241 eyes, hearing, MK

What is an external fixation?

Orthopedic device outside patient to immobilize bone & align fractures. Usually require pins to be drilled through skin & into the bone. Pins outside the body attached to the external fixator device

What are the manifestations of a strain?

Pain Stiffness Difficulty moving the affected muscle Skin discoloration Edema

What are the manifestations of corneal abrasion?

Pain, reduced vision, photophobia, eye secretions

The nurse is performing an assessment of a patient's ears. When looking at the tympanic membrane, the nurse observes a healthy membrane. What should the appearance be? Pearly gray and translucent Dark yellow with cerumen White and cloudy Pink with white exudate

Pearly gray and translucent

otitis Media is commonly second to what?

Often secondary to viral upper respiratory infection

OLD CART

Onset Location Duration Characteristics Aggravating factors Relieving factors Treatment

What is cataracts?

Opacity or clouding of the lens

What is the surgical treatment for fractures?

Open reduction with internal fixation (ORIF) Open reduction with external fixation (OREF)

What is the diagnostic tool for cataracts ?

Ophthalmoscope

Cryopexy

fixation using cold (used to repair detached retina of the eye)

What are sprains caused by?

forcing a joint into an unnatural position (e.g., twisting one's ankle)

What are the complications of otitis Externa?

hearing loss, cellulitis, necrosis, osteomyelitis, and meningitis

What is an opthalmoscope?

instrument used to examine the interior of the eye

What is the goal of sprains and strains, and what are they?

Goal = prevention Exercise Warm up Stretching Body mechanics Protective Gear (helmet, pads, seat belt, etc.)

How to diagnosis sprains and strains?

History Physical exam ◦ Edema ◦ Ecchymosis ◦ Deformity ◦ Inability to bear weight ◦ 6 Ps Imaging-x-ray, ultrasound, MRI

Auditory System Assessment

History-Current health-Past illnesses-Smoking history-Allergies-Family history Personal hygiene-Cotton swabs use?

Bone mineral density studies identify what?

Identify patients with osteoporosis and monitor treatment

Allergic Conjunctivitis

Inflammation of the conjunctiva due to a reaction from allergy-causing substances such as pollen or pet dander.

What are sprains?

Injury to a ligament that often involves stretching or tearing of the ligament

What is a strain?

Injury to a muscle or tendon that often involves stretching or tearing of the muscle or tendon. May occur suddenly or develop over time.

A client comes to the walk-in clinic complaining of a "bug in my ear." What action should be taken when there is an insect in the ear? a) Instillation of mineral oil b) Use of a small forceps c) Instillation of hot water d) Instillation of carbamide peroxide

Instillation of mineral oil

Complicated causes of cataracts?

Intra ocular idease (pigmentos, glaucoma, retinal detachment)

Which tool does the nurse use to assess a client's color vision? Ishihara chart Snellen chart Jaeger or Rosenbaum card Confrontation test

Ishihara chart

Psychosocial assessment for MSK?

Job status Chronic pain Anxiety Depression Body image

What are the diagnostic studies for MSK? (laboratory)

Laboratory studies ◦ Calcium levels ◦ Vitamin D levels ◦ Estrogen levels

Panretinal photocoagulation

Laser therapy, used for proliferative diabetic retinopathy

What's is the cause of cataracts toxic?

Long term cortosteriod use, phenoothiazine, beta blockers and miotic medications

If low back pain does not go away?

Low back pain that does not go away may mean injury to a disk

Manifestations of retina detachment?

Manifestations: typically painless, flashes of light in the peripheral visual field, blurred vision, floaters, and darkening vision (like a curtain drawing across a visual field)

Low back pain may be a result of ?

May be the result of disease or injury

what is a tonometer ?

Measures intraocular pressure within the sterile field

What is the surgical treatment of meniscus?

Meniscus Injury Treatment

How many syndromes are linked to hearing loss?

More than 400 syndromes are linked to hearing loss

Chlamydial conjunctivitis

Most common causative agent of neonatal conjunctivitis Presents few days-->weeks post birth -Can present w/ pneumonia w/ rales, but no fever and no wheezing

What is the most common area for sprains?

Most common in the ankle and knee

laser photocoagulation

intense, precisely focused light beam (argon laser) creates an inflammatory reaction that seals retinal tears and leaky retinal blood vessels

What is an Slit lamp?

intraocular pressure testing

What are the 6 ps of sprains and strains?

pain, pressure, paralysis, pallor, paresthesia, pulselessness

What is an internal fixation?

pins, plates, screws, wires most are left in for life, more costly

What are the risk factors of low back pain?

poor body mechanics cigarette smoking morbid obesity poor sleeping position poor posture occupations that require heavy lifting vibrations caused by motor vehicles or industrial machinery.

What is visual acuity?

sharpness of vision, measured by the ability to discern letters or numbers at a given distance according to a fixed standard. (Snellen and rosenbaum charts)

What is a Rosenbaum chart?

special hand held card to test near vision

What causes retinal detachment?

spontaneously, severe nearsightedness, trauma, diabetes mellitus, inflammation, degenerative aging changes, and scar tissue

What is a transverse fracture?

straight across the bone

vitrectomy

surgical removal of all or part of the vitreous humor

What is the cornea?

the transparent layer forming the front of the eye.

What is a greenstick fracture?

type of fracture where the bone bends and splits, causing a crack or incomplete break; common in children

Rosenbaum chart

used to assess near vision acuity

Snellen chart

used to measure visual acuity

Which of the following instructions regarding swimming should the nurse give to the client who is recovering from otitis externa? Choose the correct option. a) Wear a scarf. b) Avoid cold water. c) Wear soft plastic earplugs. d) Insert a loose cotton earplug in the external ear.

wear soft plastic earplugs

What are the risk factors of conjunctivits?

wearing contact lenses and using contaminated makeup or ophthalmic medications

What is the nonsurgical management of cataracts?

• Change glasses RX • Magnifying glass • Increase lighting • Lifestyle adjustments, reassurance • Refrain from driving

What are the complications of otitis media?

• Complications: rupture of the tympanic membrane, scar tissue formation, hearing loss, mastoiditis, meningitis, and osteomyelitis

What is the pre-operative care for retina detachment?

• Education • Activity restriction • Restrict head movement • Eye patch to reduce eye movement • Medications

What is the treatment of otitis media?

• Position of comfort (pressure off tympanic membrane) • Surgery

What are the risk factors of otitis Media?

• Risk factors: environmental smoke exposure and a history of allergic rhinitis

What will you educate the patient after cataract surgery?

• Signs of complications: - Sharp, sudden pain in eye - Bleeding or increased discharge-Lid swelling - Decreased vision - Flashes of light or floating shapes

What is the surgical treatment of corneal abrasion?

• Surgical exploration • Suture placement

What are the clinical manifestations of external otitis?

• Swelling • Tenderness • Pain upon movement of outer auricle • Erythema and/or edema in canal • Purulent drainage from the ear canal

Bacterial conjunctivitis manifestation

• Tearing • Lid crusting • Gritty feeling • Purulent discharge • Sclera pink/inflamed • Eyes may be itchy

Viral conjunctivitis manifestations

• Tearing • Lid crusting • Sclera and conjunctiva are pink and inflamed • Puffy eyelids • Itchy

What are the clinical manifestations of otitis media?

• Tugging or pulling at ears • Trouble sleeping or lying flat • Fever • Fluid or blood draining from the ears • Hearing loss • Infants/children often refuse to feed

What is retinal detachment?

