    • Involves changes in the labyrinthine structures over time
    • Initially, a decrease in high-frequency sound
    • Tinnitus (noise in ear) may accompany
  18. Meniere’s Disease
    • Affects both vestibular and auditory function
    • Caused by excess endolymph in the vestibular and semicircular canals. NS is CX for pt w/Miniere's. 
    • Hearing loss is fluctuant, usually subtle, and reversible in early stages
  19. Nursing considerations for pt w/hearing loss
    • Talk directly to the client while facing him or her
    • Speak clearly but do not overaccentuate words
    • Speak in a normal tone; do not shout
    • Mover closer to the client and toward the better-hearing ear
    • Do not smile, chew gum, or cover the mouth