EENT Flashcards by kylie hopper

EENT

-ears, eyes, nose, & throat
-provide not only sensory information to the body, but also contribute to nourishment & respiration

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eyes

-the eyes gather information for interpretation
-research estimates that 80-85% of our perception, learning, cognition, & activities are meditated through vision

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common diseases impacting sight

-glaucoma
-cataracts
-macular degeneration
-diabetic retinopathy

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risk factors for losing vision

-old age
-injury or TBI
-diabetes
-sickle cell anemia
-stroke
-smoking
-meds, such as prolonged use of corticosteroid’s
-dry eye disease

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ears

hearing allows us to interpret the daily cues we depend on to assess our environment, & to communicate w others

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common disorders of the ear

-otitis media
-tinnitus
-gradual hearing loss due to loud noises
-menieres disease

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risk factors for developing hearing loss

-recurrent &/or prolonged exposure to loud noises
-aging
-trauma
-recurrent infections that scar the tympanic membranes
-genetics
-autoimmune inner ear diseases
-ototoxic drugs

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nose

the human sense of smell is more sensitive than taste, being able to detect over 10000 odors

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risk factors for a decreased or loss of smell

-environmental factors that contribute to allergies
-chronic nosebleeds
-nasal polyps
-injury to nose or head trauma
-some meds
-toxic chemicals
-cocaine abuse
-age
-alzheimers, parkinsons, ms
-hormonal imbalance
-congenital conditions
-radiation tx of head/neck cancers

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throat/mouth

-the avg human tongue is covered w an avg 10000 taste buds
-the cells of the taste buds have an avg span of 10 days
-many URI begin in the throat, & inspection of the oral passages will give a clue to those infections
-loss of taste is not as common as loss of smell

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risk factors for loss of taste

-diseases of the facial nerve
-infections
-cytotoxic drugs, beta blockers, ACE inhibitors, lithium
-aging, esp. after 60
-nasal/sinus problems
-allergies
-nasal polyps
-periodontal disease
-long term smoking
-autoimmune diseases such as sjogrens syndrome
-head injuries
-nutritional deficiencies such as vit. b12, zin

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inspection of the EENT system

-assessing the structures of the ear, eye, nares, & throat
-utilization of an otoscope to inspect the tympanic membrane, illuminate the nares & septal tissues, & inspect the oropharynx

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palpation of the EENT system

-used to feel for surface abnormalities
-assessment of the auricle, mandibular, maxillary sinuses, & lymph nodes

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percussion of the EENT system

can be used to reveal tenderness as in assessing sinuses

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auscultation of the EENT system

-usually involves use of a stethoscope
-may use weber test to identify auricular issues

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common EENT diseases

-cataracts
-glaucoma
-menieres disease
-macular degeneration

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cataracts

-progressively worsening opacity of the lens of the eye
-the lends of the eye, normally transparent, becomes more dense, due to precipitating process
-the onset is slow, w a gradual worsening overtime
-may feel like they are looking through the cloudy window

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cataracts is the leading cause of

preventable blindness

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people more @ risk for cataracts

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-those who have had trauma to the eye
-are older
-been on chronic steriod tx
-increased exposure to UV rays
-HTN
-have diabetes

s/s of cataracts

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-blurred vision is the primary sign
-pain is not a symptom
-“foggy vision”, halos around objects, esp lights
-sensitivity to glare from bright lights
-yellow tint or washed out colors
-diplopia; double vision

physical assessment of cataracts

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-an absence of red reflex in children
-may see a while pupil reflex
-grey-while opacity of lens
-the red reflex may be absent or the cataract may appear as a black area on fundoscope exam

diag studies for cataracts

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-visual field acuity w shellen chart
-slit-lamp or ophthalmoscope exam; allows the examiner to view the cornea, iris, & lens & observes for abnormalities
-retinal exam; eyes are dilated so the examiner can more clearly see the back of the eye & look for signs

medical management for cataracts

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-need to have annual age exams
-protect eyes & head w hat & sunglasses
-manage co-morbid diseases such as diabetes
-corrective eyeglasses should be prescribed
-mydriatic drops; often recommended for dilating the lens & allowing pupillary dilation
-nonsterodial anti-inflammatory ophthalmics; used to decrease pain & inflammation w cataract surgery

surgical management for cataracts

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-lens extraction; usually includes artificial lens implant
-lens implant
-both are done on output basis

surgical risks of cataracts

-generally rare -inflammation -infection -bleeding/swelling -ptosis -lens dislocation -retinal detachment -glaucoma -loss of vision -secondary cataract

nursing management for cataracts

-quit smoking -manage bs & bp -encourage diet that includes plenty of fruits & veg -reduce alcohol consumption -adaptive devices; magnification, large print reading material

questions to ask if pt has cataracts

-can you see to safely do your job & to drive? -do you have problems reading or watching tv? -is it difficult to cook, shop, do yardwork, climb stairs, or take meds? -do vision problems affect your lvl of independence? -do bright lights make it more difficult to see?

glaucoma

-progressive, chronic eye disease, 2 main types, that result in vision loss & possible blindness due to optic nerve -develops when vitreous humor drains off too slowly, resulting in increased pressure -can happen in 1 or both eyes

glaucoma is caused by

increased ICP

acute glaucoma

-is a medical emergency -involves narrow angle blockage

glaucoma cure

-no cure but early tx can often stop the damage & protect vision -tx includes immediately decreased eye pressure

chronic glaucoma

involves wide angle blockage

s/s of glaucoma

-start slowly -usually starting w loss of peripheral vision of inner canthus -slow loss of wide peripheral visio -mild ache/pain in the eyes -photophobia

s/s of acute glaucoma

-unilateral pain -pupils moderately dilated/nonreactive to light -mildly blurred vision -halos around lights -n/v -increased than normal LOC -abnormal eye exam -cupped optic disc -redness -tearing -corneal clouding -ptosis

physical assessment of glaucoma

-eye exam w ophthalmoscope -measure eye pressure -inspect eye drainage angle & optic nerve for damage -measure thickness of cornea

diag studies of glaucoma

-tonometry; checks for IOP -slit lamp examinations -visual field tests -fundoscopy

med management for open angle glaucoma

-alpha agonists -beta blockers -carbonic anhydrase inhibitors -miotics -prostaglandin analogs

alpha agonists

decrease amt of fluid in the eye produces & increases amt that drains from the eyes to decrease pressure

beta blockers

reduce amt of fluid eye produces

carbonic anhydrase inhibitors

-decrease amt of fluid eyes produce -taken as drops or pill

miotics

make pupils constrict to decrease amt of fluid that drains from the eyes

prostaglandin analogs

increases drainage out of the eye

closed angle glaucoma

-is an emergency -immediate use of acetazolaminde iv to decrease ocular pressure is indicared, followed by iv mannitol if needed

surgical management

-laser surgery -trabeculectomy

pt education

-diet rich in fruits, veg, leafy greens while decreasing caffine & salt intake is recommended -avoid inverted yoga poses or other activities that put eyes below the heart -pt should avoid playing wind instruments -be sure ophthalmologist knows rx meds -assess needs for modifying home environment as vision worsens -teach proper application of eye drops

EENT Flashcards

(45 cards)