Med Surg

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Med Surg
2013-07-27 11:44:08
Neuro Exam

Neurosensory Vision and Hearing
Show Answers:

  1. Which diagnostic test is used to determine gross hearing acuity?
    • 1. Whisper Test
    • 2. Rinne Test
    • 3. Weber Test
  2. Which data collection item would be collected for hearing loss?
    The patient may either talk to softly, or shout
  3. What ear structure function equalizes pressure in the middle ear so tat the eardrum can vibrate freely?
    Eustachian Tube
  4. What part of the eye it color?
  5. What gelatin-like substance gives the eye its shape and fills the space behind the lens?
    Vitreous humor
  6. What would you consider a normal finding if noted in the lining of the ear canal?
  7. What technique would the nurse use when testing a patient's peripheral visual ability?
    • By visual fields
    • - confontation ability of the person to see peripheral while looking straight ahead
  8. What does PEERLA mean?
    Pupils are Equal, Round, Reactive to light & acccomdation
  9. What lighting enviornment would the nurse use to examine the patient's pupils?
    • Darkened room
    • * use a pen light = start on the side and come mid line
  10. How would you interpret a Snellen chart finding of 20/60?
    Its a visual impairment - means that patient has a lessened acuity of vision

    -- means that the patient can read at 20 feet what a normal person can read at 60 feet.
  11. Why does the nurse apply pressure to the inner corner of the eye for 1 minute after administering eye drops?
    Prevent/reduce a systemic effect of the meds through the tear duct
  12. What behavior observed during the interview would indicate a hearing loss?
    The cup their ear, struggling to hear
  13. What instructions would the nurse give to a patient who asks how to remove cerumen from ears?
    • Do not remove it
    • The ear is self cleaning, wax is usually removed during shower
    • Do not put anything in the ear
    • Wax is a protective mechanism, it lubricates and protects earducts
  14. What type of hearing loss would a hearing aid assist with the patient's hearing disorder?
    Conductive hearing loss
  15. How does the nurse evaluate if hearing aid is functioning properly?
    if the patient can carry a conversation with them
  16. What intervention would most enhance the nurse's communication with the patient who has presbycusis?
    Presbycusis = age related/ gradual hearing loss

    • use low frequency/low tone
    • patient cannot hear these consonants 
    •     = s, z, f, t, g, sh
  17. What structure changes the shape of the lens of the eye?
    Ciliary muscles
  18. What signs/symptoms are indicative of cataract formation?
    • Foggy/cloudy vision
    • glare at night
    • difficulty reading fine print
    • halos around lights
    • decrease in color vision
  19. What causes cataract in the elderly?
    • Age
    • Medical conditions
    • Smoking
    • Steroids
    • Nutritional deficiency
    • Infection
    • Trauma
  20. Why is atropine not utilized as a preoperative medication for a patient with acute angle glaucoma? if ordered what would you  do?
    Atropine can cause blindness

    I should notify the RN or physician/ question the order
  21. What teaching content would you review with a patient who has open ended glaucoma?
    Life long eyedrops == to keep ocular pressure down
  22. What is the expected effect of pilocarpine?
    Pilocarpine = myotic

    It promotes drainage of aqueous humor == Decreases ocular pressure
  23. How would you instruct your patient on how to give eye medications?
    • Tilt head back
    • Lower lid to make a pocket
    • use pinky to anchor the hand
  24. What visual changes is the patient experiencing with macular degeneration?
    • Peripheral vision only
    •  - Central vision is gone
  25. The patient has a ruptured eardrum. What precaution should the patient take against water?
    • Keep the ear dry, do not get any water in it
    • if water gets in, bacteria can grow = infection
  26. What nursing intervention would you include for a patient who had myringoplasty?
    • Not a lot of head movement
    • the graft is very delicate and will not take if the head is moving alot
  27. Your patient is a swimmer. She is complaining of pain and itching of the ear. What condition might she have?
    External otitis/ Swimmers Ear
  28. What signs/symptoms would the nurse expect while admitting a patient with Meniere's disease?
    Triad == Vertigo, Hearing loss, Tinitis (ringing)
  29. What precautions would the nurse put a patient with Meniere's disease on?
    Fall precautions
  30. What symptoms would the patient be experiencing if they have an inner ear disorder?
    • dizziness
    • vertigo
    • equilibrium/sensory neuro loss
  31. What data collection findings would support a patient that has a visual impairment?
    • Not interested in the TV
    • Social isolation
  32. What nursing intervention would the nurse do for a patient who lives alone and has a visual impairment?
    • Look at the safety of the home:
    • - no throw rugs
    • - make sure there are banisters near steps

    they structure the environment  - put/keep things in there right place

    make sure patient goes to all scheduled eye exams
  33. What is myopia?
  34. How do you treat myopia?
    With concave lenses
  35. What discharge instruction will be crucial for the patient who is discharged with diabetic retinopathy?
    Have to control diabetes to prevent complications
  36. What nursing action is most appropriate when caring for a patient who is to have cataract surgery and asks is it a safe procedure?
    the patient needs to talk to doctor
  37. Which nursing action is most important when communicating with a hearing impaired patient?
    • Face patient
    • Level to level with patient
    • eye contact with patient
    • do not shout
    • talk into ear
  38. What medical condition is contraindicated for a patient who is about to receive an ear irrigation due to impacted cerumen?
    Previous perforated eardrum
  39. How would the nurse explain Meniere's Disease to her patient who is emotionally upset?
    • that episodes might occur suddenly
    • might have a warning: i.e. headache
    • can occur 3-4 times a year
    • it can go into remission 
    • she should reduce anxiety
  40. Patient has an eye injury and is covered with an eyepatch. What discharge instructions would you review with patient on care of eye?
    • Keep covered
    • Dressing should be tight enough to keep eye shut
    • refrain from watching tv/reading = eye strain
  41. What is a cataract formation?
    • it formed over time
    • opacity of the lens of the eye that causes a loss of vision

    vision is diminished because light rays arent able to get to retina
  42. What nursing action is taken when the nurse assesses an eye enucleation site and there is a large amount of bleeding on dressing?
    • reinforce
    • notify RN/physician
  43. How do you administer ear drops to an adult?
    Pull pinna up and back
  44. Nystagmus
    involuntary, cyclical, rapid, movement of the eyes in response to vertical, horizontal, rotary movement
  45. Myopia
  46. Retinopathy
    • illness of retina
    • Diabetes/scare changes of retinal blood vessels
  47. Ptosis
    dropping of eyelid
  48. Astigmatism
    unequal curvature on shape of cornea
  49. Conjuctivitis
    • inflammation of joining membrane of the eye
    • "pink eye"
  50. hypertrophy
  51. Pred Forte
    Anti inflammatory
  52. Liquifilm tears
  53. Timoptic
    Beta adrenergic blocker for glaucoma
  54. Xalatan
    beta adrenergic blocker for glaucoma
  55. tobrex
    anti infective
  56. dobrex
    ceruminoltyic -- for cerumen
  57. List 4 eye injuries that may occur if safety measures are not followed?
    • 1. Foreign objects
    • 2. chemical splashes
    • 3. corenal lens abrasion/infection contact lens
    • 4. UV light
    • 5. visual deficits in adults with corrective lenses
    • 6. eye strain from computer usage
    • 7. eye injury from sports