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MS2 Exam 2
223 Questions
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MS2 Exam 2

Created by
@TrustyFantasy

Questions and Answers

What factor affects elderly patients' recovery from anesthesia?

  • Increased subcutaneous fat
  • Higher cardiac reserves
  • Improved gastrointestinal activity
  • Slower renal and hepatic function (correct)

    • Which statement about informed consent for surgery is accurate?

  • A surgeon must explain the risks and benefits of the procedure. (correct)
  • The nurse is not required to clarify information regarding the procedure.
  • Consent does not need to be in writing for emergency procedures.
  • Consent is valid after the administration of psychoactive premedication.

    • What is a crucial preoperative nursing intervention before administering premedication?

  • Transport the patient to the presurgical area.
  • Remove all jewelry and inspect the mouth.
  • Have the patient void. (correct)
  • Engage the family members in discussion.

    • Why is it particularly important to prepare the patient's bowel before surgery?

    <p>To ensure clear visibility for surgical procedures.</p> Signup and view all the answers

    What psychosocial intervention could help reduce a patient's anxiety before surgery?

    <p>Using cognitive coping strategies like imagery.</p> Signup and view all the answers

    Which of the following conditions can lead to delayed recovery after anesthesia in competitive surgical patients?

    <p>Presence of respiratory compromise.</p> Signup and view all the answers

    What is a primary reason for patients to undergo preoperative education about mobility?

    <p>To ensure they can ambulate immediately the day after surgery.</p> Signup and view all the answers

    What is the minimum time frame for fasting before non-emergent surgery to prevent aspiration?

    <p>8 hours</p> Signup and view all the answers

    What is the primary goal of using diuretics within the context of treating vertigo symptoms?

    <p>To reduce ear fluid buildup</p> Signup and view all the answers

    Which treatment option is best suited for individuals with profound sensorineural hearing loss who do not respond to conventional hearing aids?

    <p>Cochlear implant</p> Signup and view all the answers

    In the perioperative nursing phase, what is the significance of verifying completion of preoperative diagnostic testing?

    <p>To assess the patient's readiness for surgery</p> Signup and view all the answers

    What class of medication is critical to taper before surgery to prevent complications?

    <p>Corticosteroids</p> Signup and view all the answers

    Which of the following factors should be assessed in the preoperative assessment to avoid potential intraoperative nausea and vomiting?

    <p>Past surgical experiences</p> Signup and view all the answers

    Which surgical classification involves procedures that are performed to enhance a person's appearance for aesthetic purposes?

    <p>Cosmetic</p> Signup and view all the answers

    During communication with a hearing-impaired person, which technique is most effective for ensuring clarity?

    <p>Face the person directly while speaking</p> Signup and view all the answers

    What is the primary focus of vestibular rehabilitation therapy?

    <p>Enhancing balance and stability</p> Signup and view all the answers

    What is the recommended first step when maintaining an IV line with normal saline solution?

    <p>Assess the patient's vital signs</p> Signup and view all the answers

    Which type of surgical approach is classified as 'urgent'?

    <p>Appendectomy</p> Signup and view all the answers

    What dietary recommendation might significantly improve symptoms for a patient experiencing vertigo?

    <p>Low-sodium diet of 1,000-1,500 mg/day</p> Signup and view all the answers

    Which symptom should prompt notification of a primary provider during a transfusion reaction?

    <p>Presence of urticaria</p> Signup and view all the answers

    Which blood type can a patient with A^-^ blood receive from without risking a transfusion reaction?

    <p>O-</p> Signup and view all the answers

    What is the primary responsibility when a suspected transfusion reaction occurs?

    <p>Stop the transfusion immediately</p> Signup and view all the answers

    What does the presence of antibodies in the blood plasma indicate?

    <p>The blood type lacks specific antigens</p> Signup and view all the answers

    Which of the following findings during assessment is least concerning in a transfusion reaction?

    <p>Slight back pain</p> Signup and view all the answers

    What is the correct approach to implementing a transfusion over the prescribed time frame?

    <p>Administering at a slow rate of 10-20 gtt/min</p> Signup and view all the answers

    Why must the patient’s identity and blood component identifying tags be verified?

    <p>To confirm compatibility and ensure safety during transfusion</p> Signup and view all the answers

    What condition may result from untreated oligomenorrhea?

    <p>Myocardial hypertrophy and heart failure</p> Signup and view all the answers

    Which treatment option is effective in 80-90% of patients with Graves' disease?

    <p>Radioactive iodine</p> Signup and view all the answers

    What is NOT a symptom of thyroid storm?

    <p>Bradycardia</p> Signup and view all the answers

    What is a primary cause of adrenal insufficiency?

    <p>Autoimmune disorders</p> Signup and view all the answers

    Which medication can lead to adrenal insufficiency when suddenly stopped?

    <p>Rifampin</p> Signup and view all the answers

    Which symptom is unlikely to be associated with Addison's disease?

    <p>Severe hypertension</p> Signup and view all the answers

    What should not be administered during a thyroid storm?

    <p>Aspirin</p> Signup and view all the answers

    Which of the following is a sign of an Addisonian crisis?

    <p>Severe hypotension and confusion</p> Signup and view all the answers

    Which symptom correlates with hyperkalemia in adrenal insufficiency?

    <p>Nausea</p> Signup and view all the answers

    In the treatment of thyroid storm, which medication is used for blocking the conversion of T3 and T4?

    <p>Methimazole</p> Signup and view all the answers

    What is the purpose of the PCA pump in medication administration?

    <p>To allow automated dosing according to prescribed limits</p> Signup and view all the answers

    Which of the following hormones is responsible for stimulating ovulation?

    <p>Luteinizing hormone (LH)</p> Signup and view all the answers

    Why is it important to monitor a patient's respiratory rate when using a PCA pump?

    <p>To assess for potential respiratory distress as a complication</p> Signup and view all the answers

    What is the main function of cortisol in the body?

    <p>To affect glucose metabolism and stress response</p> Signup and view all the answers

    What role do aldosterone and glucocorticoids play in the body?

    <p>Both regulate sodium levels and glucose metabolism respectively</p> Signup and view all the answers

    What does the negative feedback loop involving cortisol entail?

    <p>High levels of cortisol suppress ACTH release from the pituitary gland</p> Signup and view all the answers

    What should a nurse document before discontinuing a PCA pump?

    <p>Patient's attempts to use the PCA compared to medication delivered</p> Signup and view all the answers

    How does the hypothalamus communicate with the pituitary gland?

    <p>By sending hormones via blood vessels within the stalk</p> Signup and view all the answers

    Which hormone is primarily involved in regulating water balance in the body?

    <p>Antidiuretic hormone (ADH)</p> Signup and view all the answers

    Which hormone is connected to sleep regulation?

    <p>Melatonin</p> Signup and view all the answers

    What is a primary complication associated with PCA use?

    <p>Respiratory distress</p> Signup and view all the answers

    Which Type of hormone is primarily produced by the adrenal cortex?