•Acute condition that occurs when the retina separates from its supporting structures

What is the first line of protection against infection on the eye?

•Clear thin membrane is the first line of protection for the eye against infection

What is the function of conjuncvtiva?

•Function to lubricate the front portion of the eye as well as the eyelids.

Is retinal detachment is left untreated then?

•If Untreated = blindness in affected eye •Once completely separated, painless loss of central or peripheral vision

What is the retina?

•Innermost layer of the eye. Consists of photoreceptors and nerve cells. Responds to light, converting light to nerve impulses.

Surgical management of retinal detachment?

•Laser photocoagulation • Pan retinal photocoagulation • Cryopexy • Pneumatic retinopexy • Scleral buckling • Vitrectomy

What causes the retina to peel away?

•Leakage of vitreous humor leads to the retina peeling away

Does cataracts always effect both eyes?

•May affect one or both eyes and does not necessarily affect eyes symmetrically

What do people report with retinal detachment?

•Report of floaters, or a curtain coming across the vision of one eye Bright flashes of light • Patients do not complain of pain

What is the Lens?

•Transparent, flexible structure that lies behind the iris. It focuses on various objects and separates the eye interior into two cavities.

What is an Ophthalmic examination?

•View retina, vessels and structures with ophthalmoscope •Pupil dilation

What are the three things you need to assess a corneal abrasion?

•Woods lamp • Fluorescein dye • Dark room

A pt is scheduled for a CT scan of the left femur. What should the nurse expect the findings of this diagnostic test to reveal? 1) Fractures 2) Disk disease 3) Osteomyelitis 4) Ligamentous tears

1-Fractures

_ 5. The nurse is evaluating teaching provided to a patient with bacterial conjunctivitis. Which patient statement indicates that additional teaching is required? 1) "I should place my towel in the bathroom." 2) "I should wash my hands frequently during the day." 3) "I should complete all of my prescribed medications." 4) "I should make a follow-up appointment as directed."

"I should place my towel in the bathroom."

Which statement indicates that the client needs additional teaching about ear hygiene? "I will use a cotton swab to get the extra water out of my ears after I swim." "I can rinse my ears with lukewarm sterile water if ear wax builds up." "I will clean my ears with plain warm water and a washcloth every day." "I will wash my hands before I put in my earplugs at work."

"I will use a cotton swab to get the extra water out of my ears after I swim."

An older client is concerned because the eyes are dry and feel gritty. What should the nurse respond to this client's concern? "This is because the tear glands and conjunctiva don't lubricate the eye as well with aging." "This is an emergency and needs to be treated immediately." "This is because the arteries in the eyes narrow with aging." "This is because the eyelids lose elasticity with aging."

"This is because the tear glands and conjunctiva don't lubricate the eye as well with aging."

What is otitis Media?

- Inflammation of the middle ear canal commonly by a bacterial source. - Fluid buildup behind the eardrum leads to bacterial growth and infection

What causes cataracts to be traumatic?

- blunt or penetrating Injury of foreign body In eye Exposure to radiation or UV

What are the expected findings for cataracts?

- decreased visual at night/ color perception - blurred vision - diplopia ( double vision )

Why are cataracts age related?

- drying of the lense due to water loss - increase in lens density due to lens fiber comparison

Allergic conjunctivas

- itching - tearing - pink or red inflamed sclera/conjunctiva

Assessment history for vision disorders?

- personal history - family history - nutritional history - history of eye trauma

What are some physical assessment findings of someone who has cataracts?

- progressive and painless loss of vision - visible opacity - absent red reflux

Chlamydial conjunctivas

- tearing - red/pink conjunctiva - sticky eye mucus discharge - photophobia = foreign body sensation

Prevention of Cataracts? What protects the eye?

- wear sunglasses - protective eye wear - encourage eye exams over the age of 40

What is the pathophysiology of otitis Externa? and caused most commonly by what?

-Develops as a result of excessive water exposure yielding a decrease in cerumen -Most commonly caused by bacteria

How long to wear sunglasses during day and night after cataract surgery?

1 week

6. While playing tennis a patient fell and fractured the right elbow. For which treatment should the nurse prepare this patient? 1) Cast 2) Splint 3) External fixator 4) Pressure dressing

1) Cast

During a softball game a child was hit in the eye with a bat. What common manifestation should the nurse expect when assessing this patient? 1) Edema 2) Blood-tinged tears 3) Loss of central vision 4) Loss of peripheral vision

1) Edema

22. A patient is diagnosed with a third-degree sprain. What should the nurse expect to assess in this patient? Select all that apply. 1) Edema 2) Severe pain 3) Ecchymosis 4) Inability to ambulate 5) Altered ability to ambulate

1) Edema 2) Severe pain 3) Ecchymosis 4) Inability to ambulate

A patient is diagnosed with viral conjunctivitis. What should the nurse expect to be prescribed for this patient? Select all that apply. 1) Eye lubricants 2) Cold compresses 3) Topical steroid drops 4) Ocular decongestants 5) Topical antihistamine drops

1) Eye lubricants 2) Cold compresses 4) Ocular decongestants

7. A patient recovering from surgery to repair a fractured femur is experiencing extreme pain and pulselessness. What should the nurse expect to be prescribed for this patient? 1) Fasciotomy 2) Limb CT scan 3) Intravenous fluids 4) Anticoagulant therapy

1) Fasciotomy

12. A patient seeks medical treatment for a meniscus injury. What assessment finding would suggest a reason this injury occurred? 1) History of chronic joint disease 2) Participation in cycling or golf 3) Intake of sufficient water and protein 4) Use of nonsteroidal anti-inflammatory drugs (NSAIDs)

1) History of chronic joint disease

25. A patient is diagnosed with a small meniscus tear of the right knee. What should the nurse expect to be prescribed for this patient? Select all that apply. 1) Ice 2) Limited rest 3) Physical therapy for a month 4) Total immobility for several weeks 5) Use of nonsteroidal anti-inflammatory drugs (NSAIDs)

1) Ice 2) Limited rest 5) Use of nonsteroidal anti-inflammatory drugs (NSAIDs)

14. The nurse suspects that while playing basketball a patient sustained a meniscus tear. What information did the nurse use to make this decision? 1) Knee pops when bent 2) Weak peripheral pulses 3) Reduced muscle tone of the thigh 4) Calf cramping with the knees bent

1) Knee pops when bent (The diagnosis of meniscus injuries is based upon physical examination using either the McMurray's or Steinman's test in which the knee is supported and flexed while the lower leg is rotated internally and externally.)

The nurse is preparing information about cataracts for a community health fair. What should the nurse include about risk factors for the disorder? Select all that apply. 1) Obesity 2) Age over 60 3) Family history 4) Alcohol intake 5) Chronic health problems

1) Obesity 2) Age over 60 3) Family history 5) Chronic health problems

15. The nurse notes that a patient recovering from surgery to repair a torn meniscus has a blood pressure of 158/90 mm Hg. This finding would suggest that the nurse also assess the patient for which condition? 1) Pain 2) Edema 3) Infection 4) Hemorrhage

1) Pain

The nurse suspects that a patient is experiencing a corneal abrasion. What did the nurse assess to come to this conclusion? Select all that apply. 1) Tearing 2) Eye pain 3) Squinting 4) Photophobia 5) Purulent drainage

1) Tearing 2) Eye pain 3) Squinting 4) Photophobia

A patient seeks treatment for a corneal abrasion that occurred the previous week. What should the nurse expect to be prescribed to reduce this patient's risk of developing a complication? 1) Tetanus vaccination 2) Topical steroid drops Copyright © 2017 F. A. Davis Company 3) Systemic pain medication 4) Topical antihistamine drops

1) Tetanus vaccination

The nurse is preparing to conduct a physical assessment of a pt's musculoskeletal system. Which techniques should the nurse use for this assessment? Select all that apply. 1)Palpation 2)Inspection 3)Evaluation 4)Percussion 5)Auscultation

1,2

The nurse is assessing a pt's musculoskeletal system. Which observation indicates that the muscles are functioning appropriately? Select all that apply. 1)Limb bends at a joint. 2)A body part is raised. 3)Action occurs automatically. 4)Arm moves in a circle around the shoulder. 5)Limb moves away from the midline of the body.

