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Terms in this set (76)A patient requires dorzolamide (Trusopt) for glaucoma. What is the nurse's priority patient assessment before therapy is begun? A. Medication list The nurse's priority is the compilation of a list of the patient's medications to help identify potential drug interactions and the potential for cross-sensitivity to sulfa drugs. The nurse will analyze the medication list for sulfa drugs and sulfonamides and diuretics because these medications have side-effect profiles similar to the hematologic, gastrointestinal, integumentary, and metabolic effects of carbonic anhydrase inhibitors. The nurse wants to decrease the risk of secondary infections and
complications associated with the use of antimicrobial eyedrops. What is the nurse's priority instruction during teaching of patients who are beginning to use the eyedrops? D. Avoid touching the medication container to the eye. The nurse stresses the importance of avoiding contact between the medication container and the infected tissue as a means of preventing both contamination of the medication and secondary infections. Tilting the head, applying gentle pressure, and retracting the lower eyelid are reasonable nursing instructions for a patient using eyedrops; however, these measures are unrelated to infection control. The nurse is teaching patients with glaucoma to self-administer their
medications. Which patient teaching should the nurse provide? B. Allow eyedrops to fall on the conjunctival sac. The nurse instructs the patients to allow the medication to fall on the conjunctival sac and not directly on the eye. Ointment is applied under the lower eyelid. Excess medication may be dabbed away with a tissue, provided the patient is careful not to allow the tissue to remove medication from the eye. The nurse avoids instructing patients to wipe the eyes with a warm compress because the heat may affect the absorption of the medication. An older client has decided to give up driving due to cataracts. What assessment information is most important to
collect? B A client is in the preoperative holding area waiting for cataract surgery. The client says Oh, yeah, I forgot to tell you that I take clopidogrel, or Plavix. What action by the nurse is most important? D A client does not understand why vision loss due to glaucoma is irreversible. What explanation by the nurse is best? A A clients intraocular pressure (IOP) is 28 mm Hg. What action by the nurse is best? C A client has a foreign body in the eye. What action by the nurse takes priority? A A client who is near blind is admitted to the hospital. What action by the nurse is most important? C A client is taking timolol (Timoptic) eyedrops. The nurse assesses the clients pulse at 48 beats/min. What action by the nurse is the priority? D A client has been prescribed brinzolamide (Azopt). What assessment by the nurse requires consultation with the provider? B A client is brought to the emergency department after a car crash. The client has a large piece of glass in the left eye. What action by the nurse takes priority? B A nurse is seeing clients in the ophthalmology clinic.
Which client should the nurse see first? B A client had cataract surgery. What instructions should the nurse provide? (Select all that apply.) A,B,C,E A nurse has delegated applying a warm compress to a clients eye. What actions by the unlicensed assistive personnel (UAP) warrant intervention by the nurse? (Select all that apply.) A,B The nurse is caring for a client who reports slow onset of a gradual loss of vision in the center of both eyes. The client describes vision as "foggy" and reports concerns of ongoing
headaches from "trying to concentrate to see." What condition does the nurse anticipate? B Glaucoma The nurse is teaching a client who must instill multiple types of eyedrops before cataract surgery. Which client statement requires further teaching? C Which action by a nurse is most likely to increase accurate communication with a client who has low vision? C (Iggy 982) For which client will the nurse avoid performing an otoscopic examination?
