MDC 1 - Exam 2 Study Guide 2024 Questions with 100% Correct Answers

MDC 1 - Exam 2 Study Guide 2024 Questions with 100% Correct Answers - Always knock or announce your entrance into the patient's room or area and introduce yourself. - Orient the patient to the environment, counting steps with him or her to the bathroom - Help the patient place objects on the bedside table or in the bed and around the bed and room and do not move them without the patient's permission - Remove all objects and clutter between the patient's bed and the bathroom. - Use a normal tone of voice. -Answer-What are some nursing interventions for visual impairment? anisocoria -Answer-a condition in which the pupils are unequal in size exophthalmos -Answer-protrusion of the eyeballs, as seen in Graves disease enophthalmos -Answer-sunken eyes, eyeballs are recessed ptosis -Answer-prolapse, downward displacement, dropping - Put in lower conjunctival sac - Do not drop in center of eye - Stabilize hands on facial structures (bony prominences) - Hold the inner eye to avoid systemic effects (punctal occlusion) - Do not let dropper touch their eye - Wash hands before -Answer-Patient education for instilling eye drops punctal occlusion -Answer-Drainage of topical drops from the eye and their systemic absorption can be prevented by _________ _________? · Blurred vision · Clouded vision · Decreased color perception · May think that glasses are smudged · Double vision · Halos around objects · Problems with ADL'S · Affects reading and driving · Impaired night vision · Frequents changes in eyeglass prescription · Without surgical intervention blindness follows -Answer-Signs and symptoms of cataracts · Wear dark glasses and avoid bright sunlight · Do not drive · Develop a schedule for the administration of post-op eye drops. Be sure client or family can demonstrate the correct technique for administering the drops. · Report Worsening Vision · Observe for increasing eye redness · Decrease in vision · Floaters · Sharp, or sudden pain in eye · Green or yellow drainage on the lids and lashes ***avoid anything that increases IOP like... · Do no bend at the waist · Lift more than 10 pounds · Sneeze or cough · Blow your nose · Strain to move bowels · Have sexual intercourse · Vomit · Keep head in a dependent position · Wear tight shirt collars -Answer-Patient Education for post-op cataract surgery glaucoma -Answer-When the intraocular pressure increases it leads to compression of the retinal blood vessels and photoreceptors and their nerve fibers resulting in hypoxemia and death of the tissue and permanent loss of vision - Sudden severe pain around the eyes radiating over the face - Headache or brow pain - Nausea and vomiting - Seeing colored halos around lights - Sudden blurred vision - Reddened sclera - Foggy cornea - Moderately dilated pupil that does not react to light - Cupping and atrophy of the optic disc -Answer-Signs and symptoms of glaucoma 10 mm Hg - 21 mm Hg -Answer-What is the normal intraocular range pressure? reduce intraocular pressure -Answer-What is the goal of treatment for glaucoma? tonometry - measures IOP ultrasonic imaging of the retina and optic nerve - creates a three-dimensional view of the back of the eye; tells us the TYPE of glaucoma -Answer-How do you test for glaucoma? corneal staining -Answer-dye outlines irregularities of corneal surface (used for corneal trauma, problems caused by contacts, or presence of foreign bodies, abrasions, ulcers, or other corneal disorders). Assess vital signs (specifically BP and P) These drugs (like timolol) potentiate the effects of systemic beta blockers and can cause an unsafe drop-in heart rate and blood pressure -Answer-Before administering eye drops, what must the nurse assess and why? Meniere's disease -Answer-Abnormal condition within the labyrinth of the inner ear that can lead to a progressive loss of hearing. The symptoms are dizziness or vertigo, hearing loss, and tinnitus (ringing in the ears). Patient should not drive Can be intermittent. Cause is unknown/genetic Can be dangerous to patient (fall risk!) ***build-up of fluids - Turn head slowly - Stop smoking - Reduce sodium intake (so less fluid buildup/pressure) - Use medications as directed -Answer-Patient education for Meniere's disease monitor vital signs -Answer-Post surgical care for tympanoplasty Weber test -Answer-The ________ test is performed by placing a vibrating tuning fork on the middle of the patient's head and asking him or her to indicate in which ear the sound is louder. Sound heard equally in both ears -Answer-What are normal results of the Weber test? systolic (90-120) diastolic (60-80) -Answer-Normal blood pressure ranges for systolic and diastolic 60-100 bpm -Answer-Normal pulse ra