Summary Nurs 3628 exam 3 review

Alterations in Sensory Perception
 Vision
o Errors of refraction
 Myopia
 Hyperopia
 Presbyopia
 Astigmatism
o Cataracts
 PATHO:
 Cloudy lens
 Epidemiology:
 3rd leading cause of disability (behind arthritis and heart disease)
 Most common cause of visual impairment
 A common cause of preventable blindness
 R/F:
 Aging
 Diabetes
 UV light exposure
 Trauma
 Obesity
 Malnutrition
 Medications (ex. Steroids)
 S/S:
 Blurred vision
 Light sensitivity
 Poor acuity
 Decreased contrast sensitivity
 Reduced light transmission
 DX:
 Slit-lamp examination
 Snellen chart
 TX:
 Reduce risk factors
 Surgical removal of lens & replacement (one eye at a time)
 Pre-Op
 Dilating eye drops, steroid/antibiotic, same stuff w/peri-
op pt.
 Post-Op
 Eyepatch (usually hard - sleep with it on to protect eye)
 May remove after 1 day
 Sunglasses
 Restricted activities that may increase intraocular
pressure (IOP)
 Schedule of eyedrops (steroid & antibiotic for 10 days)
 First 24 hr - r/f bleeding
 After 24 hr - r/f infection
o Glaucoma "Dam that wont open"
 PATHO:

,  Increased IOP
 Outflow of aqueous humor is blocked
 Leads to optic nerve damage
 2nd leading cause of irreversible blindness
 Early S/S:
 Increased IOP
 Decreased ability to focus
 Late S/S:
 Ocular pain
 Blurred vision w/halos around lights
 Eye redness
 N/V
 Dilated; non-reactive pupil
 Vision loss
 Headaches
 DX:
 Measurement of IOP
 Puff of air test
 Central visual field testing
 TX:
 Decrease IOP
 Pharmacologic
 Increase drainage
 Decrease production of aqueous humor
 Topical meds
 Surgery
 Laser trabeculoplasty
 S/E:
 Eye pain
 Pressure
 Swelling
 Inflammation
 If these occur more than 1 day
= PROBLEMS
 Care: eye drops for the rest of their lives
 MEDS:
 Pilocarpine - helps reduce IOP = increases outflow of the
aqueous humor
 Beta blockers (eye drops) = decrease pressure in eye &
decreases fluid in aqueous humor
 Nursing Care:
 Tx is lifelong
 Teach pt how to admin drugs and about them
 Follow-up eye exams are CRITICAL
o Diabetic Retinopathy
o Macular Degeneration
 PATHO:
 Deterioration of central part of vision (macula)

,  TX:
 Photodynamic therapy - used to seal leaking blood vessels
 Maximize independence
 Alterations in Hearing
o Conductive Hearing Loss
 PATHO:
 Sound waves do not travel to inner ear
 R/F:
 Cerumen
 Otitis media
 Otosclerosis
 Trauma
 S/S:
 Tinnitus
 Inability to hear in group
 Turning up volume of the tv
 Asking to repeat questions
 Not answering questions correctly
 Behavioral changes - increased isolation
 DX:
 Diagnostic testing
 TX:
 Treat underlying cause
 Hearing aids
o Meniere's Disease
 PATHO:
 Inner ear problem caused by too much production or not enough
reabsorption of endolymphatic fluid
 Cause is generally not known
 S/S:
 Vertigo - whirling dizziness
 Progressive sensorineural hearing loss
 Tinnitus
 Pressure or fullness in ear
 n/v
 DX:
 Audiometry testing
 TX:
 No cure
 Monitor pt safety
 Adjust diet (low Na)
 Lifestyle changes
 Medication
 Surgery

Cerebrovascular Accident (CVA) - Stroke
 PATHO:
o Blood flow is not going to the brain (compromised blood flow)