exam 3

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giep
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76766
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exam 3
Updated:
2011-04-02 17:02:12
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nurse
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eyes
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  1. inflammation of the eye
    conjunctivitis
  2. what can cause conjunctivitis
    bacterial or viral infection

    • *staph
    • *hemophilius
  3. is conjunctivitis contagious
    yes.. readily contagious
  4. what can cause conjunctivitis but not be contagious
    allergens/irritants
  5. what does PERRLA stand for
    • P upils
    • E qual
    • R ound
    • R eactive
    • L ight
    • A ccomodation
  6. what happens during accomodation
    • 1. lens thicken
    • 2. pupils constrict
    • 3. eyes converge
  7. what thickens during pupil dilation
    iris
  8. if the eyes fail to respond to light, what might this indicate
    • 1. optic nerve problem
    • 2. major neurologic prob
    • 3. retinal damage
  9. if the eyes fail to respond to accomodation, this may indicate.....
    neurological probs
  10. failure of the eyes to respond to both ACCOMODATION and LIGHT can be related to what condition
    diabetes mellitus
  11. treatment for allergic conjunctivitis
    instillation of vasoconstrictors and corticosteroid eye drops
  12. what's an important teaching for women pts with conjunctivitis
    avoid using make up around the eye until all sx have subsided
  13. bacterial conjunctivitis aka?
    pink eye
  14. manifestations of allergic conjunctivitis
    edema, burning sensation, engorgement fo blood vessels (blood shot appearance), excess tears, itching
  15. manifestations of bacterial conjunctivitis
    blood vessel dilation, mild conjunctival edema, tears, discharge

    the discharge is watery at firstm then becomes thicker w/ shreds of mucus
  16. treatment for bacerial conjunctivitis
    topical abx
  17. #1 teaching for pts with conjunctivitis?
    HANDWASHING!

    prevent spreading

    avoid sharing wash cloths and towels
  18. this is a chronic bilateral scarring form of conjunctivitis
    trachoma
  19. What causes trachoma?
    Chlamydia Trachomatis
  20. This is the chief cause of preventable blindness in the world
    trachoma
  21. What climate are the incidences of Trachoma highest?
    tropical climates
  22. Trachoma is an endemic in w/c parts of the world?
    middle east, parts of africa and asia

    *poor sanitation
  23. is trachoma contagious?
    yes

    *proper handwashing again!
  24. How is Trachoma treated
    Tetracycline or erythromycin will cure infection
  25. nursing intervention of Trachoma includes:
    • 1.i nfection control
    • 2. proper handwashing
    • 3. no sharing washcloths, separate launder

    *complete course of abx
  26. Incubation period of trachoma
    5 - 14 days
  27. manifestations of trachoma
    at first it resemble bacterial conjunctivitis: tears, photophobia, edema of eye lids and conjunctiva

    follicles form on the upper eyelid conjunctiva

    as the disease progresses, the eyelid scars and turns inward

    causes the eye lashes to damage the cornea
  28. Common complaint of those with cataracts?
    cloudy vision
  29. how do cataracts form?
    age --> lose water in lense --> increase density (from compresed older lens fibers and new fibers) --> lens proteins dry out and form crystals

    as density of lens increase --> lens becomes opaque w/ painless loss of transparency

    *most age related are bilateral w/ no pain
  30. what vision is lost first with cataract formation
    peripheral vision first
  31. are cataracts only age related?
    no

    may be present at birth, may develop anytime

    may be age related (lens water loss and fiber compaction)

    or caused by trauma (penetrating eye injury, intraocular forein bodies, radiation exposure) or exposure to toxic agents (corticosteroids, moitic agents, phenothiazine derivatives)

    may occur with other disease or ocular disorders (dm, hypoparathyroidism, downs, chronic sunlight exposure)
  32. teaching for preventing cataract formation
    • wear sunglasses
    • limit uv lights in eyes
    • wear protective gear during sports
  33. can cataracts cause blindness?
    yes, without surgical intervention
  34. whats important to know about age related cataracts
    no pain or eye redness
  35. what is the only cure for cataracts
    surgery

    impanted lens, glasses or contact lens
  36. post surgery care for cataracts?
    abx stat
  37. after cataract surgery a pt has a blood shot appearnce and mild itching. is this an emergency?
    no, it's normal

    the eye lid may be slightly swollen

    **it's not normal to have significant swelling and bruising
  38. pain early after cataract surgery may indicate what?
    • complications:
    • increased IOP
    • hemorrhage
    • w/ n/v
  39. important teachings post cataract surgery?
    • 1. avoid increased IOP:
    • bending from waist
    • lifting >10lbs
    • blowing nose, coughing, vomiting
    • straining for bm
    • tight collars

    • 2. s/s of infection:
    • redness in eye
    • change in visual acuity
    • tears
    • photophobia
    • creamy white dry crusty discharge
    • yellow green drainage

