Chapters 42,56,59&60. Medsurg

What should a nurse include when educating a patient with Ménière disease?

"Decrease your sodium intake and take your diuretic medication between attacks."

Displaying her hands, a patient asks, "Do you think my liver is OK? Look at all these liver spots!" What is the most appropriate nursing response?

"The spots are normal aging changes and have nothing to do with your liver."

Which patient problem should take priority in planning care for a patient with Ménière disease?

Potential injury

Which discharge instruction will the nurse include for a patient sent home from the clinic who is taking an adrenergic ophthalmic solution for an acute inflammation?

Avoid driving or operating machinery until blurring subsides.

What is the mechanism of action of osmotic agents when used to decrease IOP?

Increasing plasma osmolarity and drawing extracellular fluid into the blood

A patient recently diagnosed with glaucoma is to begin drug therapy with carbonic anhydrase inhibitors. For which assessments) would the nurse need to contact the healthcare provider? (Select all that apply.)

a. Electrolyte levels C. Allergy to sulfonamides

A patient who has had surgery this morning for cataracts is now going home. What should the nurse include when providing discharge instructions? (Select all that apply.)

b. Use stool softeners. c. Avoid bending over. d. Avoid lifting anything heavier than 5 lb.

A confused patient has been restrained because of combativeness and hyperactivity. What skin assessment may occur as a result of the restraints?

senile purpura

What information should a nurse provide to a patient with vitiligo receiving phototherapy?

wear protective clothing

____________ are often formed when excess cells accumulate in a cyst or sac formed near the tympanic membrane.

Cholesteatomas

During an intake physical examination, a patient reports that he has been taking 10 aspirin tablets a day for his arthritis. What question should the nurse ask based on this information'?

Do you have ringing in your ears?

The nurse is caring for a patient immediately following a right-sided trabeculectomy. When positioning this patient, the nurse will encourage a ____________ position.

Left side lying

What should a nurse ask about when taking the functional assessment of a patient with a skin disorder?

Exposure to chemicals or irritants

What is the cause of glaucoma?

increased intraocular pressure

A 75-year-old patient reports to a nurse that although she has cleaned her ears with cotton-tipped applicators for weeks, she still cannot hear her television unless the volume is loud, and she misses a great deal of conversations. What should the nurse anticipate when examining her ears?

C. Dry cerumen across the canal

A 52-year-old patient reports that he must hold his paper farther and farther away from his tace to read it. What is the nurse's most informative response?

C."You have presbyopia. Nonprescription reading glasses will help you."

Which surgical implementation is most effective with retinal detachment?

Scleral buckling Scleral buckling is used to hold the retinal repair in place. The band is left in place to keep together the layers of the eye tissue

A daughter of an older adult patient who has just returned from surgery is distressed about her father's pale, cold hands and feet. What is the best response by the nurse after covering the patient with an extra blanket?

When patients have blood loss during surgery, superficial vessels close off temporarily resulting in cold extremities

A. patient reports to a home health care nurse of having cloudy vision and seeing spots and halos around lights. What should the nurse suspect based on these patient symptoms?

a. Cataracts Cataracts are the cause of cloudy vision and seeing spots or halos.

nurse explains that laser-assisted in situ keratomileusis (Lasik) and photorefractive keratectomy (PRK) are methods to correct refractive errors surgically. What do these procedures reshape?

a. Cornea Both surgical procedures are used to reshape the cornea. The clinician will need to determine which structure of the eye will need surgery to correct the vision.

How does closed-angle glaucoma differ from open-angle glaucoma?

a. The onset is acute. Closed-angle glaucoma has an acute onset with eye pain and other systemic symptoms, such as nausea and vomiting. Reducing the intraocular pressure is an ocular emergency.

7. What information will the nurse include when teaching the patient and family about postoperative care for a trabeculectomy? (Select all that apply)

a. Use aseptic technique for all dressing changes and medication administration. C.Avoid heavy lifting. d. Redness in the eye, pain, and swelling are common occurrences after surgery. E.Avoid straining on defecation.

A patient with glaucoma is taking a beta-adrenergic blocking agent, timolol (Timoptic). For which potential side effect should the nurse assess the patient?

a. Wheezing Beta-adrenergic blocking agents cause bronchospasm and tachycardia.

A patient comes to the primary care clinic complaining of a head cold and ear pain with drainage. What should the nurse suspect this patient is experiencing?

acute otitis media

Which type of medication would be used to dilate the pupils before an eye examination?

adrenergic agent

A nurse collecting tissue for a Izanck test should: elect the appropriate interventions and place the steps in sequence. Do not separate answers with a space or punctuation.

d. Wash the lesion. A.Open the lesion with a hypodermic needle C.Saturate the sterile swab with exudates. B.Place the specimen in a culture tube and take it to the laboratory.

What is the action of timolol maleate (Timoptic), a beta-adrenergic blocking agent?

decreases production of aqueous humor

The nurse is preparing a patient for an ophthalmic examination. Which action occurs when the nurse instills eyedrops to produce mydriasis?

extreme dilation of the pupil

Which is a potential serious adverse effect associated with mannitol (Osmitrol)?

fluid overload

Which conditions can be improved with negative pressure therapy? (Select all that apply.)

