NURS 190 - QUIZ 2 STUDY GUIDE 2023 (100%
CORRECT)
Quiz 2
Chapter 15: Eyes
● Eye: only a small portion of the eye is seen → 3 layers
○ Sclera- made of a fibrous material that can help the eye to keep its shape;
■ Can indicate presence of jaundice (yellowing)
■ Contains the cornea- protection in front of lens; can repair itself
○ Choroid- middle layer
■ Iris- colored part of the eye; can constrict or dilate the pupil
■ Pupil- center of the iris; opening for light to travel into the eyes
● Mydriasis- when dim light enters, and the pupil enlarges
● Miosis- bright light enters, making the pupil constrict
○ Retina- where the optic nerve should be gathered
■ Optic disc- blind spot: red free filter helps see optic disc
■ Macular- responsible for central vision
● Refraction of the eye- light travels in a straight line
○ Cornea → refracts and directs through pupil and into eye
○ Emmetropia- normal refractive condition of the eye;
■ Focal point → RIGHT ON retina
○ Myopia (nearsightedness)- light rays focus in front of the retina
■ Can see close, but have difficulty seeing far away : 12-14 in away from
paper
○ Hyperopia (farsightedness)- light rays focus behind the retina
■ Can see fine from far away but have a difficulty seeing close up
○ Hemianopsia- portion of the visual field would not be seen due to a lesion
● Accessory structures of the eye
○ Eyebrows- protect the eye
○ Eyelids (palpebrae) - moveable folds of skin that cover and protect
■ Palpebral fissure- opening between upper and lower eyelids
■ Meibomian glands- oily substance that helps lubricate the eyes
○ Eyelashes- protect from eyelids and curl outward
○ Conjunctivae- prevents foreign bodies from entering the eye
○ Lacrimal apparatus- tears are secreted
● Extraocular muscles: cranial 3, 4, 6
○ Cardinal fields of gaze → assess whether there are any deviations
● Lifespan considerations:
○ Infants and children
■ Visual acuity → not as sharp as adults
■ Typically have 20/20 by age 7
■ At birth, the iris has little color but changes to permanent color by 3
months
■ Red reflex- should be seen at birth
● Absence or white reflection → indication of cancer or
congenital cataracts
■ Binocular vision develops at 6 weeks (seeing through both eyes)
,NURS 190 - QUIZ 2 STUDY GUIDE 2023 (100%
CORRECT)
■ Assess eye muscles early → delay can lead to permanent visual
damage
○ Pregnant female
■ Dryness of the eyes
● May not be able to wear contacts
■ Vision changes
● Due to shifting fluid in cornea
● Blurriness
● Distorted vision
● Up to 6 weeks postpartum → do not need any permanent
fixing
○ Older adult (common changes in the adult eye)
■ Xanthelasma- early warning sign that cholesterol may be building up
● Patient needs cholesterol checked !
● Yellowish deposit of cholesterol underneath the skin. Usually
occurs on or under the eyelids
■ Pinguecula- benign growth on eye; linked to frequent exposure to dust or
wind
● Not concerning → just over exposed to sunlight or wind
● A yellowish white spot on the conjunctiva - looks fatty & is
d/t accumulation of connective tissue
■ Presbyopia- age related vision loss / farsightedness
● Lens elasticity decreases
■ Arcus senilis- present at birth and reappear at old age – narrow opaque
bnd encircling the cornea
■ Cataracts- lens of the eye becomes opaque – thickening & yellowish
discoloration
● Similar to headlights → when they are exposed to a lot of
sun / debris, they become opaque and yellow; lights
become dim
● Eyes become opaque with exposure to alcohol, cigarettes,
sun exposure, aging → surgery can be done to replace the
lens in order to clear up the vision
● Cure = cataract surgery
■ Macular degeneration- deterioration of retina; central vision loss
● Have problems seeing faces, reading, etc
● Can be medicated if caught early → BUT not
something you can cure
● Can slow the progression but will eventually cause that blindness
● Cultural & environmental considerations
○ Changes that occur normally in various races & ethnic groups are equal until
about age 70
■ White → all increased risk
■ Hispanic → diabetic retinopathy
■ Black → glaucoma and cataracts (increased risk of hypertension)
, NURS 190 - QUIZ 2 STUDY GUIDE 2023 (100%
CORRECT)
○ Excessive sun exposure can cause → macular degeneration and cataracts
○ Medications can cause vision problems:
■ Corticosteroids → cataracts, glaucoma
■ Chemotherapy, Flomaxx, Accutane, ethambutol, etc
○ Hygiene practices
■ How a person washes their hands
■ Contact hygiene → are they changing them out the way they are
supposed to? Are they using solution properly?
