Saunders Eye and Ear

The nurse is assigned to care for a client with a detached retina. Which finding should the nurse expect to be documented in the client's record?

A sense of a curtain falling across the field of vision

The nurse notes that the primary health care provider (PHCP) has documented a diagnosis of presbycusis on the client's chart. Which explanation should the nurse give to the client to explain this condition?

A sensorineural hearing loss that occurs with aging

The nurse in the outpatient unit is preparing a client who is scheduled for a laser trabeculoplasty for the treatment of primary open-angle glaucoma. Which instructions should the nurse reinforce to the client?

"You may return to work 1 or 2 days following the procedure."

A client is diagnosed with glaucoma. Which data gathered by the nurse indicate a risk factor associated with glaucoma?

Cardiovascular disease

A client with a diagnosis of otosclerosis is admitted to the ambulatory care unit for stapedectomy, and the nurse reinforces instructions to the client regarding home care following the procedure. Which statement by the client indicates a need for further teaching?

"I need to avoid air travel for at least 6 months."

A client has been diagnosed with a hearing loss caused by age-related changes in the ear. The nurse reinforces information about obtaining and learning to use a hearing aid. Which statement by the client indicates understating of the information?

"I should obtain a hearing aid as soon as possible."

The nurse is assigned to care for a client with a diagnosis of Ménière's disease. After reinforcing discharge instructions, which client statement indicates a need for further teaching?

"I will become totally deaf if I don't follow instructions."

The nurse has reinforced instructions to a client who is scheduled for a cataract extraction. Which statement by the client indicates a need for further teaching?

"No eating or drinking for at least 18 hours before the surgery."

A client with glaucoma has suffered significant eye damage before diagnosis and now has impaired vision. The nurse determines that the client needs further assistance in adapting to this situation if the client makes which statement?

"There is no difficulty driving at dusk."

A client has been diagnosed with open-angle glaucoma. Which signs and symptoms are found in open-angle glaucoma? Select all that apply.

-Blurred or hazy vision -Colored rings around lights -Tonometry reading 30 mm Hg

The nurse is reviewing the health record of a client diagnosed with a cataract. Which are signs and symptoms of cataract formation? Select all that apply.

-Floaters in visual field -Difficulty in night vision -Decreased color perception

Which medications cause ototoxicity? Select all that apply.

-Ibuprofen -Furosemide -Vancomycin

A clinic nurse is reviewing the record of a client recently diagnosed with a cataract. Which clinical manifestations associated with this disorder should the nurse expect to be documented in the client's record? Select all that apply.

-Increasing nearsightedness -Need for more light when reading -Painless progressive loss of vision

A client who frequently experiences hearing loss due to built-up cerumen in the ears asks the nurse about ways to deal with the problem including irrigating the ears. Which information is correct for the nurse to include in the teaching plan? Select all that apply.

-Irrigate the ear canal with lukewarm tap water around 98° F. -The ear irrigation should be stopped if the client becomes dizzy or nauseous. -Instill drops of mineral oil and hydrogen peroxide for several days to soften dried cerumen before irrigation.

Which nursing interventions are appropriate for a client recovering from surgery for retinal detachment? Select all that apply.

-Monitor for hemorrhage -Administer eye medications -Maintain the eye patch or shield -Assist with activities of daily living -Educate regarding symptoms of retinal detachment

Which are age-related changes to the eyes? Select all that apply.

-Presbyopia -Arcus senilis -Yellow-tinged sclera -Decreased ability to see in dim light

The nurse is preparing to instill an otic solution into the adult client's right ear. The nurse should include which action while performing this procedure? Select all that apply.

-Pulling the auricle of the right ear upward -Pulling the auricle of the right ear backward -Warming the solution to room temperature -Placing the client in a left side-lying position

A client is diagnosed with labyrinthitis. Which are signs and symptoms of labyrinthitis? Select all that apply.

-Severe dizziness (vertigo) -Nausea -Vomiting -Abnormal jerking movement of eyes (nystagmus)

The nurse assigned to care for a hearing-impaired client should use which approach to communication in order to enhance communication and preserve the client's self-esteem? Select all that apply.

-Speaking slowly and clearly -Standing directly in front of the client while speaking -Turning down the volume on the radio or TV when talking

The nurse is observing an unlicensed assistive personnel (UAP) talk to a client who is hearing impaired. The nurse should intervene if which actions are performed by the UAP during communication with the client? Select all that apply.

-The UAP speaks in a very loud voice. -The UAP speaks while cleaning the room. -The UAP speaks directly into the impaired ear.

A client was just admitted to the hospital to rule out a gastrointestinal bleed. The client has brought several bottles of medications prescribed by different specialists. During the admission assessment, the client states, "Lately, I have been hearing some roaring sounds in my ears, especially when I am alone." Which medication should the nurse determine to be the cause of the client's complaint?