    <p>Steroid hormones</p> Signup and view all the answers

    What is the main physiological effect of oxytocin?

    <p>Stimulating uterine contractions during childbirth</p> Signup and view all the answers

    How does the pineal gland affect sleep cycles?

    <p>By releasing melatonin in response to darkness</p> Signup and view all the answers

    What occurs when a sterile barrier is breached during a surgical procedure?

    <p>The area is considered contaminated.</p> Signup and view all the answers

    Which of the following factors is NOT a cause of anesthesia awareness?

    <p>Patient's previous experiences</p> Signup and view all the answers

    What condition is associated with malignant hyperthermia during anesthesia?

    <p>Inherited muscle disorders</p> Signup and view all the answers

    What complication can result from low temperature in the operating room?

    <p>Hypothermia</p> Signup and view all the answers

    What is a common CNS change experienced in patients post-anesthesia?

    <p>Mood swings</p> Signup and view all the answers

    Which condition is characterized as a rare, life-threatening manifestation of severe thyroid hormone deficiency?

    <p>Myxedema coma</p> Signup and view all the answers

    Which symptom is most commonly associated with hyperthyroidism and may cause significant patient distress?

    <p>Anxiety and restlessness</p> Signup and view all the answers

    What is the recommended initial daily dosage range of levothyroxine for treating hypothyroidism in adults?

    <p>75 - 150 mcg</p> Signup and view all the answers

    What is the most significant risk factor for morbidity and mortality in older surgical patients?

    <p>Respiratory and cardiac compromise</p> Signup and view all the answers

    Which action should take priority when preparing a patient for anesthesia?

    <p>Having the patient void before administration of premedication</p> Signup and view all the answers

    Which physiological change is expected in patients with untreated hypothyroidism?

    <p>Decreased body temperature</p> Signup and view all the answers

    What adverse effect could elderly patients face when treated for hypothyroidism?

    <p>Dementia-like symptoms</p> Signup and view all the answers

    Which necessary component must be included in the informed consent process?

    <p>Surgeon must explain benefits and risks of the procedure</p> Signup and view all the answers

    Why is it essential to implement cognitive coping strategies before surgery?

    <p>To help reduce anxiety and improve patient outlook</p> Signup and view all the answers

    What is the legal requirement regarding consent prior to administering psychoactive premedication?

    <p>Consent must be signed before premedication is given</p> Signup and view all the answers

    Which preoperative intervention directly contributes to reducing the risk of respiratory complications?

    <p>Educating the patient about incentive spirometry</p> Signup and view all the answers

    What is a common misconception about the timing of food intake prior to surgery?

    <p>Fasting should be a minimum of 4 hours prior to surgery.</p> Signup and view all the answers

    Which factor contributes most to the difficulties elderly patients may face during anesthesia recovery?

    <p>Abnormal heart rhythms from herbal supplements</p> Signup and view all the answers

    What is a common presentation in patients experiencing retinal detachment?

    <p>Sensation of a shade or curtain over one eye</p> Signup and view all the answers

    Which surgical procedure involves the removal of vitreous humor to access the retina?

    <p>Vitrectomy</p> Signup and view all the answers

    What is a significant risk factor for developing macular degeneration?

    <p>Family history</p> Signup and view all the answers

    Which treatment option is typically used for managing wet macular degeneration?

    <p>Medications to prevent abnormal blood vessel growth</p> Signup and view all the answers

    What symptom is commonly associated with diabetic retinopathy?

    <p>Painless visual disturbances</p> Signup and view all the answers

    In cases of chemical eye injury, what initial action should be taken?

    <p>Flush the eyes continuously with water</p> Signup and view all the answers

    Which type of hearing loss is characterized by damage to the cochlea or vestibulocochlear nerve?

    <p>Sensorineural hearing loss</p> Signup and view all the answers

    What is a typical manifestation of Ménière's disease?

    <p>Episodic vertigo and hearing loss</p> Signup and view all the answers

    What characterizes the dry type of age-related macular degeneration?

    <p>Accumulation of drusen in the macula</p> Signup and view all the answers

    Which of the following is an early symptom of hearing impairment?

    <p>Increased inability to hear speech clearly</p> Signup and view all the answers

    In which situation is a scleral buckle commonly indicated?

    <p>Treatment for retinal detachment</p> Signup and view all the answers

    What is a common visual disturbance reported by those with retinal detachment?

    <p>Sudden onset of floaters in the affected eye</p> Signup and view all the answers

    What is one potential ocular complication associated with systemic disease like hypertension?

    <p>Optic disc edema</p> Signup and view all the answers

    What is a significant aspect of nursing management post-retinal surgery?

    <p>Need for patient education about potential complications</p> Signup and view all the answers

    What condition is defined by an elongated eyeball leading to nearsightedness?

    <p>Myopia</p> Signup and view all the answers

    Which of the following is the correct range for normal intraocular pressure measured by tonometry?

    <p>10 - 21 mmHg</p> Signup and view all the answers

    What visual acuity score indicates moderate visual impairment?

    <p>20/70 to 20/160</p> Signup and view all the answers

    Which type of ophthalmic medication is contraindicated in patients with narrow angles or shallow anterior chambers?

    <p>Mydriatics and cycloplegics</p> Signup and view all the answers

    Which statement describes the impact of anti-inflammatory drugs when used long-term?

    <p>They may lead to glaucoma and cataracts.</p> Signup and view all the answers

    In which adaptation strategy can the 'clock method' be used for assisting individuals with visual impairments?

    <p>Describing locations of items on a tray</p> Signup and view all the answers

    What specific visual acuity measure indicates legal blindness?

    <p>BCVA of no light perception</p> Signup and view all the answers

    What condition is characterized by multiple focal points due to the irregular shape of the cornea or lens?

    <p>Astigmatism</p> Signup and view all the answers

    What is a key consideration when administering topical ocular medications?

    <p>Their absorption is limited due to specific physiological barriers.</p> Signup and view all the answers

    What are the characteristics of low vision as defined in the assessment criteria?

    <p>BCVA of 20/70 to 20/200</p> Signup and view all the answers

    What is the primary function of parathyroid hormone released by the parathyroid glands?

    <p>Regulate calcium and phosphorus metabolism</p> Signup and view all the answers

    Which substance is essential for the synthesis of thyroid hormones T3 and T4?

    <p>Iodine</p> Signup and view all the answers

    What is the role of TSH in the secretion of T3 and T4 hormones?

    <p>TSH regulates the secretion of T3 and T4 hormones.</p> Signup and view all the answers

    What effect does an increase in serum calcium levels have on the secretion of parathyroid hormone?

    <p>It leads to decreased secretion of parathyroid hormone.</p> Signup and view all the answers

    Which hormone is responsible for the fight or flight response and has a primary secretion muscle?

    <p>Epinephrine</p> Signup and view all the answers

    What is a significant reason for patients in the elderly demographic to experience postoperative complications?

    <p>Slower renal and hepatic function affecting drug metabolism</p> Signup and view all the answers

    What essential component must be included when obtaining informed consent for a surgical procedure?