■ Make up
○ Trauma / damage
■ Wearing safety goggles
● Psychosocial considerations
○ Decreased vision / impaired vision in older adults → can greatly impact
the individual’s independence and quality of life
■ Children may have developmental delays
■ Stress for families (caregiving)
○ Eye contact within cultures, age, gender
○ Asians → prominent epicanthal folds
○ Dark-skinned person may have dark spots on sclera & retina may
appear darker → may feel like they are looked at differently
○ Light colored eyes have better night vision → but MORE SENSITIVE to
bright light
● Focused Interview / eye assessment:
○ General: “Describe your vision today…”
○ Consider expectations based on:
■ Age
■ Race
■ Environment
■ Health practices
■ Past & current problems / therapies
○ Ask about any infections, surgeries, or injuries
○ Consider patient’s ability to participate → based on any problems
stated that are significant
○ Symptoms, pain and behaviors
○ “When was your last eye exam?” → especially in an older client, diabetic
patients
○ Techniques:
■ Inspection
■ Palpation
■ Ophthalmoscope
● Lifespan considerations:
○ Infants and children:
■ Did the mother have a vaginal infection?
■ Was the child full term or premature? If premature, how early?
CORRECT)
Quiz 2
Chapter 15: Eyes
● Eye: only a small portion of the eye is seen → 3 layers
○ Sclera- made of a fibrous material that can help the eye to keep its shape;
■ Can indicate presence of jaundice (yellowing)
■ Contains the cornea- protection in front of lens; can repair itself
○ Choroid- middle layer
■ Iris- colored part of the eye; can constrict or dilate the pupil
■ Pupil- center of the iris; opening for light to travel into the eyes
● Mydriasis- when dim light enters, and the pupil enlarges
● Miosis- bright light enters, making the pupil constrict
○ Retina- where the optic nerve should be gathered
■ Optic disc- blind spot: red free filter helps see optic disc
■ Macular- responsible for central vision
● Refraction of the eye- light travels in a straight line
○ Cornea → refracts and directs through pupil and into eye
○ Emmetropia- normal refractive condition of the eye;
■ Focal point → RIGHT ON retina
○ Myopia (nearsightedness)- light rays focus in front of the retina
■ Can see close, but have difficulty seeing far away : 12-14 in away from
paper
○ Hyperopia (farsightedness)- light rays focus behind the retina
■ Can see fine from far away but have a difficulty seeing close up
○ Hemianopsia- portion of the visual field would not be seen due to a lesion
● Accessory structures of the eye
○ Eyebrows- protect the eye
○ Eyelids (palpebrae) - moveable folds of skin that cover and protect
■ Palpebral fissure- opening between upper and lower eyelids
■ Meibomian glands- oily substance that helps lubricate the eyes
○ Eyelashes- protect from eyelids and curl outward
○ Conjunctivae- prevents foreign bodies from entering the eye
○ Lacrimal apparatus- tears are secreted
● Extraocular muscles: cranial 3, 4, 6
○ Cardinal fields of gaze → assess whether there are any deviations
● Lifespan considerations:
○ Infants and children
■ Visual acuity → not as sharp as adults
■ Typically have 20/20 by age 7
■ At birth, the iris has little color but changes to permanent color by 3
months
■ Red reflex- should be seen at birth
● Absence or white reflection → indication of cancer or
congenital cataracts
■ Binocular vision develops at 6 weeks (seeing through both eyes)
,NURS 190 - QUIZ 2 STUDY GUIDE 2023 (100%
CORRECT)
■ Assess eye muscles early → delay can lead to permanent visual
damage
○ Pregnant female
■ Dryness of the eyes
● May not be able to wear contacts
■ Vision changes
● Due to shifting fluid in cornea
● Blurriness
● Distorted vision
● Up to 6 weeks postpartum → do not need any permanent
fixing
○ Older adult (common changes in the adult eye)
■ Xanthelasma- early warning sign that cholesterol may be building up
● Patient needs cholesterol checked !
