Med Surg Week 2- Ear & Eyes

A college student reports eye pain after studying for finals. What assessment should the nurse make first in determining the possible cause of this eye pain?

Do you wear contacts? Rationale: College students frequently wear contact lenses and stay up late or all night studying for finals. If the student wears contacts, the wearing of them while studying, care of them, and length of wear time will be assessed before looking for a corneal abrasion from extended wear with fluorescein dye. There are no manifestations of allergies or visual changes mentioned.

A patient has ptosis resulting from myasthenia gravis. Which assessment finding would the nurse expect?

Drooping of the upper lid margin in one or both eyes Rationale: Ptosis is the term used to describe drooping of the upper eyelid margin, which may be either unilateral or bilateral. Ptosis can be a result of mechanical causes, such as an eyelid tumor or excess skin, or from myogenic causes such as myasthenia gravis. Redness, swelling of the conjunctive, or crusting along the eyelid margins may indicate an infection such as viral or bacterial conjunctivitis. Small superficial white nodules along the eyelid margin may indicate hordeolum (sty).

A patient reporting frequent vertigo is scheduled for electronystagmography to test vestibular function. Which instructions should the nurse provide to the patient before the procedure?

Eat a light meal before the procedure. Teach patient to eat a light meal before the test to avoid nausea

When planning care for a patient with disturbed sensory perception related to increased intraocular pressure caused by primary open-angle glaucoma, what nursing action would be a priority?

Encouraging compliance with drug therapy for the glaucoma to prevent vision loss Rationale: Drug therapy is necessary to prevent the eventual vision loss that may occur as a consequence of glaucoma. For this reason, encourage the patient to remain compliant with drug therapy.

After an acoustic neuroma is removed from a patient, the nurse teaches the patient about tumor recurrence. What should the nurse instruct the patient to monitor? (Select all that apply.)

Episodes of dizziness Worsening of hearing Inability to close the eye Rationale: An acoustic neuroma is a unilateral benign tumor that occurs where the vestibulocochlear nerve (cranial nerve [CN] VIII) enters the internal auditory canal. Clinical manifestations of tumor recurrence including facial nerve (CN VII) paralysis can be manifested by intermittent vertigo, hearing loss, and inability to close the eye.

What should be included in the discharge teaching for the patient who had cataract surgery

Eye discomfort is relieved with mild analgesics, notify the provider if an increase in redness or drainage occurs, following activity restrictions is essential to reduce intraocular pressure

The nurse is developing a teaching plan for a client with glaucoma. Which instruction would the nurse include in the plan of care?

Eye medications will need to be administered for life

The nurse in a health care clinic is preparing to test a client for accommodation. Initially, the nurse would ask the client to take which action?

Focus on a distant object

A patient reports tinnitus and balance problems. The medication that may be responsible is

Furosemide

When assessing an adult patient's external ear canal and tympanum, what assessment techniques should the nurse use?

Gently pull the auricle up and backward to straighten the canal. Rationale: When examining a patient's external ear canal and tympanum, ask the patient to tilt the head toward the opposite shoulder. Grasp and gently pull the auricle up and backward to straighten the canal. A healthy, normal tympanic membrane will appear pearl gray, white, or pink and have a cone-shaped light reflex.

When administering eyedrops to a patient with glaucoma, which nursing measure is most appropriate to minimize systemic effects of the medication?

Have the patient put pressure on the inner canthus of the eye after administration. Rationale: Systemic absorption can be minimized by applying pressure to the inner canthus of the eye. The other options will not minimize systemic effects of the medication.

A patient is prescribed intravenous (IV) gentamicin after repair of an intestinal perforation. The nurse should assess for which adverse effect of this medication?

Hearing loss Rationale: Aminoglycosides such as gentamicin are drugs that are potentially ototoxic and may cause damage to the auditory nerve. When this drug is used, careful monitoring for hearing and balance problems (e.g., hearing loss, tinnitus, vertigo) is essential.

