N316A – Adult Health Nursing – Exam 3 Review Questions and Answers
Astigmatism Tx: corrective lenses - lens or cornea are irregularly shaped causing light to be
improperly focused
- cylindrically curved corrective lens adjust for abnormality in lens or cornea
Glaucoma: causes & risk factors - caused by elevated IOP (intraocular pressure)
- "silent thief of sight" bc progression is gradual
- increased pressure on optic nerve, may result in blindness
Risk Factors:
- age > 40 y.o.
- ethnicity (Black & Latinx @ greatest risk)
- hx of migraine HA's
- cardiovascular dz
Primary open-angle glaucoma (POAG) - silent slow progression
- 90% of glaucoma pts
Acute angle-closure glaucoma (AACG) - occurs suddenly
- emergency (short-term extreme rise in IOP)
- 10% of glaucoma pts
POAG pathophysiology - not completely understood (increased IOP thought to be
implicated, however, is NOT present in ALL cases)
- changes in ciliary muscle, trabecular meshwork, & canal of Schlemm preventing drainage of
aqueous fluid from anterior chamber
,- as ocular fluid can not drain, pressure is placed on retina & junction of optic nerve
- optic cup enlarges under high IOP
- elevated IOP is NOT the only factor resulting in optic nerve damage in glaucoma
What happens if glaucoma is untreated? blindness
Glaucoma Dx Increased optic cup to optic disc ratio on fundoscopic exam
Glaucoma Tx - reduce IOP by decreasing aqueous fluid or improving aqueous fluid outflow
- topical eye medication, oral medications, laser procedures, incisional surgery
- medical marijuana can decrease IOP temporarily
Otitis Media - infection of middle ear
- can be r/t URI's (tend to follow URI infxn) --> most common in children bc they have shorter,
wider, & more horizontal eustachian tubes that adults; common causes include S. pneumonia,
H. influenzae
- pneumatic otoscope will demonstrate decreased movement of the tympanic membrane
Otitis Media s/s, side effects, Dx, and Tx - S/S: fever, earache (children may present w/
nonspecific s/s such as ear tugging, poor feeding (hurts to suck), irritability)
- side effects: tympanic membrane rupture is possible
- Dx: physical exam reveals reddened tympanic membrane
- Tx: can include tympanotomy --> incision in tympanic membrane to promote drainage (so
membrane doesn't rupture itself)
Hypertension prevalence & risk factors - 1 in 3 adults in the U.S. have this
Risk Factors
, - age, African American ethnicity, obesity, family hx, diabetes mellitus, tobacco use, stress, high
salt diet, excessive alcohol intake, hypersensitivity to angiotensin II, high renin secretor
Aneurysm a localized weak spot or balloon-like enlargement of the wall of an artery
- presentation depends on size, location, & integrity
- may be missed until rupture occurs
Abdominal aortic aneurysm (AAA) - may present w/ abdominal or back pain
- may compress organs causing nausea & vomiting & bowel issues
- in thin pt, may see pulsatile mass
- deep palpation should not be performed
- bruit may be present
- an abrupt onset of severe constant back, flank, or abdominal pain occurs with rupture
Cerebral aneurysm - normally silent
- if rupture = subarachnoid hemorrhage --> most often fatal
Peripheral Arterial Disease - examine for s/s of arteriosclerosis & atherosclerosis, HTN,
hyperlipidemia, diabetes, CAD, MI
- Assessment of pt symptoms: pain & numbness w/ exertion alleviated by rest, etc.
- examine for diminished or absent pulses (bilateral comparison), palpable coolness,
paresthesia, pallor, sensation distal to proximal
Effect of Glucose on Arteries - Glucose injures endothelial cells (glycoslation/glycation);
forms AGE's (advanced glycosylation end products) --> leading to inflammation & plaque build
up
- AGE's increase endothelin release leading to vasoconstriction
Astigmatism Tx: corrective lenses - lens or cornea are irregularly shaped causing light to be
improperly focused
- cylindrically curved corrective lens adjust for abnormality in lens or cornea
Glaucoma: causes & risk factors - caused by elevated IOP (intraocular pressure)
- "silent thief of sight" bc progression is gradual
- increased pressure on optic nerve, may result in blindness
Risk Factors:
- age > 40 y.o.
- ethnicity (Black & Latinx @ greatest risk)
- hx of migraine HA's
- cardiovascular dz
Primary open-angle glaucoma (POAG) - silent slow progression
- 90% of glaucoma pts
Acute angle-closure glaucoma (AACG) - occurs suddenly
- emergency (short-term extreme rise in IOP)
- 10% of glaucoma pts
POAG pathophysiology - not completely understood (increased IOP thought to be
implicated, however, is NOT present in ALL cases)
- changes in ciliary muscle, trabecular meshwork, & canal of Schlemm preventing drainage of
aqueous fluid from anterior chamber
,- as ocular fluid can not drain, pressure is placed on retina & junction of optic nerve
- optic cup enlarges under high IOP
- elevated IOP is NOT the only factor resulting in optic nerve damage in glaucoma
What happens if glaucoma is untreated? blindness
Glaucoma Dx Increased optic cup to optic disc ratio on fundoscopic exam
Glaucoma Tx - reduce IOP by decreasing aqueous fluid or improving aqueous fluid outflow
- topical eye medication, oral medications, laser procedures, incisional surgery
- medical marijuana can decrease IOP temporarily
Otitis Media - infection of middle ear
- can be r/t URI's (tend to follow URI infxn) --> most common in children bc they have shorter,
wider, & more horizontal eustachian tubes that adults; common causes include S. pneumonia,
H. influenzae
- pneumatic otoscope will demonstrate decreased movement of the tympanic membrane
Otitis Media s/s, side effects, Dx, and Tx - S/S: fever, earache (children may present w/
nonspecific s/s such as ear tugging, poor feeding (hurts to suck), irritability)
- side effects: tympanic membrane rupture is possible
- Dx: physical exam reveals reddened tympanic membrane
- Tx: can include tympanotomy --> incision in tympanic membrane to promote drainage (so
membrane doesn't rupture itself)
Hypertension prevalence & risk factors - 1 in 3 adults in the U.S. have this
Risk Factors
, - age, African American ethnicity, obesity, family hx, diabetes mellitus, tobacco use, stress, high
salt diet, excessive alcohol intake, hypersensitivity to angiotensin II, high renin secretor
Aneurysm a localized weak spot or balloon-like enlargement of the wall of an artery
- presentation depends on size, location, & integrity
- may be missed until rupture occurs
Abdominal aortic aneurysm (AAA) - may present w/ abdominal or back pain
- may compress organs causing nausea & vomiting & bowel issues
- in thin pt, may see pulsatile mass
- deep palpation should not be performed
- bruit may be present
- an abrupt onset of severe constant back, flank, or abdominal pain occurs with rupture
Cerebral aneurysm - normally silent
- if rupture = subarachnoid hemorrhage --> most often fatal
Peripheral Arterial Disease - examine for s/s of arteriosclerosis & atherosclerosis, HTN,
hyperlipidemia, diabetes, CAD, MI
- Assessment of pt symptoms: pain & numbness w/ exertion alleviated by rest, etc.
- examine for diminished or absent pulses (bilateral comparison), palpable coolness,
paresthesia, pallor, sensation distal to proximal
Effect of Glucose on Arteries - Glucose injures endothelial cells (glycoslation/glycation);
forms AGE's (advanced glycosylation end products) --> leading to inflammation & plaque build
up
- AGE's increase endothelin release leading to vasoconstriction