1,2,4,5

The nurse is preparing educational material for the parents of children recovering from fractures. What should the nurse include as parts of long bones? Select all that apply.1)Diaphysis2)Epiphysis3)Ligaments4)Periosteum5)Endosteum

1,2,4,5

A pt's bone scan results showed a 3 cm cold spot area on the right fibula. What does this finding indicate? 1)Cancer 2)Bone infection 3)Healing fracture 4)Bone metabolism disease

1-Cancer

A patient has a low level of thyroid stimulating hormone(TSH). How will this affect the muscultoskeletal system? 1) Reduces bone growth 2) Initiates the growth of bone 3) Slows the rate of bone destruction 4) Promotes the number of osteoblasts

1-Reduces bone growth

The nurse is preparing information about bone health for a community fair. What part of the bone should the nurse identify as containing living bone cells? 1) Nerves 2) Collagen 3) Osteoblasts 4) Blood vessels

3-Osteoblasts

The nurse is evaluating teaching provided to a patient recovering from eye trauma. Which statement indicates that additional teaching is required? 1) "I have to wear the eye patch." 2) "I can play ball again this weekend." 3) "I need to see the doctor in a few days." 4) "I should call the doctor if my sight changes."

2) "I can play ball again this weekend."

5. A patient with Paget's disease is demonstrating manifestations of a fracture. What diagnostic test should be ordered to confirm if a fracture has occurred? 1) X-ray 2) Bone scan 3) Myelogram 4) Angiogram

2) Bone scan

9. A patient contemplating cataract surgery asks if there are any risk factors. How should the nurse respond? 1) Blindness 2) Detached retina 3) Corneal abrasion 4) Macular degeneration

2) Detached retina

9. A patient with peripheral vascular disease has a non-healing leg wound. Which observation indicates that the patient is at risk for an elective amputation? 1) Mutilation of soft tissue 2) Development of gangrene 3) Crushed lower extremity bone 4) Severed blood vessels and nerves

2) Development of gangrene

A patient is demonstrating signs of a detached retina. What is the reason this occurred? 1) Blood vessels in the eye spasm 2) Inner layers of the retina separate 3) Overgrowth of vessels damages vision 4) Drainage of vitreous humor is blocked

2) Inner layers of the retina separate

A patient comes into the emergency department with manifestations of retinal detachment. What should the nurse do to minimize this patient's eye movements? 1) Provide a sedative 2) Loosely cover both eyes 3) Elevate the head of the bed 45 degrees 4) Apply an eye patch over the affected eye

2) Loosely cover both eyes

24. A victim of a motor vehicle crash has a partially severed lowered extremity. What emergency care does this patient need? Select all that apply. 1) Administer antibiotics 2) Prepare for blood transfusions 3) Prepare for emergency surgery 4) Assess for active hemorrhaging 5) Monitor effectiveness of tourniquet

2) Prepare for blood transfusions 3) Prepare for emergency surgery 4) Assess for active hemorrhaging 5) Monitor effectiveness of tourniquet

8. A patient recovering from surgery to repair a fractured hip is placed on skin traction. Which finding indicates that the traction is being effective? 1) Strong peripheral pulses 2) Reduction in muscle spasms 3) Improved mobility of the foot 4) Reduction of lower extremity edema

2) Reduction in muscle spasms

A pt is scheduled for an MRI of the pelvis. What should the nurse include when preparing this pt for the test? Select all that apply. 1)Insert a urinary catheter 2)Assess for metal implants 3)Remove all medication patches 4)Ensure all metal jewelery and hair items are removed 5)Maintain nothing by mouth status for 8 hours before the test

2,3,4,5

A pt has loose bone fragments w/in the knee. Which diagnostic test should be considered to remove these fragments? 1)Bone scan 2)Arthroscopy 3)Arthrocentesis 4)Electromyography

2-Arthroscopy

A pt's bone density results are -2.7. For which potential health problem should the nurse instruct this pt? 1)Pain 2)Fractures 3)Contractures 4)Muscle atrophy

2-Fractures

The nurse notes that a 55 yr old female pt's home density test has changed from -1.2 to a current level of -2.5. What could be the reason for this change? 1)Immobility 2)Loss of estrogen 3)Chronic diseases 4)Poor nutritional status

2-Loss of estrogen

The nurse is assessing a patient's musculoskeletal status. Which observation indicates that the gait is normal? 1) Base is as wide as the patient's hips 2) Symmetrical arm swing occurs with each step 3) Foot is on the ground for 40% of the stance phase 4) Foot is off of the ground for 60% of the swing phase.

2-Symmetrical arm swing occurs with each step

A patient has a muscle that has been torn from the bone. Which structure has been injured in this patient? 1) Fascia 2) Tendon 3) Hip contracture 4) Pain with movemen

2-Tendon

The nurse notes that the pt is scheduled for an arthrogram. What is the purpose of this test? 1) Evaluate healing of a bone fracture 2)Visualize joint soft tissue structures 3)Identify the location of a bone tumor 4)Determine the cause for muscle weakness

2-Visualize joint soft tissue structures

It is documented in the medical record that a patient has a rhegmatogenous detached retina. How should this diagnosis be explained to the patient? 1) Eye trauma causes the retinal to detach from the retinal pigment epithelium (RPE). 2) Eye inflammation causes vitreous fluid leaks into the area under the retina. 3) Vitreous fluid moves under the retina and separates the retina from the pigmented cell layer. 4) Scar tissue on the retina causes the retina to separate from the retinal pigment epithelium (RPE).

3) Vitreous fluid moves under the retina and separates the retina from the pigmented cell layer.

How many MSK injuries occur annually?

20 to 27 million musculoskeletal injuries occur annually

How long to wear eye path after cataract surgery?

24 hours

2. A patient is treated for a second-degree sprain. Which patient statement indicates that teaching about care has been ineffective? 1) "I should apply ice." 2) "I should elevate my leg." 3) "I should expect the leg to feel numb." 4) "I should take pain medication as directed."

3) "I should expect the leg to feel numb."

4. A patient has an injury where one side of the bone is bent and the other is fractured. How should the nurse document this fracture? 1) Spiral 2) Oblique 3) Greenstick 4) Comminuted

3) Greenstick

The nurse notes that a patient is diagnosed with primary open-angle glaucoma. What diagnostic test would have been used to diagnose this health problem? 1) MRI 2) CT scan 3) Tonometry 4) Ultrasound

3) Tonometry

The nurse notes that a patient has muscular and skeletal balance. What should this observation indicate to the nurse? 1) Joints are stressed 2) Muscles are damaged 3) Body organs are aligned 4) Bones are compensating

3-Body organs are aligned

The nurse is preparing teaching material on the musculoskeletal system. What should the nurse include about the function of short bones? 1) Produces blood cells 2) Controls movement of the body 3) Provides stability with little movement 4) Controls contraction of organs and blood vessels

3-Provides stability with little movement

The nurse is evaluating a pt's musculoskeletal system. Which approach should be used to determine joint mobility? 1) Gait 2) Posture 3) Range of motion 4) Palpation of muscle tone

3-Range of motion

An older pt is diagnosed w/ a fractured hip joint. What should the nurse consider as the reason for this fracture? 1)Mineral deposits 2)Decreased joint fluid 3)Thinner joint cartilage 4)Loss of fluid in tendons

3-Thinner joint cartilage

What do you need to know about casts?

