RNSG 1430-Sensory Perception w/NCLEX QUESTIONS

"Silent Thief of Sight"

Glaucoma

Expressive aphasia

Neurological disorder influencing the production and understanding of language. The inability to produce language ( despite being able to understand language)

Gustatory

Pertaining to the sense of taste

Glaucoma patients lose

peripheral vision due to increased IOP

macular degeneration

progressive damage to the macula of the retina

Normal IOP range

10-21 mmHg

Sensorineural hearing loss

Impairment of function of inner ear or auditory cranial nerve. Aging, ototoxic meds, noise exposure can cause. Ability to hear sound, but not understand speech.

Nystagmus

Rapid, shaking, involuntary movement of the eyes

Sensory overload

An overabundance of stimuli from the environment and from internal sources such as pain, noise, IV alarms.

What are the two post-surgery cataract anti-inflammatory ophthalmic drops? A. Tramadol B. Ketorolac C. Morphine D. Captopril E. Prednisolone acetate

B. Ketorolac & E. Prednisolone acetate

When teaching the diabetic client about foot care, the nurse should instruct the client to do which of the following? 1. Avoid going barefoot. 2. Wear diabetic socks and buy shoes a half size larger. 3. Cut toenails at an angle. 4. Use elevation and a heating pad for sore legs and feet.

1. Avoid going barefoot.

Hear better in noisy environment

Conductive Hearing Loss

Strabismus

Inability to focus with both eyes, one does not point in same direction as other, misalignment of eye

Conductive hearing loss

Inadequately conducted sound through the external or middle ear to the sensorineural apparatus of the inner ear.

The nurse is assisting a client who has new-onset vision loss to transition home from the hospital. The client can see shadows and light in the right eye only. When at home, the client is at greatest risk for which of the following? 1. Loss of sensory perception. 2. Injury from falls. 3. Denial of changes in vision. 4. Isolation from social activities.

2. Injury from falls.

What should the nurse provide as part of the information to prepare the client for tonometry? 1. Oral pain medication will be given before the procedure. 2. It is a painless procedure with no adverse effects. 3. Blurred or double vision may occur after the procedure. 4. Medication will be given to dilate the pupils before the procedure.

2. It is a painless procedure with no adverse effects.

The nurse is assess an older adult who is thought to have macular degeneration. What would the nurse expect to be impaired? 1. Loss of central vision. 2. Loss of peripheral vision. 3. Total blindness. 4. Blurred vision.

2. Loss of peripheral vision.

A patient being treated for chronic open angle glaucoma (COAG) asks the nurse, "How does glaucoma damage my eyesight?" 1." Results from chronic eye inflammation." 2." Causes increased intraocular pressure." 3." Leads to detachment of the retina." 4. "Is caused by decreased blood flow to the retina."

2." Causes increased intraocular pressure."

Sensorineural hearing loss results from which condition? 1. Presence of fluid and cerumen in the external canal. 2. Sclerosis of the bones of the middle ear. 3. Damage to the cochlear or vestibulocochlear nerve. 4. Emotional disturbance resulting in a functional hearing loss.

3. Damage to the cochlear or vestibulocochlear nerve.

Glaucoma definition

Increased intraocular pressure that puts pressure on the optic nerve leading to loss of peripheral visual fields.

Angle closure glaucoma (ACG) or Acute glaucoma

complete blockage of aqueous humor drainage, IOP rises rapidly > 50 mm HG, which is considered a medical emergency

When the nurse enters the Patient's room, the nurse perceives that the patient is staring straight ahead. What is the best course of action for the nurse to take next? 1. Wash hands, enter room and get up close so patient can see and hear. 2. Introduce yourself in a loud voice, knocking as you enter into the room. 3. Observe the patient and his or her body language to determine if blind. 4. Address the patient by name speaking in normal slow clear tone.

4. Address the patient by name speaking in normal slow clear tone.

When approaching a hearing-impaired client, the nurse should do which of the following first? 1. Knock on the room door loudly. 2. Close and open the vertical blinds rapidly. 3. Talk as you are walking into the room. 4. Get the client's attention before talking.

4. Get the client's attention before talking.

tonometry test

A simple test with an instrument that blows a small puff of air & shines a bright light into the eye, & measures the pressure inside the eyeball. It is painless.(22 to 30 mm Hg = glaucoma)

What are the two post-surgery cataract antibiotic ophthalmic drops? A. Ofloxacin B. Sudafed C. Besifloxacin D. Furosemide E. Cephalexin

A. Ofloxacin & C. Besifloxacin

After returning home, a patient who has glaucoma will need to continue to instill eye drops in the affected eye. The primary purpose of applying pressure at the nasolacrimal duct is that the pressure: A. Prevents the medication from entering the tear duct. B. Decreases the aqueous humor production in the eye. C. Allows the medication to absorb into the cornea to adjust to the medication. D. Prevents absorption of medication into systemic circulation.

A. Prevents the medication from entering the tear duct.

What type of prevention is informing the patient about Vitamin C & Vitamin E? A. Primary B. Secondary C. Tertiary

A. Primary - To prevent Age-related macular degeneration (AMD)

What type of prevention is promoting to wear ear plugs while mowing the yard? A. Primary B. Secondary C. Tertiary

A. Primary - To prevent sensorineural hearing loss

Proprioception

Ability of the body to sense it position and movement in space

Presbycusis

Age related hearing loss

Which Exemplar? Risk factors: Age, smoking, UV light exposure, high CRP, smoking, HTN, genetic & family history, light eyes

Age-Related Macular Degeneration

The nurse teaches a patient prescribed latanoprost eyedrops to manage chronic open-angle glaucoma. Which statement, if made by the patient to the nurse, indicates that further teaching is needed? A. "The eyedrops could cause a slow heart rate and drop in blood pressure." B. "I will need to take the eyedrops twice a day for at least 2 to 3 months." C. "I may have eye discomfort and redness from the use of these eyedrops." D. "I will apply gentle pressure on the inside corner of my eye after each eyedrop."