    <p>Details about the risks and benefits of the procedure</p> Signup and view all the answers

    Which of the following actions is crucial for a nurse to complete before administering preoperative medication?

    <p>Ensure the patient has voided</p> Signup and view all the answers

    Which of these interventions is most relevant for enhancing postoperative recovery in patients undergoing ambulatory surgery?

    <p>Educating patients about ambulatory discharge processes</p> Signup and view all the answers

    What is considered a critical reason for ensuring a patient has fasted for a minimum of 8 hours before a surgical procedure?

    <p>To facilitate better anesthesia absorption and reduce aspiration risk</p> Signup and view all the answers

    Why might elderly patients require multiple explanations of surgical procedures postoperatively?

    <p>As a result of decreased cognitive processing speed</p> Signup and view all the answers

    What primary patient safety measure should be taken when preparing for surgery?

    <p>Verifying the patient’s identity and procedure</p> Signup and view all the answers

    In the context of preoperative nursing interventions, which of the following methods can help reduce anxiety and fear in patients?

    <p>Using cognitive coping strategies like imagery and optimism</p> Signup and view all the answers

    Which condition is characterized by an elongated eyeball causing nearsightedness?

    <p>Myopia</p> Signup and view all the answers

    What is the normal range for intraocular pressure, measured in mmHg?

    <p>10 - 21 mmHg</p> Signup and view all the answers

    Which type of vision impairment requires devices and strategies for correction in patients with BCVA of 20/70 up to 20/200?

    <p>Low vision</p> Signup and view all the answers

    Which ocular condition is associated with the use of corticosteroids long-term?

    <p>Glaucoma</p> Signup and view all the answers

    What does the Snellen chart primarily assess?

    <p>Best corrected visual acuity from distance</p> Signup and view all the answers

    Which type of medications are preferred for treating ocular conditions due to their lesser invasiveness?

    <p>Topical medications</p> Signup and view all the answers

    Which visual acuity designation indicates legal blindness?

    <p>20/200</p> Signup and view all the answers

    Which medication category is contraindicated for patients with a history of narrow angles or shallow anterior chambers?

    <p>Mydriatics and cycloplegics</p> Signup and view all the answers

    What should the focus be for nursing assessment in patients with blindness?

    <p>Coping strategies and social adaptation</p> Signup and view all the answers

    Which option does NOT impact the ability of the eye to absorb medications effectively?

    <p>Electrolyte levels</p> Signup and view all the answers

    Which surgical procedure involves compressing the sclera to treat retinal detachment?

    <p>Scleral buckle</p> Signup and view all the answers

    Which condition is characterized by the gradual accumulation of drusen leading to blurry vision?

    <p>Dry macular degeneration</p> Signup and view all the answers

    In which scenario should a patient dial 911 or notify their provider immediately?

    <p>Experiencing sensations of shade or curtain over their vision</p> Signup and view all the answers

    What is the primary cause of permanent vision loss associated with high blood sugar over time in patients with diabetes?

    <p>Diabetic retinopathy</p> Signup and view all the answers

    What treatment might be employed to prevent the growth of abnormal blood vessels in wet macular degeneration?

    <p>Laser surgery</p> Signup and view all the answers

    Which eye condition is often described as painless and progresses gradually in a patient with diabetes?

    <p>Diabetic retinopathy</p> Signup and view all the answers

    In the management of Ménière's disease, which symptom is commonly presented?

    <p>Episodic vertigo</p> Signup and view all the answers

    What is a potential consequence of untreated oligomenorrhea?

    <p>Severe myocardial hypertrophy</p> Signup and view all the answers

    Which treatment method for Graves' disease has the highest effectiveness rate?

    <p>Radioactive iodine</p> Signup and view all the answers

    Which factor is a common risk associated with the development of age-related macular degeneration?

    <p>Family history</p> Signup and view all the answers

    What characterizes pretibial myxedema in Graves' disease?

    <p>Dry, waxy swelling of the lower legs</p> Signup and view all the answers

    What nursing intervention is essential for monitoring after a patient undergoes retinal surgery?

    <p>Monitoring for signs of infection and increased intraocular pressure</p> Signup and view all the answers

    What is a key symptom of thyroid storm?

    <p>Exaggerated hyperthyroid symptoms</p> Signup and view all the answers

    Which action should be taken for an eye with a foreign object that cannot be removed?

    <p>Cover with a metal shield or paper cup</p> Signup and view all the answers

    What medication should be avoided during the treatment of a thyroid storm?

    <p>Aspirin</p> Signup and view all the answers

    What is a primary complication of long-term untreated hypertension related to ocular health?

    <p>Arterial constriction in retinal vessels</p> Signup and view all the answers

    Which type of hearing loss is often caused by damage to the cochlea or vestibulocochlear nerve?

    <p>Sensorineural hearing loss</p> Signup and view all the answers

    Which of the following is NOT associated with adrenal insufficiency?

    <p>Increased energy levels</p> Signup and view all the answers

    In an Addisonian crisis, which symptom indicates a medical emergency?

    <p>Confusion and restlessness</p> Signup and view all the answers

    What is the immediate first aid step for a chemical eye injury?

    <p>Flush the eye with water for 20 minutes</p> Signup and view all the answers

    What is a common trigger for thyroid storm?

    <p>Stress such as surgery or emotion</p> Signup and view all the answers

    What type of replacement therapy is essential for patients with adrenal insufficiency?

    <p>Glucocorticoid and mineralocorticoid replacement</p> Signup and view all the answers

    What laboratory finding is commonly associated with hyperkalemia in adrenal insufficiency?

    <p>High potassium levels</p> Signup and view all the answers

    Which structure within the retina is responsible for color discrimination and fine detail vision?

    <p>Photoreceptor cells (cones)</p> Signup and view all the answers

    What visual condition is characterized by involuntary oscillation of the eyeball?

    <p>Nystagmus</p> Signup and view all the answers

    What characteristics of retinal vessels indicate poor management of diabetes or hypertension?

    <p>Distorted vessels</p> Signup and view all the answers

    Which layer of the retina contains a single layer of cells responsible for absorbing light?

    <p>Retinal Pigment Epithelium (RPE)</p> Signup and view all the answers

    What is the primary function of rods within the sensory retina?

    <p>Night and low-light vision</p> Signup and view all the answers

    What is the primary effect of calcitonin on plasma calcium levels?

    <p>Reduces plasma calcium levels by enhancing calcium deposition in bones</p> Signup and view all the answers

    Which of the following statements about the thyroid hormones is true?

    <p>They influence metabolism and are essential for brain development</p> Signup and view all the answers

    What triggers the secretion of parathyroid hormone?

    <p>Low plasma levels of calcium</p> Signup and view all the answers

    What condition may result from prolonged low levels of iodine in the diet?

    <p>Goiter due to exaggerated TSH production</p> Signup and view all the answers

    Which gland primarily secretes catecholamines, and which hormone represents the majority of its secretion?

