care of clients with problems in perception and coordination
TRANSCRIPT
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` A detailed imaging and recording of the ocular
circulation by a series of photographs after the
administration of a dye
` This test is useful for assessing problems with
retinal circulation, such as those that occur in
diabetic retinopathy, retinal bleeding, and
macular degeneration to rule out intraoculartumors
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` Assess the client for allergies and previousreaction to dyes
` Obtain informed consent
` A mydriatic medication, which causes pupildilation, is instilled into the eye 1 hour before thetest
` Dye is injected into the vein of the clients arm
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` Inform the client that dye may cause the skin to
appear yellow for several hours after the testand is eliminated gradually through the urine
` Encourage rest after the procedure
` Encourage fluid intake to assist in eliminating
the dye
` Urine might appear bright green
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` Allows examination of the anterior ocular
structures under microscopic magnification
` The client leans on a chin rest to stabilize thehead while a narrowed beam light is aimed so
that it illuminates only a narrow segment of the
eye
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` Explain the procedure to the client
` Advise the client about the brightness of the light
and the need to look forward at a point over theexaminers ear
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` Is used to primarily assess for an increase of
IOP and potential glaucoma
` Normal IOP is 10 to 21 mmHg
` Client must be instructed to avoid rubbing the
eye following the examination if the eye has
been anesthetized because of the potential for
scratching the cornea
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` Assesses the mastoid, middle ear, and inner ear
structures
` Multiple radiographs of the head are obtained
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` All jewelry is removed
` Lead eye shields are used to cover the cornea
to diminish the radiation dose to the eyes
` The client must remain still in a supine position
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` Opacity of the lens that distorts the image
projected onto the retina and that can progressto blindness
` Causes include the aging process (senile
cataracts), inherited (congenital cataracts), andinjury (traumatic cataracts)
` Interventions is indicated when visual acuity hasbeen reduced to a level that the client finds to beunacceptable or adversely affects his or herlifestyle
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` Blurred vision and decreased color perceptionare early signs
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Halos around lights
` Reduced visual acuity
` Presence of w white pupil
` Loss of vision
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` Surgical removal of the lens, one eye at a time
` Instruct the client regarding the postoperative
measures to prevent or decrease intraocularpressure
` Stress to the client that care after surgeryrequires instillation of different types of eyedrops several times a day for 2 to 4 weeks
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` Administer eye medications preoperatively,
including mydriatics and cyclopegics as
prescribed
` After the surgery, elevate the head of the bed 30
to 45 degrees
` Turn the client to the nonoperative side
` Maintain an eye patch as prescribed; orient the
client to the environment
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` Position the clients personal belongings to the
nonoperative side
` Use side rails for safety
` Assist with ambulation
` Use an eye shield at bed time
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` A group of ocular diseases resulting in increasedIOP
` Results form inadequate drainage of aqueoushumor from the canal of Schlemm or
overproduction of aqueous humor
` The condition damages the optic nerve and canresult in blindness
` Gradual loss of visual fields may go unnoticed
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` Acute closed-angle or narrow angleglaucoma results form obstruction to outflowof aqueous humor
` Chronic closed-angle glaucoma follows anuntreated attack of acute closed-angleglaucoma
` Chronic open-angle glaucoma results fromoverproduction or obstruction to the outflow ofaqueous humor
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` Acute glaucoma is a rapid onset of IOP
higher than 50 to 70 mmHg
` Chronic glaucoma is a slow progressive,
gradual onset ofIOP higher than 30 to 50 mmHg
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` Diminished accommodation and increased IOP
` Loss of peripheral vision
` Decreased visual acuity
` Halos around lights
` Headache or eye pain
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` Treat acute glaucoma as a medical emergency
` Administer medications as prescribed to lower
IOP
` Prepare the client for peripheral iridectomy,
which allows aqueous humor to flow from the
posterior to the anterior chamber
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` Administer miotics, carbonic anhydrase
inhibitors, and betablockers as prescribed
` Instruct the client of the need for lifelong
medication use
` Instruct the client to avoid anticholinergic
medications
` Instruct client to report eye pain and changes in
vision
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` Prepare the client for trabeculoplasty as
prescribed to facilitate aqueous humor drainage
` Prepare the client for trabeculectomy as
prescribed, which allows drainage of aqueous
humor into the conjunctival spaces by thecreation of an opening
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` Detachment or separation of the retina from the
epithelium
` Occurs when the layers of the retina separate
because of the accumulation of fluid between
them, or when both retinal layers elevate awayfrom the choroid as a result of a tumor
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Partial detachment becomes complete ifuntreated, which can lead to blindness
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` Flashes of light
` Floaters or black spots (signs of bleeding)
` Increase in blurred vision
` Sense of curtain being drawn over the eye
` Loss of a portion of the visual field
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` Provide bed rest
` Cover both eyes with patches as prescribed
` Speak to the client before approaching
` Protect the client from injury
` Avoid jerky head movements
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` Minimize eye stress
` Prepare the client for a surgical procedure as
prescribed
` Scleral buckling, to hold the choroid and retina
togetehr with a splint until scar tissue forms,
closing the tear
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` An inflammatory disorder usually caused by an
infection of the middle ear occurring as a result
of a blocked Eustachian tube, which prevents
normal drainage
` Common complication of an acute respiratory
infection
` Infants and children are more prone
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` Fever
` Irritability and restlessness
` Loss of appetite
` Pulling on or rubbing the ear
` Ear pain
` Purulent drainage
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` Encourage fluid intake
` Feed infants in upright position t prevent reflux
` Lie with the affected ear down
` Dry the ear by wicking
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` Administer antipyretics as prescribed
` Administer antibiotics as prescribed
` Screen for hearing loss
` Instruct the parents about the procedure for
administering era medications
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` Also called as endolymphatic hydrops
` Dilation of the endolymphatic system byoverproduction or decreased reabsorption ofendolymphatic fluid
` Characterized by tinnitus, sensorineuralhearing loss, and vertigo
` Symptoms occur in attacks and last for severaldays, and the client becomes totallyincapacitated during the attacks
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` Initial hearing loss is reversible but as the
frequency of attacks continue, hearing loss
becomes permanent
` Damage to the cochlea cause increase fluid
pressure leads to permanent hearing loss
` Caused by viral and bacterial infections, allergic
reactions, vascular disturbance
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` Feelings of fullness in the ear
` Tinnitus
` Hearing loss
` Vertigo
` Nausea and vomiting
` Headaches
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` Prevent injury during vertigo attacks
` Provide bed rest in a quiet environment
` Provide assistance with walking
` Instruct the client to move the head slowly
` Initiate sodium and fluid restrictions asprescribed
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` Instruct the client to stop smoking
` Administer nicotinic acid (niacin) as prescribed
for vasodilatory effects
` Administer antihistamines as prescribed
` Administer antiemetics as prscribed
` Labyrinthectomy may be performed
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` Dilate the pupils (mydriasis) and relax the ciliary
muscles (cyclopegia)
` Used preoperatively or for eye examinations
` Contraindicated with glaucoma
` Tropicamide (Mydriacil, Tropicacyl, Opticyl)
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` Reduce IOP by constricting pupils and
contracting the ciliary muscle
` Open the anterior chamber angle and increasethe outflow of aqueous humor
` Pilocarpine hydrochloride (Isopto Carpine)
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` Interfere with the production of carbonic acid,
which leads to decreased aqueous humor
formation and decreased IOP
` Long term treatment for open angle glaucoma
` Acetazolamdie (Diamox)