1
Q
glaucoma
A
- increased IOP
- optic nerve atrophy
- peripheral visual field loss
2
Q
normal IOP
A
10-21 mmHg
3
Q
prevention of glaucoma
A
early detection and treatment
4
Q
pathophysiology of glaucoma
A
rate of aqueous production (inflow) is greater than the rate of aqueous reabsorption (outflow)
-IOP rises above the normal limits
5
Q
primary open angle glaucoma
A
- most common type
- outflow is decreased in the trabecular meshwork
- drainage channels become clogged
- damage to the optic nerve can result
6
Q
s/s of primary open angle glaucoma
A
- develops slowly without symptoms
- tunnel vision
- IOP: 22-32 mmHg
7
Q
primary closed angle glaucoma
A
- reduction in outflow
- lens bulging forward d/t aging
8
Q
causes of acute closed angle glaucoma
A
- drug induced mydriasis
- emotional excitement
- darkness
- is an ocular emergency
9
Q
s/s of acute closed angle glaucoma
A
- sudden excruciating pain in or around the eye
- n/v
- HA
- IOP>50
- colored halos around lights
- blurred vision
- ocular redness
10
Q
s/s of subacute/chronic closed angle glaucoma
A
- colored halos around lights
- blurred vision
- ocular redness
- eye or brown pain
11
Q
collaborative care for chronic open angle glaucoma
A
- argon laser trabeculoplasty
- trabeculectomy/filtration surgery
12
Q
argon laser trabeculoplasty
A
- non surgical tx
- used when meds are not successful
- outpt procedure
- laser stimulates scarring and contraction of trabecular meshwork, which opens outflow channels
- reduces IOP approx 75%
13
Q
trabeculectomy
A
- surgery
- removes part of the iris and trabecular meshwork
- closes scleral flaps loosely
- success rate: 75-85%
14
Q
collaborative care acute closed angle glaucoma
A
- miotics
- mannitol
- laser peripheral iridotomy
- surgical iridectomy
15
Q
glaucoma assessment
A
- pt’s ability and psychological reaction
- visual acuity
- visual fields
- IOP
- fundus changes
16
Q
glaucoma teaching
A
- avoid activity that increases IOP: bending, straining, coughing, suctioning
- instillation of eye drops
- wear ID bracelet
- avoid self treatment
17
Q
gerontological considerations
A
- additive effects of beta adrenergic blocking glaucoma agents
- contraindications for beta adrenergic blockers: bradycardia, HTN, heart block, bronchospasm
- aspirin and CAI= increased salicyclic toxicity and acidosis
- eye drops and systemic absorption
18
Q
cataracts
A
- opacity within the lens
- can be in one of both eyes
- age related
19
Q
s/s of cataracts
A
- gradual decreased vision
- abnormal color perception/color blind
- glare worse @ night, when pupils dilate
20
Q
non surgical treatment for cataracts
A
- postpones the need for surgery
- change prescription of glasses
- strong reading glasses or magnifiers
- increased lighting
- lifestyle changes: no driving at night
21
Q
cataract extraction
A
- when palliative measures no longer provide acceptable visual function
- anterior capsule opened and the lens nucleus and cortex are removed
- capsular bag is intact
- surgery is the only cure
22
Q
assessment for cataracts
A
- visual acuity
- impact of visual disability
- level of knowledge
23
Q
age related macular degeneration (AMD)
A
- degenerative disease of the central portion of retina
- results in loss of central vision
- most common cause of irreversible central vision loss in 60+
24
Q
dry AMD
A
- nonexudative
- macular cells start to atrophy
- leads to a slowly progressive and painless vision loss
- close vision tasks become difficult
25
wet AMD
- exudative
- more severe
- rapid onset
- development of abnormal blood vessel in or near the macula
- pt with wet had dry first
26
causes of AMD
- aging
- genetics
- long term exposure to UV light
- hyperopia
- cigarette smoking
- light colored eyes
- nutrition
27
s/s of macular degeneration
- blurred vision
- darkened vision
- scotomas (blind spots in vision)
- metamorphopsia (distortion of vision)
28
diagnosing macular degeneration
* visual acuity
* opthalmoscopy
- amsler grid test: finds involved area
- fundus photography
- IV angiograph
29
treatment for wet AMD
- photodynamic therapy
- meds
- vitamins and minerals
- smoking cessation
30
photodynamic therapy
destroys abnormal blood vessels without permanent damage to retinal pigment epithelium and photoreceptor cells
31
treatment for dry AMD
no treatment
32
retinal detachment
separation of the sensory retina and underlying pigment epithelium, with fluid accumulation between the 2 layers
33
risk factors for retinal detachment
- increasing age
- severe myopia
- eye trauma
- diabetic retinopathy
- cataract surgery
- family or personal hx
34
untreated retinal detachment
become blind
35
retinal holes
atrophic retinal breaks that occur spontaneously
36
retinal tears
vitreous humor shrinks during again and pulls on the retina
37
s/s of retinal detachment
- photopsia (light flashes)
- floaters
- cobweb or hairnet vision
- ring int he field of vision
- painless loss of peripheral or central vision
- curtain falling like vision
38
diagnostic studies for retinal detachment
- visual acuity
- opthalmoscopy
- slit lamp microscopy
- ultrasound
39
treatment for retinal detachment
* *goal is to seal any retinal breaks
- laser photocoagulation
- cryopexy
* *and to relieve inward traction on the retina
- scleral buckling
- vitrectomy
- pneumatic retinopexy
40
postop care for retinal detachment
- topical agents: abx, steroids, dilators, analgesics
- position: prone
- activity restriction: no flying d/t high altitude
MedSurg
flashcards
Decks in class (22)
# Cards
-
neuro module21
-
acute intracranial problems36
-
acute intracranial problems 248
-
acute intracranial problems 313
-
chronic neurologic problems32
-
chronic neuro problems 223
-
chronic neuro problems 320
-
liver dysfunction21
-
liver dysfunction 218
-
HIV/AIDS22
-
CVA/SAH33
-
CVA/SAH 216
-
spinal cord injury20
-
spinal cord injury 26
-
AKI20
-
CKD16
-
drug tx and dialysis18
-
eye disorders40
-
autoimmune dx37
-
endocrine dx34
-
dx of adrenal cortex25
-
new deck3