    <p>Adrenal glands; epinephrine</p> Signup and view all the answers

    What is a characteristic feature of megaloblastic anemia?

    <p>It is characterized by the production of abnormal, immature RBCs.</p> Signup and view all the answers

    Which condition is most likely to lead to B12 deficiency due to its impact on intrinsic factor production?

    <p>Crohn's disease</p> Signup and view all the answers

    Which symptom is commonly associated with patients suffering from B12 anemia?

    <p>Smooth, sore, red tongue</p> Signup and view all the answers

    Which inherited blood disorder is characterized by the production of abnormal hemoglobin?

    <p>Thalassemia</p> Signup and view all the answers

    Which of the following anemia types is linked to a decrease in functional bone marrow stem cells?

    <p>Aplastic anemia</p> Signup and view all the answers

    What is the primary difference between dehiscence and evisceration in postoperative wounds?

    <p>Dehiscence is usually a result of excessive strain on the surgical site.</p> Signup and view all the answers

    Which of the following statements is NOT true regarding Jackson-Pratt drains?

    <p>They can only be used for joint surgeries.</p> Signup and view all the answers

    What is the immediate action to take if evisceration occurs post-surgery?

    <p>Notify the surgeon immediately and cover the area.</p> Signup and view all the answers

    What is a primary goal of using Patient Controlled Analgesia (PCA)?

    <p>To maintain therapeutic medication levels and enhance mobility.</p> Signup and view all the answers

    Which dressing system is specifically designed to maintain the integrity of the incision without requiring changes?

    <p>Prevena VAC dressing.</p> Signup and view all the answers

    What could potentially happen if a nurse does not apply a sterile technique when changing a postoperative dressing?

    <p>Increased risk of delayed wound healing.</p> Signup and view all the answers

    Which statement best describes the function of the Hemovac drain?

    <p>It is used for joint surgeries and compresses to maintain suction.</p> Signup and view all the answers

    What is a key consideration when teaching a patient about their PCA pump?

    <p>They must understand how to self-dose to use it effectively.</p> Signup and view all the answers

    What is a common manifestation of retinal detachment?

    <p>Sensation of a shade or curtain in one eye</p> Signup and view all the answers

    Which method is primarily used for treating wet macular degeneration?

    <p>Medications to target abnormal blood vessels</p> Signup and view all the answers

    What is a key nursing management strategy post retinal surgery?

    <p>Ensuring the patient maintains a prone position for several days</p> Signup and view all the answers

    Which condition accounts for the highest percentage of blindness in older adults?

    <p>Macular degeneration</p> Signup and view all the answers

    What is a characteristic of presbycusis?

    <p>Age-related gradual loss of higher pitched sounds</p> Signup and view all the answers

    Which procedure aims to provide better access to the retina during retinal surgery?

    <p>Vitrectomy</p> Signup and view all the answers

    What is a significant risk factor for developing diabetic retinopathy?

    <p>Prolonged diabetes duration</p> Signup and view all the answers

    What is the recommended action for a patient with a chemical eye injury?

    <p>Flush the eye with water for at least 20 minutes</p> Signup and view all the answers

    Which symptom is NOT typically associated with Ménière's disease?

    <p>Severe headaches</p> Signup and view all the answers

    In cases of sympathetic ophthalmia, what is a possible consequence of an injury to one eye?

    <p>Blindness in the uninjured eye</p> Signup and view all the answers

    Which of the following best illustrates the management of blood glucose in relation to diabetic retinopathy?

    <p>Maintain blood glucose levels within normal range</p> Signup and view all the answers

    Which description inaccurately represents the dry type of macular degeneration?

    <p>It involves the abrupt onset of symptoms.</p> Signup and view all the answers

    What is a common early symptom of hearing impairment?

    <p>Tinnitus or ringing in the ears</p> Signup and view all the answers

    Which complication is associated with advanced HIV/AIDS in relation to ocular health?

    <p>Cytomegalovirus retinitis</p> Signup and view all the answers

    What does a Rinne test evaluate?

    <p>Presence of conductive hearing loss</p> Signup and view all the answers

    Which statement about the photoreceptors in the retina is correct?

    <p>Rods are absent in the fovea but scattered throughout the retina.</p> Signup and view all the answers

    What characteristic of the optic disc indicates poor retinal health?

    <p>Blurred or indistinct outline</p> Signup and view all the answers

    Which of the following interventions is NOT a common treatment for strabismus?

    <p>Use of eye drops to improve vision</p> Signup and view all the answers

    What type of examination is typically used to assess near vision?

    <p>Rosenbaum pocket screener</p> Signup and view all the answers

    Which statement accurately contrasts strabismus and nystagmus?

    <p>Strabismus is a voluntary motion, while nystagmus is an involuntary movement.</p> Signup and view all the answers

    What is a primary indication for using a Jackson-Pratt drain following surgery?

    <p>To maintain suction and measure drainage</p> Signup and view all the answers

    What complication involves a complete separation of the abdominal wall resulting in the protrusion of internal organs?

    <p>Evisceration</p> Signup and view all the answers

    In postoperative care, which method should be employed to minimize strain on the surgical site when a patient feels the urge to cough?

    <p>Provide a pillow for splinting</p> Signup and view all the answers

    What is a distinguishing feature of the Hemovac drainage system compared to other types of drains?

    <p>It utilizes a bulb for suction</p> Signup and view all the answers

    Which of the following is NOT a purpose of postoperative dressings?

    <p>Stop the healing process</p> Signup and view all the answers

    What is the goal of employing Patient Controlled Analgesia (PCA) in the postoperative setting?

    <p>To maintain a therapeutic level of pain medication</p> Signup and view all the answers

    Which statement correctly describes the function of the Prevena VAC dressing?

    <p>It provides negative pressure to enhance wound healing</p> Signup and view all the answers

    What should be the immediate nursing action if evisceration occurs post-surgery?

    <p>Notify the surgeon immediately</p> Signup and view all the answers

    What dietary change is recommended to alleviate symptoms associated with vertigo?

    <p>Adopt a low-sodium diet</p> Signup and view all the answers

    Which of the following is NOT a typical component of preoperative assessment?

    <p>Evaluation of financial status</p> Signup and view all the answers

    What class of medication is indicated for patients experiencing motion sickness?

    <p>Meclizine</p> Signup and view all the answers

    Which surgical classification is utilized for procedures that are not time-sensitive and can be scheduled at the patient's convenience?

    <p>Elective</p> Signup and view all the answers

    In the perioperative nursing context, what phase follows the patient's transfer onto the operating room bed?

    <p>Intraoperative phase</p> Signup and view all the answers

    Which condition is specifically associated with the need for vestibular rehabilitation?

    <p>Conditions affecting inner ear balance</p> Signup and view all the answers

    What is a potential side effect of administering diuretics in a surgical context?

    <p>Excessive respiratory depression</p> Signup and view all the answers

    Which of the following techniques is least effective for communicating with a hearing-impaired person?

