Med-Surg Unit 14 Sensory

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Terms in this set (...)

Conjunctivitis
Inflammation of the conjunctiva of the eye
Caused by air, direct contact, allergies, bacterial and viral are contagious.
Nystagmus
Rapid involuntary movements of the eyes
Ptosis
Drooping of the upper eyelid due to paralysis or disease, or as a congenital condition
Pupil
The black of the eye
Dilates/constricts in response to light
Visual acuity
Sharpness of vision, measured by the ability to discern letters or numbers at a given distance according to a fixed standard
Cataract
A medical condition in which the lens of the eye becomes progressively opaque, resulting in blurred vision
Diplopia
Double vision
Enucleation
Removal of the eye
Due to injury or disease
Hordeolum
A sty
Inflammation and infection of oil glands caused by staph aeureus
Cornea
The transparent part of the eye that covers the front portion of the eye
Glaucoma
A group of eye conditions that damage the optic nerve, which is vital to good vision. This damage is often caused by an abnormally high pressure in your eye. One of the leading causes of blindness in the United States. It can occur at any age but is more common in older adults
Myopia
Nearsightedness. A visual defect in which light that enters the eye is focused in front of the retina rather than directly on it, so that distant objects appear blurred
Photobia
Discomfort or pain in the eyes
Conjunctiva
The mucous membrane that covers the front of the eye and lines the inside of the eyelids
Hyperopia
Farsightedness
Sclera
White of the eye
Protects structures, connects to cornea, iris and pupil
Presbyopia
Gradual loss of eyes ability to see near objects such as reading
Macular degeneration
Causes breakdown/damage of macula-point on retina where light rays converge
Inner/outer canthus of eye
Corner of eyes where eye lids meet
Otitis externa
Infection of the skin covering the outer ear canal that leads in to the ear drum, usually due to bacteria such as streptococcus, staphylococcus, or pseudomonas. Swimmer's ear is usually caused by excessive water exposure. Infection with a fungus may also occur
Otitis media
Inflammation of the middle ear characterized by the accumulation of infected fluid in the middle ear, bulging of the eardrum, pain in the ear and, if eardrum is perforated, drainage of purulent material (pus) into the ear canal
Otoscope
Auriscope is a medical device which is used to look into the ears
Tinnitus
Ringing in the ears
Conductive hearing loss
Interference in transmission of sound. Cerum in ear, otitis media
Sensorineural hearing loss
Result of nerve impairment. (Age related changes and environmental exposure to sound over time) ototoxic meds
Retinal detachment
A separation of the retina from its connection at the back of the eye.
Sensory layer becomes separated from pigmented layer of retina.
Hole or tear
Labyrinthitis
Vestibular neuritis, is inflammation of the inner ear. It results in vertigo and also possible hearing loss or ringing in the ears
Vertigo
Dizziness
Pinna
The projection part of the ear
Otalgia
Ear pain
Cerumen
Ear wax
Upper lid
Cover of the eye, protects eye, moves
Eyelashes
Strap debris
Iris
A flat, colored, ring-shaped membrane behind the cornea of the eye, with an adjustable circular opening (pupil) in the center
Inner canthus
The point where the eyelids meet next to the nose
Functions of the eyelids?
Protect against foreign bodies/adjust amount of light that enters the eye.
Spreads tears over surface of eye-lubrications.
Blinking clears dust and particles from surface of eye.
What are the eye exam recommendations?
-Adults without eye disease/disorders-one exam in 20s twice in 30s. Baseline comprehensive screening age 40 (signs of disease and visual changes around this time)
-Exam every 2 years vetween age 40-60
What is a snellen eye chart?
Tests vision for far not close
-20/20, placed at distance of 20 foot from subject. normal visual acuity
-Legally blind 20/200 or less (with corrective lenses)
-Blindness-20/400 to no light perception
What does 20/20 vision mean?
Normal vision acuity
How is color vision tested?