Must include joint above and below fractured long bone Rigid, restricts joint movement No soft tissue access Does not allow for swelling Must stay dry - if plaster Assessment?

The nurse is reviewing teaching provided to a patient with glaucoma. Which patient statement indicates that teaching has been effective? 1) "I should consider surgery to cure this disorder." 2) "I should use the eye drops when my vision blurs." 3) "I should cut down on eating salty and high-fat foods." 4) "I should call my doctor before taking any over-the-counter medications."

4) "I should call my doctor before taking any over-the-counter medications."

The nurse suspects that a patient is developing a cataract. What finding did the nurse use to make this clinical decision? 1) Itching of both eyes 2) Tearing of both eyes 3) Redness of the sclera 4) Double vision in one eye

4) Double vision in one eye

10. The nurse is caring for a patient recovering from cataract removal surgery. Which action should the nurse take to reduce intraocular pressure (IOP)? 1) Restrict fluids 2) Position on the operative side 3) Administer mydriatic eye drops 4) Elevate the head of the bed 45 degrees

4) Elevate the head of the bed 45 degrees

6. A patient is diagnosed with a corneal abrasion. Which diagnostic test was used to confirm this diagnosis? 1) MRI 2) CT scan 3) Ultrasound 4) Fluorescein stain

4) Fluorescein stain

A patient is recovering from surgery to repair a third-degree strain. What needs to be emphasized to the patient about postoperative care? 1) Elevate the extremity 2) Rest the extremity for up to 72 hours 3) Apply ice to the area three to five times a day 4) Immobilize the extremity for four to six weeks

4) Immobilize the extremity for four to six weeks

The nurse notes that a patient known to the community clinic was unable to recognize the health-care provider. What health problem should the nurse suspect is occurring with this patient? 1) Cataracts 2) Glaucoma 3) Corneal abrasions 4) Macular degeneration

4) Macular degeneration

13. A patient sustained a meniscus injury several months ago and did not seek medical attention. What is this patient at risk of developing? 1) Tendonitis 2) Fractured patella 3) Dependent edema 4) Permanent joint damage

4) Permanent joint damage

A patient is diagnosed with bacterial conjunctivitis. What should the nurse expect to assess in this patient? Select all that apply. 1) Tearing 2) Red sclera 3) Puffy eyelids 4) Purulent eye discharge 5) Matting of the eyelashes

4) Purulent eye discharge 5) Matting of the eyelashes

A pt is recovering from an arthrocentesis of the right knee. What should the nurse instruct the pt regarding care at home? 1)Elevate the extremity 2)Ambulate w/ crutches 3)Avoid all weight bearing for 3-5 days 4)Apply ice to the wound for the first 24 hours

4-Apply ice to the wound for the first 24 hours

An older pt asks what can be done to prevent bone fractures. What should the nurse suggest to this pt? 1)Limit exposure to the sun 2)Increase the intake of water 3)Increase frequency of rest periods 4)Engage in weight bearing exercise

4-Engage in weight bearing exercise

A patient is experiencing bursitis of the hip. What physical finding should the nurse expect to assess in this patient? 1) Muscle edema 2) Shortened limb 3) Hip contracture 4) Pain with movement

4-Pain with movement

How long do you have to be NPO before cataract surgery?

NPO 6-8 hours prior

A client newly diagnosed with otitis media reports that the pain and pressure in the ear has suddenly disappeared. What is the best action by the nurse? A) Assess the tympanic membrane. B) Document the effectiveness of medications. C) Educate the client on the therapeutic effects of medications. D) Irrigate the ear.

A) Assess the tympanic membrane. Explanation: A client diagnosed with otitis media who feels sudden relief of pain and/or pressure should be assessed for a tympanic membrane rupture. Educating the client on the therapeutic effects of medications is appropriate for newly diagnosed otitis media, but it does not address the sudden disappearance of pain and pressure. Because the medication usually takes 48 to 72 hours to be effective, documenting the medication as effective would be inappropriate. It is not necessary to irrigate an ear with otitis media.

How many unintentional injuries occur due to MSk trauma?

60% of unintentional injuries are due to musculoskeletal trauma

What percentage of otitis externa is bacterial or fungal?

90% are bacterial, and 10% are fungal infections

After receiving change-of-shift report on the orthopedic unit, which client should the RN assess first? A client who had an open reduction and internal fixation of a left femoral fracture 6 hours ago and states, "I can't feel my left foot". A client who developed a deep vein thrombosis in the right leg after a hip replacement and has heparin infusing. A client who is being discharged with an upper extremity external fixation device and needs teaching about pin care. A client who had an open reduction and internal fixation and casting of a tibial fracture 3 days ago and is complaining of nausea.

A client who had an open reduction and internal fixation of a left femoral fracture 6 hours ago and states, "I can't feel my left foot".

What is a cataract?

A condition in which the lens of the eye becomes opaque or cloudy and making vision difficult. It is usually a slow gradual loss of vision in the affected eye. They are common in elderly but may also be caused by some drugs like corticosteroids.

A mother brings her daughter to the clinic for an evaluation because the child is complaining of ear pain. Which of the following would lead the nurse to suspect that the child is experiencing otitis externa and not otitis media? A) Aural tenderness B) Bulging eardrum C) Fever D) Ear drainage

A) Aural tenderness Explanation: A client with otitis externa typically experiences aural tenderness. This finding is usually absent in clients with otitis media. Fever and ear drainage may be present with either otitis externa or otitis media. A bulging eardrum would suggest otitis media.

The nurse in the ED is caring for a 4 year-old brought in by his parents who state that the child will not stop crying and pulling at his ear. Based on information collected by the nurse, which of the following statements applies to a diagnosis of external otitis? A) External otitis is characterized by aural tenderness. B) External otitis is usually accompanied by a high fever. C) External otitis is usually related to an upper respiratory infection. D) External otitis can be prevented by using cotton-tipped applicators to clean the ear.

A) External otitis is characterized by aural tenderness.

Which terms refers to the progressive hearing loss associated with aging? A) Presbycusis B) Exostoses C) Otalgia D) Sensorineural hearing loss

A) Presbycusis Explanation: Age-related changes of both the middle and inner ear result in hearing loss. Exostoses refer to small, hard, bony protrusions in the lower posterior bony portion of the ear canal. Otalgia refers to a sensation of fullness or pain in the ear. Sensorineural hearing loss is loss of hearing related to damage of the end organ for hearing and/or cranial nerve VIII.

2. A patient asks you to explain how the intraocular pressure is measured to help detect glaucoma. You state that IOP (intraocular pressure) is measured by what instrument below? A. Goniscope B. Tonometry C. Ophthalmoscope D. Phoroptor

A. Goniscope B. Tonometry C. Ophthalmoscope D. Phoroptor

Surgical Management of cataracts pre-op?