    <p>Shout to ensure they hear you</p> Signup and view all the answers

    What type of auditory device specifically helps individuals with profound sensorineural hearing loss?

    <p>Cochlear implants</p> Signup and view all the answers

    Which factor is crucial when assessing a patient for potential malignant hypothermia in the preoperative phase?

    <p>Family history of fever with elevated temperature</p> Signup and view all the answers

    What is a consequence of untreated oligomenorrhea?

    <p>Myocardial hypertrophy</p> Signup and view all the answers

    Which of the following symptoms is most closely associated with exophthalmos?

    <p>Altered vision</p> Signup and view all the answers

    What is the mechanism behind thyroid storm?

    <p>Severe acute stress response</p> Signup and view all the answers

    Which of the following is NOT a primary treatment for Graves' disease?

    <p>Prednisone</p> Signup and view all the answers

    Which electrolyte imbalance is commonly seen in adrenal insufficiency?

    <p>Hyperkalemia</p> Signup and view all the answers

    What characterizes the presentation of Addisonian crisis?

    <p>Severe hypotension</p> Signup and view all the answers

    Which treatment is contraindicated during thyroid storm?

    <p>Salicylates</p> Signup and view all the answers

    What is one of the main causes of adrenal insufficiency?

    <p>Autoimmune conditions</p> Signup and view all the answers

    What is a significant complication associated with untreated hyperthyroidism?

    <p>Thyroid storm</p> Signup and view all the answers

    What is the primary goal of glucocorticoid replacement therapy in adrenal insufficiency?

    <p>To maintain blood glucose levels</p> Signup and view all the answers

    Which factor can significantly impede wound healing in older adults?

    <p>Comorbidities such as diabetes</p> Signup and view all the answers

    What is vital for maintaining ventilation and oxygenation postoperatively?

    <p>Supplemental oxygen administration</p> Signup and view all the answers

    Which response is expected from the PACU nurse when assessing a patient recovering from anesthesia?

    <p>Mild drowsiness is a normal finding</p> Signup and view all the answers

    What is one primary reason for conducting comprehensive assessments in the PACU?

    <p>To monitor for complications and ensure patient safety</p> Signup and view all the answers

    What condition is indicated by rapid, weak, and thread pulse alongside low blood pressure?

    <p>Hypotensive shock</p> Signup and view all the answers

    Which is a critical precaution to protect patients from injury during surgery?

    <p>Verifying patient identification consistently</p> Signup and view all the answers

    What is a key intervention in managing postoperative anxiety and pain?

    <p>Lowering lights and reducing noise in the recovery area</p> Signup and view all the answers

    Which nursing action is essential for maintaining cardiovascular stability postoperative?

    <p>Monitoring fluid status and vital signs</p> Signup and view all the answers

    What instruction should a nurse provide regarding patient discharge after outpatient surgery?

    <p>Provide prescriptions and information on complications</p> Signup and view all the answers

    What nursing intervention is required when a patient shows signs of hypovolemic shock?

    <p>Administering IV fluids and monitoring vital signs</p> Signup and view all the answers

    Which factor might contribute to increased postoperative confusion in elderly patients?

    <p>Decreased physiologic reserve</p> Signup and view all the answers

    Why should a nurse monitor a patient's skin color and LOC in the PACU?

    <p>To assess for potential respiratory complications</p> Signup and view all the answers

    What is a common indication for administering antiemetics in the PACU?

    <p>To control nausea and vomiting due to anesthesia</p> Signup and view all the answers

    Which complication requires immediate reporting during a transfusion reaction?

    <p>Severe chest pain and sudden anxiety</p> Signup and view all the answers

    Study Notes

    Symptoms and Management

    • Symptoms include feelings of fullness, pressure, nausea, and vomiting, often bilateral.
    • Factors exacerbating symptoms: smoking, infections, high-salt diets.
    • Treatment options:
      • Dietary modifications: Low-sodium diet (1,000-1,500 mg/day), avoid caffeine, quit smoking.
      • Medications: Meclizine, Valium (tranquilizers), Promethazine (antiemetics), diuretics for ear fluid.
      • Surgical options: Endolymphatic sac decompression, middle and inner ear perfusion, vestibular nerve sectioning to alleviate vertigo.

    Hearing Impairment Treatments

    • Hearing aids: Devices that amplify sound for better hearing.
    • Cochlear implants: Auditory prostheses for profound sensorineural hearing loss not improved by hearing aids.
    • Vestibular rehabilitation: Therapy focused on balance and stability for inner ear-related conditions.

    Communicating with Hearing Impaired Individuals

    • Use a low-tone, clear voice and speak slowly.
    • Minimize background noise; face the person to engage attention.
    • Speak into the less impaired ear and use gestures or facial expressions.
    • If needed, provide written information or arrange for a sign language interpreter.

    Perioperative Nursing Phases

    • Preoperative: Begins after surgical decision; ends at OR transfer.
    • Intraoperative: Starts at OR bed transfer; ends with PACU admission.
    • Postoperative: Starts at PACU admission; concludes with follow-up evaluation.

    Surgical Classifications

    • Types of surgery: Diagnosis (e.g., laparotomy), cure (e.g., appendicitis), reconstruction (e.g., mammoplasty), cosmetic (e.g., facelift), palliative (e.g., tumor debulking), rehabilitative (e.g., joint replacement).
    • Urgency classifications:
      • Emergent: Immediate, e.g., hemorrhage.
      • Urgent: within 24-30 hours, e.g., appendectomy.
      • Required: few weeks/months, e.g., cataract surgery.
      • Elective: non-life-threatening options, e.g., scar repair.
      • Optional: based on preference, e.g., Brazilian Butt Lift (BBL).

    Preoperative Care and Assessments

    • Preadmission testing: Collect demographics, health history, diagnostic testing verification, and initiate discharge planning.
    • Assessment components: Health history, allergies, medication review, nutritional status, dentition, substance use, and psychosocial factors.

    Medications Affecting Surgical Experience

    • Key medications: Corticosteroids (must taper), diuretics (risk of respiratory depression), anticoagulants (increased bleeding risk), anticonvulsants, and herbal remedies (e.g., Ginkgo can increase bleeding, St. John’s Wort can hinder anesthesia recovery).

    Gerontologic Considerations

    • Age-related physiological changes include decreased cardiac reserve and renal/hepatic function.
    • Increased risk of respiratory and cardiac complications; may require extra time for understanding postoperative care.
    • Must be written and obtained before non-emergency surgery.
    • The surgeon explains the procedure and risks; nurses clarify information and witness signatures.
    • Valid only if signed before psychoactive medication administration.

    Preoperative Nursing Interventions

    • Education focuses on: Deep breathing, coughing, incentive spirometry, mobility, and pain management.
    • Encourage early ambulation post-surgery if no complications arise.
    • Address anxiety; respect cultural and religious beliefs.
    • Safety and preparation: Bowel preparation, skin antiseptic, and ensuring all preoperative tasks are carried out.

