Care of patient with eye and vision problems

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  1. What is Blepharitis and why does it occur?
    -an inflammation of the eyelid edges, itchy, red, burning and Seborrhea of eyebrows and lids 

    -occurs in older adults and dry eye syndrome

    -reduced tear production leads to bacterial infection b/c tears inhibit bacteria growth
  2. How do you treat Blepharitis?
    -warm, moist compress followed by gentle scrubbing with dilute baby shampoo

    -avoid rubbing eye as can spread infection
  3. what is seborrhea
    excessive secretion of sebum resulting in greasy, itching scaling
  4. what is entropion? How do you care for it?
    -turning inward of the eyelids causing the lashes to rub against the eye.

    -demonstrate instillation of eye drops

    -leave patch on until appointment with   ophthalmologist

    -report any draining or pain, clean surgical site and apply ointment
  5. What is ectropion?
    -turning outward and sagging of the eyelid, occurs with aging, muscle relaxation/weakness

    -reduces washing action of tears leading to corneal drying and ulceration (constant tears)

    -surgery to correct, care same as with entropion
  6. what is hordeolum?

    -infection of the sweat glands in the eyelid (external hordeolum) or of the eyelid sebaceous gland (internal hordeolum)

    -red, swollen, tender area occurs on the skin surface sid of the eyelid

    -vision not affected, effects one eye at a time
  7. How do you treat a hordeolum?
    -apply warm compress 4 times a day and apply antibacterial ointment

    -pus will drain and pain will subside

    -ointments may cause blurred vision, remove from eyes before driving by close eye and wipe from nasal outward
  8. How do you instill ointment?
    -each eye should have different bottle, label right and left

    -wash hands, gloves

    -stand behind sitting patient with head tilted back

    -pull down lower lid, squeeze ointment in from nasal outward, gently release lid

    -instruct pt not to squeeze lid when closed, wipe away excess, keep eye closed for 1 min.

    -remove ointment
  9. How do you apply an Ocular Compress?
    -fold clean washcloth into 4ths

    -soak under warm running water

    -place cloth over closed eye, keep in place with minimal pressure until cloth cools

    -refold so new section will be applied to eye, resoak, repeat applications 3 times, as many times as prescribed
  10. How do you apply an eye patch?
    -apply skin preparation to the patient's forehead and cheek

    -instruct to close both eyes and apply patch, tape from cheek to forehead, cover patch with overlapping pieces of tape
  11. How do you apply a pressure eye patch?
    -apply skin preparation to pts forehead and cheek, close both eyes

    -fold one eye patch in half, place over eye and apply unfolded patch over top

    -tape from cheek to forehead with overlapping pieces over patch
  12. what is chalazion?
    -inflammation of a sebceous gland in the eyelid, pt /o eye fatigue, light sensitivity,a nd excessive tearing

    -apply warm compress 4xper day and ointment

    -if removed surgically, eye patch for 6 hours, remove and apply warm compress, eyedrops
  13. What is keratoconjuctivitis sicca, and how is it managed?
    (Dry eye syndrome)

    -changes in tear production from diseases or drugs

    -pt c/o foreign body sensation in eye, burning, itching, light sensitivity, mucous strands in tears

    -eyedrops, artificial tears, lubricating ointment, sx repair of eyelid 
  14. How can hemorrhage occur?
    -blood vessels break with increased pressure, sneezing, coughing, vomiting, hypertension, trauma or blood clotting problems

    -no pain or visual impairment, resolves within 14 days w/o tx
  15. what is the difference b/w allergic conjuctivitis and bacterial conjuctivitis?
    -allergic caused from allergens or irritants, c/o edema, burning, bloodshot, excessive tears and itching

    -bacteria caused c/o blood vessel dilation, mild edema, tears, and discharge (watery and pus)
  16. What is trachoma?
    -chronic conjuctivitis caused by Chlamydia, scars conjuctiva causing blindness

    -control infection oral and topical antibiotics are used
  17. what do corneal disorders cause?
    -reduce the refracting power of the cornea and some can lead to blindness
  18. what is corneal abrasion? Ulceration?
    -a scrape/scratch of the cornea that disrupts its integrity

    -organisms entered abrasion causing infection-URGENT (no seperate blood supply)

    -caused by small foreign body, trauma or contact lenses, malnutrition, dry eye cancer therapies

