Chapter 52

Progressive deafness caused by the ankylosis of the stapes is the condition of__________.

a. otosclerosis

Arrange the parts of the eye from the exterior to the most interior.

b. Cornea c. Aqueous humor f. Iris e. Lens d. Retina a. Choroid

When the newly blind male home health patient asks the nurse how he might get assistance, who might the nurse suggest he contact?

. American Foundation for the Blind for a list of agencies

What is the ability of the eye to focus on objects at various distances?

B. Accommodation

The total removal of an eye is a(n) ___________.

a. Enucleation

One of the housekeepers splashes a chemical in the eyes. What should be the first priority?

d. Irrigate with normal saline solution for 20 minutes

What factors have been associated with the formation of cataracts? (Select all that apply.)

A. Aging B. Ultraviolet light D. Exposure to maternal rubella E. Smoking G. Diabetes mellitus

Select all the conditions that may cause conductive hearing loss. (Select all that apply.)

a. Buildup of cerumen b. Foreign bodies c. Otosclerosis of external auditory canal f. Otitis media with effusion

Which of the following are causes of cataracts? (Select all that apply.)

a. Long-term use of corticosteroids c. Congenital from exposure to maternal rubella d. Diabetes mellitus f. Smoking

Why would the nurse encourage a group of teenagers to protect their eyes with dark sunglasses while using a UV lamp?

a. The lamp can cause cataracts.

What should the nurse do when assisting a blind person to walk in an unfamiliar hospital environment? (Select all that apply.)

c. Describe the surroundings d. Encourage the patient to ask for verbal cues e. Place patient hand on nurse's shoulder or elbow

Four hours after a stapedectomy the patient complains that hearing has not improved at all. What knowledge would the nurse use to shape a response?

c. Hearing will not return until edema subsides

Place the nursing intervention in appropriate order for the immediate care of a patient with a penetrating wound of the eye.

c. Lay the patient down flat a. Assess eye, do not remove object d. Check for the irregularity of the pupil b. Cover both eyes with an eye shield or cup e. Obtain medical attention immediately

The nurse counsels the 16-year-old boy that playing his music at high volume can result in impairment in hearing related to:

c. damage of the fine hair cells in the organ of Corti.

The nurse takes into consideration that the Weber test indicated a conductive hearing loss in a patient because the patient reported hearing the tone:

c. louder in his affected ear.

The surgical incision into the eardrum with either a knife or a heated wire loop to relieve pressure in the middle ear is a(n)

c. myringotomy

What would a nurse do when the patient arrives in the PACU after a left stapedectomy? (Select all that apply.)

a. Turn the patient to his right side d. Leave the bed flat e. Medicate immediately on the complaint of nausea

What must a patient do following a left vitrectomy?

b. Position self in a face-down position for 4 to 5 days

The nurse is aware that the patient has 20/40 vision. This means that the patient can see at 20 feet what the normal eye can see at _______ feet.

d. 40

What does the cataract treatment of phacoemulsification involve?

d. Breaking the cataract with ultrasound

The patient tells the nurse that he is legally blind. How would this information impact the nurse's plan of care for this patient?

d. The nurse would need to determine how this patient's visual impairment affects normal functioning

The nurse clarifies that the difference between a photorefractive keratectomy (PRK) and a laser in-situ keratomileusis (LASIK) is that a LASIK:

c. removes some internal layers of the cornea.

What should the nurse advise the 20-year-old to do who has been put on cefaclor (Ceclor) for a resistant otitis media?

c. Avoid alcoholic beverages

What should a patient who has had a cataract repair avoid?

. The lifting of heavy objects

What is the visual disorder characterized by slow, progressive loss of central and near vision?