NPO 6-8 hours prior Eye meds 4X/day for two days: Antibiotic Corticosteroid Anti-inflammatory No eye make-up

nonsurgical treatment of fractures

Narcotics NSAIDs Antibiotics Closed reduction

6. A client had a retinal detachment and has undergone surgical correction. What discharge instruction is most important? a. "Avoid reading, writing, or close work such as sewing." b. "Dim the lights in your house for at least a week." c. "Keep the follow-up appointment with the ophthalmologist." d. "Remove your eye patch every hour for eyedrops."

ANS: A After surgery for retinal detachment, the client is advised to avoid reading, writing, and close work because they cause rapid eye movements. Dim lights are not indicated. Keeping a postoperative appointment is important for any surgical client. The eye patch is not removed for eyedrops.

1. The nurse has given a community group a presentation on eye health. Which statement by a participant indicates a need for more instruction? a. "I always lose my sunglasses, so I don't wear them." b. "I have diabetes and get an annual eye exam." c. "I will not share my contact solution with others." d. "I will wear safety glasses when I mow the lawn."

ANS: A Clients should be taught to protect their eyes from ultraviolet (UV) exposure by consistently wearing sunglasses when outdoors, when tanning in tanning salons, or when working with UV light. The other statements are correct.

12. A client has been prescribed brinzolamide (Azopt). What assessment by the nurse requires consultation with the provider? a. Allergy to eggs b. Allergy to sulfonamides c. Use of contact lenses d. Use of beta blockers

ANS: B Brinzolamide is similar to sulfonamides, so an allergic reaction could occur. The other assessment findings are not related to brinzolamide.

6. 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? a. Inform the provider of the issue. b. Obtain a new bottle of eyedrops. c. Rinse the client's right eye thoroughly. d. Wipe the left eye bottle with alcohol

ANS: B The nurse has contaminated the "clean" bottle by using it on the infected eye. The nurse needs to obtain a new bottle of solution to use on the left eye. The other actions are not appropriate.

What is the pharmacological treatment of cataracts?

No pharmacologic treatment

What is the pharmacological treatment of retinal detachment?

None

What do you need to know about skin traction?

Not tx of choice in U.S. Complications:•Skin breakdown • UTI's • DVT & PE Labor intensive (Bucks traction?)

11. 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? a. Ask the client about excessive salivation. b. Assess the client for shortness of breath. c. Give the drops using punctal occlusion. d. Hold the eyedrops and notify the provider.

ANS: D The nurse should hold the eyedrops and notify the provider because beta blockers can slow the heart rate. Excessive salivation can occur with cholinergic agonists. Shortness of breath is not related. If the drops are given, the nurse uses punctal occlusion to avoid systemic absorption.

Otitis Media is commonly seen in who?

Affects adults but commonly seen in children

What are the common causes of cataracts ?

Age related, traumatic, Toxic, associated, and complicated

An 88-year-old client has a history of hearing loss and is returning for his annual hearing examination. During your client education session, you explain to the client that hearing involves which areas of the ear? The middle section of the ear is involved in perceiving sound. The outer section of the ear is involved in perceiving sound. The inner section of the ear is involved in perceiving sound. All sections of the ear are involved in perceiving sound.

All sections of the ear are involved in perceiving sound.

Sensory conditions associated with aging

All the ear structures thicken, affecting balance and hearing. - Hearing may decline slightly, especially with high-frequency sounds. - Hearing loss accelerates in people who were exposed to excessive noise or smoking when they were younger. -Presbycusis: age-related hearing loss. -Hearing acuity may decline slightly beginning at about 50 years of age, possibly caused by changes in the auditory nerve. -Impacted cerumen-Tinnitus is common

What is conjunctivitis caused by?

Allergens, irritants or organisms create inflammation or infection

A patient has been experiencing a gradual loss of central vision. Which tool should the nurse use when assessing this patient? 1) Jaeger card 2) Amsler grid 3) Snellen chart 4) Ishihara chart

Amsler grid

otitis externa occurs in how many people?

Occurs annually in 4 of every 1,000 persons

When can cataracts occur?

Can occur as a congenital condition or develop later in life

While playing tennis a client fell and fractured the right elbow. For which treatment should the nurse prepare this client? Cast Sling External fixator Pressure dressing

Cast

Bacterial conjunctivitis treatment

Antibiotic ointment or drops

A client with external otitis rates pain as 8 on a scale of 0 to 10. What action does the nurse take to address the client's comfort? Apply warm, dry heat to the ear Position the client in a prone position Position supine with the affected ear down Apply warm tap water to the inner ear

Apply warm, dry heat to the ear

High doses of which of the following medications can produce bilateral tinnitus? a) Promethazine b) Aspirin c) Dramamine d) Antivert

Aspirin

A patient newly diagnosed with otitis media reports the pain and pressure in the ear has suddenly disappeared. What is the best action by the nurse? a) Irrigate the ear. b) Assess tympanic membrane. c) Educate on therapeutic effects of medications. d) Document effectiveness of medications.

Assess tympanic membrane

Which of the following instructions regarding swimming should the nurse give to the patient who is recovering from otitis externa? a) Avoid swimming for 7-10 days b) Avoid cold water c) Wear a scarf d) Insert a loose cotton pledget in the external ear

Avoid swimming for 7-10 days or wear soft plastic ear plugs

A group of high school students is attending a concert, which will be at a volume of 80 to 90 dB. What is a health consequence of this sound level? A) Hearing will not be affected by a decibel level in this range. B) Hearing loss may occur with a decibel level in this range. C) Sounds in this decibel level are not perceived to be harsh to the ear. D) Ear plugs will have no effect on these decibel levels.

B

catracts

Clouding of the eye lens, causing impairment and/or blindness.

Allergic Conjunctivitis Treatment

Ocular antihistamine

Why does retina detachment cause vision loss?

Becomes ischemic and stops functioning, causing vision loss

The manager notes that several nurses have been seen in employee health for low back pain over the last month. What type of education should the manager plan to help reduce the incidence of this health problem? Body mechanics Safety Coordinating care Stress management

Body mechanics

Which of the following nursing interventions would most likely facilitate effective communication with a hearing-impaired patient? A) Ask the patient to repeat what was said in order to evaluate understanding. B) Stand directly in front of the patient to facilitate lip reading. C) Reduce environmental noise and distractions before communicating. D) Raise the voice to project sound at a higher frequency.

C

What are the manifestations of cataracts?

Cloudy, fuzzy, foggy, or filmy vision •Color intensity loss • Diplopia (double vision)•Impaired night vision gradually progressing to impaired day vision • Halos around lights • Photosensitivity • Frequent changes in eyeglass or contact lens prescription

A nurse who is applying eyedrops to a client holds pressure against the corner of the eye nearest to the nose after instilling the drops. The client asks what the nurse is doing. What response by the nurse is the best? A. "Doing this allows time for absorption" B. " I am keeping the drops in the eye" C. " This prevents systemic absorption" D. "I am stopping you from rubbing your eye."

C. This prevents systemic absorption

Viral conjunctivitis Treatment

Cold compresses, eye lubricants, ocular decongestants

4. A patient has watery eye discharge affecting both eyes. Which health problem should the nurse suspect this patient is experiencing? 1) Cataracts 2) Eye trauma 3) Conjunctivitis 4) Corneal abrasions

Conjunctivitis

What contains no blood vessels and is the first and most powerful lens in the optical system of the eye?

