PrepU Patho Ch 38

An adult client has undergone testing for otosclerosis. Which interview question is most appropriate to the pathophysiology of this disease?

"Has anyone else in your family been diagnosed with this disease?" Nondrug therapies for BPPV using habituation exercises and canalith repositioning are successful in many people. Canalith repositioning involves a series of maneuvers in which the head is moved to different positions in an effort to reposition the free-floating debris in the endolymph of the semicircular canals. Surgery is not a noted treatment option and even in the absence of hearing loss, treatment is warranted.

Which of these clients' statements would be most suggestive of retinal detachment?

"I feel like there's a shadow that's blocking my vision." The primary symptom of retinal detachment consists of painless changes in vision. Commonly, flashing lights or sparks, followed by small floaters or spots in the field of vision, occur as the vitreous pulls away from the posterior pole of the eye. As detachment progresses, the person perceives a shadow or dark curtain progressing across the visual field. It is not associated with headache or bleeding.

The father of a third-grade girl has brought his daughter to a walk-in clinic because he believes the child has pink eye, which has been going around the students in her class. The nurse at the clinic concurs with the father's suspicion of conjunctivitis. Which follow-up explanation by the nurse is most accurate?

"The surfaces of her eyes have bacteria or a virus established, and it's important to maintain good hand hygiene until it goes away." Conjunctivitis often spontaneously resolves, so diligent hand hygiene is critical. The pain associated with conjunctivitis usually produces only mild discomfort compared with severe discomfort associated with corneal lesions or deep and severe pain associated with acute glaucoma. Conjunctivitis may spread to other family members. The corneal surface is not primarily involved and pain that is severe suggests corneal involvement rather than conjunctivitis. Sight damage is not likely to result.

A client with a diagnosis of benign paroxysmal positional vertigo (BPPV) is receiving teaching from her physician about her diagnosis. The client is eager to avoid future episodes of vertigo and has asked the physician what she can do to prevent future episodes. How can the physician best respond?

"There are some exercises that I'll teach you to help reorient your inner ear and prevent vertigo." Nondrug therapies for BPPV using habituation exercises and canalith repositioning are successful in many people. Canalith repositioning involves a series of maneuvers in which the head is moved to different positions in an effort to reposition the free-floating debris in the endolymph of the semicircular canals. Surgery is not a noted treatment option and even in the absence of hearing loss, treatment is warranted.

An 83-year-old client presents to the outpatient clinic with a report of external ear pain. The ear is red, swollen, and tender to touch. What factors are likely contributors to this condition? Select all that apply.

Hearing aid Glasses Factors that contribute to otitis externa (AOE) are allergic dermatitis and irritation, which often comes from devices such as hearing aids or earphones. Frequent exposure to moisture, trauma, and scratching are predisposing factors. Because the tympanic membrane serves as a barrier between the external and middle ear, acute otitis media (AOM) does not predispose clients to external ear inflammation. Children between the ages of 5 and 9 are most prone to AOE followed by children ages 10 through 14.

The nurse is conducting a community education class on acute otitis media. Which statement by the participants indicates to the nurse that they understand the education?

It can be caused by a bacterial infection. The nurse determines that the participants understand the information when they state that acute otitis media can be caused by a bacterial infection. Breast-fed babies have a lower incidence of acute otitis media. The tympanic membrane appears cloudy in otitis media with effusions. Acute otitis media is not another name for swimmer's ear.

A college junior calls his mother, a nurse, reporting "not being able to see." When questioned further, he describes the following: "A gray curtain just went down my right visual field. I don't know what to do." The nurse should recognize this symptom as which condition and have the teenager go to the emergency department immediately?

Retinal detachment The primary symptom of retinal detachment consists of painless changes in vision. Commonly, flashing lights or sparks followed by small floaters or spots in the field of vision occur as the vitreous pulls away from the posterior pole of the eye. As detachment progresses, the person perceives a shadow or dark curtain progressing across the visual field.

Otitis media (OM), which can occur is any age group, is the most common diagnosis made by health care providers who care for children. Which bacterial pathogen causes the largest proportion of cases that result in sensorineural hearing loss?

Streptococcus pneumoniae S. pneumoniae is the most common cause of bacterial meningitis that results in sensorineural hearing loss after the neonatal period. Acoustic neuromas is a cancer that causes impaired hearing. Parainfluenza and influenza viruses are common viral pathogens in OM.

A young client is brought to the clinic with symptoms of a runny nose, small amount of drainage from both eyes, fever, and malaise. The mother states to the nurse, "I knew she was going to be sick. That swimming pool she played in 2 days ago was filthy." What disease should the nurse suspect this child is experiencing?

Viral conjunctivitis The client is suffering from viral conjunctivitis, which causes generalized conjunctival hyperemia, copious tearing, and minimal exudate and is usually accompanied by pharyngitis, fever, and malaise. Children are often affected by it more than adults and contaminated swimming pools are common sources of infection.

The ophthalmologist is performing a client's annual eye exam and notes an increase in intraocular pressure. The condition most likely is the result of:

imbalance between aqueous production and outflow. Increases in intraocular pressure occur when there is an imbalance between aqueous production and outflow. A cell breakdown in the macula lutea results in macular degeneration. Cataracts may cause blurring of vision but do not alter pressure. Reference: