Ear & Eye Med Surg 2

What are the methods for administering eye medications
Instilled eye drops
Applied ointments

Common abbreviations are
OU = both eyes
OD = right eyes
OS = left eyes

Cataracts is
Lens opacity or cloudiness-leading cause of blindness

Surgery for cataracts is
basically like lasik

Pre-op care for cataracts
Ask pt if they have a history of taking alpha antagonists (interfere with pupil dilation)
Dilation drops are administered
Educate about eye meds (self admin to prevent postop infection & inflammation)

Post-op care for cataracts
Verbal & written education regarding eye protection
Wear eye shield at night for first week (avoid injury)
Should have minimal discomfort after surgery
Mild analgesic
Antibiotics, antiinflammatory, corticosteriods

Teaching for cataracts
Prevent rubbing or poking of eye
Wear eye patch for first 24 hours
Eyeglasses worn during day & night
Sunglasses worn outdoors during days (sensitive to light)
Slight morning discharge, red, scratchy feeling (expected)
Damp washcloth to remove discharge
Notify surgeon for new floaters, flashing lights, decrease in vision, pain, increase in redness (increases risk of retinal detachment)

Glaucoma is
Increased pressure within the eyeball, gradual loss of sight

Open Angle Glaucoma is
Eye is unable to drain, filtration area does not function normally causing increasing pressure & damages optic nerve.
No symptoms at first & than vision becomes compromised
Peripheral vision first affected than central

Closed Angle Glaucoma is
Abnormality in eye structure preventing drainage & increased eye pressure.
Medical emergency

Manifestations of Glaucoma
“Silent thief of sight”- pt unaware until vision changes
Blurred vision, halos around light, difficulty focusing, difficulty adjusting eyes in low light, loss of peripheral vision, aching around eyes, headache
*Drain channel completely blocked = extreme eye pain, nausea, blurred visiom, halos

Treatment for Glaucoma
*All promote outflow & decrease pressure
Mitotics (cause constriction)
Laser trabeculoplasty (laser burns to open spaces)
Filtering procedures (create an opening or fistula)
Trabeculectomy (remove part of meshwork)
Drainage implants/shunts (implanted & shunts)
Trabectome surgery (when nothing else has worked-stabilizes optic nerve & minimizes further damages)

Medication for Glaucoma
Beta blockers, adrenergic agents, carbonic anhydrase inhibitors, prostaglandins

Menieres disease is
Chronic disorder, hearing loss, vertigo, & tinnitus

Diet for Menieres disease
Low sodium diet (1000-1500 mg/day)
Stay hydrated!
Meals & snacks at regular intervals
Avoid coffee, tea, soft drinks, MSG
Limit alochol
Avoid aspirin
Take foods with potassium

Medication for Menieres disease
Antihistamines (shortens attack)
Transquilizers (vertigo)
Antiemtic (nausea, vom, vertigo)
Duirectics (lower pressure)

What is done for severe cases of menieres disease
Labyrinthectomy (excision on labyrinth)

The nurse is educating patients with glaucoma about medications. What medications will the nurse educate the patients about that decrease aqueous production. Select all that apply

Alpha-adrenergic agonists
Cabonic anhydrase inhibitors
Beta Blockers
Calcium channel blockers

Alpha-adrenergic agonists
Cabonic anhydrase inhibitors
Beta Blockers

Which of the following eye disorders is caused by an elevated intraocular pressure (IOP)?



A patient has had cataract extractions and the nurse is providing discharge instructions. What should the nurse encourage the patient to do at home?

Maintain bedrest for 1 week
Avoid bending the head below the waist.
Lie on stomach while sleeping
Lift weights to increase muscle strength

Avoid bending the head below the waist.

Which of the following medications needs to be withheld for 5 to 7 days prior to cataract surgery?



Some clients with acoustic neuromas have vertigo. What is a priority nursing action with clients with vertigo?

Protect the client from injury.
Protect the client from injury. rovide ice to the affected ear
Mobilize the client at every opportunity.
Provide small meals of tipid foods

Protect the client from injury.

The nurse is assisting the client in planning care during exacerbations of Ménière’s disease. Which diet would the nurse identify as appropriate at this time?

A low-sodium diet
A High protein
A low fat
A calorie controlled

A low-sodium diet

The client has been diagnosed with objective vertigo. Which symptom would the nurse relate to the tentative diagnosis?

Hearing ability fluctuations
Pain in the outer ear
Frequency of a headache
A sensation of things moving

A sensation of things moving

A client with Meniere’s disease has a nursing diagnosis of risk for injury related to gait disturbances and vertigo. Which of the following would be most appropriate to include in this client’s plan of care?

Sitting down at the first signs of dizziness
Moving the head from side-to-side when vertigo occurs
Closing the eyes when lying down during an episode of vertigo
Performing self-care activities when the vertigo first starts

Sitting down at the first signs of dizziness

A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract …

A client is color blind. The nurse understands that this client has a problem with: cones. The nurse is reviewing the medical record of a client with glaucoma. Which of the following would alert the nurse to suspect that the …

The nurse is educating a preoperative client about colostomy surgery. The colostomy surgery is Cosmetic Curative Diagnostic Palliative Palliative surgery is performed to relieve symptoms of a disease process but does not cure the disease. In going through the preoperative …

A high school athlete has suffered a nasal fracture. What is the priority action of the nurse caring for the client? Assess for airway patency. After facial trauma, a client has a nasal fracture and is reporting constant nasal drainage, …

A client’s cast is removed. The client is worried because the skin appears mottled and is covered with a yellowish crust. What advice should the nurse give the client to address the skin problem? Apply lotions and take warm baths …

The client is admitted to the telemetry unit diagnosed with acute exacerbation of congestive heart failure (CHF). Which signs/symptoms would the nurse expect to find when assessing this client? Apical pulse rate of 110 and 4+ pitting edema of feet. …

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