D (Iggy p990) nearsightedness (difficulty seeing things that are far) Myopia farsightedness (difficulty seeing things that are close) Hyperopia deviation of eye due to poor muscle control (lazy eye), Treated with patch therapy Strabismus the front surface of the eye or the lens (cornea) is curved differently in one direction than the other Astigmatism constricted pupil Myosis dilated pupil Midrysis a half-circle of gray, white, or yellow deposits in the outer edge of your cornea, the clear outer layer on the front of your eye Arcus senilis ... farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age Presbyopia involuntary shaking of the eye; may be caused by alcohol, inner ear problems, MS, stroke) Nystagmus OD right eye OS left eye OU both eyes sensorineural hearing loss associated with aging; hearing loss is gradual and bilateral and client may state they have no problem Presbycusis occurs when sound waves are blocked to the inner ear fibers; may be caused by inflammatory process or obstruction conductive hearing loss pathological process of inner ear or of sensory fibers that lead to cerebral cortex; often permanent Sensorineural hearing loss Punctal occlusion Apply light pressure on lacrimal sac for 1 minute after instilling drops in order to avoid systemic absorption This class of medication both reduces aqueous humor production and increases its outflow. Allergic reactions frequently occur with this class of medication. Can increase BP, Pupils can remain dilated Alpha adrenergic Agonists: This type of medication works to lower eye (intraocular) pressure by reducing aqueous humor production and decreasing the rate at which the fluid flows into the eye; topical eye drop administration; lowers BP & RR, monitor for SOB & hypotension; contraindicated for pt's with asthma, (-olol) endings Beta-blockers Timolol (Timoptic) beta-blocker used to lower IOP These are eye drops or pills that reduce fluid production in the eye; cause frequent urination and tingling in hands and feet; ask about sulfa allergy; (-amide) endings Carbonic Anhydrase Inhibitors Dorzolamide (Trusopt®) carbonic anhydrase inhibitor, reduce IOP by reducing fluid production, ask about sulfa allergy! Acetazolamide (Diamox®) an oral carbonic anhydrase inhibitor, reduce IOP by reducing fluid production, ask about sulfa allergy! This type of medication is a cholinergic agent, which causes the pupil to become much smaller in diameter and helps increase fluid drainage from the eye Miotics Pilocarpine Miotic, decreases IOP by increasing fluid drainage this class of medication cause eye to darken, lashes to increase; reduces eye pressure by increasing the outward flow of fluid from the eye (-ost) endings Prostaglandin analogs Latanoprost (Xalatan®) prostaglandin analog, reduces IOP by increasing outward flow of fluid, will darken eye color Travoprost (Travatan®) prostaglandin analog, reduces IOP by increasing outward flow of fluid, will darken eye color a modern cataract surgery method in which the eye's internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye Phacoemulsification Normal IOP range 10-21 mmHg puff of air test that involves an eye's resistance to a puff of air from a small handheld jet, which calculates a range of intraocular pressure (IOP) noncontact tonometry flattened cone is brought in contact with cornea and amount of pressure needed to flatten cornea is measured Contact tonometry what does increased IOP (>21) indicate? glaucoma Which patient is most in need of immediate examination by an ophthalmologist? The 40-year-old patient with glasses and a reddened sclera who reports brow pain, headache, and seeing colored halos around lights is exhibiting signs and symptoms of increased intraocular pressure (IOP). This is a priority because the optic nerve can be damaged, which can cause possible blindness. Acute angle-closure glaucoma can occur in those 40 years of age and older. A patient with a cataract wishes to undergo cataract surgery. In which age group must this patient be in order for this
procedure to be covered by Medicare? 65-75 years Which is the primary cause of glaucoma in a patient? Heredity is a primary cause of glaucoma. Diabetes is the associated cause of glaucoma, but it is not the direct or primary cause of glaucoma. Hypertension is associated with glaucoma because the increased blood pressure affects the optic nerve as well. Neovascular disorders are the secondary cause for glaucoma. (Iggy 972) Which condition is observed in a patient with cataracts? Increase in lens density Which surgical procedure removes the lens of the eye and, in most cases, replaces it with an artificial lens? Cataract surgery Which surgical procedure creates a new channel for fluid outflow as a treatment for open-angle glaucoma? Trabeculectomy Which is a common cause of toxic cataracts? Phenothiazine derivative is a common cause of toxic cataracts. Chronic sunlight exposure is a common cause of associated cataracts. Blunt injury to the eye or head is a common cause of traumatic cataracts. Lens water loss and fiber compaction are common causes of age-related cataracts. (Iggy 969) What is a typical cause of sensorineural hearing loss? Prolonged exposure to noise damages the hair cells of the cochlea, resulting in sensorineural hearing loss. Sensorineural hearing loss occurs when the inner ear sensory nerve fibers that lead to the cerebral cortex are damaged. Other causes of sensorineural hearing loss include acoustic neuroma, diabetes mellitus, and presbycusis. Conductive hearing loss occurs when sound waves are blocked from contact with inner ear nerve fibers because of external ear or middle ear disorders. Presence of cerumen in the ear, perforation of the tympanic membrane, and presence of a foreign body in the ear are some of the causes of conductive hearing loss. (Iggy 989) In what ways can trauma to the eardrum be prevented? Select all that apply. Slapping over the ear increases pressure in the ear canal and can tear the eardrum. Excessive nose blowing changes the pressure in the middle ear. High pressure damages the ossicles and can perforate the eardrum. The nose should be blown gently without occluding either nostril and with the mouth open. Ear plugs should be used when swimming to prevent external otitis, not trauma. The use of cotton-tipped applicators or ear candles to remove cerumen should be avoided to prevent trauma to the external canal. What