Acetylsalicylic acid

Which diagnostic test would verify the diagnosis of macular degeneration?

Amsler grid test

A client who was hit in the eye with a baseball bat sustains a contusion of the eyeball. The emergency department nurse implements which immediate action?

Applies ice to the affected eye

A client arrives in the emergency department with a foreign body in the eye. Which action should the nurse plan to perform first?

Apply an eye patch to both eyes.

Pilocarpine hydrochloride is prescribed for the client with glaucoma. Which medication should the nurse plan to have available in the event of systemic toxicity?

Atropine sulfate

A client with Ménière's disease is experiencing severe vertigo. The nurse reinforces instructions to the client to do which to assist with controlling the vertigo?

Avoid sudden head movements

The nurse should check for vision loss in a client with which condition?

Diabetes mellitus

The nurse is collecting data from a client who has a history of untreated cataracts. The nurse checks the client for which associated manifestation?

Difficulty with driving a car at night

After an eye examination, a client has been diagnosed with acute angle-closure glaucoma. The nurse collecting data from the client asks the client about an accompanying history of which sign/symptom?

Eye pain

The nurse determines that the client diagnosed with Ménière's disease understands the reinforced dietary instructions when the client states that which food will be avoided in the diet?

Hot dogs

The nurse has been assigned to a client with a hearing impairment. To enhance nurse-client communication, the nurse should plan to communicate with the client by speaking in which manner?

In a normal tone while facing the client

The nurse is reinforcing education to a client who has just obtained a hearing aid about its use and maintenance. The nurse tells the client that it is helpful to follow which practice?

Keep an extra battery readily available.

The nurse is communicating with a client who is hard of hearing in both ears. To facilitate communication with this client, the nurse should perform which?

Lower the voice pitch and face the client when speaking.

The nurse is caring for a client who is hearing-impaired and should take which approach to facilitate communication?

Speak in a normal tone

Betaxolol hydrochloride eye drops have been prescribed for the client with glaucoma. Which nursing action is most appropriate related to monitoring for the side/adverse effects of this medication?

Monitoring blood pressure

The nurse is caring for a client with acute otitis media. The nurse plans care knowing which treatment for this problem is likely to be included?

Myringotomy

A client has been diagnosed with glaucoma. The nurse who is teaching the client principles of self-care should encourage the client to limit or refrain from which usual activity on a repeated basis?

Picking objects up off the floor

The nurse is preparing a plan of care for a client being admitted to the hospital with a diagnosis of retinal detachment. Which measure should the nurse include in the plan of care?

Place an eye patch over the affected eye.

During the early postoperative stage, the client who had a cataract extraction complains of nausea and severe eye pain over the operative site. Which action should the nurse implement?

Report the client's complaints.

The nurse is preparing to communicate with an older client who is hearing impaired. Which intervention should be implemented initially?

Stand in front of the client

The nurse is inserting soft contact lenses into the eyes of a client. Which direction does the nurse tell the client to look?

Straight ahead

The nurse is reviewing the primary health care provider's prescriptions for a client admitted to the hospital with a diagnosis of an acute attack of Ménière's disease. Which prescription noted on the client's chart should the nurse question?

The administration of a vasoconstrictor

The nurse is caring for a client who will be undergoing surgical treatment for Ménière's disease. The nurse plans care based on which expected outcome?

The surgery relieves pressure from accumulation of inner ear fluid in the endolymphatic sac.

In preparation for cataract surgery, the nurse is to administer cyclopentolate eye drops. The nurse administers the eye drops knowing that which is the purpose of this medication?

To dilate the pupil of the operative eye

Which intervention should be implemented for the older client with presbycusis who has a hearing loss?

Use low-pitched tones

The nurse is speaking with a client with a hearing impairment. The nurse refrains from doing which least likely helpful action when communicating with this client?

Using many exaggerated hand gestures while talking

The nurse is caring for a client with glaucoma. Which medication prescribed for the client should the nurse question?

Atropine sulfate

The nurse is providing client and family instructions for a client who has been recently diagnosed with glaucoma. Which statement indicates that the client's family member needs further teaching regarding the eye drop application of pilocarpine hydrochloride? Select all that apply.

-"I should apply the eye drops directly over my family member's pupil." -"I have to contact the prescriber if my family member develops a small pupil." -"I need to wipe off the tip of the eye drop bottle with a tissue between administrations."

The nurse is reinforcing home-care instructions to a client and family regarding care after left cataract surgery with lens implant. Which statements made by the client indicate an understanding of the instructions? Select all that apply.

