neuro

Cards (29)

  • Cataracts
    Eye disease that causes cloudy lens and obscures light passage
  • Causes of Cataracts
    • Aging
    • Other ocular conditions (infection)
    • Toxic factors (cigarettes, calcium, iron, gold, silver)
    • Down's syndrome
    • Intrauterine rubella
    • Diabetes
    • Hypoparathyroidism
    • UV light
    • Medications (steroids)
    • Nutrition (obesity, malnutrition)
    • Trauma
  • Clinical Manifestations of Cataracts
    • What are the cues your patient will give you???
  • Diagnosis of Cataracts
    1. Visual acuity assessment (Snellen chart)
    2. Ophthalmoscope examination
    3. Slit-lamp examination
  • Treatment of Cataracts
    1. Attempt to reduce risk factors but there are no non-surgical treatments
    2. Surgical removal of lens
    3. Lens replacement
  • Preoperative and Postoperative Interventions for Cataracts
    1. Preoperative: NPO, medication history, will wear eye patch for 24 hrs to rest eye
    2. Postoperative: No increase of intraocular pressure, Don't bend over, Avoid sneezing or coughing hard, Use stool softener to avoid straining
  • Glaucoma
    • Increased intraocular PRESSURE!!!!
    • Second leading cause irreversible blindness
  • Types of Glaucoma
    • Open angle (primary)
    • Angle closure (formerly narrow angle)
  • Glaucoma Pathophysiology
    1. Blocked duct= increased IOP
    2. Need to slow down progression
    3. Less invasive drops
  • Clinical Manifestations of Glaucoma
    • Early vs Late Cues?
  • Diagnostic Testing for Glaucoma
    1. Measurement of IOP
    2. Ophthalmoscopic exam of optic disc
    3. Central visual fluid testing
  • Treatment of Glaucoma
    1. Decrease Intraocular Pressure
    2. Pharmacologic: Increase drainage, Decrease production of aqueous humor, Topical medications
    3. Surgical Intervention: Laser trabeculosplasty, Trabeculectomy
  • Marijuana can be used to treat Glaucoma
  • Nursing Care of Glaucoma
    • This is a lifelong disease
    • Flow to administer medication
  • Retinal Detachment
    • Involves the separation of the retina from the epithelium
    • Blindness will occur if complete detachment occurs
  • Clinical Manifestations and Interventions for Retinal Detachment
    • What cues will your patient have?
    • How do you intervene?
  • Surgical Treatment for Retinal Detachment
    Scleral Buckling procedure
  • Nursing Care after Scleral Buckling Procedure What MUST your patient avoid?
    increasing intraoccqular pressure:
  • Meniere's Disease
    • Inner ear problem caused by too much production or not enough reabsorption of endolymphatic fluid
    • Also known as endolymphatic hydrops
    • Classified as sensorineural hearing at times
    • Cause is generally not known
    • Onset occurs between 20-60
  • Clinical Manifestations of Meniere's Disease
    • What are the patient cues???
  • Diagnostic Testing for Meniere's Disease
    1. Audiometry testing
    2. Otoscopic examination
    3. Weber & Rinne testing
    4. Balance testing
  • Interventions for Meniere's Disease
    1. No cure
    2. Monitor patient safety
    3. Diet adjustments
    4. Promote lifestyle changes
    5. Medication
    6. Safety
  • Ophthalmic Medication Administration
    • Wash hands and don gloves
    • Administer drops first if both eye drops and ointment are scheduled
    • Wait 3-5 minutes if two medications are scheduled
    • Place medication in lower conjunctival sac
    • Apply gentle pressure to nasolacrimal duct 30 seconds-1 minute following administration
  • Mydriatics, Cycloplegic and Anticholinergic Medications
    • Dilate pupils, relax muscles, contraindicated in glaucoma
    • Side effects: tachycardia, photophobia, hypertension, atropine toxicity (dry mouth, urinary retention, conjunctivitis)
    • Interventions: monitor side effects and toxic effects, educate that burning sensation may occur during installation
  • Medications to Treat Glaucoma
    • Reduce IOP
    • Open anterior chamber angle and increases outflow of aqueous humor
    • Side effects: myopia, headache, eye pain, decreased vision in poor light
    • Interventions: assess vital signs, risk for injury, degree of diminished vision, monitor for side effect and toxic effects, monitor for postural hypotension
  • Beta Blockers Eye Medications
    • Decrease IOP and decreases aqueous humor production, contraindicated in asthmatic and COPD patients
    • Side effects: ocular irritation, bradycardia, hypotension, bronchospasm
    • Interventions: monitor apical pulse, blood pressure, monitor for shortness of breath and notify PCP if occurs, educate patient to change positions slowly to reduce risk of orthostatic hypotension
  • Carbonic Anhydrase Inhibitors

    • Decrease aqueous humor formation and IOP, contraindicated in patients allergic to sulfonamides and used with caution in those with severe renal or liver disease
    • Side effect: paresthesias, polyuria, hypokalemia, photosensitivity, drowsiness
    • Interventions: assess risk for injury, monitor intake and output, assess visual acuity, monitor for paresthesias and hypokalemia signs
  • Osmotic Medications
    • Mannitol (Osmitrol) lowers IOP and are used in emergent treatment of acute closed angle glaucoma
    • Side effects: headache, GI disturbances, disorientation
    • Interventions: monitor side effects, assess risk for injury, assist with monitoring effectiveness of medication
  • Medications to Treat Macular Degeneration
    • Pegaptanib (Macugen), Ranizumab (Lucentis), Bevacizumab (Avastin), Aflibercept (Eylea)
    • Side effects: blurred vision, cataracts, endophthalmitis
    • Interventions: teach patient about administration, side effects and when to notify PCP