Cornea

A child has been experiencing recurrent episodes of acute otitis media (AOM). The nurse should anticipate that what intervention is likely to be ordered? A) Ossiculoplasty B) Insertion of a cochlear implant C) Stapedectomy D) Insertion of a ventilation tube

D

A nurse is teaching preventative measures for otitis externa to a group of older adults. What action should the nurse encourage? A) Rinsing the ears with normal saline after swimming B) Avoiding loud environmental noises C) Instilling antibiotic ointments on a regular basis D) Avoiding the use of cotton swabs

D

A client comes to the emergency department, reporting that a bee has flown into his ear and is stuck. The client reports a significant amount of pain. Which of the following would be most appropriate to use to remove the bee? A) Hair pin B) Irrigation C) Tweezers D) Mineral oil

D) Mineral oil Explanation: An insect in the ear canal can be dislodged by instilling mineral oil, which kills the insect and allows removal. Irrigation is contraindicated because the insect would swell. Hair pin or tweezers should not be used due to the risk for trauma.

You are teaching the daughter how to instill ear drops into her father's ear to remove impacted cerumen. What is a priority action to teach this woman? A) Direct the flow of the ear drops toward the eardrum. B) Insert the irrigating syringe deeply. C) Refrigerate before instillation. D) Place the container in warm water before instillation.

D) Place the container in warm water before instillation. Explanation: If irrigation or instillation of liquids is ordered, the nurse should warm the liquid to body temperature by placing the container in warm water. Cold or hot liquids cause dizziness, and the potential for injury exists if the liquid is hot. The nurse should avoid inserting the irrigating syringe too deeply so as not to close off the auditory canal. The nurse should direct the flow toward the roof of the canal, rather than the eardrum.

A nurse is doing discharge teaching with a client who is hearing impaired. What is the best way to make sure the client understands the teaching? A) Mime B) Speak slowly C) Learn a second language D) Use illustrations

D) Use illustrations Explanation: The nurse uses illustrations, pamphlets, and written directions to aid teaching and includes a family member. He or she asks the client to repeat information and demonstrate technical skills. The nurse initiates a referral to a community agency to evaluate if and how well the client is performing self-care after discharge. The nurse could speak slowly and learn a second language but they would not mime.

When caring for a client after ear surgery, what is an important aspect of nursing care? A) Assess social support. B) Feed small frequent meals to minimize nausea. C) Fit for a hearing aid. D) Validate client's feelings of discomfort.

D) Validate client's feelings of discomfort. Explanation: Validate client's feelings of discomfort. This measure promotes the nurse-client relationship and reassures the client that his or her needs are important.

Musculoskeletal System family history?

Genetic risk ◦ Positive family history of some disorders may be important.

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? A. Ask client when the last dose was B. Check results of the prothrombin time (PT) and international normalized ratio (INR). C. Document the information in the chart D. Notify the surgeon immediately

D. Notify the surgeon immediately

What is compartment syndrome?

Damage to nerves and vasculature of an extremity due to compression

What are the manifestations of fractures?

Deformity (e.g., angulation, shortening, and rotation) Edema Tenderness/pain Inability to move the affected limb Crepitus Paresthesia Muscle flaccidity progressing to spasms

What are the complications of fractures?

Delayed union, malunion, or nonunion Compartment syndrome Fat embolism Osteomyelitis Osteonecrosis

What are EARs used for?

Detect and process sound, detect body position, and maintain balance

What is associated with cataracts?

Diabetes mellitus, hypo parathyroid, Down syndrome, chronic sun exposure

Arthroscopic examination

Diagnose, repair, and remove loose or foreign materials in the joint ◦ Monitor progress of a previously diagnosed disease ◦ Abnormal color/shape of the ligaments and cartilage ◦ Presence of growths or cysts ◦ Evidence of joint dysfunction such as arthritis ◦ Presence of infection

The nurse suspects that a client is developing a cataract. What finding did the nurse use to make this clinical decision? Double vision in one eye Redness of the sclera Tearing of both eyes Itching of both eyes

Double vision in one eye

What is the treatment for external otitis?

Dry warm heat for comfort • Ice for edema

What are the clinical manifestation of low back pain?

Dull or acute pain in the lower back area Muscle spasms Pain radiating into the buttock or down the leg

What are the manifestations of a sprain?

Edema Pain Joint stiffness Limited function Discoloration

A nurse is performing an otoscopic examination on a client. Which finding would the nurse document as abnormal? External auditory canal erythema Umbo in the center of the tympanic membrane Tympanic membrane pearly gray Manubrium superior to the umbo

External auditory canal erythema

What is the non-surgical treatment of corneal abrasion?

Eye drops • Eye patching • Tetanus vaccination

Catracts post- op?

Eye medications continue Eye patch 24 hours post surgery Sunglasses during the day & eye shield at night for 1 week Prevent increasing IOP (no bending over)

Cataract medications for how many days pre-op?

Eye meds 4X/day for two days: Antibiotic Corticosteroid Anti-inflammatory

What is a bone scan used for?

Find damage to bones, disease, infection, or trauma

How do you get a corneal abrasion?

Foreign body, trauma, contact lens

Musculoskeletal system assessment

General inspection of posture, gait Face and neck Spine Hand Hip Ankles and feet Neurovascular assessment Psychosocial assessment

Which nursing suggestion would be most helpful to the client with recurrent otitis externa? Use a cotton applicator to ensure that the ear canal is dry. Flush the ear with hydrogen peroxide Place ear plugs into the ears before swimming Avoid lying on the side of the affected ear

Place ear plugs into the ears before swimming

You are teaching the daughter how to instill ear drops of her father to remove impacted cerumen. What is a priority action to teach this woman? a) Insert the irrigating syringe deeply. b) Refrigerate before instillation. c) Place the container in warm water before instillation. d) Direct the flow of the ear drops toward the eardrum.

Place the container in warm water before instillation

Which of the following is hearing loss associated with degenerative changes? a) Strabismus b) Myopia c) Presbycusis d) Presbyopia

Presbycusis

What is the postoperative care of retinal detachment?

Promote measures that limit mobility • Restrict activity that causes rapid eye movements • Supine or on unaffected side • Patch/shield the eye • Mild analgesics for discomfort • Avoid heavy lifting, bending

A patient is newly diagnosed with otitis externa. Which of the following should the nurse teach the patient before the patient leaves the clinic? a) Cleaning ear canal with cotton-tip applicator after showering b) Proper instillation of prescribed ear drops c) Side effects of oral antibiotics d) Strategies to cope with the temporary sensorineural hearing loss

Proper instillation of prescribed ear drops

PQRST

Provokes Quality Radiates Severity Time

The nurse is evaluating a client's musculoskeletal system. Which approach should be used to determine joint mobility? Range of motion Gait Posture Palpation of muscle tone

Range of motion

nonsurgical treatment of meniscus?

Rest NSAID's Complete immobility not recommended

What is the management of sprains and strains?

Rest Ice Compression Elevation Medication: Nsaids

Strains result from what?

Results from an awkward muscle movement or excess force that can be caused by an accident, improper use of a muscle, or overuse of a muscle.

what is arthrogram?

Reveals degenerative changes in cartilage Partial or complete tear Enlarged/ruptured joint capsule, or cyst

What are the risk factors for cataracts?

Risk factors for adult-onset cataracts: family history, advancing age, smoking, ultraviolet (UV) light exposure (natural or artificial), metabolic conditions (e.g., diabetes mellitus), certain medications (e.g., corticosteroids), and eye injury (e.g., trauma and infection)

What are otitis Externa risk factors?

Risk factors: swimming in contaminated water, scratching the outside or inside of the ear, and insertion of foreign objects

What do you need to know about splinting?

Secured with straps, not circumferential Allows for adjustment if swelling occurs Visualization of soft tissues Preferred over casts

WHY ARE HEALTHY BONES IMPORTANT?