The nurse is assessing a patient's medical history. What aspects of the patient's medical history are most likely to have potential consequences for the patient's visual system?

Hypertension and diabetes Rationale: Hypertension and diabetes frequently contribute to visual pathologies. The other health problems are less likely to have a direct, deleterious effect on a patient's vision.

Increased intraocular pressure may occur because of

Increased aqueous humor production by the ciliary process

A patient newly diagnosed with glaucoma asks the nurse what has made the pressure in the eyes so high. Which is the nurse's most accurate response?

Increased production of aqueous humor or blocked drainage increases pressure. Rationale: Intraocular pressure is increased in glaucoma as a result of excess aqueous humor production or decreased outflow. Cardiac or cerebral circulation changes do not cause glaucoma. Lacrimal anomalies do not affect aqueous humor production.

A client arrives at the emergency department with a foreign body in the left ear and tells the nurse that an insect flew into the ear. Which intervention would the nurse implement initially?

Instillation of mineral oil

The nurse reviews the findings from a physical exam done on a client for ear or hearing disorders and notes documentation that the client has hyperacusis. Which would the nurse expect to note on assessment of the client?

Intolerance for sound levels that do not bother other people

nystagmus

Involuntary rapid eye movements

An older adult patient states they do not seem to hear well and have to ask people to repeat themselves. What should the nurse do first to determine the cause of the hearing loss?

Look for cerumen in the ear. Rationale: Gerontologic differences in the assessment of the auditory system include increased production of and drier cerumen, which can become impacted in the ear canal and contribute to hearing loss. Conductive hearing loss with impacted cerumen may lead to speaking softly as the patient's voice conducted through bone seems loud to the patient. Although increased hair growth occurs, it will not impact the hearing. Presbycusis may be occurring, but it should not be assumed. There is no reason to ask the patient if he has fallen because dizziness and vertigo are not a normal change of aging of the ear.

When administering a scheduled dose of pilocarpine, in which area should the nurse place the drops?

Lower conjunctival sac Rationale: Ocular medications, such as pilocarpine, should be instilled into the lower conjunctival sac. Never apply eyedrops directly to the cornea. Applying the drops to the inner canthus will cause them to be distributed systemically.

Betaxolol hydrochloride eye drops have been prescribed for a client with glaucoma. Which nursing action is most appropriate related to monitoring for side and adverse effects of this medication?

Monitoring blood pressure Monitoring body weight Rationale: This medication is an antiglaucoma medication and a β-adrenergic blocker. The nurse assesses for evidence of heart failure manifested by dizziness, night cough, peripheral edema, and distended neck veins. Intake greater than output, weight gain, and decreased urine output also may indicate heart failure. Hypotension (manifested as dizziness), nausea, diaphoresis, headache, fatigue, and constipation or diarrhea also are potential systemic effects of the medication. Nursing interventions include monitoring body weight; periodically evaluating blood pressure for hypotension; and assessing the apical or radial pulse for strength, weakness, irregular heart rate, and bradycardia.

An adolescent is diagnosed with conjunctivitis, and the nurse provides information to the adolescent about the use of contact lenses. Which statement by the client would indicate the need for further information?

My contact lenses can be worn if they are cleaned properly

The nurse is caring for a client following enucleation to treat an ocular tumor and notes the presence of bright red drainage on the dressing. Which action would the nurse take at this time?

Notify the health care provider (HCP) Rationale: If the nurse notes the presence of bright red drainage on the dressing, it must be reported to the HCP, because this indicates hemorrhage. Options 1, 2, and 4 are inappropriate at this time.

The triage nurse at an ambulatory clinic receives a call from a person with possible metal fragments in both eyes. Which instructions would the nurse provide for emergency care of this potential eye injury?

"Apply a loose dressing over your eyes." Rationale: An initial intervention for a penetrating eye injury includes covering the eye(s) with a dry, sterile patch and protective shield. The fragments should not be removed by the person or others. Penetrating eye injuries should not be irrigated (only irrigate for chemical eye injuries).

