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Visual and Auditory ProblemsMedical-Surgical Nursing

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Question Answer
__________ is a simple technique involving telling a client to sit closer to a TV or to bring print closer to their face in order to see it better.
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Approach management
________ techniques involve watching TV in black and white, placing dark objects against light backgrounds (like a white plate on a black placemat), using opposite colors to demarcate the edges of steps or curbs.
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Contrast enhancement
Which type of lighting is most effective for partially sighted individuals? Fluorescent or Halogen?
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Halogen (also direct sunlight or gooseneck lamps)
What are the overall expected outcomes for a client with visual impairment?
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No further progression of vision loss, be able to express adaptive coping strategies, no decrease in self-esteem or social interactions and/or able to function safely within her/his own environment
What are some factors that can further affect an elderly person who has developed vision problems?
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Concurrent deficits (like cognitive impairment, limited mobility), limited financial resources, societal devaluation leading to isolation/poor self esteem, decreased ability to perform ADLs
One of your elderly clients has been prescribed eye drops to help with her glaucoma. What should you assess prior to sending her home?
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Her ability (manual dexterity) to instill the drops
What condition, concurrent with vision problems, increases the risk of falls in the elderly population?
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Confusion
You are taking a walk when you hear a piercing scream. You decide to investigate and come across a child with something lodged in his eye. Someone has already called 911. What should you do?
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Assess visual acuity, do not put pressure on the eye, tell the child NOT to blow their nose, stabilize the foreign object, cover the eye with dry, sterile patches and a protective shield (which you get immediately from the ambulance as it arrives) and don't give any food or fluids.
You are taking a tour of a chocolate factory when someone starts screaming, You got that crap in my eye! It's burning! Help! Help! You realize the person screaming has a chemical eye injury, what do you do?
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Begin ocular irrigation immediately with a sterile, pH balanced fluid like saline. If none is available, you use water. Continue until emergency personnel arrive. Assess visual acuity, don't put pressure on the eye, instruct the person not to blow their nose, no food or fluids.
You have a patient that has been brought into the ER that has a significant eye injury. What should you do?
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Reassure the patient, monitor their pain level and anticipate surgical repair for penetrating injury, globe rupture or globe avulsion (tearing). Elevate the head of the bed 45 degrees. Don't put anything into the eye unless the Dr. says to.
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__________ is the most preventable cause of visual impairment.
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Trauma
How can a nurse reduce the instances of preventable vision loss?
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By educating the community/individuals about the importance of wearing protective eyewear during potentially hazardous work, hobbies or sports activities. Trauma is the number 1 preventable cause of vision loss.
What is the most common condition encountered by an ophthalmologist?
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Inflammation/infection of the external eye
You have a client that was just diagnosed with a hordeolum. What instructions do you give that person?
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Apply warm, moist compresses to the area at least four times a day until it improves. This is usually the only treatment, occasionally antibiotic ointments are prescribed. Hordeolum=sty
You have a client that is suffering from recurrent episodes of hordeolum. What should you teach them to do?
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Perform daily eyelid scrubs
A _________ is a chronic inflammatory granuloma of the meibomian (sebaceous) glands of the eyelid. It can evolve from a hordeolum or be caused by the contents released during rupture of a blocked gland.
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Chalazion
The doctor tells you to give care instructions to a patient diagnosed with a chalazion. You know to tell the patient to...
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Apply warm, moist compresses to the area at least 4 times a day. If it doesn't resolve, the patient may need the doctor to surgically remove the lesion (office procedure) or inject it with corticosteroids.
________ is a common chronic bilateral infection of the eyelid margins. The lids are red rimmed with many scales/crusts along the margins and lashes.
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Blepharitis
What are the signs/symptoms of blepharitis?
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Reddened lid margins, crusts along lashes and lids, itching, burning, irritation, photophobia.
What condition can occur concurrently with blepharitis?
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Conjunctivitis
What are the two types of blepharitis?
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Blepharitis caused by staphylococcus and seborrheic blepharitis
  
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