B. "I will need to take the eyedrops twice a day for at least 2 to 3 months." Once you start taking eye drops to treat glaucoma , you're on them for the rest of your life (unless another treatment is performed).

What type of prevention is a exam for Glaucoma? A. Primary B. Secondary C. Tertiary

B. Secondary - Screening for early detection

What type of prevention is learning to use wheelchair chair after spinal cord injury? A. Primary B. Secondary C. Tertiary

C. Tertiary - already happened

A patient with glaucoma is being discharged from the hospital. When teaching the patient and family ways to improve home safety, the nurse tells the family to: A. Use throw rugs to prevent tripping. B. Paint the floor black and white to improve perception. C. Install extra incandescent lighting. D. install handrails painted the same color as the walls. E. Increase the amount of Vitamin D in diet.

C. install extra incandescent lighting.

Aqueous humor

Clear watery fluid composed of electrolytes, growth factor, and proteins. Located between lens & cornea. Balanced secretion is important.

Cataract

Condition that causes lens of the eye to become cloudy and impairs vision

A short time after cataract surgery, the patient complains of feeling nauseated. What priority action is necessary? A. Instruct the patient to take a few deep breaths until the nausea subsides. B. Explain that this is a common feeling that will pass quickly. C. Tell the patient to call the nurse promptly if vomiting occurs. D. Medicate the patient with an antiemetic, as prescribed.

D. Medicate the patient with an antiemetic, as prescribed.

Macular degeneration

Damage to the area of the retina that provides central vision leading to loss of vision in the central visual fields.

Sensory deprivation

Decreased stimulation from the environment

Cataract: Postoperative Care

Discharge within 1 hour with dark glasses Eye is unpatched Eye shield day of surgery & for sleep Antibiotic & corticosteroid eye drops for one month Avoid IOP Don't rub eye, don't squeeze eyes shut hard Follow up appointment within 24 hours

Post operative care: Trabeculoplasty

IOP checked by surgeon 1-2hr Eye patch & shield first day Shield for sleep Position on back or non-operative side Avoid getting H2O & Soap in eye Eye hygiene to prevent infection Eliminate activities that increase IOP Do not take ASA/Ibuprofen/Vitamin E x 5 days Report severe pain, N/V, loss of vision, flashing lights

Sensorineural hearing loss causes

Impairment of the inner ear OR vestibulocochlear nerve (CN VIII) damage Congenital Rubella syndrome Hereditary (Genetic Link) Loud Noise exposure Aging (presbycusis) Meniere's disease Trauma

Receptive aphasia

Inability to comprehend written or spoken language.

AR Muscular Degeneration: Wet (exudative)

More severe; abnormal blood vessels develop in or near macula. Rapid onset of vision loss; AMD-related blindness vascular endothelial growth factor-->new blood vessels grow and bleed--> scar tissue

Aphasia

Neurological disorder influencing the production and understanding of language

Cataract Treatment

Non-surgical - stronger reading glasses, increase amount of light NO MEDS CAN CURE OR DECREASE Surgical - clouded lens removal and lens implant inserted called Phacoemulsification

Conductive hearing loss causes

Otitis media with effusion Impacted cerumen Perforation of TM Otosclerosis Narrowing of the external auditory canal

Olfactory

Pertaining to the sense of smell

Ototoxicity

Referring to a drug or substance having a harmful effect on the 8th cranial nerve. Symptoms include tinnitus, hearing loss, balance problems. Medications-NSAID, loop diuretic, some antibiotics, certain chemotherapy can cause

Vertigo

Sensation of dizziness or spinning

Stereognosis

Sense that allows a person to recognize an object's size, shape, and texture.

AR Muscular Degeneration: Dry (nonexudative)—atrophy of macular cells

Slow, progressive, painless loss of vision. Abnormal drusen deposits in the retinal pigment epithelium; atrophy and degeneration of the macular cells occur over time

Tinnitus

Subjective ringing sound in the ear

antiemetic

a drug effective against vomiting

AR Muscular Degeneration: Clinical manifestations

acute vision loss blurred or darkened vision scotomas (blind spots) metamorphopsia (visual distortion)

OAG Treatment: Timolol

decreases aqueous humor production

Peripheral neuropathy

disorder of the peripheral nerves that carry information to and from the brain and spinal cord. Nerve damage away from the center of the body.

OAG Treatment: Latanoprost

facilitates aqueous humor outflow

Presbyopia

impaired vision as a result of aging

OAG Treatment: Brimonidine

lowers pressure by allowing fluid drainage and also by reducing the amount of fluid formed in the eye.

Primary open-angle glaucoma (POAG)

peripheral vision is lost gradually, bc outflow of aqueous flow is decreased & if continues then central vision is lost & total blindness due to damage of the optic nerve

Laser Trabeculoplasty (if meds do not work)

treatment of open-angle glaucoma by creating openings in the trabecular meshwork to allow fluid to drain properly.