The student nurse is working with a registered nurse (RN) in the clinic. The RN is educating the student nurse on dysfunction in the area of the semicircular canals of the ear. Which statement by the student nurse indicates that the teaching has been effective?

"Disturbance in balance occurs."

The nurse is assessing an older adult patient who has just been transferred to the long-term care facility. Which assessment question will best allow the nurse to assess for the presence of presbycusis?

"Have you noticed any change in your hearing in recent months and years?" Presbycusis is an age-related change in auditory acuity.

The nurse is preparing to administer timolol eyedrops for treatment of glaucoma. What statement made by the patient would cause the nurse to hold the medication and report to the health care provider?

"I have chronic obstructive pulmonary disease." Rationale: Timolol is a nonselective β-adrenergic blocker that could lead to bronchoconstriction and bronchospasm. For this reason, it should not be used in patients with COPD. Timolol may be used to treat migraine headaches, and it does not affect sinusitis or chronic urinary tract infections.

A patient is diagnosed with severe myopia. Which type of correction is the patient planning to have if they state, "I can't wait to be able to see after they implant a contact lens over my lens"?

Phakic intraocular lenses (phakic IOLs) Rationale: Phakic intraocular lenses (phakic IOLs) is the implantation of a contact lens in front of the natural lens. PRK is used with low to moderate amounts of myopia, and the epithelium is removed and the laser sculpts the cornea to correct the refractive error. Refractive IOL is also for patients with a high degree of myopia or hyperopia and involves removing the natural lens and implanting an intraocular lens. LASIK surgery is similar to PRK except that the epithelium is replaced after surgery.

During a health history, a 43-yr-old teacher reports increasing difficulty reading printed materials for the past year. What change related to aging does the nurse suspect?

Presbyopia Rationale: Presbyopia is a loss of accommodation causing an inability to focus on near objects. This occurs as a normal part of aging process starting around age 40 years. Myopia is nearsightedness (near objects are clear and far objects are blurred). Astigmatism results in visual distortion related to unevenness in the cornea. Hyperopia is farsightedness (near objects are blurred and far objects are clearly seen).

Which patient behaviors would the nurse promote for healthy eyes?

Protective sunglasses when bicycling, taking part in a smoking cessation program, supplementing diet intake of vitamin c and beta-carotene, washing hands thoroughly before putting in or taking out contact lenses

When examining the patient's eyes, which finding would be of most concern to the nurse?

Small, white nodule on the upper lid margin

The nurse is caring for a hearing-impaired client. Which approach will facilitate communication?

Speak at a normal volume.

The nurse is teaching a patient about timolol eyedrops for the treatment of glaucoma. What statement made by the patient demonstrates that teaching was effective?

"I may have some temporary blurring of vision after instilling these eyedrops." Rationale: It is common for patients to have a temporary blurring of vision for a few minutes after instilling eyedrops. This should not cause concern to the patient. Because timolol is a β-blocker, heart rate may slow, and blood pressure is more likely to decrease if absorbed systemically.

What assessment technique should the nurse use to assess an adult patients tympanic membrane

Stabilize the otoscope with your fingers on the patients cheek

The nurse is providing instructions to a client and the family regarding home care after right eye cataract removal. Which statement by the client would indicate an understanding of the instructions?

"I need to sleep on my left side"

The nurse is providing discharge teaching to a patient with type 2 diabetes after a scleral buckling procedure. Which statement, if made by the patient, indicates that the discharge teaching is effective?

"I should avoid lifting heavy objects and straining." Rationale: Patients should avoid heavy lifting (more than 20 lb) and straining. A patient with a detached retina is at risk for detachment of the other retina. Patients usually have little to no discomfort after scleral buckling. Severe, persistent pain should be reported immediately to the health care provider. Vision is restored in about 90% of retinal detachments. Vision will not be restored immediately and takes days to weeks to improve.

The nurse is providing discharge instructions to the client being discharged after a fenestration procedure for the treatment of otosclerosis. Which statement made by the client indicates a need for further instruction?

