nursing management: visual and auditory problems chapter 22 overview copyright © 2011, 2007 by...

Nursing Management:Nursing Management:Visual and Auditory Visual and Auditory

ProblemsProblems

Chapter 22 OverviewChapter 22 Overview

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

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Visual ProblemsVisual Problems


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Correctable Refractive ErrorsCorrectable Refractive Errors

• Nonsurgical CorrectionsNonsurgical Corrections Corrective glassesCorrective glasses Contact lensesContact lenses Corneal moldingCorneal molding

• Surgical TherapySurgical Therapy LaserLaser ImplantImplant Thermal proceduresThermal procedures


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Uncorrectable Visual Uncorrectable Visual ImpairmentImpairment

• Levels of Visual ImpairmentLevels of Visual Impairment


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Uncorrectable Visual Uncorrectable Visual ImpairmentImpairment


Table 22-2. Definition of Legal Blindness in the United States.

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Nursing Management: Nursing Management: Visual ImpairmentVisual Impairment

• Nursing AssessmentNursing Assessment• Nursing DiagnosesNursing Diagnoses• PlanningPlanning


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Nursing Management: Nursing Management: Visual ImpairmentVisual Impairment

• Nursing ImplementationNursing Implementation Health promotionHealth promotion Acute interventionAcute intervention Ambulatory and home careAmbulatory and home care

• Optical devices for vision Optical devices for vision enhancementenhancement

• Nonoptical methods for vision Nonoptical methods for vision enhancementenhancement

• EvaluationEvaluationCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

8Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Gerontologic Considerations: Gerontologic Considerations:

Visual ImpairmentVisual Impairment

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Eye TraumaEye Trauma


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Extraocular DisordersExtraocular Disorders


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Inflammation and InfectionInflammation and Infection

• HordeolumHordeolum


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Fig. 22-1. Hordeolum (sty) on the upper eyelid caused by staphylococcal infection.

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• ChalazionChalazion• Blepharitis Blepharitis • Conjunctivitis Conjunctivitis

Bacterial infectionsBacterial infections Viral infectionsViral infections Chlamydial infections Chlamydial infections Allergic conjunctivitisAllergic conjunctivitis


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• KeratitisKeratitis Bacterial infectionsBacterial infections Viral infectionsViral infections Other causes of keratitis Other causes of keratitis Corneal ulcerCorneal ulcer


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Fig. 22-2. Corneal ulcer. Infection associated with poor contact lens care.

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Nursing Management: Inflammation Nursing Management: Inflammation and Infectionand Infection

• Nursing AssessmentNursing Assessment• Nursing DiagnosesNursing Diagnoses• PlanningPlanning• Nursing ImplementationNursing Implementation

Health promotionHealth promotion Acute interventionAcute intervention Ambulatory and home careAmbulatory and home care

• EvaluationEvaluationCopyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

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Dry Eye DisordersDry Eye Disorders


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StrabismusStrabismus


Fig. 22-3. Strasbismus with right exotropia and fixation of the left eye.

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Corneal DisordersCorneal Disorders

• Corneal Scars and OpacitiesCorneal Scars and Opacities


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Fig. 22-4. Sutures on a donated cornea after penetrating keratoplasty (corneal transplant).

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• Keratoconus Keratoconus


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Intraocular DisordersIntraocular Disorders


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CataractCataract

• Etiology and PathophysiologyEtiology and Pathophysiology• Clinical ManifestationsClinical Manifestations• Diagnostic StudiesDiagnostic Studies


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CataractCataract

• Collaborative CareCollaborative Care Nonsurgical therapyNonsurgical therapy Surgical therapySurgical therapy

• Preoperative phasePreoperative phase• Intraoperative phaseIntraoperative phase


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CataractCataract


Fig. 22-5. Intraocular lens implant after cataract surgery.

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CataractCataract

• Collaborative CareCollaborative Care Surgical therapy, continuedSurgical therapy, continued

• Postoperative phasePostoperative phase


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Nursing Management: Nursing Management: CataractsCataracts



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Nursing Management: Nursing Management: CataractsCataracts


• EvaluationEvaluation


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Gerontologic Considerations: Gerontologic Considerations: CataractsCataracts


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RetinopathyRetinopathy


Fig. 22-6. Diabetic retinopathy. Intraretinal dot or blot hemorrhages.

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Retinal DetachmentRetinal Detachment

• Etiology and PathophysiologyEtiology and Pathophysiology


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Table 22-7. Risk Factors for Retinal Detachment.

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• Clinical ManifestationsClinical Manifestations• Diagnostic StudiesDiagnostic Studies


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• Collaborative CareCollaborative Care Surgical therapySurgical therapy

• Laser photocoagulation and Laser photocoagulation and cryopexycryopexy

• Scleral bucklingScleral buckling


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Fig. 22-7. Retinal break with detachment: surgical repair by scleral buckling technique.