Strong bones support us and allow us to move Bones are a storehouse for vital minerals Strong bones protect our heart, lungs, brain and other organs

Chlamydial conjunctivitis treatment

Systemic antibiotics

Manifestations of Meniscus injuries?

Tenderness/pain Edema Popping sensation Stiffness Difficulty straightening the knee

13. A patient with glaucoma is ordered eye medication for the right eye in the form of an ointment and eye drop. The nurse will administer which type of medication first? A. Ointment and then the eye drops B. Eye drops and then the ointment

The answer is B. The nurse will administer eye drops FIRST and then the ointment.

12. A patient is scheduled to take Brimonidine and Latanoprost eye drops for management of glaucoma at 1000. What correct action below will the nurse take when administering these eye drops? A. The nurse assists the patient with using the index finger to gently place pressure at the side of the nose bridge for about 30 seconds after administering each eye drop medication. B. The nurse waits at least 3-5 minutes before administering the second eye drop medication. C. The nurse administers each eye drop directly on the eye via the cornea. D. The nurse encourages the patient to blink after each eye drop administration.

The answer is B. This is the only correct action by the nurse. The nurse should wait at least 3-5 minutes before administering the second medication. This is so that the first medication can be used by the eye and not washed out by the second medication.

Where is the common site for strains?

The lower back is the most common site.

What are does low back pain occur?

The lumbar region of the back is where most back pain occurs

A client seeks medical attention for ear pain. What findings indicate that this client is experiencing external otitis? Select all that apply. The patient's ear is edematous. The patient's ear canal is reddened. The patient flinches when the ear is touched. The patient reports pressure when the outer auricle is moved. The patient has copious amount of purulent drainage from the nose.

The patient's ear is edematous. The patient's ear canal is reddened. The patient flinches when the ear is touched. Answer The patient reports pressure when the outer auricle is moved.

What is the conjunctiva?

The pink tissues surrounding the eye.

What is a slit lamp?

The slit lamp is a binocular microscope that provides the examiner with a stereoscopic (ie, three dimensional) view of the eye

What do you need to know about traction?

Use of weights and force to reduce the fracture and relieve muscle spasms Skeletal traction ◦ Pins, tongs, screws, and wires are surgically secured to the bone, and weight is then applied to provide realignment Skin traction ◦ Utilizes a flexible harness, boot, or belt to secure the extremity while 5 to 10 lb of weight is applied to relieve muscle spasms

What is an oblique fracture?

When the fracture is diagonal to the bone's long axis.

What are the imagining diagnostic studies for MSK?

X-ray CT MRI Arthrogram Bone mineral density studies Bone scan

Are bacterial and viral conjunctivitis highly contagious through direct contact?

YES

Is retinal detachment a medical emergency?

YES

A client is diagnosed as having serous otitis media. When describing this condition to the client, which of the following would be most accurate? a) "You have a common infection in one of the bones of your face." b) "Your eardrum has ruptured because of the extreme pressure in your middle ear from the infection." c) "It has resulted from the several recurrent episodes of acute otitis media you've had." d) "You have some fluid that has collected in your middle ear but no infection."

You have some fluid that has collected IN your middle ear but no infection

pneumatic retinopexy

a gas bubble is injected in vitreous cavity to help reattach the retina

scleral buckling

a procedure to repair a detached retina. A strip of sclera is resected, or a fold is made in the sclera. An exoplant is used to hold and buckle the sclera

What is a simple fracture?

a single break with bone ends maintaining their alignment and position

The client's chart indicates a sensorineural hearing loss. What assessment question does the nurse ask to determine the possible cause? Select one: a. "Have you been exposed to loud noises?" b. "Do you feel like something is in your ear?" c. "Do you have frequent ear infections?" d. "Have you been told your ear bones don't move?"

a. "Have you been exposed to loud noises?"

The nurse is teaching a client about visual changes that occur with age. Which statement does the nurse include? Select one: a. "It may take your eyes longer to adjust in a darkened room." b. "You probably will have to move reading materials closer to your eyes." c. "When the sclera starts to turn yellow, this means you might have problems with your liver." d. "Most visual changes occur before age 40."

a. "It may take your eyes longer to adjust in a darkened room."

The patient tells you that he has to hold his paper farther and farther away from his face to read it. It has become a joke in his family about how far away he needs to hold reading material. You tell the patient: Select one: a. "You have presbyopia, which is a normal age-related change. Reading glasses will help you. b. "You may have astigmatism, and your eyes will get used to the problem." c. "You may have an eye infection that is affecting your vision. You will need an antibiotic ointment to instill into your eyes." d. "You have myopia. Glasses will help you read."

a. "You have presbyopia, which is a normal age-related change. Reading glasses will help you."

The nurse is performing an eye assessment on a client. Which finding confirms normal accommodation during visual assessment? a. Both pupils constrict when focusing on an object being moved in toward the nose. b. Both pupils constrict when a light is shined at one eye. c. The client blinks in response to a threatening movement. d. The client is able to hold an upward gaze without moving the head for 15 seconds.

a. Both pupils constrict when focusing on an object being moved in toward the nose

A client had cataract surgery. What instructions should the nurse provide? (Select all that apply.) a. Call the doctor for increased pain. b. Do not bend over from the waist. c. Do not lift more than 10 pounds. d. Sexual intercourse is allowed. e. Use stool softeners to avoid constipation.

a. Call the doctor for increased pain. b. Do not bend over from the waist. c. Do not lift more than 10 pounds. e. Use stool softeners to avoid constipation.

The nurse is caring for an older adult client with sensorineural hearing loss. Which assessment finding does the nurse correlate with the client's health history? Select one: a. Worked in a sawmill for the last 20 years b. History of frequent ear infections c. Had a tumor removed from his left eardrum last year d. Swims frequently

a. Worked in a sawmill for the last 20 years

The nurse giving you a report on a newly admitted profoundly deaf patient says that the patient is confused and difficult to assess because she does not respond to questions appropriately or sometimes does not respond at all. The oncoming nurse will consider: Select one: a. assessing the patient to determine if her hearing aids are in. b. reporting to the physician that the patient is "sundowning." c. assessing medications to check for an overdose. d. having a psychiatrist see the patient to determine if the patient has dementia.

a. assessing the patient to determine if her hearing aids are in.

Risk factors for cataracts?

advanced age, diabetes, heredity, smoking, eye trauma, excessive exposure to the sun, chronic corticosteroid use

What is the snellen chart?

an eye chart that can be used to measure visual acuity 20/20

You are admitting a 30-year-old who has a hearing impairment. The client is accompanied by family members. What information would be important to ask the family members to help you care for your client? a) How the client lost their hearing b) The client's preferred method of communication c) How much the client weighs d) What allergies the client has

b) The client's preferred method of communication

A client has been educated about activities that can increase intraocular pressure. Which statement indicates that the client requires further teaching? Select one: a. "I will avoid wearing tight shirt collars and ties." b. "I will not put my arms above my head." c. "I will take stool softeners daily to prevent straining." d. "I will try not to sneeze, cough, or blow my nose."

b. "I will not put my arms above my head."

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? Select one: a. "I am keeping the drops in the eye." b. "This prevents systemic absorption." c. "I am stopping you from rubbing your eye." d. "Doing this allows time for absorption."

b. "This prevents systemic absorption."