"I should use a straw to drink liquids for the next 2 to 3 weeks."

The nurse teaches a patient prescribed dipivefrin eyedrops to manage chronic open-angle glaucoma. Which statement, if made by the patient to the nurse, indicates that further teaching is needed?

"I will apply gentle pressure on the inside corner of my eye after each eyedrop." Rationale: To avoid systemic reactions such as tachycardia and hypertension, the patient should apply punctual occlusion after instillation of the eyedrops. Dipivefrin will control chronic open-angle glaucoma but will not cure the disease. Side effects associated with dipivefrin include ocular discomfort and redness, tachycardia, and hypertension.

The nurse is educating a client on how to eliminate whistling from a hearing aid. The nurse recognizes that further teaching is needed when the client makes which statement?

"I will raise the volume of my hearing aid."

The nurse is teaching a patient with glaucoma about administration of pilocarpine. What statement is important for the nurse to include during the instructions?

"It is important not to do activities requiring visual acuity immediately after administration." Rationale: Pilocarpine causes blurred vision and difficulty in focusing, so it is important not to engage in any activities requiring visual acuity until the vision clears. It should not cause prolonged eye irritation, and this should be immediately reported to the prescribing care provider. This medication will decrease intraocular pressure.

The nursing student is caring for a client with a diagnosis of presbycusis. The nursing instructor determines that the student understands presbycusis when which statement is made?

"It's a sensorineural hearing loss that occurs with the aging process."

The nurse is providing care for a patient with loss of hearing acuity over the past several years. Which statement by the nurse is most accurate?

"Many people experience an age-related decline in their hearing." Rationale: Presbycusis is a loss of hearing that is both common and age-related.

A patient says she was diagnosed with astigmatism. When she asks what is this? What is the best explanation the nurse can give to this patient?

"The cornea of the eye is uneven or irregular with astigmatism"

A miotic medication has been prescribed for the client with glaucoma, and the client asks the nurse about the purpose of the medication. Which response would the nurse provide to the client?

"The medication causes the pupil to constrict and will lower the pressure in the eye." Rationale: Miotics are used to lower the intraocular pressure, which then increases blood flow to the retina. This in turn decreases retinal damage and loss of vision. Miotics cause a contraction or constriction of the ciliary muscle and widen the trabecular meshwork. The other options are incorrect.

A client who is scheduled for cataract surgery requires preoperative instillation of cyclopentolate eye drops as prescribed. The client asks the nurse why this medication is needed, and the nurse provides education. Which statement by the client indicates that teaching has been effective?

"The medication dilates the pupil of the operative eye." Rationale: Cyclopentolate is a rapidly acting mydriatic and cycloplegic medication that is used preoperatively to dilate the eye. It is effective in 25 to 75 minutes, and accommodation returns in 6 to 24 hours. The statements in the other options are incorrect.

The nursing student is assigned to care for a client with glaucoma for whom pilocarpine hydrochloride eye drops have been prescribed. The nursing instructor asks the student to describe the action of the eye medication. Which statement by the student indicates an understanding of the purpose of this medication?

"The medication increases the blood flow to the retina and also will lower the pressure in the eye." Rationale:Pilocarpine hydrochloride is a miotic that is used to lower the intraocular pressure, thereby increasing blood flow to the retina and decreasing retinal damage and loss of vision. Miotics cause a contraction of the ciliary muscle and a widening of the trabecular meshwork

When teaching a patient about the pathophysiology related to open-angle glaucoma, which statement is most appropriate?

"There is decreased draining of aqueous humor in the eye, causing pressure damage to the optic nerve." Rationale: With primary open-angle glaucoma, there is increased intraocular pressure because the aqueous humor cannot drain from the eye. This leads to damage to the optic nerve over time. Primary angle-closure glaucoma is caused by the lens bulging forward and blocking the flow of aqueous humor into the anterior chamber.

A patient reports intermittent eye dryness. Which question should the nurse ask the patient to determine the etiology of this symptom?