Ishihara
Optometrist
Doctor of optometry, test vision, examine eyes, prescribe corrective lenses/contacts in some states may treated limited eye disease, including rx eye meds (Can in missouri) no surgery or laser tx
Ophthalmologist
MD/DO
Medical and surgical treatment of eye diseases, able to dx and tx eye disorders, prescribe corrective lenses/contacts.
-If hx of diabetes, HTN, or eye diseases they go here
Patient ocular history?
-Are you having any problems with your eyes?
-Have you experienced blurred, double, or distorted vision?
-Are both eyes affected?
-How long?
-What medications are you taking?
Eye trauma/foreign objects?
Trauma may cause scar tissue to form which affects refraction of light
-Use of fluorescent dye to determine corneal abrasion or small foreign body.
What is the patient care for eye trauma/foreign objects?
First aid-flush eyes, eye drops/ointment, eye patch
-For chemical injury flush eyes with running water for 10-15 minutes. tilt head to side-divert flow of water from nasal area downward of affected eye. This prevents contamination of other eye.
-Do not try to remove penetrating foreign body. cover and stabilize (Paper cup)
What are the S&S of conjunctivitis?
Redness, excessive tearing, pain, burning, itching, possible purulent drainage, photophobia, Usually starts in one eye, but spreads to the other through hand contact.
What are the treatments for conjunctivitis?
Eye drops, ointment, warm moist compress, remove exudate, clean inner to outer corner, handwashing.
Do not touch, exclusion from work/school for 24 hours after tx if bacterial or viral
Bacterial conjunctivitis
-Usually one eye affected
-Same S&S as pink eye
-Yellowish purulent drainage from eye/crusting in morning
-Treat with antibiotic eye drops or ointment
Viral conjunctivitis
-Clear drainage
-One eye affected
-No purulent drainage, same S&S as pink eye
-Tx: relieve symptoms and prevent bacterial conjunctivitis
Allergic conjunctivitis
-Caused by allergens
-Allergy S&S-runny nose, itchy water eyes, both eyes affected
-Same S&S as pink eye except clear tearing no drainage
-TX: PO antihistamines, antihistamine eye drops, relieve symptoms
Proper administration of eye gtt/ointment?
Cotton ball below bottom eyelid to catch drops, pt looks up, bottom eyelid pulled down slightly, dropper above eye, drops placed in conjunctival sac, for ordered number of drops, then eye closed
Blepharitis
Inflammation of eyelid margins (Eyelashes)
Blepharitis S&S?
Greasy scales/dandruff of eyelid/eyelashes, lid margins red and inflammed, patchy flakes on eyelashes, eyelashes may be missing, possible purulent drainage
Tx of blepharitis?
Topical antibiotic ointment, cleanse eyelids 1-2 times a day with dilute baby shampoo
S&S of Hordeolum?
Tender, swollen, red pustule in internal or external tissue of eyelid, may have purulent drainage
Tx of hordeolum?
Warm moist compress, topical antibiotic possible, discard makeup, frequent handwashing, do not touch, do not reuse washcloths
What does macular degeneration cause?
Vision loss/blindness (Family hx is risk)
S&S of macular degeneration?
Slow progression, blurred vision, distortion of vision, diminished color perception, visual field target with bulls-eyes area absent
Tx of macular degeneration?
Meds, surgery, diet and eye health vitamins (Occuvite), adaptation equipment for visually impaired/blind
What does glaucoma cause?
Major blindness, increased intraocular pressure due to aqueous fluid imbalance in eye, causes optic nerve damage, tunnel vision
S&S of glaucoma?
Slow onset, visual changes occur slowly, may be asymptomatic until has eye exam. eye discomfort, occasional/ temporary blurred vision, tunnel vision
Tx of glaucoma?
No cure-symptoms tx and reduce/control IOP, prevention of optic nerve damage, medications, eye drops, possible surgery
-Avoid heavy lifting, crying, eye strain, straining to have BM
What do cataracts cause?
Vision to decrease because light no longer has transparent pathway to retina (Normal aging, born with)
S&S of cataracts?