    Immediate Preoperative Nursing Actions

    • Prepare the patient: change hospital gown, inspect mouth, store valuables.
    • Administer preanesthetic medication.
    • Maintain accurate preoperative records and manage patient transitions.

    PCA Pump Management

    • Setup and monitoring: Administer medication per protocol; patient can self-administer within specified limits.
    • Assess vital signs, pain levels, consciousness, and IV site.
    • Document pain assessments, vital signs, and any PCA discontinuation processes.

    Endocrine System Overview

    • Hypothalamus connects the brain to the endocrine system, regulating pituitary hormone release.
    • Pituitary gland functions:
      • Anterior: Produces ACTH (stress), FSH (reproductive function), GH (growth), LH (ovulation/testosterone).
      • Posterior: Stores ADH (water balance) and oxytocin (childbirth).

    Hormonal Regulation

    • Positive feedback loop demonstrated through oxytocin release during breastfeeding.
    • Negative feedback loop occurs when elevated cortisol levels inhibit further release from the hypothalamus and pituitary.

    Adrenocortical Insufficiency (Addison's Disease)

    • Results from adrenal cortex damage, causing decreased cortisol and aldosterone.
    • Symptoms include fatigue, weight loss, hyperpigmentation, and electrolyte imbalances.
    • Treatment involves glucocorticoid and mineralocorticoid replacement therapy.

    Blood Typing and Transfusion Process

    • Blood type determined by antigens present on cell surfaces.
    • Universal donor: type O, universal recipient: type AB.
    • Rh factor influences transfusion compatibility.
    • Patient A^- can receive from A^- or O^- blood types and requires careful transfusion administration within 3-4 hours.

    Eye and Vision Assessment

    • Eyelid and sclera evaluation includes pupil response in a dark room.
    • Assess eye gaze and eyelid position; ptosis may indicate congenital issues, aging, or diseases like Myasthenia Gravis.
    • Check extraocular movements associated with cranial nerves III, IV, and VI, crucial for eye function.

    Internal Eye Assessment

    • Fundus examination involves viewing retina, macula, fovea, optic disc, and blood vessels.
    • Tonometry measures intraocular pressure; normal range is 10-21 mmHg to assess glaucoma risk.

    Impaired Vision and Refractive Errors

    • Visual impairment may be corrected with glasses or contact lenses to achieve best corrected visual acuity (BCVA).
    • Myopia (nearsightedness) results from a longer eyeball, while hyperopia (farsightedness) is due to a shorter eyeball.
    • Astigmatism arises from irregularities in the cornea or lens, leading to multiple focal points and blurry vision.

    Snellen Chart Usage

    • Snellen chart measures BCVA for distance vision; 20/20 represents normal vision.
    • Larger denominators signify worse vision, e.g., 20/200 is legal blindness.
    • Mild to moderate visual impairments fall between 20/30-20/160, while profound visual impairment ranges from 20/500 to 20/1000.
    • Color discrimination tested using red and green bars.

    Ophthalmic Medications

    • Eye absorption for medications is limited due to factors like conjunctival sac size and corneal barriers.
    • Topical medications are favored for being less invasive and having fewer side effects compared to oral medications.
    • Mydriatics and cycloplegics may cause complications in patients with narrow angles, glaucoma, or those on certain antidepressants.
    • Anti-infective medications can be antibiotics, antifungals, or antivirals.
    • Glaucoma treatments aim to increase aqueous outflow or decrease production, affecting pupil constriction and vision.
    • Long-term corticosteroid use can lead to glaucoma, cataracts, and delayed wound healing.

    Low Vision and Blindness

    • Low vision requires devices and strategies to aid vision; BCVA ranges from 20/70 to 20/200.
    • Blindness is defined as BCVA from 20/200 to no light perception.
    • Impaired vision often leads to functional limitations and coping challenges.

    Management of Low Vision and Blindness

    • Support emotional coping and adaptation strategies for patients.
    • Environmental adaptations include proper item placement and descriptive methods like the "clock method."
    • Utilize communication aids, collaborate with specialists, and consider braille or service animals.

    Retinal Detachment

    • Occurs from the separation of the sensory retina and retinal pigment epithelium (RPE).
    • Symptoms include a sensation of a curtain over the vision, bright flashing lights, and sudden floaters.
    • Diagnostic tools: indirect ophthalmoscope, slit lamp, and fundus photography.

    Surgical Treatments for Retinal Detachment

    • Scleral buckle procedure compresses the sclera to treat detachment.
    • Vitrectomy removes vitreous humor for better retinal access; involves positioning the patient face down post-surgery.

    Macular Degeneration

    • Leading cause of blindness in older adults. The macula affects central visual acuity.
    • Dry macular degeneration is the most common form, characterized by drusen accumulation.
    • Wet macular degeneration involves abnormal blood vessel growth leading to rapid vision loss.
    • No effective therapy exists for dry AMD; treatment for wet type includes medications to inhibit leaky blood vessels.

    Ocular Systemic Diseases

    • Diabetic retinopathy damages retinal blood vessels, a common cause of blindness in young to middle-aged adults.
    • Hypertension-related changes in the eye occur late, with signs including cotton wool spots and hemorrhages.
    • Advanced HIV/AIDS can lead to cytomegalovirus retinitis, characterized by severe visual impairment.

    Trauma and Eye Safety

    • Emphasize injury prevention and patient education on eye safety.
    • Immediate care for chemical injuries includes flushing with water and avoiding removal of foreign bodies.
    • Sympathetic ophthalmia is a serious condition that can affect the uninjured eye.

    Hearing Assessment

    • Ear assessment involves inspection, palpation, and otoscopic examination.
    • Hearing tests can include whisper tests and tuning fork tests like Weber and Rinne.

    Hearing Impairment

    • Presbycusis is age-related hearing loss, mainly affecting high frequencies, prevalent in older adults.
    • Types of hearing impairment include conductive, sensorineural, mixed, and functional.

    Ménière's Disease

    • Affects the inner ear with symptoms of vertigo, tinnitus, and hearing loss due to fluid balance issues.
    • Informed consent must be obtained in writing before non-emergent surgeries, explaining risks and procedures.
    • Preoperative care includes patient education on mobility, pain management, and maintaining safety and comfort.
    • Immediate interventions involve preparing the patient and family, administering pre-anesthetic medications, and ensuring readiness for surgery.

    Intraoperative Complications

    • Risks include anesthesia awareness, nausea, hypothermia, and malignant hyperthermia; each requires specific management.
    • Awareness and prevention of complications are vital for optimal patient outcomes.

    Age Considerations

    • Older adults are at higher risk for complications from surgery and anesthesia due to underlying health conditions and physiological changes.

    Eyelid and Ocular Assessment

    • Assess eyelids, sclera, pupils, and pupillary response in a darkened room.
    • Observe gaze, eye position, and eyelid conditions like ptosis (can be congenital, due to aging, or conditions like Myasthenia Gravis).
    • Evaluate extraocular movements involving cranial nerves III, IV, and VI.

