Eye/Ear Disorders, Care of Patients with Eye and Vision Problems, Assessment of the Eye and Vision

The nurse is counseling an adolescent patient who has recurrent otitis externa and who works as a lifeguard in the summer about preventing this condition. The nurse will teach this patient to?

use a hair dryer to dry the ears after swimming.

A client had a retinal detachment and has undergone surgical correction. What discharge instruction is most important?

"Avoid reading, writing, or close work such as sewing."

A client does not understand why vision loss due to glaucoma is irreversible. What explanation by the nurse is best?

"Because eye pressure was too high, the tissue died."

The nurse has given a community group a presentation on eye health. Which statement by a participant indicates a need for more instruction?

"I always lose my sunglasses, so I don't wear them."

The nurse is providing teaching for a patient who will begin using tobramycin ointment (Nebcin) 0.5 inches 3 times daily. The patient currently uses pilocarpine HCl (Isopto Carpine) drops to treat glaucoma. Which statement by the patient indicates a need for further teaching?

"I should put the ointment on first and then instill the eyedrops."

A client has been taught about retinitis pigmentosa (RP). What statement by the client indicates a need for further teaching?

"Since I'm going blind, sunglasses are not needed anymore."

A nurse who is applying eyedrops to a client holds pressure against the corner of the eye nearest the nose after instilling the drops. The client asks what the nurse is doing. What response by the nurse is best?

"This prevents systemic absorption."

The nurse administers proparacaine HCl (Ophthaine) drops to a patient prior to an eye examination. What sign will the nurse look for to determine when the examination can begin?

Absence of the blink reflex

The nurse is preparing to administer olopatadine (Patanol) eyedrops to a patient who has allergic conjunctivitis. The patient tells the nurse that the drops have caused burning and stinging. What action will the nurse take?

Administer the drops and reassure the patient that this is a normal side effect.

A client has a foreign body in the eye. What action by the nurse takes priority?

Administering ordered antibiotics

A client has been prescribed brinzolamide (Azopt). What assessment by the nurse requires consultation with the provider?

Allergy to sulfonamides

The nurse is performing a medication history on a patient who has glaucoma. The patient cannot remember the name of the drug prescribed but tells the nurse that the drug causes light sensitivity. The nurse knows that the drug is among which class of medications?

Alpha-adrenergic agonists

The nurse is administering timolol (Timoptic) eye drops to a patient who has glaucoma. To prevent bradycardia, the nurse will perform which action?

Apply pressure to the lacrimal ducts.

The nurse is caring for a patient who has increased intraocular pressure. The provider has ordered a cholinergic agonist. The nurse will perform a thorough health history to make sure the patient does not have a history of which condition?

Asthma

The nurse is preparing to administer atropine sulfate drops as a mydriatic agent. Which assessment would cause the nurse to withhold the drug and notify the provider?

Blood pressure of 140/90 mm Hg

The nurse reads on a client's chart that the client has exophthalmos. What assessment finding is consistent with this diagnosis?

Bulging eyes

A client has a corneal ulcer. What information provided by the client most indicates a potential barrier to home care?

Chronic use of sleeping pills

A nurse is seeing clients in the ophthalmology clinic. Which client should the nurse see first?

Client who has had cataract surgery and has worsening vision

A client presents to the emergency department reporting a foreign body in the eye. For what diagnostic testing should the nurse prepare the client?

Corneal staining

A client's chart indicates anisocoria. For what should the nurse assess?

Difference in pupil size

A client had proxymetacaine (Ocu-Caine) instilled in one eye in the emergency department. What discharge instruction is most important?

Do not touch or rub the eye until it is no longer numb.

A client is brought to the emergency department after a car crash. The client has a large piece of glass in the left eye. What action by the nurse takes priority?

Ensure the client has a patent airway.

An older client has decided to give up driving due to cataracts. What assessment information is most important to collect?

Feelings related to loss of driving

A client is taking timolol (Timoptic) eyedrops. The nurse assesses the client's pulse at 48 beats/min. What action by the nurse is the priority?

Hold the eyedrops and notify the provider.

A patient has an infection of the eyelash follicles and in the gland on the eyelid margin. The nurse recognizes these symptoms as being consistent with which condition?

Hordeolum

A client is in the preoperative holding area waiting for cataract surgery. The client says "Oh, yeah, I forgot to tell you that I take clopidogrel, or Plavix." What action by the nurse is most important?

Notify the surgeon immediately.

The nurse is administering eyedrops to a client with an infection in the right eye. The drops go in both eyes, and two different bottles are used to administer the drops. The nurse accidentally uses the left eye bottle for the right eye. What action by the nurse is best?

Obtain a new bottle of eyedrops.

A client who is near blind is admitted to the hospital. What action by the nurse is most important?

Orient the client to the room using a focal point.

A client's intraocular pressure (IOP) is 28 mm Hg. What action by the nurse is best?

Plan to teach about drugs for glaucoma.