Sensory Vision test like questions

Which communication method is appropriate when the nurse is interacting with a client who is deaf? A. Use pictures and writing B. Speak with enunciated words C. Ask client to read the nurse's lips D. Dialogue with the client's caregivers

A

Individuals with advanced AMD should be advised to include the following dietary supplements in their normal diet because of their antioxidant properties:

Vitamin C Vitamin E Lutein Zeaxanthin Zinc

A nurse is caring for a patient who has prolonged pupil dilation related to ophthalmic medication usage. The nurse will monitor the patient for which signs of acute PACG? A: Acute vision loss B: Nausea, vomiting, and acute eye pain C: Ocular redness, hypertension, and headaches D: Growth of new blood vessels in an abnormal location

B

The nurse is preparing to assess a patient with an eye condition. What is the primary reason for the nurse to include the patient's family in the assessment process? A: The family may become the primary care provider. B: So that the family can verify information that the patient has provided. C: To determine how long the patient has had a visual impairment. D: To have an additional source of information about how the patient is coping.

A

A nurse is caring for a patient with a new diagnosis of primary open-angle glaucoma (POAG). When reviewing the health care provider's orders, which prescription should the nurse question? A: Ibuprofen B: Betaxolol C: Dipivefrin D: Brinzolamide

A

A patient with a visual impairment is being admitted to the hospital after abdominal surgery. As the nurse prepares the room for the patient, which action must be taken? A: Take note of the furniture placement in the room B: Begin discharge planning to a rehabilitation facility C: Ensure that the bed is placed next to the window to maximize light exposure D: Place a bedpan on the bedside table so the patient doesn't need to find the bathroom

A

Which of the following factors does the nurse recognize as being a risk for altered sensory perception in the older adult client? A. Diabetes mellitus B. Hypotension C. Osteoarthritis D. Peptic ulcer disease

A

Which supplement will the nurse recommend to a client who wants to enhance eye health? A. Lutein B. Vitamin D C. Magnesium D. Saw palmetto

A

While educating a patient with age-related macular degeneration (AMD), the nurse discusses modifiable risk factors. Which modifiable risk factor should the nurse include in the teaching? A: Smoking B: Alcohol use C: Hypotension D: White ethnicity

A

primary angle-closure glaucoma (PACG), also known as closed angle glaucoma.

A reduction in the outflow of aqueous humor that results from angle closure Caused by the lens bulging forward (can occur as a result of the aging process) May occur because of pupil dilation in the patient with anatomically narrow angles Acute attack of PACG may be precipitated by prolonged pupil dilation, causing increase in IOPDrug-induced mydriasis (ophthalmic and systemic medications)Emotional excitement Darkness

A nurse is caring for a patient who reports loss of peripheral vision that developed over time. Which diagnostic tests would the nurse anticipate the patient to undergo? Select all that apply. A: Tonometry B: Gonioscopy C: Glare testing D: IV angiography E: Amsler grid test

A,B

The nurse is caring for a patient with age-related macular degeneration (AMD) and refers the patient to a psychologist. Which responses by the nurse are appropriate when the patient questions the reason for the referral? Select all that apply. A: "The permanent loss of central vision can be very difficult." B: "This is done to discuss the need for additional support systems." C: "Safety issues are a top priority in patients who have sight problems." D: "This is done to determine if you will still be able to care for yourself after this diagnosis." E: "This is done to evaluate your understanding of the disease process and treatment.

A,B

Which assessment data do the nurse anticipate when a client presents to the emergency department reporting the sensation of a foreign body in the eye? Select all that apply. A. Pain B. Fever C. Tearing D. Photophobia E. Blurred vision

A,B,C

During an education session for a patient with a chronic visual sensory perception problem, which information should the nurse ensure the patient knows? Select all that apply. A: Details of the treatment regimen B: Long-term effects of the disease process C: How to recognize emergency care needs D: How to do regular self-eye examinations E: That food preferences and nutritional habits can affect eyesight

A,B,C,E

Which client statement regarding a new diagnosis of tinnitus requires nursing teaching? Select all that apply. A. "I am so glad this condition will go away permanently." B. "It is important that I do not drive when I have tinnitus." C. "Watching my diet will make a difference in my condition." D. "Surgery is the only treatment that is available for tinnitus." E. "I have found a couple of support groups that I like to attend."

A,C,D

Dry AMD

Age related Abnormal accumulation of yellowish extracellular deposits (drusen) in the retinal pigment epithelium

What are cataracts?

Are an opacity within the lens that distorts the images pare an opacity within the lens that distorts the images projected onto the retina, causing blurred vision. They can be present in one or both eyes and often develop slowly over time.rojected onto the retina, causing blurred vision. They can be present in one or both eyes and often develop slowly over time.

The nurse is developing a nutritional plan for a patient at risk for age-related macular degeneration (AMD). Which food item should the nurse encourage in the patient's diet? A: Skim milk B: Kale salad C: Lean protein D: Carrots and sweet potatoes

B

Which client statement affirms that nurse teaching about instillation of multiple different eyedrops has been effective? Select all that apply. A. "It will be very easy for me to instill all of the drops at one time." B. "A schedule will help me remember when to instill the eyedrops." C. "If I have trouble instilling the drops, there are devices that can be helpful." D. "I can label the eyedrops by color to help me easily distinguish which one is which." E. "I will not touch the droppers to my eyes as this can cause contamination and infection."

B, C, D, E

The nurse is preparing a patient for surgery to correct an age-related cataract of the left eye. Which nursing assessments are appropriate for this patient? Select all that apply. A: Pain levels B: Anxiety levels C: Visual acuity in the right eye D: Presence of metamorphopsia E: Knowledge of different therapeutic options

B, C, E

The nurse is caring for a patient with a family history of age-related macular degeneration (AMD), a medical history of high blood pressure, and a social history including daily cigar smoking. The patient asks if there is any way to prevent development of the disease. Which responses by the nurse are correct? Select all that apply. A: "Protect your eyes from trauma." B: "Reduce or quit smoking cigars." C: "Keep your blood pressure under control." D: "AMD is not genetic; you have nothing to worry about." E: "If you have the gene for the disease, then there is no way to prevent development."

B,C

Which symptom will the nurse teach the client who just had surgery to correct a retinal detachment to immediately report to the eye care provider? Select all that apply. A. Pain in the affected eye B. Pus in the affected eye C. Decreased visual acuity D. Temperature of 99.0°F E. Pupil that constricts in response to light

B,D,

Clinical manifestations of AMD

Blurred and darkened vision Decline in central vision Blind spots in the visual field (scotomas) Distortion of vision (metamorphopsia) If only one eye is affected, the individual may not notice early vision changes.

A visually impaired diabetic patient states that he has lost the call light. What is the next action the nurse should take? a. Clip the call light closer to the patient. b. Tell the patient that the call light is clipped to the bed. c. Describe the call light location; then, take the patient's hand and guide it to that location. d. Instruct the patient to verbally call for a staff member because "someone is always nearby."

C

The health care provider is educating a 65-year-old patient on a new diagnosis of primary open-angle glaucoma (POAG). Which statement by the patient shows an understanding of the discussion? A: "I will have an ophthalmologic examination every 2 to 4 years." B: "I should consider getting a service dog since I am going to go blind." C: "I will need to follow my treatment plan to prevent damage to the optic nerve." D: "This is related to the car accident that I had last week and nothing can be done."

C

The patient with acute angle-closure glaucoma is preparing for surgery. The nurse notes that the patient consented for a lens removal procedure. How should the nurse proceed? A: Administer topical apraclonidine drops B: Administer the preoperative cholinergic agents C: Contact the surgeon for revision of the consent form D: Explain to the patient that the surgery will not provide a cure

C

What finding does the nurse anticipate when assessing a client with a new diagnosis of glaucoma? A. Seeing "shooting stars" B. Decrease in central vision C. Gradual loss of visual fields D. Abrupt onset of excruciating pain

C

What teaching will the nurse provide to a client who continues to experience more frequent episodes associated with Ménière disease? Select all that apply. A. Reducing activity can reduce frequency of episodes. B. Episodes will eventually decrease in severity and number. C. Reducing sodium, caffeine, and alcohol intake can be beneficial. D. The only treatment that is effective is to undergo labyrinthectomy. E. When moving from sitting to standing, be cautious and take your time.

C,E

When teaching a community group of older adults, what information will the nurse include regarding normal hearing changes associated with aging? Select all that apply. A. Hair in the ear thins and falls out B. Hearing acuity changes in all older adults C. Cerumen dries and becomes impacted more easily D. The ability to hear low-frequency pitches diminishes first E. Sounds such as f, s, sh, and pa may be more difficult to discern

C,E

Postmenopausal women receiving hormone replacement therapy are at increased risk for

Cerebrovascular accidents (CVAs) caused by clots.

Nurse is counseling a patient about to undergo cataract surgery. The patient will have cataracts removed from both eyes, but just the poorest eye will be operated on initially. Which statement demonstrates that the patient understands the procedure? A: "The surgery will allow the abnormal blood vessels to be sealed." B: "The eye with poorer vision is at greater risk for permanent damage." C: "Permanent damage in the poorer eye could be caused by increased IOP." D: "If a complication arises in the eye with poorest vision, I will still have some vision in the better eye."

D

The nurse is caring for a patient with cataracts. The health care provider informs the nurse that the patient will be undergoing surgery to replace the affected lens. The nurse anticipates preparing the patient for which procedure? A: Gonioscopy B: IV angiography C: Indirect ophthalmoscopy D: Keratometry and A-scan ultrasound

D

The nurse is preparing teaching materials for a patient who is newly diagnosed with glaucoma. What information is appropriate for this patient? A: The need to avoid sun exposure B: That the treatment will be curative C: The importance of eating green vegetables D: The importance of compliance with taking medications

D

What is the appropriate nursing response when a 66-year-old healthy client asks how often a visit to the eye care provider is recommended? A. "Annually." B. "Every 6 months." C. "Only if you have vision problems." D. "Every 1-2 years if you have no eye problems."

D

What teaching will the nurse provide to a client who has just been fitted for new hearing aids? A. Turn off the hearing aid when not using it. B. Immerse the ear mold in alcohol to fully clean it. C. Store the hearing aid in a warm, humid bathroom when not in use. D. Avoid using hair spray, makeup, and personal care products around the device.

D

When caring for four clients, which client does the nurse report to the health care provider who should not receive an otoscopic examination? A. 25-year-old with throat and ear pain B. 39-year-old experiencing dizziness C. 46-year-old who has type 2 diabetes D. 60-year-old experiencing delirium

D

Which patient does the nurse identify as being at risk for developing cataracts? A: A newborn with an unsuccessful vision examination B: A 45-year-old with blue eyes experiencing eye pain C: A 30-year-old who irregularly takes vitamin supplements D: A 20-year-old who sustained an injury to the right eye after a car accident

D

Which patient does the nurse identify at highest risk for development of dry age-related macular degeneration (AMD)? A. 55-year-old client who recently began wearing glasses B. 59-year-old client who has controlled hypertension C. 62-year-old client with hypothyroidism D. 65-year-old client with diabetes

D

Sensory deprivation can occur in patients who have sensory

Deficits, especially visual or auditory impairment.

A nurse is caring for a patient newly diagnosed with open-angle glaucoma. The patient asks, "How could I possibly have glaucoma? I haven't noticed a thing." What is an appropriate response by the nurse? A: "Glaucoma can be precipitated by exposure to bright lights." B: "Glaucoma is usually caused by trauma. Have you been in an accident recently?" C: "Let me start your assessment, and your provider will be able to tell you D: based on the results." E: "People with glaucoma often don't have symptoms right away, and are not aware of the disease until they are evaluated by a health care provider."

