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Communicating with elders
Terms in this set (62)
factors that affect elder communication are _______ changes (trouble hearing, seeing, dentures etc.,), ________ issues (cant talk to male if female or offensive to make eye contact), _______ anxiety (late 80s 90s, 100s not used to having doc.s), ________ overload (too much talking or info at once), ______ distractions (pain and anxiety), and __________ approach meaning not pre judging and dont cover your mouth when comm.
sensory, cultural, stranger, sensory, internal, interviewer
Ear canal gets ______, glands that secrete _______ dry up, hair (cilli) get stiffer too, and ________ membrane start to _______.
stiffer, cerumen, tympanic, atrophy
There are two major types of hearing impairments __________ hearing loss which cant hear low pitched sounds resulting from fullness in the ear can be in only one ear. And __________ hearing loss which results in not being able to hear high pitched sounds can be caused by rubella or trauma and is bilateral and caused related to aging.
__________ exam is a test that looks at the tympanic membrane make sure there is no trauma. _________ test which is where you stand 1 to 2 feet behind one side and block the ear not listening in and whisper a multi syllable word and ask them to repeat.
_______ test is something that a Dr. or NP does when they put a tunning fork on the pt. head and then ask them where they hear the vibration (on bone conduction sound)
Hearing aids and cochlear implants are considered ______ prevention (intervention for hearing).
FUN FACT!!! if impaction => hearing loss must be removed if we cant remove it then we refer to ENT ( irrigation) look in the ear with autoscope assess for pain first use cerumen olitic (soften cerumen) with irrigation syringe ie. colace/ hydrogen peroxide then room temp h2o direct it to the back wall of the ear then tip the ear.
_______ is near sitedness "cant see far away", ______ is far sitedness, and _______ is decreased ability to focus on near objects due to age
myopia, hyperopia, presbyopea
development of _______ ________ which is whitening of the iris it is normal in anyone over age 60 normal under should be tested for cholesterol.
_______ or clouding or opacity of the lens in the eye. _____ is a classification changes of aging gradually progressive slow loss of vision causes include no use of sun glasses, smoking, and alcohol.
More classifications are _______ caused by trauma, ________ is when children are born with and it effects that part of the brain development. also _______ to something else going on ie diabetes
traumatic, congenital, secondary
Pathophysiology of senile cataracts (age related) decreased in ____ uptake with inital increased ______ content follow by a shift in electrolytes and dehydration of lens.
The decrease in visual acuity light rays hit the _____ and scatter instead of bending & converting on retina. some cataracts may cause secondary glaucoma.
Clinical manifestations of pt. with cataracts are a decline in vision, blurred vision, abnormal color perception. _____ problems driving at night can be caused by this. Eventually can develop _______ glares get so bad can actually cause pain from light.
What is meant by the "red reflex" absent?
similar to the red eye in a picture so when u look into a eye with cataracts with an opthalmoscope you will not see this.
Surgical treatments for cataracts are _______ which you do not remove the outer capsul just take of the top and put a lens on, two types are Phaecoemulsification & cryoextraction and _______ which is completly surgicaly removed this is not done really now.
___________ is when they insert a probe break off the cataract then another probe sucks out the pieces and then tey insert a 4 part folded lens.
_______ is the med used pre op care to dilate the pupil. _________ agents which paralyze the iris to keep it open.
Another used during pre/post op is ____________ anti inflammatory to reduce inflammation. As well as ____-______ meds, and topical antibiotics
_____________ is an increased interocular pressure ischemia to retina which develop tunnel vision. _____ _____ _____ is a type which is chronic, it comes on slowly. Build up of aqueous humor, tunnel vision or halos.
Glaucoma, primary open angle
All basic medical Rx. for glaucoma: ____ ____ open trabecular meshwork, increase outflow drainage. ______ _____ ______ decrease rate at which aqueous humor is produced. ________ ______ anhydrase inhibitors which decrease aqueous humor production. _____ ______ anhydrase inhibitors decrease aqueous humor production.
Topical miotics, topical beta blockers, systemic carbonic, topical carbonic
FUN FUN!! Additional Rx. for glaucoma are argon laser trabeculoplasty, Trabeculotomy, cyclocryotherapy
______ ______ ________ can be acute or chronic, narrow angle glaucoma cant lead to this, characteristics are outflow imparied by narrowing or closing of angle btw iris and cornea. Common causes are forward shift of iris, lens enlarges and moves forward.
closed angle glaucoma
Fluid in the middle ear without evidence of infection
The decreased ability to hear which pitched tones that naturally beings in mid-life as a result of irreversible inner ear changes.