    Internal Eye Examination

    • Inspect the fundus which includes the retina, macula, fovea, optic disc, and blood vessels.
    • Perform tonometry to assess intraocular pressure, normal range is 10-21 mmHg to evaluate glaucoma risk.

    Impaired Vision and Refractive Errors

    • Refractive errors corrected by lenses to achieve best corrected visual acuity (BCVA).
    • Conditions are due to changes in eye structure:
      • Myopia: elongated eyeball causing nearsightedness.
      • Hyperopia: shortened eyeball leading to farsightedness.
      • Astigmatism: irregularly shaped cornea or lens causing blurry vision.

    Snellen Chart for Visual Acuity

    • Used to assess BCVA at distance; normal vision is 20/20.
    • A larger denominator indicates worse vision (e.g., 20/200).
    • Ranges for visual impairment:
      • 20/30 to 20/60: near normal/mild loss.
      • 20/70 to 20/160: moderate impairment.
      • 20/200+: legal blindness.
      • 20/500 to 20/1000: profound impairment.
    • Red and green bars test for color discrimination issues.

    Ophthalmic Medications

    • Eye absorption limited due to conjunctival sac size, corneal barriers, and others.
    • Topical medications (drops, ointments) preferred for less invasiveness and fewer side effects.
    • Types of topical medications include anesthetics, mydriatics, cycloplegics, anti-infectives, and glaucoma medications.
    • Glaucoma medications either increase aqueous outflow or decrease production, impacting vision and systemic effects.

    Low Vision and Blindness

    • Low vision: BCVA between 20/70 and 20/200 requiring devices for correction.
    • Blindness: BCVA ranging from 20/200 to no light perception.
    • Nursing assessments should include functional ability, coping mechanisms, emotional and social adaptability.

    Management of Low Vision and Blindness

    • Support coping strategies and environmental adaptation.
    • Use descriptive techniques for orientation (e.g., "clock method" for items).
    • Collaborate with specialists and utilize tools like Braille or service animals.

    Retinal Detachment

    • Characterized by separation of the sensory retina and retinal pigment epithelium (RPE).
    • Symptoms include sensation of a curtain across vision, bright flashes, and sudden floaters.
    • Diagnosis involves visual acuity tests and imaging techniques.

    Surgical Treatment for Retinal Detachment

    • Scleral buckle: A common procedure compressing the sclera to treat detachment.
    • Vitrectomy: Removal of vitreous humor allowing better access to the retina; requires face-down position post-surgery for healing.

    Nursing Management for Retinal Surgery

    • Essential patient education on outpatient procedures and complication recognition.
    • Promote comfort and positioning for recovery.

    Macular Degeneration

    • Major cause of blindness in older adults, affecting central vision.
    • Types:
      • Dry AMD: most common, slow degeneration with limited treatment options.
      • Wet AMD: rapid onset with treatment focusing on preventing abnormal vessel growth.
    • Risk factors include family history, smoking, and high cholesterol.

    Systemic Diseases Impacting Ocular Health

    • Diabetic retinopathy: leading cause of blindness in those 20-74; characterized by blood vessel damage.
    • Hypertension: ocular signs develop late with retinal changes indicating vascular damage.
    • Advanced HIV/AIDS: can lead to retinal conditions like cytomegalovirus retinitis.

    Ocular Trauma and Safety

    • Emphasize injury prevention and education.
    • Use immediate care protocols for chemical injuries (flush with water) and avoid removing foreign objects.

    Preoperative Considerations

    • Informed consent is legally required pre-surgery; involves patient understanding of risks and benefits.
    • Preoperative nursing interventions include patient education on postoperative care, managing anxiety, and ensuring safety.

    Gerontologic Considerations

    • Elderly patients may exhibit decreased physiological reserves and require more time for comprehension postoperatively.

    Endocrine Considerations

    • Thyroid hormones (T3, T4) are crucial for metabolism and body function; iodine is essential for hormone production.
    • Parathyroid glands regulate calcium levels; dysfunction results in various metabolic disorders.
    • Conditions like Addison's disease cause adrenal insufficiency, requiring lifelong treatment and monitoring for crises.

    Sensory System Overview

    • Visual cortex located in the occipital lobe; auditory cortex found in the temporal lobe.

    Normal Retina

    • Retina is an extension of the optic nerve with a healthy pinkish-red appearance.
    • Retina Layers:
      • Retinal Pigment Epithelium (RPE): Single-cell layer responsible for light absorption.
      • Sensory Retina: Contains rods (night and low light vision) and cones (color discrimination and fine detail).
    • Optic Disc: Sharp outline, round or oval shape, yellow/orange to creamy pink color.
    • Retinal Vessels: Four paired veins and arteries per quadrant; arteries are brighter than veins. Vessels diminish in size away from the optic disc.

    Strabismus vs. Nystagmus

    • Strabismus: Misalignment of the eyes; can be corrected with glasses, patches, or surgery.
    • Nystagmus: Involuntary eye oscillation.

    Vision Assessment & Evaluation

    • Assess ocular history including symptoms like blurred vision; visual acuity measured with Snellen chart (distance) and Rosenbaum pocket screener (near).
    • Use finger count or hand motion assessment techniques.

    Eye Structure Examination

    • Inspect external structures for irritation and discharge; avoid bending or stooping excessively post-examination.
    • Promptly notify healthcare providers for significant concerns.

    Retinal Detachment

    • Occurs when sensory retina separates from RPE; symptoms include sensations of a curtain, flashing lights, and floaters.
    • Diagnosis involves visual acuity and retina assessment through indirect ophthalmoscope, slit lamp, and imaging techniques.

    Retinal Detachment Surgical Treatments

    • Scleral Buckle: Compresses sclera; may encircle or partially cover the eye.
    • Vitrectomy: Removes vitreous humor for retina access; requires face-down positioning post-surgery.

    Macular Degeneration

    • Causes 54% of blindness in older adults; affects center visual field.
    • Types:
      • Dry (Nonexudative): Common type, gradual vision loss due to drusen accumulation; limited treatment options.
      • Wet: Abrupt onset with abnormal blood vessel proliferation causing rapid vision loss; treated with medication.
    • Risk factors include family history, smoking, and high cholesterol.

    Ocular Consequences of Systemic Disease

    • Diabetic Retinopathy: Diabetes causes blindness; characterized by microaneurysms and potential for new blood vessel formation.
    • Hypertension: Visual signs appear late, including arterial changes and retinal hemorrhage.
    • HIV/AIDS Complications: Cytomegalovirus retinitis leads to retinal necrosis and requires antiretroviral treatment.

    Eye Trauma Management

    • Flush chemical injuries immediately; do not remove foreign objects.
    • Be aware of sympathetic ophthalmia, resulting from eye injuries.

    Patient Education and Safety

    • Educate on preventing eye injuries and ensuring safety for individuals with low vision.
    • Postoperative education about complications and the importance of reporting concerns.

    Ear and Hearing Assessment

    • Conduct ear inspections, including otoscopic examinations.
    • Perform hearing assessments using various tests (whisper, Weber, Rinne).