1.Pressure ulcers 2.Skin grafts 3.Dehisced surgical wounds

A patient in the emergency department complains of severe pain in his eye and is seeing halos around lights and feeling nauseous. Which diagnosis should the nurse suspect?

Angle-closure glaucoma

A young woman being admitted to the clinic service states that all the members of her family have been hard of hearing. She says her hearing loss became more pronounced when she was pregnant. What term explains this type of hearing loss?

a. Otosclerosis Otosclerosis is hereditary, develops in young women, and worsens with pregnancy.

Which medication is used to produce miosis following a diagnostic procedure?

pilocarpine (Pilocar)

when assessing the capillary refill, a nurse should document as normal a refill time of ______ seconds. rUse numeric characters onlv.

3

A 60-year-old patient who has had an enucleation asks when he can get his prosthesis fitted. In approximately how many weeks should this patient expect to be fitted?

4 weeks

nurse is screening patients that the plastic surgeon is considering for phototherapy. Which patient should the nurse exclude?

A 34-year-old woman with lupus erythematosus

Which statements) about aqueous humor is/are true? (Select all that apply.)

A. Bathes and feeds the lens, posterior surface of the cornea, and iris B.Drains out of the eye through drainage channels located near the junction of the cornea and sclera C.Flows out of the canal of Schlemm into the venous system of the eye

A patient recently diagnosed with glaucoma is to begin drug therapy with carbonic anhydrase inhibitors. For which assessments) would the nurse need to contact the healthcare provider? (Select all that apply.)

A. Electrolyte levels C. Allergy to sulfonamides

Which age-related skin changes should a nurse anticipate when performing a physical assessment on an 80-year-old man? (Select all that apply.)

A. Increased nasal hair B. Flattened nails D. Increased hair on the helix of the ear E. Presence of seborrheic keratosis

Which are important teaching points for the nurse to review with a patient recently diagnosed with open-angle glaucoma? (Select all that apply.)

A. The disease will cause damage to the optic disc if left untreated. C. Loss of peripheral vision is a common trigger for diagnosis. D. Total blindness may result if the glaucoma is not treated.

What information will the nurse include when instructing a patient on the correct method of instilling eyedrops? (Select all that apply.)

A. With an infection, prevent cross contamination and use a separate source of medication and droppers for each eye. B.Wash hands before and after administration. C. Place the lid on the surface area as instructed to avoid contamination. D. Nevertouch the tip of the dropper or opening of the ointment container.

What is the purpose of administering a cycloplegic agent? (Select all that apply.)

A.Facilitate examination of the eye B.Facilitate surgery on the eye D. paralyze the ciliary muscle

What information will the nurse include when teaching the patient and family about postoperative care for a trabeculectomy? (Select all that apply.)

A.Use aseptic technique for all dressing changes and medication administration. C. avoid heavy lifting D. Redness in the eye, pain, and swelling are common occurrences after surgery. E. avoid straining on defecation.

A factory worker had a chemical inadvertently splashed into his right eye. An eyewash was used at the work site. Which nursing assessments) would be important to include? (Select all that apply.)

A.Visual acuity B. Presence of pain, blurred or halo vision, or lack of vision C.Type of chemical E.presence of contacts or use of eyeglasses

What information will the nurse include when instructing a patient on the correct method of instilling eyedrops? (Select all that apply.)

A.With an infection, prevent cross contamination and use a separate source of medication and droppers for each eye. B.Wash hands before and after administration. C. Place the lid on the surface area as instructed to avoid contamination. D. Never touch the tip of the dropper or opening of the ointment container.

The nurse is educating a patient about a newly prescribed cholinergic agent. When relaying common adverse effects of this type of medication, the nurse will include information about: (Select all that apply.)

A.conjunctival irritation. B. Headache

What information should a nurse stress when teaching a patient with Ménière disease about managing the disorder?

Avoiding the use of alcohol and tobacco

What is the purpose of administering a cycloplegic agent? (Select all that apply.)

Facilitate examination of the eye Facilitate surgery on the eye Paralyze the ciliary muscle

nurse is educating a patient about a newly prescribed cholinergic agent. When relaying common adverse effects of this type of medication, the nurse will include information about: (Select all that apply.)

a. conjunctival irritation. b. headache.

A 94-year-old patient is receiving gentamicin sulfate (Garamycin) in a continuous intravenous (IV) infusion. The nurse adds to the nursing care plan the patient problem "Potential injury." What nursing action should be implemented?

measure intake and output

___________ is the creation of a small opening in the tympanic membrane to reduce pressure and allow fluid to drain.

myringotomy

The nurse is assisting with applanation tonometry on a patient at the ophthalmologist's office. The results indicate the patient's reading to be 15 mm Hg. The nurse interprets this result as ____________ IOP.

normal

A 75-year-old patient reports having difficulty hearing in crowds but can hear just fine at home with his wife. What hearing disorder should the nurse suspect?

presbycusis