E

Sensory perceptual changes with aging may lead to less discriminating taste and smell or to problems with

Equilibrium in older adults.

Diagnostic testing for cataracts may include:

History and physical examination Visual acuity measurement Ophthalmoscopy (direct and indirect) Slit lamp microscopy Glare testing (quantifies vision loss associated with light scatter) and potential acuity testing in selected patients If surgery is planned, keratometry may be performed to assess the curvature of the cornea, and an A-scan ultrasound may be done to obtain measurements for an artificial replacement lens.

Obesity predisposes patients to development of

Hypertension, putting them at a higher risk for CVAs.

Priority goal for glaucoma patients

Keep the intraocular pressure (IOP) low in order to prevent optic nerve damage.

Wet AMD

Less common than dry AMD but more severe Rapid onset of vision loss Growth of new blood vessels in an abnormal location in the retinal epithelium

Age-related macular degeneration (AMD) is a deterioration of the

Macula (area of central vision).

Glaucoma patient goals

Minimize progression of visual impairment Understand the disease process and rationale for therapy Comply with all aspects of therapy Experience no postoperative complications Understand long-term management

primary open-angle glaucoma (POAG)

Most common type of glaucoma The outflow of aqueous humor is decreased in the trabecular meshwork The drainage channels become clogged Damage to the optic nerve results

Children are more prone to otitis media because

Of the shorter, more horizontal eustachian tube in this age group.

For patients with wet AMD, medication is limited to selective inhibitors of endothelial growth factor, thus helping to slow vision loss. The following medications can be injected directly into the vitreous cavity:

Ranibizumab Bevacizumab Aflibercept Pegaptanib Injections are given at 4- to 6-week intervals, depending on treatment response. A light-sensitive medicine called verteporfin is injected into the bloodstream. The medicine collects in the abnormal blood vessels under the macula. Laser light is then shone into the eye, which activates the medicine and causes it to create blood clots that block the abnormal blood vessels. Sealing these vessels slows down:The buildup of fluid under the retina that distorts the shape and position of the maculaThe growth of scar tissue and the abnormal membrane under the retina Central vision loss

Individuals at risk for developing AMD should be advised to enroll in a

Smoking cessation program if they are smokers and begin taking vitamin and mineral supplements.

Hearing alterations with aging lead to social isolation in many patients. The person with a hearing deficit may feel embarrassed and withdraw from

Social interactions.

Nursing interventions for glaucoma

Teach about the importance and administration of medications For patients with acute closure: Administer drugs to lower IOPPre- and postoperative instructions and care as needed Teach the patient and/or caregiver about the glaucoma disease process Stress the importance of early detection and treatment in preventing visual impairment

Infants who are not touched and cuddled or who do not bond with a caregiver often suffer from

The effects of sensory deprivation.

Nursing assessment of glaucoma

The nurse will assess: The patient's level of knowledge regarding the disease process and therapeutic options The patient's ability to understand and adhere to the prescribed therapy The patient's psychologic reaction to the diagnosis of a potentially sight-threatening chronic disorder For safety issues in the patient's home and lifestyle

Management of Angle-Closure Glaucoma

Topical cholinergic agent Hyperosmotic agent Laser peripheral iridotomy Surgical iridectomy Laser peripheral iridotomy and surgical iridectomy can provide long-term treatment and prevention of subsequent episodes.

Medications may be prescribed to reduce the intraocular pressure in the eye. This can be accomplished by causing (1) a decrease in the amount of fluid being created in the eye or (2) an increase in the excretion of this fluid out of the eye. These include: (For chronic Open angle gluacoma)

β-Adrenergic blockers α-Adrenergic agonists Cholinergic agents (miotics) Carbonic anhydrase inhibitors