    Hearing Impairment

    • Presbycusis: Age-related hearing loss, initially affecting higher frequencies; prevalent in older adults.
    • Types include conductive, sensorineural, mixed, and functional hearing loss.

    Ménière's Disease

    • Caused by fluid imbalance in the inner ear, leading to vertigo and hearing loss.

    Postoperative Care

    • Surgical Drains: Types include Penrose, Jackson-Pratt, and Hemovac for managing drainage.
    • Dressings provide a healing environment, absorb drainage, and protect the surgical site.
    • First dressing change performed by a provider; use sterile technique and assess patient response.

    Potential Post-Op Complications

    • Monitor for adverse events; patient-controlled analgesia (PCA) allows for self-management of postoperative pain, enhancing recovery.

    Thyroid Function

    • Thyroid hormones (T3, T4) and calcitonin regulate metabolism and calcium levels; iodine is crucial for hormone production.
    • Euthyroid condition indicates normal thyroid function.

    Parathyroid Glands

    • Secrete parathyroid hormone, crucial in regulating calcium and phosphorus metabolism; their action follows a negative feedback mechanism.

    Hemolytic Anemias

    • Hypoproliferative Anemias: Include iron deficiency, renal disease-related anemia, aplastic anemia, and megaloblastic anemia.
    • Hemolytic Anemias: Include sickle cell disease, thalassemia, and other inherited conditions affecting hemoglobin.

    Anemia Assessment

    • Comprehensive health history and physical exam to determine the impact of anemia symptoms; include a nutritional assessment to evaluate dietary contributions to anemia.

    Sensory System Overview

    • Visual cortex located in the occipital lobe; auditory cortex in the temporal lobe.

    Normal Retina Characteristics

    • Retina extends from the optic nerve and is pinkish red when healthy.
    • Retina Layers:
      • Retinal Pigment Epithelium (RPE) absorbs light.
      • Sensory Retina contains rods (night vision) and cones (color & detail vision).
    • Optic Disc: Distinct outline, round/oval shape, yellow/orange to creamy pink in color.
    • Retinal Vessels: Four sets per quadrant; arteries are brighter than veins and they narrow away from the optic disc.

    Strabismus vs. Nystagmus

    • Strabismus: Deviation from ocular alignment; treatable with glasses, patches, or surgery.
    • Nystagmus: Involuntary oscillation of the eyeball.

    Vision Assessment and Evaluation

    • Gather ocular history (blurred vision specifics).
    • Visual acuity through Snellen chart (distance) and Rosenbaum pocket screener (near).
    • Perform finger count or hand motion tests and examine eye structures.

    Eye Structure Examination

    • Assess external characteristics for irritation, inflammation, or discharge.
    • Manage symptoms exacerbated by smoking, infections, and high-salt diets.
    • Treatments: Recommend low-sodium diets, medications like Meclizine for motion sickness, or surgical interventions for vertigo.

    Hearing Impairment Management

    • Hearing Aids: Amplify sounds for improved hearing.
    • Cochlear Implants: For profound sensorineural hearing loss when hearing aids are ineffective.
    • Vestibular Rehabilitation: Focuses on balance and stability.

    Communication Guidelines for Hearing Impaired Individuals

    • Speak slowly, clearly, and face the person while reducing background noise.
    • Utilize gestures, facial expressions, and written communication if necessary.

    Perioperative Nursing Overview

    • Phases:
      • Preoperative: From surgery decision to OR transfer.
      • Intraoperative: From OR transfer to PACU admission.
      • Postoperative: From PACU admission to follow-up evaluation.

    Surgical Classifications

    • Based on purpose (diagnostic, curative, reparative) and urgency (emergent, urgent, elective, optional).

    Preoperative Care

    • Initiate nursing process: Collect demographic and health history.
    • Verify completion of diagnostic tests and start discharge planning.

    Preoperative Assessment Considerations

    • Evaluate health history, physical exam, medications, allergies, nutritional status.
    • Assess respiratory and cardiovascular status, along with psychosocial factors.

    Medications Influencing Surgical Outcomes

    • Identify medications that may affect surgery: corticosteroids, diuretics, anticoagulants, herbal supplements.

    Patient Injury Prevention

    • Implement identification, informed consent, and verification protocols.
    • Monitor and ensure safety measures are in place (e.g., grounding equipment).

    Intraoperative Nursing Interventions

    • Reduce patient anxiety and latex exposure; ensure safe positioning.
    • Serve as an advocate and monitor for complications.

    PACU Nursing Management

    • Assess vital signs, orientation, and motor/sensory functions.
    • Monitor for surgical complications and provide frequent assessments.

    Outpatient Surgery and Direct Discharge

    • Prepare discharge instructions, including follow-up care and complications.
    • Educate patients and others accompanying them regarding recovery and medications.

    Postoperative Assessments

    • Monitor vital signs, pain levels, and mental status.
    • Assess the surgical site for complications.

    Maintaining Airway and Cardiovascular Stability Post-Op

    • Essential tasks: provide oxygen, monitor respiratory status, and maintain IV access.
    • Recognize signs of hypovolemic shock: pallor, rapid pulse, and low blood pressure.

    Postoperative Symptom Management

    • Focus on relieving pain, anxiety, nausea/vomiting.
    • Control the environment to promote comfort; administer analgesics and antiemetics as necessary.

    Gerontologic Considerations

    • Pay attention to decreased physiological reserve and increased risks post-surgery for older patients.
    • Implement careful monitoring of vital signs and hydration status.

    Wound Healing Factors and Management

    • Key factors: age, nutrition, medications, and comorbidities affecting healing.
    • Recognize dehiscence and evisceration and act immediately.

    Types of Surgical Drains

    • Penrose: Open tubing for drainage; monitor output.
    • Jackson-Pratt and Hemovac: Employ suction for measured drainage in surgical settings.

    Postoperative Dressings Purpose and Management

    • Role: healing environment, absorb drainage, protect the surgical site.
    • Change first dressing by the surgeon, apply sterile techniques, and educate patients on care.

    Potential Post-Op Complications

    • Constant vigilance for complications to ensure patient safety.

    Patient Controlled Analgesia (PCA)

    • PCA allows patients to self-administer pain medication, promoting active participation in pain management.
    • Criteria include understanding and physical ability to self-dose.

    Addison's Disease Overview

    • Characterized by adrenal insufficiency due to various causes, leading to decreased hormonal levels.
    • Symptoms include fatigue, weight loss, hyperpigmentation, and low blood pressure.

    Addisonian Crisis Management

    • Life-threatening condition requiring immediate medical intervention.
    • Treatment involves glucocorticoid/mine replacement, IV fluids, and addressing electrolyte imbalances.

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    Description

    This quiz covers the symptoms and treatment options for conditions associated with feelings of fullness, pressure, nausea, and vomiting, particularly in relation to ear disorders. It highlights lifestyle modifications, medications, and potential surgical options to alleviate symptoms. Test your knowledge on how smoking, diet, and medications affect these conditions.

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