-"I will not sleep lying on my left side." -"I will sit at the table to eat breakfast." -"I will sit in my recliner with my feet elevated." -"I will not lift anything heavier than 10 pounds." -"I will resume my exercise routine including pushups."

The nurse collects data from a client with a diagnosis of macular degeneration of the eye. The nurse should expect the client to report which symptoms? Select all that apply.

-Blurred central vision -Bending of straight lines -Inability to see color vividness

A client has been diagnosed with macular degeneration. The nurse should expect to expect which signs and symptoms noted with macular degeneration? Select all that apply.

-Blurred vision -Inability to see the vividness of colors -Objects that appear to be the wrong size

The nurse administers meclizine hydrochloride to a client diagnosed with an attack of Ménière's disease. Which observations demonstrate to the nurse that the medication is effective? Select all that apply.

-Decrease in nausea -Decrease in vertigo

Which actions should be performed when communicating with a client with presbycusis? Select all that apply.

-Speak slowly and distinctly -Face client when speaking -Use short sentences and phrases

The nurse is reviewing the results of an eye examination on a client. Which tests can detect glaucoma? Select all that apply.

-Tonometry -Visual field check

The nurse is explaining how sound is conducted from the middle ear to the inner ear in teaching a client who is experiencing hearing loss. What is the order of structures conducting sound waves from the middle ear to the inner ear? Arrange the structures in the order that they should occur. All options must be used.

1. Tympanic membrane 2. Malleus, incus, stapes 3. Oval window 4. Cochlea 5. Organ of Corti

Tonometry is performed on the client with a suspected diagnosis of glaucoma. The nurse reviews the test and determines that the intraocular pressure is normal if which result is noted?

15 mm Hg (normal 10-21mm Hg)

The nurse is reviewing the medication list for an assigned client. Which medication is the only one on the client's prescription sheet that does not have an ototoxic effect?

Acetaminophen

The nurse is reinforcing preoperative instructions to a client scheduled for cataract surgery and prepares a written list of instructions for the client. Which statement by the client indicates a need for further teaching?

"I can drink any liquids that I want to on the morning of the surgery."

Surgery has been recommended for the client with otosclerosis. The client tells the nurse that she would prefer not to have surgery and asks the nurse about alternative methods to improve hearing. The nurse should make which appropriate response to the client?

"A hearing aid may improve your hearing."

A client with glaucoma asks the nurse if complete vision will return. The nurse should make which response to the client?

"Although some vision has been lost and cannot be restored, further loss may be prevented by adhering to the treatment plan."

The nurse is reinforcing discharge teaching to a client following right eye cataract surgery. The nurse determines that the client needs further teaching about ways to avoid strain on the operative eye when the client makes which statements? Select all that apply.

"I can lie on my right side." "I will wear my eye shield only during the daytime."

The nurse reinforces home care instructions to a client after cataract removal and placement of an intraocular implant in the right eye. Which statement by the client indicates a need for further teaching?

"I need to remove the eye dressing as soon as I get home and place a warm pack on my eye."

A clinic nurse is reinforcing home care instructions to a client with a diagnosis of glaucoma. Which statement by the client indicates an understanding of the treatment plan for glaucoma?

"I need to take my eye drops for the rest of my life."

The nurse is giving the client discharge instructions concerning glaucoma. Which client statement indicates a need for further teaching?

"I will only take the eye drops until my vision improves."

The nurse is providing discharge instructions for a client who has had a fenestration procedure for the treatment of otosclerosis. Which statement by the client indicates an understanding of the instructions?

"I will take stool softeners as prescribed by my doctor."

The instructor is quizzing the student nurse concerning care of a visually impaired client. Which statement indicates a need for further teaching?

"I will take the client's arm to lead while we are walking."

A client is being discharged from the ambulatory care unit following cataract removal, and the nurse provides instructions regarding home care. Which statement by the client indicates an understanding of the instructions?

"I will wear my eye shield at night and my glasses during the day."

The nurse is providing discharge instructions to a client who is postoperative cataract surgery on the left eye. Which statement indicates a need for further teaching?

"If I have severe eye pain, I will take the narcotic pain pill that my doctor will prescribe for me."

The nurse is caring for a client hospitalized with an acute attack from Ménière's disease. The client verbalizes concern because the client has experienced a hearing loss as a result of the attack. Which response should the nurse make to the client regarding the hearing loss?

"The attack leaves a hearing loss in the involved ear."

Immediately following cataract repair, the client's affected conjunctiva and eyelids are edematous. Which statement by the nurse accurately characterizes these findings for the client?

"The edema is normal and should subside within 3 days."

The nurse is assisting a client who has just been given a hearing aid to wear for the first time. When reinforcing client teaching, the nurse should include which instruction?

"The hearing aid should not be worn if an ear infection is present."

