272 PrepUs - Week 1

Primary visual cortex

This is, the region of the posterior occipital lobe whose primary input is from the visual system

Retinal detachment

This occurs, with separation of the retina from the underlying epithelium, disrupting vision and resulting in blindness if not repaired surgically.

Cortical blindness

This type of partial or total blindness, is the bilateral loss of the primary visual cortex. However, pupillary reflexes are retained in this type of blindness.

Advise the client to discard the drug because it may have undergone chemical changes or become contaminated.

A home health nurse visits a client who's taking pilocarpine, a miotic agent, to treat glaucoma. The nurse notes that the client's pilocarpine solution is cloudy. What should the nurse do first?

Types of glaucoma

-Open-angle glaucoma -Angle-closure glaucoma

Presbyopia

This, involves difficulty focusing on near objects. It is common in older adults and is caused by decreased elasticity of the lens and atrophy of the ciliary muscle.

Strabismus

Defined as abnormal deviation of the eyes (crossed eyes)

Miosis

Defined as constriction of the pupil

Healthy Intraocular Pressure (IOP) Ranges

Ranges for this are: Between 10 to 21 mm Hg

Risk factors associated with glaucoma

Risk factors associated with this disease include: -Prolonged use of topical or systemic corticosteroids -Older age -Myopia -History of cardiovascular disease

Acute angle-closure glaucoma S/S

Symptoms/Signs for this type of glaucoma include: -Corneal edema -Pupil that is fixed in a semi-dilated position -Extreme pain -Blurred vision -Halos around lights -Red eye -Cloudy cornea -Dilated, non-reactive pupil -IOP > 50 (hard eye) -Enlarged cup to disc (>.5)

Macula function

This is the retina's central portion and is responsible for focusing central vision in the eye, and it controls our ability to read, drive a car, recognize faces or colors, and see objects in fine detail.

The retina of the eye

The adverse effect of hypertension most likely will affect this part, of the eye

Inability of oxygen to diffuse to tissues in the eye

The client, newly diagnosed with diabetic retinopathy, asks what caused this disorder. What is the nurse's best response?

Narrow-Angle Glaucoma contraindication

The drug Levodopa can dilate pupils and raise intraocular pressure, therefore it is contraindicated for this disease, and the drug would be discontinued.

The Four major types of examinations are used in glaucoma evaluation, diagnosis, and management

The examinations for evaluation, diagnosis and mgmt for this condition: -Tonometry -Ophthalmoscopy -Gonioscopy -Perimetry

Diabetes mellitus Complications

The types of microvascular complications that occur with this disease, can include neuropathy, retinopathy, nephropathy, and disorders of gastrointestinal motility. This disease, is a leading cause of vision loss and blindness as well as chronic kidney disease.

Cones

These are retinal receptor cells that are concentrated near the center of the retina and that function in daylight or in well-lit conditions. They provide daylight color vision, and their stimulation is interpreted as color. If one or more types of these receptors are absent or defective, color blindness occurs.

Rods

These are retinal receptors that detect black, white, and gray; necessary for peripheral and twilight vision. They are sensitive to low levels of illumination but can't discriminate color.

Anticholinergic drug: Contraindications

These drugs, are contraindicated for patients with benign prostatic hypertrophy, myasthenia gravis, hyperthyroidism, glaucoma, tachyarrhythmia, myocardial infarction, heart failure, or conditions associated with esophageal reflux.

Epinephrine/Adrenergic drugs: Contraindications

These drugs, are contraindicated in clients with narrow-angle glaucoma (closed-angle glaucoma) because the drugs increase intraocular pressure and mydriasis.

Anticholinergic drugs

This class of drugs blocks the action of a neurotransmitter called acetylcholine. This inhibits nerve impulses responsible for involuntary muscle movements and various bodily functions. These drugs can treat a variety of conditions, from overactive bladder to chronic obstructive pulmonary disorder. Examples: Oxybutynin (Ditropan, Gelnique), tolterodine (Detrol), Darifenacin (Enablex), Solifenacin (Vesicare), Trospium (Sanctura), Fesoterodine (Toviaz)

Beta Blockers

This class of drugs, are the preferred initial medications for glaucoma that decrease the production of aqueous humor, with a resultant decrease in IOP.