"What do you take if you have allergy symptoms?" Rationale: Antihistamines or decongestants taken for allergies or colds can cause ocular dryness. Ginkgo biloba is an herbal product and has been used to treat asthma and tinnitus. Side effects of ginkgo may include headache, nausea, gastrointestinal upset, diarrhea, dizziness, allergic skin reactions, and increased bleeding. β-Adrenergic blockers can potentiate drugs used to treat glaucoma. Long-term use of prednisone (corticosteroids) may contribute to the development of glaucoma or cataracts.

Presbyobia occurs in older people because

(farsightedness) the lens becomes inflexible

When examining the patient's ear with an otoscope, the nurse observes discharge in the canal and the patient reports pain with the examination. What should the nurse next assess the patient for?

Swimmer's ear Rationale: Swimmer's ear or an infection of the external ear is probably the cause of the discharge and pain. Asking the patient about swimming, ear protection, and exposure to types of water can identify contact with contaminated water.

The nurse is observing an assistive personnel (AP) communicating with a client who is deaf. The nurse would intervene if which behavior is observed?

The AP overenunciates words when speaking.

The client sustains a contusion of the eyeball following a traumatic injury with a blunt object. Which intervention would be initiated immediately?

1. Apply ice to the affected eye Rationale: Treatment for a contusion begins at the time of injury. Ice is applied immediately

The nurse is preparing a teaching plan for a client who had a cataract extraction with intraocular implantation. Which home care measures should the nurse include in the plan? Select all that apply.

1.Avoid activities that require bending over. 3.Take acetaminophen for minor eye discomfort. 5.Place an eye shield on the surgical eye at bedtime. 6.Contact the surgeon if a decrease in visual acuity occurs.

The patient has been diagnosed with benign paroxysmal positional vertigo. The nurse knows that which anatomic area of the ear contributes to this disturbance?

2 Rationale: Benign paroxysmal positional vertigo occurs when the organ of balance (the three semicircular canals) have debris or excessive pressure within the lymphatic fluid.

A clinic nurse is preparing to evaluate the peripheral vision of a client by the confrontational method. Which method describes the accurate procedure to perform this test?

The examiner and client cover the eyes directly opposite to one another and stare at each other's uncovered eye, and a small object is brought into the visual field.

In preparation for cataract surgery, the nurse is to administer cyclopentolate eye drops at 0900 for surgery that is scheduled for 0915. What initial action would the nurse take in relation to the characteristics of the medication action?

3. Consult the surgeon, as there is not sufficient time for the dilative effects to occur. Rationale: Cyclopentolate is a rapidly acting mydriatic and cycloplegic medication. Cyclopentolate is effective in 25 to 75 minutes, and accommodation returns in 6 to 24 hours. Cyclopentolate is used for preoperative mydriasis, not pupil constriction. The nurse should consult with the surgeon about the time of administration of the eye drops since 15 minutes is not adequate time for dilation to occur.

The nurse is examining a patient's ear in the clinic to determine if recent treatment for acute otitis media has been effective. Which assessment finding indicates improvement of the middle ear infection?

Tympanic membrane is gray, shiny, and translucent. Rationale: The tympanic membrane (TM) is normally pearly gray, white or pink, shiny, and translucent. Perforation of the TM that has not healed will appear as open areas of the tympanic membrane. The absence of the cone of light indicates a retracted TM. A bulging red or blue eardrum and lack of landmarks indicates a fluid-filled middle ear. The fluid may be pus or blood.

A patient with septic shock is receiving multiple medications. The nurse assesses which intravenous (IV) medication is the most likely to cause a hearing loss?

Vancomycin The IV medication in use that is most likely to cause a hearing loss is vancomycin (Vancocin) because it is an ototoxic medication. For that reason, serum drug levels are monitored to maintain therapeutic levels and reduce the risk of ototoxicity

A patient is recovering from a motor vehicle crash that resulted in blindness. The patient is withdrawn and refuses to get out of bed. What is the nurse's priority goal for this patient?

