Exam 1: Sensory
A patient is being seen in the ophthalmology clinic for a suspected detached retina. What clinical manifestations does the nurse recognize as significant for a retinal detachment? Select all that apply.
A visual field of floating particles A definite area of blank vision Momentary flashes of light
Prostaglandins analogues
Increase uveoscleral outflow
Types of Glaucoma
1. Wide-angle or Open-angle is usually bilateral, but one eye may be affected Narrow-angle or Closed-angle Congenital Associated with other conditions
A client who presents for an eye examination is diagnosed as having a visual acuity of 20/40. The client asks the nurse what these numbers specifically mean. What is a correct response by the nurse?
A person whose vision is 20/40 can see an object from 20 feet away that a person with 20/20 vision can see from 40 feet away
A 52-year-old comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, "I'm hoping that I don't have to use these drops for very long." Which response by the nurse would be most appropriate?
"You'll need to use the drops for the rest of your life to control the glaucoma."
Risk Factors of Glaucoma
* Hypertension * Heart disease * Type II Diabetes * Sickle cell anemia
A client has been referred to an ophthalmologist for suspected macular degeneration. The nurse knows to prepare what test for the physician to give the client?
Amsler Grid
A client has been referred to an ophthalmologist for suspected macular degeneration. The nurse knows to prepare what test for the physician to give the client?
Amsler grid
A nurse is working with a client in an optometrist office. What is the role of the nurse with a client who is undergoing an eye examination and tests?
Assuring that the client receives eye care to preserve eye function and prevent further visual loss Assessing and obtaining an accurate baseline of the function and structure of the eyes Explaining the temporary inability to maintain visual focus after mydriatic eye medications
An ophthalmologist diagnoses a patient with myopia. The nurse explains that this type of impaired vision is a refractive error characterized by:
Blurred distance vision.
Which nursing intervention should be included during the assessment of a client with an eye disorder?
Check the extraocular muscles by instructing the client to keep his or her head still when following an object.
Which medication classification increases aqueous fluid outflow in the client with glaucoma?
Cholinergics
Alpha 2-Agonists
Decrease aqueous humor production
What should the nurse ask a patient about ocular history?
Does the patient wear corrective lens or glasses, previous eye injuries, previous eye surgery , loss of vision or blurred vision, last eye exam, Hx of eye conditions like glaucoma
Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests?
Ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss
The nurse is providing care to a client who has been admitted to the hospital for treatment of an infection. The client is visually impaired. Which of the following would be most appropriate for the nurse to do when interacting with the client?
Face the client when speaking directly to him.
A school-age child is brought to the pediatric clinic for the assessment of redness and discharge from the eye and is diagnosed with viral conjunctivitis. Which education would the nurse share with the parents? Select all that apply.
Handwashing can prevent the spread of the disease to others. The child should not return to school until all symptoms have resolved.
The upper eyelid normally covers the uppermost portion of the iris and is innervated by which cranial nerve?
III
A client comes to the eye clinic for a routine check-up. The client tells the nurse he thinks he is color blind. What screening test does the nurse know will be performed on this client to assess for color blindness?
Ishihara
The nurse is assessing a client using an Amsler Grid. The nurse is assessing for which of the following?
Macular problems
An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate?
Presbyopia
A client is diagnosed with a corneal abrasion and the nurse has administered proparacaine hydrochloride per orders to assess visual acuity. The client requests a prescription for this medication because it completely took away the pain. What is the best response by the nurse?
Prescriptions of this medication are generally not given because it can cause corneal problems
A 68-year-old client reports a change in vision when driving during the night. Which strategies would the nurse recommend to mitigate this problem?
Recommend contrast sensitivity testing measures to determine visual function. Contrast sensitivity testing measures visual acuity in different degrees of light and dark, which determines visual function.
Which of the following occurs when there is deviation from perfect ocular alignment?
Strabismus
Prior to an eye exam for possible macular degeneration, the nurse completes a history of symptoms. The nurse is aware that a diagnostic sign of age-related dry macular degeneration is:
The appearance of tiny, yellow spots in the field of vision.
The nurse at the eye clinic is caring for a patient with suspected glaucoma. What complaint would be significant for a diagnosis of glaucoma?
The presence of halos around lights
What diagnostic testing would be used for Glaucoma?
Tonometry to assess IOP Ophthalmoscopy to inspect the optic nerve disc Central visual field testing such as Amsler grid and fundus photography
Optic nerves
a blind spot at the back of the eye because the absence of cones & rods
Rods
allow us to see white, black & shades of gray and aid with night vision
Glaucoma
damage to the optic nerve is related to increased intraocular pressure (IOP) caused by congestion of the aqueous humor
Beta Blockers
decrease aqueous humor production
Carbonic anhydrase inhibitors
decrease aqueous humor production
Cones
help us see color- can differentiate between red, green & blue to aid in seeing shades of color
Miotics/cholinergics
increase aqueous fluid outflow
A client with an inflammatory ophthalmic disorder has been receiving repeated courses of a corticosteroid ointment, one-half inch in the lower conjunctival sac four times a day as directed. The client reports a headache and blurred vision. The nurse suspects that these symptoms represent:
increased intraocular pressure (IOP).
Closed Angle Glaucoma
iris is squeezed against the cornea, blocking the uveoscleral drains and the trabecular meshwork.
Retina
layer with photoreceptors neurons that can receive the light stimuli with the cones & rods of the retina
After a fall at home, a client hits their head on the corner of a table. Shortly after the accident, the client arrives at the ED, unable to see out of their left eye. The client tells the nurse that symptoms began with seeing spots or moving particles in the field of vision but that there was no pain in the eye. The client is very upset that the vision will not return. What is the most likely cause of this client's symptoms?
retinal detachment
Snellen chart
test ability to see distance at 20 feet
Open Angle Glaucoma
the most common form of glaucoma, where the trabecular meshwork gradually becomes blocked, causing a buildup of pressure