The nurse is reviewing the medical record of a client diagnosed with conjunctivitis. Which signs and symptoms should the nurse expect to be noted? Select all that apply.

-Itching -Redness -Sensation of foreign object

A client has been diagnosed with cataracts. Which signs and symptoms should the nurse expect to note? Select all that apply.

-photophobia -blurred vision -decreased color perception

An adult client has increased fluid in the middle ear that is causing vertigo. The nurse checks this client for which associated signs and symptoms of this condition?

Nausea and vomiting

A caloric test is prescribed for a client suspected of having a disease of the labyrinth. The nurse obtains which essential item in preparation for this test?

An otoscope

A client who has undergone cataract removal without an intraocular lens implant is visibly upset because his vision is still blurry. Which action should the nurse perform to provide realistic reassurance to this client?

Explain that vision will improve with adjustment to aphakic lenses.

A client arrives in the emergency department with a chemical eye injury. The nurse immediatelyperforms which action?

Irrigates the eye with copious amounts of sterile normal saline

The nurse in the recovery room area is preparing to care for a client following cataract extraction of the right eye. Which position does the nurse prepare to place the client?

On the left side with the head of the bed elevated

The nurse is assigned to care for a client following a cataract extraction. The nurse plans to place the client in which position?

On the nonoperative side

The nurse is preparing to administer eardrops to an adult client. The nurse administers the eardrops by which technique?

Pulling the pinna up and back

While at home, the nurse receives a telephone call from a neighbor who reports that while accidentally breaking a mirror, a piece of glass flew into her eye. Which is the appropriate initialnursing action after observing that the large glass shard is protruding from the neighbor's eye?

Secure a paper cup over the affected eye.

These are signs and symptoms of glaucoma. Which sign or symptom is found only in narrow-angle glaucoma?

Severe pain in and around eye

The nurse is attempting to communicate with a hearing-impaired client. Which strategy by the nurse would be least helpful when talking to this client?

Smiling continuously during conversation

A client is being discharged from the ambulatory care unit following cataract removal. Which instruction from the discharge teaching plan should the nurse reinforce?

Take acetaminophen if any discomfort occurs.

The nurse interprets that a client diagnosed with glaucoma needs additional information about the expected effects of this condition when the client makes which statement?

"Taking my daily walk right around dusk each evening has proven to be so enjoyable."

The nurse in the ambulatory care unit is caring for a client following cataract extraction. The client suddenly complains of nausea and severe eye pain in the surgical eye. The nurse should take which action?

Notify the registered nurse.

A client is brought to the ambulatory care department by the spouse 1 day following a cataract extraction procedure. A diagnosis of hyphema is made, which occurred as a result of the surgical procedure. The nurse reinforces instructions to the client and spouse regarding the treatment for the complication and makes which statement?

"Maintain bed rest and patching of both eyes."

The nurse is reinforcing discharge instructions with a client who is being discharged following a fenestration procedure for the treatment of otosclerosis. Which should be included on the list of instructions prepared for the client?

"You need to avoid air travel."

The nurse is preparing to reinforce a teaching plan for a client who is undergoing cataract extraction with intraocular implant. Which home care measures should the nurse include in the plan? Select all that apply.

-To avoid activities that require bending over -To take acetaminophen for minor eye discomfort -To place an eye shield on the surgical eye at bedtime -To contact the surgeon if a decrease in visual acuity occurs

A client with retinal detachment is admitted to the outpatient nursing unit in preparation for a scleral buckling procedure. Which prescription should the nurse anticipate?

Placing an eye patch over the client's affected eye

The nurse provides discharge instructions to the client who was hospitalized for an acute attack of Ménière's disease. Which statement made by the client indicates a need for further teaching?

"It is not necessary to restrict salt in my diet."

The nurse is reviewing the health care record of a client with a diagnosis of otosclerosis. Which signs and symptoms should the nurse note? Select all that apply.

-Tinnitus -Difficulty hearing voices of others -Bone conduction better than air conduction

A client arrives at the emergency department after experiencing a traumatic blow to the eye and a hyphema is diagnosed. In which position should the nurse place the client?

In semi-Fowler's position

The nurse is gathering data from a client with a history of untreated cataracts. The nurse asks the client about the presence of which sign of a cataract?

Difficulty with driving at night and blurred vision

The nurse is assigned to care for a client with a diagnosis of detached retina. Which findings would indicate that bleeding has occurred as a result of retinal detachment? Select all that apply.

-Vision may be cloudy -Complaints of a burst of black spots or floaters

The nurse is preparing to administer eye drops. Which interventions should the nurse take to administer the drops? Select all that apply.

-Wash hands. -Put on gloves. -Place the drop in the conjunctival sac. -Pull the lower lid down against the cheekbone.