are causes of conductive hearing loss? Select all that apply. Conductive hearing loss occurs when sound waves are blocked from contact with inner ear nerve fibers due to external ear or middle ear disorders. Some of the causes include cerumen impaction, presence of a foreign body in the external ear, and a ruptured tympanic membrane. Diabetes mellitus and prolonged exposure to noise damage the inner ear sensory nerve fibers leading to sensorineural hearing loss. Which technique is the correct way to instill eardrops? Place the medication bottle in a bowl of warm water before instillation. What assessment findings are usually present with sensorineural hearing loss? Select all that apply. 1,2,5 The nurse is preparing a patient for an ultrasound examination of the eye. The patient was prescribed anesthetic eye drops before the test. Which action should the nurse take when administering the eye drops? Gently press and hold the corner of the eye nearest the nose. Which term is the patient most likely to use when describing neuropathic pain? Common descriptions of neuropathic pain include shooting, burning, and fiery. Deep somatic pain is typically described as dull, aching, or cramping. A
patient has recently had cataract surgery. About which symptom does the nurse instruct the patient to notify the health care provider? A reduction in vision after cataract surgery indicates a problem, and the patient should notify the provider immediately. Increased tearing, itching of the eye, and a swollen eyelid all are expected after cataract surgery. A trauma patient has been brought in to the emergency department after sustaining severe injuries during a violent rape. What is the priority nursing intervention? Establishing a patent airway by positioning, suctioning, and giving oxygen as required If the nurse working in a hospital suspects physical abuse or neglect of an older patient, who should the nurse notify? The hospital social worker
What is the most common type of elder abuse? Neglect occurs when a caregiver fails to provide for an older adult's basic needs and accounts for almost half of all cases of elder abuse.(Iggy p39) Which does the nurse identify as the intentional use of isolation toward older adults in a family? Emotional abuse is a type of abuse in which family members use threats, humiliation, intimidation, and isolation toward an older person. Neglect refers to the failure of the caregiver to provide for the basic needs of an older adult. Physical abuse involves the use of physical force on a person. Financial abuse refers to mismanaging or misusing someone else's property. Which statement
made by a new nurse about older adult abuse and neglect requires correction from the experienced nurse? Molesting, hitting, burning, or pushing a patient are all examples of physical abuse. Hitting an older adult is an example of physical, not emotional, abuse. Failing to provide basic needs to an older adult is an example of neglect. Mismanagement of an older adult's financial resources is an example of financial abuse. When assessing a patient who is receiving a direct-acting cholinergic eyedrop as part of treatment for glaucoma, the nurse anticipates that the drug affects the pupil in which way? b. it causes miosis, or pupil constriction. (Lilley p899) When the nurse is providing teaching about eye medications for glaucoma, the nurse tells the patient that miotics help glaucoma by which mechanism of action? (SATA) 2, 3 During the assessment of a glaucoma patient who has newly prescribed carbonic anhydrase inhibitor eyedrops, the nurse would report a history of which condition? 1. allergy to sulfa drugs The nurse is administering sympathomimetic ophthalmic drops. Which therapeutic drug effect will these drops have on the patient's eyes? b. reduced IOP important teaching point when instructing on self administration of sympathomimetic eye drops apply pressure to inner canthus for 1 full minute to decrease risk for systemic adverse effects. (Lilley 898) Sets found in the same folder211 Test 281 terms Keeli_Billings7 211 Test 186 terms Keeli_Billings7 211 Final89 terms Keeli_Billings7 211 Test 331 terms Keeli_Billings7 Other sets by this creatorLilley chapter 3810 terms Keeli_Billings7 Lilley chapter 398 terms Keeli_Billings7 Chapter 37: Care of Patients with Sepsis5 terms Keeli_Billings7 Telemetry66 terms Keeli_Billings7 Other Quizlet setskin 324 Final Study guide51 terms emily_liska7 ap human geography chapter 155 terms sierra_owens 19.3 Red Blood Cells34 terms gabyg28PLUS Unit 5: Developmental Psychology QUIZ Ga…15 terms shicks722PLUS Which instruction would the nurse provide to a client who has cerumen impaction?When a patient comes in with ear pain due to impacted cerumen, the health-care provider would normally instruct the nurse to perform ear irrigation.
Which postoperative instruction would the nurse provide to a patient who has undergone cataract surgery?Postoperative instructions to the patient include wearing the eye shield at all times, no bending or straining, and reporting any drainage from the operative eye, extreme pain, a fall or injury to the eye, or decreased vision in the operative eye.
Which instruction would the nurse provide to the patient prescribed verteporfin Visudyne for age related macular degeneration AMD )?Patients should be advised to wear a wrist band to remind them to avoid direct sunlight for 5 days. During that period, patients should be advised to avoid exposure of unprotected skin, eyes or other body organs to direct sunlight or bright indoor light.
What instruction should the nurse include when teaching a caregiver ways to communicate better with a patient who has hearing loss?Speak clearly, slowly, distinctly, but naturally, without shouting or exaggerating mouth movements. Shouting distorts the sound of speech and may make speech reading more difficult. Say the person's name before beginning a conversation.
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Which instruction would the nurse provide to the client who has cerumen impaction Quizlet
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