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Visual and Auditory ProblemsMedical-Surgical Nursing

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_________ is a complementary/alternative therapy used to treat cataracts, retinopathy, PVD, varicose veins and diabetes mellitus.
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Bilberry
What are the nursing implications of a client on bilberry?
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It may lower blood glucose and blood pressure. It may increase the risk of bleeding when taken concurrently with other substances known to increase risks of bleeding. It has not been tested for its effects on lactation and safety during pregnancy. It should not be taken over long periods of time in large doses.
T/F A client with cataracts indicates a need for surgery.
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False, palliative measures alone (like changing an eyewear prescription) can improve vision enough to function.
T/F Surgery is the only treatment to cure cataracts
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True. If the cataract isn't removed, the vision will continue to deteriorate.
You have a client with cataracts that doesn't want to have surgery. What recommendations can you make to help the client function?
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Suggest an eye exam to have their prescription increased, suggest strong reading glasses or magnifiers to help with close vision. Encourage them to increase the amount of light when reading or doing other near vision tasks. Suggest they drive during the day to reduce glare and have a family member drive them at night, and inform them about what to expect during the disease process.
A client is coming in for cataract surgery. You explain that you will be administering a mydriatic agent before the surgery. The client asks what it will do. You explain...
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It is an alpha adrenergic agonist meaning it causes the pupil to dilate (by causing contraction of the iris dilator muscle).
A client is coming in for cataract surgery. You explain that you will be administering a cycloplegic drug prior to surgery. The client wants to know what it does. You explain...
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To them you say: it dilates your pupils, which is short for... It is an anticholinergic agent that causes paralysis of accommodation by blocking the effect of acetylcholine on the ciliary body. It also causes pupils to dilate by blocking the effect of acetylcholine on the iris sphincter muscle.
Cycloplegia is another word for...
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Paralysis of Accommodation (hence cycloplegic agents to prevent accommodation before cataract surgeries)
Mydriasis is another word for...
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Pupillary dilation (hence mydriatic agents used to dilate pupils for cataract surgery)
What should a client be monitored for if they are on mydriatic and cycloplegic agents for a cataract surgery?
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Signs of systemic toxicity like tachycardia, CNS effects
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A client who is having cataract surgery should be advised to bring _________ to minimize discomfort after the surgery.
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Dark sunglasses to minimize photophobia
__________ extraction is a type of cataract surgery where the entire lens is removed with the capsule intact.
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Intracapsular
__________ extraction is a type of cataract surgery where the anterior capsule is opened and the lens nucleus and cortex are removed, leaving the capsular bag intact.
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Extracapsular
During an extracapsular cataract extraction, the nucleus of the lens can be fragmented by ultrasonic vibration and aspirated from inside the capsular bag. This process is called...
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Phacoemulsification
What two methods are commonly used to remove the lens nucleus during an extracapsular cataract removal surgery?
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Scooping it out with a lens loop or by using phacoemulsification
________ incisions made during a cataract extraction surgery require sutures, whereas _________ incisions are self-closing and require no sutures. The type used is determined by the doctor.
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Corneoscleral incisions require sutures Scleral tunnel incisions are self-closing
Which method of cataract extraction, intracapsular, standard extracapsular or extracapsular phacoemulsification has a considerably smaller incision required to perform it?
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Phacoemulsification
Which type of cataract surgery (intracapsular or extracapsular) is performed most often?
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Extracapsular
What type of patient will most likely need intracapsular cataract extraction?
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Those patients who need surgery as a result of trauma
During cataract extraction surgery, where is the intraocular lens implant most commonly placed?
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In the posterior chamber in the capsular bag behind the iris.
What type of medications are administered to a patient immediately following a cataract extraction/intraocular lens implantation?
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Corticosteroids and Antibiotics are injected and then applied as ointments
  
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