Podcast
Questions and Answers
Which diagnostic test uses a dye to visualize blood vessels in the eye, requiring assessment for iodine or shellfish allergies?
Which diagnostic test uses a dye to visualize blood vessels in the eye, requiring assessment for iodine or shellfish allergies?
A client reports difficulty seeing objects at a distance, experiencing blurred vision. Which vision impairment are they likely experiencing?
A client reports difficulty seeing objects at a distance, experiencing blurred vision. Which vision impairment are they likely experiencing?
A nurse is caring for a patient with significant vision loss, what is an appropriate nursing intervention?
A nurse is caring for a patient with significant vision loss, what is an appropriate nursing intervention?
What is the primary goal of glaucoma management?
What is the primary goal of glaucoma management?
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During a slit-lamp exam, which eye structure is being examined?
During a slit-lamp exam, which eye structure is being examined?
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A patient with a central visual acuity of 20/60 in the better eye, even with corrective lenses, would be classified as having what type of vision impairment?
A patient with a central visual acuity of 20/60 in the better eye, even with corrective lenses, would be classified as having what type of vision impairment?
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Which of the following is NOT considered a testing method for glaucoma?
Which of the following is NOT considered a testing method for glaucoma?
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A patient is prescribed Betalol drops as treatment for glaucoma. As the nurse, you must monitor the patient for:
A patient is prescribed Betalol drops as treatment for glaucoma. As the nurse, you must monitor the patient for:
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Which of the following is the priority nursing intervention for a patient experiencing acute angle-closure glaucoma?
Which of the following is the priority nursing intervention for a patient experiencing acute angle-closure glaucoma?
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A patient reports seeing 'bright flashing lights' and a 'curtain coming across their vision'. Which condition is most likely?
A patient reports seeing 'bright flashing lights' and a 'curtain coming across their vision'. Which condition is most likely?
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Which of the following is a common risk factor for the development of cataracts?
Which of the following is a common risk factor for the development of cataracts?
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When educating a patient about postoperative care following cataract surgery, which instruction should be included?
When educating a patient about postoperative care following cataract surgery, which instruction should be included?
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A patient with macular degeneration is likely to display which set of symptoms?
A patient with macular degeneration is likely to display which set of symptoms?
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A patient with diabetic retinopathy should be educated about the importance of:
A patient with diabetic retinopathy should be educated about the importance of:
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What is the primary purpose of the Weber test in assessing a patient's hearing?
What is the primary purpose of the Weber test in assessing a patient's hearing?
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Which intervention should the nurse prioritize after a patient undergoes a tympanoplasty?
Which intervention should the nurse prioritize after a patient undergoes a tympanoplasty?
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Which of the following medications is most likely to cause ototoxicity?
Which of the following medications is most likely to cause ototoxicity?
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Which treatment is suitable for a patient experiencing cerumen impaction?
Which treatment is suitable for a patient experiencing cerumen impaction?
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Study Notes
Ophthalmological Diagnostics
- Ophthalmoscopy: Examines cornea, retina, lens, and optic nerve; handheld device.
- Slit-lamp Exam: Visualizes eye structures using a traditional microscope.
- Tonometry: Measures intraocular pressure; tests for glaucoma.
- Color Vision Testing: Patient differentiates colors to assess color vision.
- Amsler Grid: Tests for macular degeneration by detecting distortions in vision.
- Ultrasound: Visualizes retina, aids in identifying tumors.
- Fluorescein and Indocyanine Green Angiography: Injects dye to assess blood vessels; checks for allergies (iodine/shellfish) and kidney function; ensure hydration. Urine may turn gold.
- Corneal Abrasion Check: Evaluates for corneal damage.
- Perimetry Testing: Checks peripheral vision for defects.
Vision Impairments
- Emmetropia: Normal vision.
- Myopia: Nearsightedness (blurred distance vision).
- Hyperopia: Farsightedness (blurred near vision but good distance).
- Astigmatism: Image distortion due to cornea's irregular curvature.
- Vision Impairment: Central visual acuity of 20/40 or worse (with corrections).
- Low Vision: Visual impairment requiring assistive devices and strategies for tasks.
- Blindness: Best corrected visual acuity from 20/400 to no light perception.
- Legal Blindness: Impaired vision (20/200 or worse, or 20-degree visual field or less).
- Nursing for Blind Patients: Maintain consistent room setup, introduce yourself, familiarize the patient and announce tasks. Post visual aids for low vision. Announce departing. Safe and clean environment.
Glaucoma
- Mechanism: Elevated intraocular pressure damages optic nerve.
- Risk Factors: Age, smoking, family history, race (African American, Asian), diabetes, cardiovascular disease, hypertension, eye tumors.
- Diagnostic Tests: Tonometry, ophthalmoscopy (optic nerve), central field visual testing.