Brown, waxlike secretion found in the external auditory canal
cerumen (not sebum!)
Loss of hearing in which efficient sound transmission to the inner ear is interrupted by some obstruction or disease process
conductive hearing loss
subjective perception of sound with internal origin, unwanted noises in the head or ear (ringing ears)
Loss of hearing related to damage of the end organ for hearing, and/or cranial nerve VIII (vestibulocochlear nerve)
sensation of fullness or pain in the ear
middle ear effusion
Nearsightedness, a refractive error, in which the focus of light rays from a distant object is anterior to the retina. Can't see distant objects clearly.
Congestion of the blood vessels
the decrease in visual accommodation that occurs with advanced age
Determination of errors in the deflection of light rays as they pass from the lens to the retina.
Blind or partially blind area in the visual field.
Farsightedness: a roof rack to have air in which the focus of light rays from a distant object is behind the retina. Unable to see close objects.
Abbreviation for each is ___, for right eye it's ___, and for left eye it's _____.
OU, OD, OS
Absence of the natural lens
Complete removal of the eyeball and part of the optic nerve.
Absence of refractive error, 20/20, perfect eyesight
Ocular pain on exposure to light.
Process whereby the eye adjusts for near distance by changing the curvature of the lens to focus a clear image on the retina (eg. focusing to read) the A in PERLA.
Medication that causes pupillary dilation
Seeing one object as two: double vision
Inability to see, usually defined as corrected visual acuity of 20/40 or less, or a visual field of no more than 20° in the better eye
Involuntary oscillation of eyeball. Eyeball darts back-and-forth.
Swelling of the optic disc due to increased intercranial pressure.
"Red eye" resulting from dilation of the vasculature of the conjunctiva.
A medication that causes pupillary construction.
A condition where the pupils are unequal in size.
Age related changes in the auditory system commonly include: (select all that apply)
A. drier cerumen
B. tinnitus in both ears
C. auditory nerve degeneration
D. Atrophy of the Tim panic membrane
E. greater ability to hear high-pitched sounds.
A, C, D
Always assess the patient with an ophthalmic problem for:
A. visual acuity
B. pupillary reaction's
C. intraocular pressure
D. confrontation visual fields
Question patients using eyedrops to treat their glaucoma about
A. use of corrective lenses
B. their usual sleep pattern
C history of heart or lung disease
D sensitivity to opioid or depressants
Increased intraocular pressure may occur as a result of
A. Edema in the corneal stroma.
B. Dilation of the retinal arterioles.
C. Blockage of the lacrimal canals and ducts.
D. increased production of the aqueous humor by the ciliary process
Presbyopia occurs in older individuals because
A the eyeball elongates
B. the lens becomes inflexible
C the corneal curvature becomes irregular
D the light rays are focusing in front of the retina
Inflammation and infection of the eye
A. are caused by irritants in micro organisms B. have a higher incidence in sexually active patients
C. Are chronic problems that result in loss of vision
D are frequently treated with cold compresses and antibiotics.
Which patient behaviors would the nurse promote for healthy eyes and ears (select all that apply)
A. wearing protective sunglasses when bicycling
B. supplemental intake of B vitamins and magnesium
C playing amplified music at a 75% of maximum volume
D patient notifying the health care provider of tinnitus while on antibiotics
E a woman avoiding pregnancy for four weeks after receiving MMR immunization
What should be included in the post operative teaching of a patient who has undergone cataract surgery (select all that apply)
A. I just comfort is often relieved with mild analgesics
B a decline in visual acuity is common for the first week
C stay on bed rest and limit activity for the first few days
D notify Surgeon if an increase in redness or drainage occurs
E night time eye shielding and activity restrictions are essential to prevent eye strain
Instruct the patient who is newly fitted with bilateral hearing aids to (select all that apply) A replace batteries monthly
B clean the earmolds weekly or as needed
C clean ears with cotton tipped applicator's daily
D disconnect or remove the batteries when not in use
E initially restrict usage to quiet listening in the home.
Which strategies would best assistant nurse in communicating with a patient who has a hearing loss (SATA)
A over enunciate speech
B. speak normally and slowly
C exaggerate facial expressions
D raise the voice to a higher pitch
E write out names were difficult words.
Patients with permanent visual impairment
A feel most comfortable with other visually impaired people
B. may feel threatened when others make eye contact during a conversation
C usually need others to speak louder so that they can communicate appropriately
D may experience the same grieving process that is associated with other losses.
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