● Yellowish deposit of cholesterol underneath the skin. Usually
occurs on or under the eyelids
■ Pinguecula- benign growth on eye; linked to frequent exposure to dust or
wind
● Not concerning → just over exposed to sunlight or wind
● A yellowish white spot on the conjunctiva - looks fatty & is
d/t accumulation of connective tissue
■ Presbyopia- age related vision loss / farsightedness
● Lens elasticity decreases
■ Arcus senilis- present at birth and reappear at old age – narrow opaque
bnd encircling the cornea
■ Cataracts- lens of the eye becomes opaque – thickening & yellowish
discoloration
● Similar to headlights → when they are exposed to a lot of
sun / debris, they become opaque and yellow; lights
become dim
● Eyes become opaque with exposure to alcohol, cigarettes,
sun exposure, aging → surgery can be done to replace the
lens in order to clear up the vision
● Cure = cataract surgery
■ Macular degeneration- deterioration of retina; central vision loss
● Have problems seeing faces, reading, etc
● Can be medicated if caught early → BUT not
something you can cure
● Can slow the progression but will eventually cause that blindness
● Cultural & environmental considerations
○ Changes that occur normally in various races & ethnic groups are equal until
about age 70
■ White → all increased risk
■ Hispanic → diabetic retinopathy
■ Black → glaucoma and cataracts (increased risk of hypertension)
, NURS 190 - QUIZ 2 STUDY GUIDE 2023 (100%
CORRECT)
○ Excessive sun exposure can cause → macular degeneration and cataracts
○ Medications can cause vision problems:
■ Corticosteroids → cataracts, glaucoma
■ Chemotherapy, Flomaxx, Accutane, ethambutol, etc
○ Hygiene practices
■ How a person washes their hands
■ Contact hygiene → are they changing them out the way they are
supposed to? Are they using solution properly?
■ Make up
○ Trauma / damage
■ Wearing safety goggles
● Psychosocial considerations
○ Decreased vision / impaired vision in older adults → can greatly impact
the individual’s independence and quality of life
■ Children may have developmental delays
■ Stress for families (caregiving)
○ Eye contact within cultures, age, gender
○ Asians → prominent epicanthal folds
○ Dark-skinned person may have dark spots on sclera & retina may
appear darker → may feel like they are looked at differently
○ Light colored eyes have better night vision → but MORE SENSITIVE to
bright light
● Focused Interview / eye assessment:
○ General: “Describe your vision today…”
○ Consider expectations based on:
■ Age
■ Race
■ Environment
■ Health practices
■ Past & current problems / therapies
○ Ask about any infections, surgeries, or injuries
○ Consider patient’s ability to participate → based on any problems
stated that are significant
○ Symptoms, pain and behaviors
○ “When was your last eye exam?” → especially in an older client, diabetic
patients
○ Techniques:
■ Inspection
■ Palpation
■ Ophthalmoscope
● Lifespan considerations:
○ Infants and children:
■ Did the mother have a vaginal infection?
■ Was the child full term or premature? If premature, how early?