    -c/o pain reduced vision photophobia and eye secretions, cloudy/purulent fluid

    -eyedrops qhr for 24hrs, R & L bottles, do not wear contacts, strict orders of applying med routinely as stopping infection can save vision
  19. What is Keratoconus?
    -degeneration of the corneal tissue resulting in abnormal corneal shape, trauma or inherited

    -scar and lead to visual impairment, need sx
  20. what is keratoplasty?
    -(corneal transplant) surgery to improve clarity for a permanentcorneal disorder that obscures vision, human donor

    -teach apply antibiotic after sx, pressure patch and shield, lie on non-operative side to reduce intraocular pressure

    -do not use an ice pack on the eye, and examine eye

    -avoid jogging running, dancing, or jerky movements

    -graft rejection, purulent discharge, continuous leak or clear fulid excessive bleeding, floaters, report asap
  21. what steps do you perform on a deceased pt that is an eye donor?
    • -raise head of bed 30 degrees
    • -antibiotic eyedrops
    • -close eyesand apply ice pack
    • -contact family and physician
  22. what activities increase intraocular pressure?
    • -bending from the waist
    • -lifting more than 10lbs
    • -sneezing, coughing, blowing nose
    • -straining during bowel movement
    • -vomiting
    • -have sexual intercourse
    • -keeping head in dependent position
    • -wearing tight shirt collars
  23. what is a cataract?
    -lens opacity that distorts the image projected on the retina, becomes denser with age as it looses water

    -caused by age-related, traumatic, toxic, diseases (diabetes, hypoparathyroidism, down syndrome, chronic sunlight exposure), and chronic ( glaucoma, retinal detachment)

    -reduce risk by wearing sun glasses or eye protection during sports that promote risk

    -blurred vision and decreased color perception, no pain or eye redness, gradual loss of vision

    -sx only cure
  24. how to care for pt after cataract surgery
    -antibiotics, leave eye unpatched, pt wears dark glasses

    -teach how to instill eyedrops, itching is normal, slight swelling-spply cool compress

    -pain can be a sign of hemorrhage or intraocular pressure

    -pts expirience vision improvement on day of surgery bur best vision comes 4-6 weeks after
  25. what is glaucoma?
    -group of eye disorders resulting in increased IOP (fuid pressure within eye)

    -IOP requires a balance b/w production and outflow of aqueous humor otherwise compression of retinal blood vessels occurs causing permanent blindness
  26. what is the difference b/w Primary open-angle glaucoma (POAG) and Primary angle-closure glaucoma (PACG)
    -POAG usually effects both eyes, has no symptoms, and gradually increases IOP; tonometry reading b/w 22-32

    -PACG sudden onset and is an emergency; tonometry reading >30

    -normal tonometry is 10-21 mm Hg
  27. What instructions can you give a patient in order to tx glaucoma with a drug therpay?
    • -stick to precribed schedule of q 12 hrs
    • -dont skip doses
    • -wait 10-15 b/w medication administartion of seperate eye meds
    • -keep hand and eyedropper clean
    • -PUNCTAL OCCLUSION-pressure on corner of eye near nose to prevent systemic absorption of the drug
  28. what is a vitreous hemorrhage?
    -bleeding in the vitreous cavity, aging, systemic diseases, or trauma (detachment from the retina)

    • -mild; red haze or floaters
    • -moderate; black streaks or black dots
    • -severe; reduce visual acuity to hand motion

    -may absorb slowly with no tx or with vitrectomy (removal of vitreous)
  29. what is Anterior and Posterior Uveitis?
    -Anterior: inflammation of the iris or of the ciliary body; aching, tearing, blurred vision, photophobia, bloodshot

    • -Posterior:
    • retinitis-inflammation of the retina, chorioretinitis-inflammation of the choriod and the retina; tuberculosis, syphalis, toxoplasmosis
  30. how do you manage uveitis?
    -steroid drops to rest the ciliary bodies and dilate the pupil

    -cool/warm compresses to reduce pain, darkening the room, wearing sun glasses 
  31. what is macular degeneration
    -deterioration of the macula (area of central vision)

    -age-related(AMD) dry and wet

    -dry is more common, no cure can slow progression with antioxidants, vitamin B12, and carotenoids
  32. what is a retinal hole?
    -a break in the retina
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Care of patient with eye and vision problems
2013-04-05 20:55:34

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