Diabetic retinopathy

This disorder is characterized by: The body's inability to effectively cope with carbohydrate, fat, and protein metabolism over a long period of time resulting in a thickening of the basement membrane in large and small blood vessels. This thickening leads to changes in oxygenation of the lining of the vessels causing damage and narrowing of the vessels. The decreased blood flow through the vessels results in the inability of oxygen to rapidly diffuse across the membrane to the tissues of the eye. The tiny vessels of the eye are narrowed and closed, which causes loss of vision.

Angle Closure Glaucoma

This glaucoma causes ocular pain, blurred vision, and a fixed mid-dilated pupil.

Timolol ophthalmic

This is a beta-blocker eye drop, that also reduces pressure inside the eye and used to treat open-angle glaucoma and other causes of high pressure inside the eye.

Macular degeneration

This is a condition, caused by the deterioration of the central portion of the retina (the macula), the inside back layer of the eye that records the images we see and sends them via the optic nerve from the eye to the brain. This is the most common cause of visual loss in people older than 60 years of age.

Carbachol (Miostat)

This is a direct acting cholinergic agonist used for glaucoma and should decrease pressure in the eye. -Not used systemically.

Latanoprost

This is a prostaglandin agonist medicated eye drop that should be administered daily and helps drain fluid in the eye, thereby decreasing the intraocular pressure.

Succinylcholine

This is a skeletal muscle relaxant for intravenous (IV) administration and is the only NMJ (Neuromuscular junction) blocker that may cause increased intraocular pressure. This is contradicted for patients with glaucoma who already have increased intraocular pressure.

Mydriasis

This is defined as dilation of the pupil

Conjunctivitis

This is defined as inflammation of the conjunctiva (pink eye)- a bacterial or viral Infection established on the outer layer of the eye. Intervention: to maintain good hand hygiene

Tonometry

This is one of the four major types of examinations used in glaucoma evaluation, diagnosis, and management. This procedure, is the measurement of the IOP fluid behind the eyes.

Perimetry

This is one of the four major types of examinations used in glaucoma evaluation, diagnosis, and management. This procedure is to assess the visual fields.

Gonioscopy

This is one of the four major types of examinations used in glaucoma evaluation, diagnosis, and management. This procedure is to examine the filtration angle of the anterior chamber.

Ophthalmoscopy

This is one of the four major types of examinations used in glaucoma evaluation, diagnosis, and management. This procedure is to inspect the optic nerve.

Cataracts

This is the most common cause of visual loss, and defined as opacities of the lens. The risk factors for this, include aging, genetic factors, environmental factors (such as smoking and frequent exposure to sunlight), metabolic disorders such as diabetes, and medications such as inhaled steroids and amiodarone.

Importance of patching the eye as prescribed

This is the most important treatment to follow for strabismus

Glaucoma

This, is a chronic degenerative optic neuropathy characterized by optic disk cupping and visual field loss. It is usually associated with an elevation in intraocular pressure. It characteristically has an increase in the aqueous humor that fills the anterior and posterior chambers of the eye.

The presence of halos around lights

This, is a classic symptom of acute-closure glaucoma

Eyedrop instillation

This, is a critical component of self-care for a client with glaucoma. After demonstrating this, to the client and family, the nurse should verify their ability to perform this measure properly.

Acute angle-closure glaucoma

This, is a serious eye condition that occurs when the fluid pressure inside your eye rises quickly. This is an emergency where the nurse should refer the client for medical treatment immediately because vision may be permanently lost in 1 to 2 days.

Laser/Standard iridotomy

This, is a surgical procedure that provides additional outlet drainage of aqueous humor. This is done to lower the IOP as quickly as possible since permanent vision loss can occur in 1 to 2 days.

IOP of 25mm/ Hg

This, is considered a high IOP figure

Intraocular pressure (IOP)

This, is the pressure fluid measured inside the eyes

21 mm Hg or higher

What reading of IOP would demonstrate a sign of primary open-angle glaucoma, resulting from optic nerve damage?

Hold the medication and report the information to the physician to ensure client safety.

When checking a client's medication profile, a nurse notes that the client is receiving a drug contraindicated for clients with glaucoma. The nurse knows that this client, who has a history of glaucoma, has been taking the medication for the past 3 days. What should the nurse do first?

Open Angle Glaucoma

the most common form of glaucoma, where the trabecular meshwork gradually becomes blocked, causing a buildup of pressure