Advanced Medical-Surgical HESI Study Guide, Practice Test
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nursing (Chamberlain University)
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Advanced Medical-Surgical HESI Study Guide, Practice Test
Questions (latest Update 2023), 100% Correct and Complete
Answers with Explanations, Highly Recommended, Download
to Score A+
Work Cited: All information was found in HESI book & Junior Med
Surg book
The difference between open & closed angle glaucoma
Chronic open-angle glaucoma is also known as simple adult
primary glaucoma and as primary open-angle glaucoma.
Description: Condition characterized by increased
intraocular pressure (IOP)
A. Glaucoma involves gradual, painless vision loss
B. Glaucoma may lead to blindness if untreated
C. Glaucoma is the second leading cause of blindness in the U.S.
D. There is an increased incidence in glaucoma in older adult
populations
E. Glaucoma usually occurs bilaterally in those who have a family
history of the condition
F. Aqueous fluid is inadequately drained from the eye
G. It is generally asymptomatic, especially in the early stages
H. It tends to be diagnosed during routine visual examinations
I. It cannot be cured, but can be treated with success
pharmacologically and surgically
HESI HINT*
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Glaucoma is often painless and symptom-free. It is usually picked
up as part of a regular eye examination.
Nursing Assessment
A. Early Signs
1. Increase in IOP >22 mm Hg
2. Decreased accommodation or ability to focus
B. Late signs include:
1. Loss of peripheral vision
2. Seeing halos around lights
3. Decreased visual acuity not correctable with glasses
4. Headache or eye pain that may be so severe as to
cause nausea and vomiting (Acute closed-angle
glaucoma)
C. Risk factors include the following:
1. Family hx of glaucoma
2. Family hx of diabetes
3. Medication use and interaction of medications (e.g.
glaucoma is a side effect of antihistamines,
anticholinergics)
Primary Open-Angle Glaucoma: is the most common type of
glaucoma. The outflow of aqueous humor is decreased in the
trecbecular meshwork (area of tissue in the eye located around the base
of the cornea, near the ciliary body, and is responsible for draining the
aqueous humor from the eye via the anterior chamber). The drainage
channels become clogged like a clogged kitchen sink. Damage to the
optic nerve can then result.
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Primary Closed-Angle Glaucoma: is due to a reduction in outflow of
aqueous humor that results from angle closure. Usually this is caused
by the lens bulging forward as a result of the aging process. Angle
closure may also occur as a result of pupil dilation in the patient with
anatomically narrow angles. It may also occur due to drug-induced
myadriasis (dilation of pupil), emotional excitement, or darkness.
HESI HINT*
Eye drops are used to cause pupil constriction because movement of
the muscles to constrict the pupil also allows aqueous humor to flow
out, thereby decreasing the pressure in the eye. Pilocarpine is
commonly used. Caution the client that vision may be blurred for 1-2
hours after administration of Pilocarpine and that adaptation to dark
environments is difficult because of pupillary constriction (the desired
effect of the drug)
HESI HINT*
There is an increased incidence of glaucoma in older adult
populations. Older clients are prone to problems associated with
constipation. Therefore, the nurse should assess these clients for
constipation and postoperative complications associated with
constipation and should implement a plan of care directed at
prevention of, and if necessary, treatment for constipation.
…. Constipation and straining at stool causes an increase in intraocular
pressure (IOP)!
Syndrome of Inappropriate Antidiuretic Hormone(SIADH)
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