Verbalize feelings related to visual impairment. Rationale: The nurse's priority is to help the patient express his feelings about the vision loss resulting from the lack of coping effectively with the situation. Until the patient expresses how they feel, they will be unable to progress in the rehabilitation process.

Benign Paroxysmal Positional Vertigo

a common cause of vertigo that occurs when there is a shift in the location of small crystals in the semicircular canals or shift of the head

Age-related macular degeneration (AMD)

a condition in which the macula degenerates, gradually causing central vision loss

Ask patients using eyedrops to treat their glaucoma about

a history of heart or lung disease

Care of the patient experiencing an acute attack of Ménière's disease includes (select all that apply)

a. giving antiemetics as needed. b. implementing fall precautions. c. keeping the room dark and quiet.

presbycusis

age related hearing loss

retinopathy

any disease of the retina

Teach the patient who is newly fitted with bilateral hearing aids to (select all that apply)

b. clean the ear molds weekly or as needed. d. disconnect or remove the batteries when not in use. e. initially restrict usage to quiet listening in the home.

acoustic nueroma

benign tumor within the internal auditory canal growing from the acoustic nerve

In a patient who has a hemorrhage in the posterior cavity of the eye, the nurse knows that blood is accumulating where?

between the lens and the retina

strabismus

crossed eyes

astigmatism

defective curvature of the cornea or lens of the eye

Meniere's disease

disorder of inner ear causing vertigo, tinnitus, and hearing loss

vertigo

dizziness

common age-related changes in the auditory system include

drier cerumen, tinnitus in both ears, auditory nerve degeneration, atrophy of the tympanic membrane

hyperopia

farsighted

otosclerosis

hardening of the bony tissue of the middle ear

The patient who has a conductive hearing loss

hears better in a noisy environment

presbyopia

impaired vision as a result of aging

Glaucoma

increased intraocular pressure results in damage to the retina and optic nerve with loss of vision

keratitis

inflammation of the cornea

A normal finding the nurse would expect when assessing hearing would be

midline tone heard equally in both ears

Before injecting fluorescein for angiography, it is important for the nurse to (select all that apply)

obtain an emesis basin. inform patient that skin may turn yellow.

the nurse teaches a patient scheduled for an electronystagmography that test involves

recording eye movements associated with ear irrigation

tinnitus

ringing in the ears

Which strategies would best aid the nurse communicate with a patient who has a hearing loss

speaking normally and slowly and write out names and difficult words

hordeolum

sty; an acute infection of a sebaceous gland of the eyelid

Enucleation

surgical removal of the eyeball

external otitis

swimmers ear, inflammation of the ear canal

The most important intervention for a patient with epidemic keratoconjunctivitis is

teaching the patient and caregivers good hygiene techniques

retinal detachment

two layers of the retina separate from each other

In a patient with vertigo, the parts of the ear most likely involved are the

vestuble, semicircular canals

Always assess the patient with an eye problem for

visual acuity

The nurse is preparing to administer eye drops to a client being prepared for cataract surgery. Which actions would the nurse take to administer the drops? Select all that apply.

wash hands. put gloves on. place the drop in the conjunctival sac. pull the lower lid down against the cheekbone.

Which finding related to primary open-angle glaucoma would the nurse expect to find when reviewing a patient's history and physical examination report?

Absence of pain or pressure Rationale: Primary open-angle glaucoma is typically symptom free, which explains why patients can have significant vision loss before a diagnosis is made unless regular eye examinations are being performed. Primary angle-closure glaucoma signs and symptoms include sudden, excruciating pain in or around the eye, seeing colored halos around lights, and nausea and vomiting.

When using the otoscope, the nurse is unable to see the landmarks or light reflex of the tympanic membrane. The tympanic membrane is bulging and red. What does the nurse determine is most likely occurring in the patient's ear?

Acute otitis media Rationale: The inability to see the landmarks or light reflex of the tympanic membrane and the bulging and redness of the tympanic membrane are those of acute otitis media.

