Medication
Name one of the classes of eye drops we may use to treat glaucoma
1. Beta blocker opthalmic drops
E.G. Timolol (Timoptic) Betatoxol (Betoptic)
2. Cholingeric agents (miotics)
E.G. Physostigmine (Isopto Eserine), Pilocarpine (Pilocar)
What is presbyopia?
Inability to focus up close (farsighted) due to decreased elasticity in the lens.
What is fluorescein angiography?
Angiography with dye that uses special cameras to find leaks or damaged blood vessels in retina or deeper choroidal level
(Can be helpful diagnosing retinopathy, retinal bleeding, and macular degeneration)
Name at minimum 3 symptoms that occur with retinal detachment
Floaters
Flashes
Field cut
(Curtain being lowered, No pain, Looking through cobb webs or veil)
What does the mnemonic CALM EAR stand for?
C-cisplantin, carboplatin
A-aminoglycosides (tobramycin, gentamycin)
L-loop diuretics (furosemide)
M-malaria (quinine)
E-erythromycin
A-aspirin
R-red man syndrome (vancomycin)
How do carbonic anhydrase inhibitors work to treat vertigo?
E.G. Diamox (Acetazolamide), Dyazide (Triamterene/HCTZ)
Works by restricting the over production of fluid in the inner ear.
Name at a diagnostic test used to test visual acuity
Snellen chart
Rosenbaum
LogMar
This test is used to assess intraocular pressure and potential glaucoma
Tonometry
Discuss nursing education for a client with glaucoma. Name at least 2
-You will need to be on lifelong medication
-Avoid anticholinergic medications which cause the pupils to dilate (Atropine, Diphenhydramine, Hydroxyzine)
-Contact HCP prior to starting new medications
**NCLEX tip-wear MedicAlert bracelet**
What are signs and symptoms of otosclerosis?
Progressive bilateral hearing loss (usually begins in adolescence)
Tinnitus
Pinkish/orange tympanic membrane on otoscopic exam
What do mydriatic eye drops due?
E.G. atropine (Isopto Atropine)
Dilate pupils for examination
***Dark glasses are needed until medication wears off***
What does the 6 cardinal fields of gaze test?
Muscle balance and eye movement
What is normal intraocular pressure
10-20 mm Hg
What are the two types of macular degeneration?
(Need to describe them)
1. Dry- Photoreceptors in the macula fail
2. Wet-Retinal tissue degenerates, new fragile blood vessels form, leaking of fluid under the macula
(Slow progressive central vision loss)
What are some nursing care interventions after a stapedectomy?
Bedrest for several hours
Lie on unaffected side
Cotton ball in ear (change prn)
Sneeze with mouth open
Avoid blowing nose, flying, scuba diving, exercise
What is the mechanism of beta adrenergic blockers prescribed for the eyes?
E.G. timolol (Timoptic), betatoxol (Betoptic)
Reduces intraocular pressure by reducing aqueous humor formation and increasing its outflow
**Monitor for bradycardia, heart block, wheezing**
What is the process of hearing?
Sound waves come into ear via auditory canal
Vibrations get transmitted via the tympanic membrane to the auditory ossicles to the inner ear
Hair cells bend in inner ear and generate impulses that get transmitted to the temporal lobe of the brain via cranial nerve VII (vestibulocochlear)
What is glaucoma?
An ocular disease that damages the optic nerve by causing increased pressure in the eye from fluid build up.
Primary open angle-decreased outflow of aqueous humor
Primary angle closure-blocked out flow
What type of glaucoma is a considered a medical emergency that causes sudden eye pain?
Primary angle closure glaucoma
What is Meniere disease?
Dilation of the labyrinth
What is the mechanism of action of antiangiogenetics medications?
E.G. pegatanib (Macugen), nedocromil (Alocril)
Inhibits growth of new blood vessels and slows progression of wet age related macular degeneration
What is the process of equilibrium?
Inner ear has receptors for equilibrium within the semicircular canals. They detect movement of the head. (Vestibular system)
Hair cells bend in response to head position and generate an impulse via cranial nerve VIII (vestibular portion) to cerebellum, medulla
What is the difference between conductive hearing loss and sensorineural?
Conductive- Sound waves do not reach the inner ear due to an issue with the outer or middle ear. E.g. cerumen, otosclerosis
Sensorineural-When the inner ear, vestibulocochlear nerve, or brain's processing center are damaged. E.g. Ototoxic medications, congenital
Discuss post-op instructions after cataract surgery (name at least 3)
No heavy lifting (Less than 10 lbs)
Avoid bending at the waist
Avoid water/shampoo in eyes
Wear eye shield
What are the triad of symptoms in Menieres disease?
Tinnitus
Vertigo
Sensorineural hearing loss