NURS 612 Final Study Review

NURS 612 Final Study ReviewHEAD, EARS, NOSE, THROAT What is accommodation? The ability of the eye to change its focus from distant to near objects (and vice versa). This process is achieved by the lens changing its shape. It is the process of adjusting the focal length of a lens. Most common cause of loss of vision in adults > 45 years old: Presbyopia What does 20/40 mean? The pt sees at 20 feet what a normal person sees at 40 feet. Another way of saying this is that a person with 20/40 vision has vision that is only half as good as normal. How do you assess EOM imbalance? Have the patient look in all directions without moving their head and ask them if they experience any double vision. (CN 3, 4, and 6). Have them look in 6 different directions. How do you assess sinus pressure? Palpate the maxillary, frontal, and orbital sinuses (tenderness will result if pressure present). Why do you adjust ophthalmoscope? Adjusting the lenses compensates for both the observer’s and the patient’s refractive errors, like if the observer has no refractive error and the patient is myopic, minus lenses will be required to focus on the retina. 0 lens is used to test the red reflex. Rotate the lens selector clockwise, then counterclockwise in order to compensate for myopia. How do you examine ear adults/children? Adults: Inspect the auricles and surrounding area for size, shape, symmetry, landmarks, color, position, deformities or lesions. Palpate the auricles and mastoid area for tenderness, swelling and nodules. Inspect the auditory canal with otoscope, noting cerumen, color, lesions, discharge, and foreign bodies. Inspect the tympanic membrane for landmarks, color, contour, perforations, and mobility. Assess hearing through response to questions during history, response to whispered voice, and response to tuning fork for air and bone conduction. Children: Pretty similar to above, with a few exceptions. Try to save this examination for last if the child is prone to cry or get scared by the otoscope. Pull auricles either downward and back or upward and back to gain best view. If the child has been crying, the blood vessels in the tympanic member can cause redness. Screen their hearing by observing the response to a whispered voice and various noisemakers. The Weber and Rinne tests are usually not used until 3 and 4 years old.