Which intervention would be part of the plan of care for a patient with new vision loss

Allow the patient to express grief and anger

The patient reports a loss of central vision. What test should the nurse teach the patient about to identify changes in macular function?

Amsler grid test Rationale: The Amsler grid test is self-administered and regular testing is necessary to identify any changes in macular function. B-scan ultrasonography is used to diagnose ocular pathologic conditions (e.g., intraocular foreign bodies or tumors, vitreous opacities, retinal detachments). Fluorescein angiography is used to diagnose problems related to the flow of blood through pigment epithelial and retinal vessels. Intraocular pressure testing with a Tono-Pen is done to test for glaucoma.

A caloric test is prescribed for a client suspected of having disease of the labyrinth. The nurse would obtain which essential item in preparation for this test?

An otoscope

A patient with poor visual acuity is diagnosed with age-related macular degeneration (AMD). Which nursing action should be the nurse's priority?

Assess impact of vision on normal functioning. Rationale: The most important nursing intervention is to assess the patient's ability to function with the visual impairment. The nurse will use this information to plan nursing care, including assessment of the patient's coping strategies and teaching about vision enhancement techniques and nutrition.

A patient with Ménière's disease had decompression of the endolymphatic sac to reduce the frequent and incapacitating attacks. What should the nurse include in the discharge teaching for this patient?

Avoid sudden head movements or position changes. Rationale: After ear surgery, the patient should avoid sudden head movements or position changes. The patient should not cough or blow the nose because this increases pressure in the Eustachian tube and middle ear cavity and may disrupt healing. Airplane travel should be avoided at first as increased pressure and ear popping is normally experienced, which will disrupt healing. Antihistamines, antiemetics, and sedatives are used to decrease the symptoms of acute attacks of Ménière's disease.

A client with Meniere's disease is experiencing severe vertigo. Which instruction would the nurse give to the client to assist in controlling the vertigo?

Avoid sudden head movements. The nurse instructs the client to make slow head movements to prevent worsening of the vertigo. Dietary changes such as salt and fluid restrictions that reduce the amount of endolymphatic fluid sometimes are prescribed. Lying still and watching television will not control vertigo.

The nurse is performing an assessment on a client with a suspected diagnosis of cataract. Which clinical manifestation should the nurse expect to note in the early stages of cataract formation?

Blurred Vision

During the early postoperative period, a client who has undergone a cataract extraction complains of nausea and severe eye pain over the operative site. What would be the initial nursing action?

Call the surgeon Severe pain or pain accompanied by nausea following a cataract extraction is an indicator of increased intraocular pressure and should be reported to the surgeon immediately.

A client is diagnosed with glaucoma. Which piece of nursing assessment data identifies a risk factor associated with this eye disorder?

Cardiovascular disease

During the course of a health history to assess vision, a patient reports dry eyes. What should the nurse assess next?

Check the medication list. Rationale: The nurse should evaluate the patient's medication list to identify agents that can contribute to dry eyes so follow-up nursing care can be planned. Dry eyes aggravate wearing contact lenses, but contact lenses do not normally cause dry eyes. The nurse should not suggest saline eyedrops until the etiology of the dry eyes is determined. Eyeglasses do not cause dry eyes.

The nurse is providing discharge instructions for a patient using contact lenses who is diagnosed with bacterial conjunctivitis. What is most important for the nurse to include in the instructions?

Discard all opened or used lens care products. Rationale: The patient who wears contact lenses and develops infections should discard all opened or used lens care products and cosmetics to decrease the risk of reinfection from contaminated products. The risk of conjunctivitis is increased with not disinfecting lenses properly, wearing contact lenses too long, or using water or homemade solutions to store and clean lenses.

A patient working in a noisy factory reports being off balance when standing or walking but not while lying down. What term will the nurse use to document this patient's symptoms?

Dizziness Dizziness is a sensation of being off balance that occurs when standing or walking; it does not occur when lying down.