Halo around lights, difficulty reading, changes in color vision, glaring of objects in bright light, distortion of objects, blurred vision, poor night vision, double vision in one eye, visual acuity becomes severly reduced, white or gray spot visible behind pupil
TX of cataracts?
Surgery and monitoring
-Post-op: protective eye shield, sunglasses in bright light, eye drops, no strenuous lifting, no bending or stooping, do not immerse eyes in water, no activities that could cause dust/debris to lodge in eye
S&S of retinal detachment?
Gaps in vision field or blind spots, flashes of light, seeing spots, cobwebs or floaters, may feel like curtain drawn over visual field
-complete loss of vision may occur in affected eye
Causes of retinal detachment?
Stretching or degenerative changes
Diabetes
TX of retinal detachment?
Surgery, sometimes unrepairable, bedrest, on side with affected eye in dependent position, eye patch, eye drops
Enucleation complication after surgery?
Hemorrhage
Tx of enucleation?
Metal or plastic ball placed in capsule of connective tissue (Ocular implant imbedded in eye socket)
-After tissues healed-eye shell prosthesis placed over buried ball. the shell is hand-painted to match other eye
-The shell is the only portion that can be removed for cleaning.
-Lasts 5-6 years
What should patients know when cleaning eye after enucleation?
Shell removed every 4-6 weeks for cleaning
Daily cleaning is done with shell in place
Outer ear parts?
Lobe-Bottom portion for earings
Pinna-Top outer portion of ear
External canal-Hole to ear
Tympanic membrane-eardrum
Middle ear
Just know middle ear
Inner ear parts?
Just know inner ear
Normal hearing acuity?
20 dB
dB?
Loudness of sound/volume
Decibels
-Whisper/rustling leaves 20 dB
-Pain begins at 120 dB
Hz?
Hertz
Frequency or pitch
-high frequency-bird chirping
-low frequency-bass or tuba
-We lose high frequencies over time due to aging and damage from noise exposure
Causes of hearing loss?
Noise induced hearing loss is caused by repeated exposure to moderate levels of noise over many years
-When hair cells die/damaged
Proper administration of ear drops?
-Warm ear drops to room temp-rub between hands or place bottle in warm water
-Client lay on side with affected ear exposed
-Adult-pull ear up and back
-Young child-Pull ear down and back
-Do not touch dropper to ear
-Place drops in ear canal
-Remain on side for 1-2 mins, place cotton in ear
S&S of otitis externa?
Swimmers ear (outer ear)
Otalgia, itching, swelling of canal and opening of ear, erythema, and otorrhea
Tx of otitis externa?
Ear drops-antibacterial
Prevention of otitis externa?
Ear plugs when swimming, do not place objects in ear canals, drying ear/removal of excess water or irrigation after swimming
S&S of otitis media?
Ear pain, fever, cold S&S, hearing decreased
Tx of otitis media?
Otic analgesic, auralgan ear drops, PO antibiotics
If untreated can lead to complications
S&S of otosclerosis?
Progressive, bilateral hearing loss, tinnitus, pinkish-orange eardrum
Otosclerosis
overgrowth ear bone. Decreased vibration of stapes-causes diminished transmission of sound to inner ear
Tx of vertigo?
Based on cause
Meds
Antihistamines most common
S&S vertigo?
Dizziness, imbalance
Teaching for vertigo?
Avoid driving, heavy machinery, Fall risk
S&S of Meniere's disease?
Vertigo, tinnitus, hearing loss, NV, nystagmus, preattack headache, unilateral
What causes meniere's disease?
Changes in fluid volume in labyrinth
Tx of meniere's disease?
Reducing fluid production in inner ear, facilitating drainage, treating S&S, low-sodium diet, bed rest, meds, surgery
Ototoxicity
Toxic levels of salicylates and vancomycin
S&S of ototoxicity?
Tinnitus, sensorineural hearing loss, lightheadedness, vertigo NV
Causes of ototoxicity?
Medications, salicylates, loop diuretics, antibiotics such as vancomycin

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