A nurse is seeing clients in the ophthalmology clinic. Which client should the nurse see first? a. Client with intraocular pressure reading of 24 mm Hg b. Client who has had cataract surgery and has worsening vision c. Client whose red reflex is absent on ophthalmologic examination d. Client with a tearing, reddened eye with exudate

b. Client who has had cataract surgery and has worsening vision

Which client is at highest risk for hearing loss? Select one: a. Client with asthma receiving high-dose methylprednisolone (Solu-Medrol) therapy b. Client with osteomyelitis receiving IV gentamicin (Garamycin) c. Client with heart failure receiving digoxin (Lanoxin), 0.125 mg orally daily d. Client with hyperkalemia being treated with intravenous glucose and insulin

b. Client with osteomyelitis receiving IV gentamicin (Garamycin)

An older client has decided to give up driving due to cataracts. What assessment information is most important to collect? a. Family history of visual problems b. Feelings related to loss of driving c. Knowledge about surgical options d. Presence of family support

b. Feelings related to loss of driving

In planning care for a child who has been diagnosed with a hearing impairment, and considering the impact of a hearing deficit, the nursing diagnosis that would be appropriate would be: Select one: a. Risk for injury related to hearing impairment. b. Risk for social isolation related to hearing impairment. c. Anxiety related to hearing impairment. d. Knowledge deficit related to hearing impairment.

b. Risk for social isolation related to hearing impairment.

When you ask your patient about his vision, he says that the last time he had it tested, it was recorded as 20/50. This means that: Select one: a. the patient needs to be 50 feet from objects to see them. b. the patient can read at 20 feet what a person with normal vision can read at 50 feet. c. the patient can read at 50 feet what a person with normal vision can read at 20 feet. d. the patient's best vision is between 20 feet and 50 feet from objects.

b. the patient can read at 20 feet what a person with normal vision can read at 50 feet.

What is a complete fracture?

bone is broken all the way through

What is a compression fracture?

bone is crushed; common in porous bones

What is an incomplete fracture?

bone is damaged but still in one piece

What is a closed fracture?

break that does not penetrate the skin

What is an open fracture?

broken bone that penetrates the skin

Which is the most important information for the nurse to teach a client who is receiving cycloplegic drug therapy? Select one: a. "Remain on bedrest for 24 hours in a prone position." b. "Use at least a 30 SPF sunscreen agent when going outdoors." c. "Do not drive or operate machinery until the drug wears off." d. "Turn up the lights because acuity will be decreased in low-light environments.

c. "Do not drive or operate machinery until the drug wears off."

The nurse is assessing a client for the possibility of a lens opacity. Which assessment finding confirms this problem? Select one: a. Positive corneal staining b. Decreased central vision c. Absence of a red reflex d. Increased intraocular pressure

c. Absence of a red reflex

The nurse is assessing the blink reflex in a client who is blind. Which is the best technique to use? Select one: a. Shine a bright light at the client's pupils one at a time. b. Ask the client to blink first with one eye and then with the other. c. Expel a syringe of air toward the client's eyes. d. Suddenly bring a finger toward the client's face.

c. Expel a syringe of air toward the client's eyes.

A client who is near blind is admitted to the hospital. What action by the nurse is most important? a. Allow the client to feel his or her way around. b. Let the client arrange objects on the bedside table. c. Orient the client to the room using a focal point. d. Speak loudly and slowing when talking to the client.

c. Orient the client to the room using a focal point.

A client has recently had cataract surgery. About which symptom does the nurse instruct the client to notify the health care provider? Select one: a. Swollen eyelid b. Increased tearing c. Reduced vision d. Itching of the eye

c. Reduced vision

The nurse is caring for a client who is admitted with mastoiditis. Which assessment data obtained by the nurse requires the most immediate action? Select one: a. The lymph nodes are swollen and painful to touch. b. The client's oral temperature is 100.1° F (37.8° C). c. The client reports a headache and a stiff neck. d. The eardrum is red, thick-appearing, and immobile.

c. The client reports a headache and a stiff neck.

A nurse is caring for a client who has a new diagnosis of cataracts. Which of the following manifestations should the nurse expect? SATA a. eye pain b. floating spots c. blurred vision d. white pupils e. bilateral red reflexes

c. blurred vision d. white pupils

What is a spiral fracture?

caused by twisting a bone excessively

The nurse is teaching a client about home care after cataract surgery. Which statement indicates that the client requires further teaching? Select one: a. "I am glad that I don't need an eye patch after the surgery." b. "I will try a cool compress to decrease the swelling around the operated eye." c. "Dark sunglasses will be necessary when I am in the sun." d. "Pain, nausea, and vomiting are normal after this surgery."

d. "Pain, nausea, and vomiting are normal after this surgery."

A nurse is providing postoperative teaching to a client following cataracts surgery. Which of the following statements should the nurse include in the teaching? a. "you can resume playing golf in 2 days." b. "you need to tilt your head back when washing your hair." c. "you can get water in your eyes in 1 day." d. "you need to limit your housekeeping activities."

d. "you need to limit your housekeeping activities."

Which assessment alerts the nurse to the possible presence of a cataract in a client? Select one: a. Loss of central vision b. Dull aching in the eye and brow areas c. Loss of peripheral vision d. Blurred vision and reduced color perception

d. Blurred vision and reduced color perception

A client had the anesthetic proxymetacaine (Ocu-Caine) instilled in one eye in the emergency department. What discharge instruction is most important? Select one: a. Rinse the eye with warm saline solution at home. b. Monitor the eye for any bleeding for the next day. c. Use all the eyedrops as prescribed until they are gone. d. Do not touch or rub the eye until it is no longer numb.

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

The nurse is teaching a client how to apply eye medication. Which is the correct technique for applying ointment into the eye? Select one: a. Against the inner aspect of the eyelid b. From the outer canthus to the inner canthus c. From the middle out d. From the inner canthus to the outer canthus

d. From the inner canthus to the outer canthus

A client has sustained bilateral damage to cranial nerve II after a traumatic injury. Which intervention does the nurse anticipate to help accommodate for this injury? Select one: a. Daily eye assessment using the six cardinal positions of gaze b. Artificial tears c. Ensuring that the client wears sunglasses when the curtains are open or when the room light is on d. Identifying food on the client's plate using the clock method

d. Identifying food on the client's plate using the clock method

Which proper technique does the nurse use for eyedrop instillation? Select one: a. Opening the eye by raising the upper eyelid b. Instilling the drops into the inner canthus c. Touching the bottle tip to the eyeball d. Placing the eyedrop in the lower lid pocket

d. Placing the eyedrop in the lower lid pocket

The nurse instructs a family member how to guide a visually impaired person when ambulating by: Select one: a. allowing the visually impaired person to hold the shoulder of the helper and walk slightly behind the helper. b. holding the nondominant hand, wrapping the arm around his or her waist, and walking side by side. c. holding the visually impaired person by his or her nondominant arm and walking side by side. d. allowing the visually impaired person to hold the helper's arm, with the helper slightly ahead.

d. allowing the visually impaired person to hold the helper's arm, with the helper slightly ahead.

What is presbyopia?

decrease in ability to see objects close up

What are the risk factors for strains?

excessive physical activity, improper stretching prior to activity, and poor flexibility.

Musculoskeletal System patient history?

◦ Accidents, illnesses, lifestyle and drugs ◦ Men are at greatest risk of MVCs ◦ Older Adults - High risk for falls

What is arthrocentesis?

◦ Fluid is aspirated from a joint ◦ For diagnostic reasons and pain relief

Why would you compare one side to the other?

◦ Swelling ◦ Size◦Deformity ◦ Poor alignment ◦ Tenderness ◦ Pain ◦ Mobility ◦ Strength

Musculoskeletal system nutritional history?

◦ Weight loss/gain, lactose intolerance, lack of resources?