A. Age-related macular degeneration

What is the process when the lens of the eye changes its curvature to focus on the retina?

a. Accommodation

What should the nurse remind the hearing aid wearer to do when the nurse hears a whistling hearing aid?

a. Reinsert the ear mold

What factors must the nurse consider when assessing readiness to learn when teaching health promotion practices for the visually and hearing impaired?

a. Cultural beliefs b. Values c. Habits

What is a common mistake that hinders communication when communicating with the hearing impaired?

a. Overaccentuating words

Which may contribute to otitis media? (Select all that apply.)

a. Exposure to cigarette smoke b. Allergies c. Upper respiratory infections

Which complaint made by a 64-year-old patient during a health interview would alert the nurse to the possibility of cataracts?

b. Difficulty driving at night

What do miotic eyedrops do for a patient with glaucoma?

d. Constrict the pupil and open the canal of Schlemm

What is the thick, white, opaque connective tissue that is part of the outermost layer of the eye-ball?

C. Sclera

What are the most appropriate nursing care and patient teaching for the patient with external otitis?

D. Washing hands before and after changing cotton plugs

Why is otitis media found more frequently in children 6 to 36 months?

Eustachian tubes in children are shorter and straighter.

When the patient stares at the black dot on an Amsler grid, what should the nurse ask him to report?

. Any distortion of the grid

A patient who had an enucleation of the right eye has been admitted PACU. What should the nurse include in the plan of care?

. Apply a pressure dressing over the right eye socket

What does diabetes retinopathy result from?

. Capillaries in retina hemorrhage

When the patient in the emergency room complains of seeing flashing lights and a curtain down over his right eye, the nurse recognizes this as a symptom of which condition?

. Detached retina

What is the first indication of macular degeneration?

. The loss of central vision

How should the nurse advise a patient who has severe vertigo from labyrinthitis?

Lie immobile and hold the head in one position until the vertigo lessens.

When taking care of a patient with newly diagnosed type 1 diabetes mellitus, the nurse notes the patient is expressing some fears about long-term complications of the disease. She states, "I know I'll go blind within 10 years. Why should I bother controlling my blood sugar?" On what knowledge can the nurse's best response be based?

B. Diabetic retinopathy occurs more frequently in patients with long-standing, poorly con-trolled diabetes mellitus.

When caring for a patient who has just undergone a corneal transplant (keratoplasty), what is the most important nursing intervention?

C. Reporting any severe or progressive pain to the surgeon immediately

The nurse is caring for a patient who has had functional blindness for 10 years. Which statement is true?

D. A comprehensive approach to patient care is essential with blind patients.

The nurse is caring for a 75-year-old patient who has experienced some sensory deficits. What change might be explained by age-related changes of the sensory system?

D. Increased difficulty focusing on close objects

What should the nurse include in the plan of care following a tympanoplasty?

Elevating head of bed with operative side facing upward

What does a tympanoplasty correct?

a. Conductive hearing loss

Which is a sign of acute angle closure glaucoma (AACG)?

Large fixed pupil

What type of hearing loss involves normal sound conduction through the external and middle ear, but distortion in the inner ear, making discrimination difficult?

A. Sensorineural hearing loss

The nurse will assess for _____________ when the older adult home health patient complains that the entire right side of his head hurts and he cannot chew without pain.

b. external otitis

The home health patient complains of tearing and a feeling of dryness in the right eye. The nurse assesses that the eyelid is turned inward and the sclera is red. The nurse documents the presence of a(n)_________________.

b. Entropion

The 62-year-old home health patient who is recovering from eye surgery complains of a feeling of "grittiness" in the eye and is having blurred vision. The eyes are reddened and have stringy mucus. What do these complaints indicate?

a. Sjögren syndrome

The nurse explains that a pneumatic retinopexy is a repair of a retinal detachment using a bubble of_________ to put pressure on the damaged retina.

b. gas

How would the nurse explain the purpose of photocoagulation to a diabetic patient with diabetic retinopathy? a. The procedure will destroy the retina, which is not getting enough blood supply.

d. The procedure will destroy new blood vessels, seal leaking vessels, and help prevent retinal edema.