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Visual and Auditory ProblemsMedical-Surgical Nursing

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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
What activities does the ophthalmologist typically discourage immediately after cataract surgery?
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Any activity that may increase intraocular pressure like stooping, coughing and lifting.
What does a surgeon assess during postoperative visits of a cataract extraction patient?
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Visual acuity, anterior chamber depth (a flat one can cause adhesions of the iris and cornea), corneal clarity (trauma to the endothelium can cause haziness or cloudiness) and intraocular pressure.
How long after cataract surgery are patients completely healed and ready for an eye exam to measure for new glasses?
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6-8 weeks
Why is it important for a nurse to assess the visual acuity of an eye not undergoing surgery?
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To determine the how visually compromised a patient will be while the operative eye is healing
Phenylephrine HCL acid also known as Neo-Synephrine or Mydfrin is a ____________ drug used during cataract surgeries.
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Mydriatic (alpha adrenergic agonist)
How can systemic absorption of a mydriatic medication be limited during cataract surgery?
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Using punctal occlusion (the punta drains into the lacrimal duct and then into the nasolacrimal duct to the nasal cavity. From there it enters the system....blocking the duct prevents this)
Tropicamide, homatropine hydrobromide, scopolamine, and atropine are _________ drugs that may be used during cataract surgery.
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Cycloplegic (anticholinergics)
What are some reactions a patient can have from a mydriatic medication that a nurse should monitor for?
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Tachycardia or elevated BP (especially in the elderly). A reflexive decrease in heart rate may occur when BP rises.
What are some concerns associated with using the cycloplegic medication cyclopentolate HCL acid that a nurse should monitor for?
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Psychotic reactions and behavioral disturbances (the duration of the drug is 6-24 hours)
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Which surgical location (outpatient surgical location or inpatient surgical location) has better outcomes?
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Both had the same visual outcomes, but outpatient is preferred by the patient and costs less than inpatient.
When administering topical medications for pupil dilation prior to cataract surgery, what patient characteristic may denote the need for a larger dose?
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Dark irides (essentially, brown eyes)
What sensations can a patient expect from the topical medications applied prior to cataract surgery?
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Transient stinging/burning and photophobia
What condition is a contraindication for the topical medications typically applied prior to cataract surgery? Why?
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Narrow angle glaucoma. These medications may cause angle closure glaucoma (which increases intraocular pressure and can cause optic nerve damage and permanent vision loss)
__________ is the process of microvascular damage to the retina.
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Retinopathy
What health conditions are closely associated with retinopathy? (2)
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Diabetes mellitus and hypertension
_______________ retinopathy is the most common form of diabetic retinopathy and is characterized by capillary microaneurysms, retinal swelling and hard exudates.
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Nonproliferative
________ edema is a sign that retinopathy is worsening.
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Macular edema (which causes plasma to leak from the macular blood vessels)
_________ retinopathy is characterized by new blood vessel growth. The vessels are abnormal, fragile and predisposed to leak, leading to severe vision loss.
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Proliferative
How is diabetic macular edema (from retinopathy) treated?
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Through laser photocoagulation
Hypertensive retinopathy is caused by high blood pressure creating _______ in the retinal blood vessels.
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Blockages
  
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