Special senses.pdf

HLTENN007: Administer and monitor medicines and intravenous therapy Eyes Review the anatomy and physiology of the eye http://trinityvisioncenter.info/wp-content/uploads/2014/02/eyeanatomy.jpg Administering eyedrops Review the nursing actions when administering an eyedrop to a patient Indicati...

HLTENN007: Administer and monitor medicines and intravenous therapy Eyes Review the anatomy and physiology of the eye http://trinityvisioncenter.info/wp-content/uploads/2014/02/eyeanatomy.jpg Administering eyedrops Review the nursing actions when administering an eyedrop to a patient Indications for eye medications Glaucoma Infection Inflammation Eye pain from surgical repair Eye examinations Glaucoma ▪Increased intra-ocular pressure in anterior chamber of the eye ▪Caused by impaired drainage of aqueous humour fluid in the eye ▪ Increased Pressure damages optic nerve. Once damaged, optic nerve cannot be repaired ▪Failure to treat increased pressure in the eye will result in progressive blindness Glaucoma Patient may be symptom free until loss of vision occurs Once diagnosed, treatment can halt progression of the disease Aim of treatment is to lower the pressure in the eye http://www.glaucoma.org/glaucoma/anatomy-of-the-eye.php Glaucoma Laser treatment can enhance drainage of eye Surgical treatment can create a channel to bypass fluid filter in the eye to reduce intro-ocular pressure (IOP) Eyedrops is main treatment and are administered once or twice a day Glaucoma – drug therapy • Aims to decrease intra-ocular pressure – may have systemic effects • If using more than one eyedrop, allow at least 5 minutes between each one • Contact lenses should be removed for eyedrops and not replaced for at least 15 minutes Infection Anti-infective agents may be used to treat: • Conjunctivitis • Eye infections • Infected corneal ulcers • Blepharitis (inflammation of the eyelid) • Trachoma (Chlamydia) Infection Anti-infective Choice of therapy depends on micro-organism Anti-bacterials kill or inhibit growth of bacteria: • Chloramphenicol (Chloromycetin) • Ciprofloxacin • Gentamicin • Tobramycin • Soframycin • Tetracycline Infection Anti-infective • Acyclovir (Zovirax) - Antiviral: inhibits viral replication by interfering with DNA synthesis • Chloramphenicol - Antibacterial Side effects of anti-bacterial and anti-viral agents: • hypersensitivity/allergy • secondary eye infection from prolonged use Anti-inflammatory eye drops • Non Steroidal Anti-inflammatories (NSAIDs) • Used to reduce pain, inflammation and itching by inhibiting prostaglandin production • Diclofenac (Voltaren) used post-op to reduce pain and inflammation • Ketorolac (Acular) Can be used for seasonal allergies causing itchy eyes Anti-inflammatory eye drops Corticosteroids Used for blepharitis and inflammatory conditions of cornea, iris, conjunctiva and sclera Medication name Side Effects Prednisolone Hydrocortisone Dexamethasone •Corticosteroids can cause stinging, burning, cataract formation and secondary viral or bacterial infection from immunosuppression. •May also have some systemic effects Eyedrops for eye examinations Not commonly administered by nurses, but you may care for a patient who has had these eyedrops Nasal medication • Aerosol or drops • Decongestant / antihistamine • Repeated use may = nasal irritation / rebound effect • If nasal decongestant is swallowed may = systemic effects • Usually easier for individual to self administer OTIC Inflammation / infection / remove wax Discard 28 days after opening INSTILLING EAR DROPS • Ensure drops are at room temperature • • Patient sit / lie comfortably Cleanse ear canal before instilling • Pull ear auricle upwards and backwards to straighten external canal • Instil drops into canal without touching the ear • Maintain position for 2-3 minutes Reference List • Bullock, S., Galbraith, A. and Manias, E., 2006. Fundamentals of Pharmacology, 5th edition. Prentice-Hall Health, Pearson Education Australia. • Crisp, J. & Taylor, C. 2005. Potter & Perry’s Fundamentals of Nursing 2nd edition. Elsevier. Australia. • Funnell, R., Koutakidis, G., Lawrence, L. 2009. Tabbner’s Nursing Care, Theory & Practice. 5th Edition. Elsevier. Sydney. • Images from: http://www.google.com.au/images (accessed 21/7/10)