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• Collaborative CareCollaborative Care Surgical therapy, continuedSurgical therapy, continued

• Intraocular proceduresIntraocular procedures• Postoperative considerationsPostoperative considerations


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Age-related Macular Age-related Macular DegenerationDegeneration

• Etiology and PathophysiologyEtiology and Pathophysiology• Clinical ManifestationsClinical Manifestations• Diagnostic StudiesDiagnostic Studies• Collaborative Care Collaborative Care


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GlaucomaGlaucoma

• Etiology and PathophysiologyEtiology and Pathophysiology• Clinical ManifestationsClinical Manifestations• Diagnostic StudiesDiagnostic Studies


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GlaucomaGlaucoma


Fig. 22-8. A, In the normal eye, the optic cup is pink with little cupping. B, In glaucoma, the optic disc is bleached and optic cupping is present. (Note the appearance of the retinal vessels, which travel over the edge of the optic cup and appear to dip into it.)

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GlaucomaGlaucoma

• Collaborative Care Collaborative Care Chronic open-angle glaucoma Chronic open-angle glaucoma Acute angle-closure glaucomaAcute angle-closure glaucoma Secondary glaucoma Secondary glaucoma


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Nursing Management: Nursing Management: GlaucomaGlaucoma



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Nursing Management: Nursing Management: GlaucomaGlaucoma


• EvaluationEvaluation


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Gerontologic Considerations: Gerontologic Considerations: GlaucomaGlaucoma


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Intraocular Inflammation and Intraocular Inflammation and InfectionInfection


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Ocular TumorsOcular Tumors


Fig. 22-9. Uveal melanoma. A large tumor in the choroid, the most common location in the eye for melanoma.

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EnucleationEnucleation


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Ocular Manifestations of Ocular Manifestations of Systemic DiseasesSystemic Diseases


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Auditory ProblemsAuditory Problems


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External Ear and CanalExternal Ear and Canal


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TraumaTrauma


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External OtitisExternal Otitis

• EtiologyEtiology• Clinical Manifestations and Clinical Manifestations and ComplicationsComplications


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Nursing Management: Nursing Management: External OtitisExternal Otitis


Table 22-12. Patient and Caregiver Teaching Guide.

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Cerumen and Foreign Bodies Cerumen and Foreign Bodies in External Ear Canalin External Ear Canal


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Malignancy of External EarMalignancy of External Ear


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Middle Ear and MastoidMiddle Ear and Mastoid


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Acute Otitis MediaAcute Otitis Media


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Otitis Media With EffusionOtitis Media With Effusion


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Chronic Otitis Media and Chronic Otitis Media and MastoiditisMastoiditis

• Etiology and PathophysiologyEtiology and Pathophysiology• Clinical ManifestationsClinical Manifestations• ComplicationsComplications• Diagnostic StudiesDiagnostic Studies


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Fig. 22-10. Perforations of the tympanic membrane. A, Small central perforation (hearing is usually good). B, Large central perforation around the handle of the malleus (hearing is usually poor). C, Marginal perforation of Shrapnell’s membrane (hearing is usually good). Cholesteatomas commonly occur in patients with a marginal perforation that does not heal.

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• Collaborative CareCollaborative Care


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Table 22-13. Collaborative Care.

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• Collaborative Care, continuedCollaborative Care, continued Surgical therapySurgical therapy


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Nursing Management: Chronic Nursing Management: Chronic Otitis Media Otitis Media

• Following Tympanoplasty Following Tympanoplasty


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Nursing Management: Chronic Nursing Management: Chronic Otitis Media Otitis Media


Table 22-14. Patient and Caregiver Teaching Guide.

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OtosclerosisOtosclerosis

• Collaborative Care Collaborative Care


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OtosclerosisOtosclerosis


Table 22-15. Collaborative Care.

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Nursing Management: Nursing Management: OtosclerosisOtosclerosis


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Inner Ear ProblemsInner Ear Problems


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Ménière’s DiseaseMénière’s Disease


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Nursing and Collaborative Nursing and Collaborative Management: Ménière’s Management: Ménière’s

DiseaseDisease


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Benign Paroxysmal Positional Benign Paroxysmal Positional VertigoVertigo


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Acoustic NeuromaAcoustic Neuroma


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Hearing Loss and DeafnessHearing Loss and Deafness


Fig. 22-11. Causes of hearing loss.

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Hearing Loss and DeafnessHearing Loss and Deafness

• Types of Hearing LossTypes of Hearing Loss Conductive hearing loss Conductive hearing loss Sensorineural hearing lossSensorineural hearing loss Mixed hearing lossMixed hearing loss Central and functional hearing Central and functional hearing lossloss

Classification of hearing loss Classification of hearing loss • Clinical ManifestationsClinical Manifestations


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Nursing and Collaborative Nursing and Collaborative Management: Hearing Loss and Management: Hearing Loss and

Deafness Deafness

• Health PromotionHealth Promotion Environmental noise controlEnvironmental noise control ImmunizationsImmunizations Ototoxic substancesOtotoxic substances


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Deafness Deafness

• Assistive Devices and Assistive Devices and TechniquesTechniques Hearing aidsHearing aids Speech readingSpeech reading Sign languageSign language Cochlear implantCochlear implant


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Deafness Deafness


Fig. 22-12. Cochlear implant.

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Deafness Deafness

• Assistive Devices and Assistive Devices and Techniques, continuedTechniques, continued Assisted listening devices Assisted listening devices


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Gerontologic Considerations: Gerontologic Considerations: Hearing LossHearing Loss


Table 22-20. Classification of Presbycusis.

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