- Goals: Prevent vision loss, maintain IOP in safe range.
- Nursing Management: Monitor IOP, changes in vision or light sensitivity.
- Open-Angle Glaucoma: Most common, bilateral, gradual pressure increase, mild pain, blurred vision, halos.
- Treatment: Beta-blocker eye drops (possible bradycardia).
- Nursing Considerations: Maintain medication adherence; manage pain/nausea.
- Angle-Closure Glaucoma: Emergency, sudden angle closure, rapidly increasing IOP (≥ 30 mm Hg).
- Symptoms: Corneal edema, rapid vision loss, severe eye pain (with N/V, bradycardia, sweating, headache), dilated/fixed pupils.
- Treatment: Immediate IOP reduction (trabeculectomy, iridotomy).
- Post-Op Care: Wear sunglasses, report drainage, avoid affected side, report severe pain, avoid IOP-increasing activities (bending, coughing, lifting, neck flexion). Final vision improvement typically 4-6 weeks.
Cataracts
- Mechanism: Opacity (cloudiness) of lens, leading cause of blindness, leading cause of vision disability in the US.
- Risk factors: Age, family history, trauma, retinal detachment, long-term steroid/beta-blocker/miotic use, smoking, poor nutrition, obesity, previous eye surgery, excessive sunlight, diabetes, alcohol.
- Manifestations: Painless, halos, decreased color perception, double vision, lens opacity, light sensitivity.
- Nursing Care: Check visual acuity with Snellen chart, assess functional capacity, adjust lighting, and adapt care to accommodate vision impairment.
- Treatment: Cataract surgery, lens replacement.
- Post-Op Teaching: Wraparound sunglasses, padded eye protector, prescribed drops (antibiotics, corticosteroids, NSAIDs).
Retinal Detachment
- Mechanism: Separation of sensory retina from retinal pigment epithelium; an emergency.
- Manifestations: Sensation of shadow or curtain, flashing lights, sudden floaters, no pain.
- Treatment: Surgery.
Macular Degeneration
- Mechanism: Central vision loss.
- Risk Factor: Age over 60.
- Diagnosis: Amsler grid.
- Manifestations: Loss of depth perception, blurred vision, distortion of objects, potential blindness.
- Treatment: Laser therapy, injections.
- Education: Encourage consumption of antioxidant-rich foods (carotene, vitamin E, B12).
Diabetic Retinopathy
- Mechanism: Microvascular changes in the eye due to diabetes.
- Manifestations: Floaters, blurred or darkened vision.
- Education: BG control, BP control, smoking cessation.
Conjunctivitis
- Mechanism: Inflammation of conjunctiva (eye lining).
- Manifestations: Photophobia, burning, itching, redness, drainage.
- Bacterial: Antibiotic drops.
- Viral: Supportive care.
- Education: Avoid eye rubbing, warm compresses. Highly contagious.
Otic Diagnostics
- Weber Test: Evaluates bone conduction of sound.
- Rinne Test: Compares air and bone conduction to identify hearing loss type.
- Otoscopy: Visual inspection of the ear canal and eardrum.
- Audiometry: Hearing test.
- Tympanogram: Measures middle ear pressure.
- Electronystagmography: Assesses vestibular function (performed by a physician).
Hearing Loss
- Risk Factors: Family history, congenital defects, ototoxic medications (e.g., aminoglycosides, furosemide, NSAIDs, aspirin), recurrent ear infections, loud noise exposure, tympanic membrane perforation.
- Conductive Hearing Loss: External or middle ear problems (otitis media, otosclerosis, foreign bodies, earwax).
- Sensorineural Hearing Loss: Damage to cochlea or auditory nerve.
- Mixed Hearing Loss: Combination of conductive and sensorineural.
- Functional Hearing Loss: Psychogenic, emotional reaction.
- Diagnostics: Weber and Rinne tests.
Cerumen Impaction
- Treatment: Irrigation, suction, cerumen softeners (glycerin, mineral oil or H2O2).
External Otitis
- Mechanism: Inflammation/infection of the external ear canal. Most common: bacterial or fungal.
- Signs: Edema, redness, pain, tenderness, discharge, hearing loss, itching.
- Treatment: Antibiotic or antifungal drops.
Tympanic Membrane Perforation
- Causes: Infection or trauma.
- Signs: Sudden hearing loss.
- Treatment: Repair (tympanoplasty) for perforations.
- Nursing Care: Monitor for infection.
Acute and Chronic Otitis Media
- Acute Otitis Media: Acute viral or bacterial infection of the middle ear; common in children.
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Description
Explore the critical techniques used in ophthalmological diagnostics and the various vision impairments. This quiz covers essential methods like ophthalmoscopy, tonometry, and color vision testing, alongside common conditions such as myopia and hyperopia. Test your knowledge and understanding of these vital aspects of eye care.