    **** vision should improve not get worst, best to call doctor if it worsens
  40. normal intraocular pressure?
    10-21 mm/hg
  41. if someone has IOP of >21?
    increase IOP
  42. what measures the pressure in the eyes
    tonometry
  43. what are complications of increased IOP
    perfusion is decreased --> ischemia
  44. This is a group of ocular disease resulting in increased IOP
    glaucoma
  45. what causes the increased IOP in glaucoma
    imbalnce between production and outflow of aqueous humor
  46. visual loss for glaucoma is irreversible. why?
    due to increased IOP, pressure is put on the blood vessels in the eyes w/c prevents blood flow.

    this results in poor oxygenated photoreceptors

    these sensitive nerve tissues become ischemic and die

    when too many have died, sight is lost and permanently blindness occurs
  47. what are the primary risk factors for developing glaucoma
    age and race

    • also: trauma, dm, htn
    • (anything that can affect cappillaries and outflow)
  48. What eye drug do we not want to give to someone with glaucoma?
    atropine (mydratics)
  49. Why wouldn't we want to give mydriatics (atropine) to someone with glaucoma?
    this will dilate eyes and further increase IOP

    *remember glaucoma pts already have an issue with increased IOP
  50. 2 types of glaucoma?
    • 1. open angle
    • 2. angle closure
  51. of the two types of glaucomas, w/c type is an emergency
    angle closure
  52. why would ANGLE-CLOSURE GLAUCOMA be an emergency?
    it has sudden onset and can cause blindness in 1-2 days

    • *the angle narrows or closes completely:
    • -corneal flattening
    • -lens thickening with accomodation
    • -iris thickens w/ dilation
  53. w/c medications are used in ANGLE CLOSURE GLAUCOMA to "buy time"
    • diuretics (help get fluids off)
    • mannitol
  54. What is the treatment for ANGLE CLOSURE GLAUCOMA
    ONLY SURGERY! this is an EMERGENCY!
  55. what med is given to decreased IOP before surgery?
    diamox (carbonic inhydrase inhibitors)
  56. OPEN ANGLE GLAUCOMA is painful. t or f?
    false

    *angle closure glaucoma is painful because it has sudden onset

    *open angle is slow and painless
  57. w/ OPEN ANGLE GLAUCOMA, what vision is slowly lost? central or peripheral?
    peripheral
  58. with OPEN ANGLE GLAUCOMA, the angle between the cornea and iris is normal. It's the flow between the __ and the ___ that is obstructed
    canal of schlemm and trabecular meshwork
  59. EYE MEDS
    1. adrenergics do what?
    • decrease aqueous humor production &
    • attempt to increase out flow

    ex. epinephrine
  60. EYE MEDS
    2. carbonic anhydrase inhibitors
    inhibit/decrease production of aqueous humor

    ex. diamox
  61. EYE MEDS
    3. cholinergics (miotics)
    • increase drainage of aqueous humor
    • (constrict pupil)

    book: decrease amt of aquaous humor production
  62. EYE MEDS
    4. beta-blockers
    decrease rate at w/c fluid flows into the eye
  63. EYE MEDS
    5. prostaglandins
    increase outflow of aqueous humor

    book: dilate blood vessels w/c increase absorption
  64. where are the photoreceptors of the eyes
    in the retina
  65. what is the retina's job?
    the retina contains photoreceptors of the eyes

    they allow for perception of light, image transmission
  66. if the retina is detached, what does vision look like
    spots, lines, flashes, floaters, blurred
  67. what can cause retina detachment
    trauma or age
  68. how is the retina detachment managed?
    surgery!

    • cyryotherapy (freezing)
    • photocoagulation (laser)
    • diathermy (high freq current)

    *common repair procedure is scleral buckling
  69. post retinal surgery teaching
    avoid reading, writing, close work (sewing) in first week to avoid rapid eye movement and promote detachment

    infect (loss of visual acuity, pain, pupil no response to light)
  70. diabetic retinopathy is related to ____ control
    glycemic
  71. what happens to the capillaries of the retina in diabetic retinopathy
    they become sclerotic and lose their ability to transport o2 and other nutrients (decreased perfusion)

    can cause ischemia
  72. those with diabetic retinopathy have increased risk for what
    retinal detachment
  73. what is done to treat diabetic retinopahty
    laser photocogulation to treat

    *this slows process, but DOES NOT CURE
  74. the area of central vision is the what?
    macula
  75. there are 2 types of macular degeneration
    • 1. dry
    • 2. wet
  76. which of the 2 types of macular degeneration is an emergency
    wet

    because is consists of weak and leaky blood vessels which can cause blockage of capilaries and blood flow
  77. what happens with dry macular degeneration
    the macula shrinks and and has deposits
  78. what is the treatment for dry macular degeneration? wet?
    dry - antioxidants

    wet - surgery

    *no cure, but slows process
  79. which of the two macular degenerations is slower
    dry
  80. what vision is lost with macular degeneration? central or peripheral?
    central

    peripheral remains
  81. wet macular degeneration is also known as?
    exudative

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