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1
Question
What are the main components of general eye care and health promotion?
Answer
- Regular eye exams - Adequate nutrition supporting eye health (vitamin A; fruits and red/orange/dark green vegetables) - Eye protection (sunglasses for UV, sports/occupation protection, reduce screen-time risks) - Preventing eye infections - Control systemic conditions (diabetes, hypertension) and stop smoking to protect visual sensory perception
2
Question
Define cataract and explain its basic pathophysiology.
Page 3
Answer
Definition: The lens of the eye loses transparency (clouds). Pathophysiology: The lens is composed mostly of water and protein. With age (or other insults) it dehydrates, the proteins denature/aggregate, the lens thickens and becomes less transparent, scattering light and reducing vision.
3
Question
List common modifiable and nonmodifiable risk factors for cataracts.
Page 5
Answer
Modifiable: Smoking, uncontrolled diabetes, hyperlipidemia, UV/sunlight exposure without protection. Nonmodifiable: Aging, trauma.
4
Question
What are typical symptoms and clinical manifestations of cataracts?
Page 7
Answer
- Gradual loss of vision - Blurred/cloudy/hazy or foggy vision - Diplopia (double vision) - Decreased color perception - Reduced visual acuity - White/cloudy pupil appearance (visible opacity) - May see halos or increased glare
5
Question
What is the standard treatment for visually significant cataracts and key post-op nursing instructions?
Page 9
Answer
Treatment: Surgical removal of the cataract (phacoemulsification with intraocular lens implant). Post-op nursing: Postoperative antibiotics and anti-inflammatories (often eyedrops), dark glasses outdoors, eye patch at night, avoid activities that increase intraocular pressure (bending at waist, heavy lifting >10 lb/4.5 kg, straining, vomiting, sexual intercourse, tight collars/ties), avoid ASA/antiplatelets until cleared, keep follow-up appointments, report severe pain/redness/vision loss/green or yellow drainage.
6
Question
Name common nursing diagnoses for cataract patients.
Page 11
Answer
- Disturbed Sensory Perception (Visual) - Fear/Anxiety - Risk for Injury - Social Isolation - Deficient Knowledge (about postop care and prevention) - Impaired Home Maintenance
7
Question
Define glaucoma and describe the difference between open-angle and closed-angle glaucoma.
Page 12
Answer
Definition: A group of eye conditions where drainage of intraocular fluid is disrupted, leading to increased intraocular pressure and optic nerve damage. Open-angle: Trabecular meshwork is partially obstructed but some drainage still occurs; develops slowly. Closed-angle: No drainage occurs because the angle between iris and cornea is closed—can be acute and is an ophthalmic emergency.
8
Question
What are key signs/symptoms of open-angle glaucoma?
Page 13
Answer
- Develops slowly; often affects both eyes - Often asymptomatic early - Foggy vision - Mild eye ache or headaches - Late signs: halos around lights, loss of peripheral vision leading to tunnel vision
9
Question
What treatments are used to lower intraocular pressure in glaucoma?
Page 14
Answer
Medical: Topical ophthalmic medications such as beta blockers (timolol), prostaglandin analogs, alpha agonists, carbonic anhydrase inhibitors. Procedural/surgical: Laser trabeculoplasty, trabeculectomy, or shunts. In acute closures: pilocarpine to open meshwork, osmotic diuretics (mannitol) to rapidly reduce pressure. Nursing: Monitor use of medications (timolol reduces aqueous production), teach administration and side effects.
10
Question
Define macular degeneration and name the two types.
Page 16
Answer
Definition: Loss of central vision clarity due to degeneration of the macula (central retina responsible for detailed vision). Types: Dry (atrophic) — more common, slower, associated with drusen/yellow deposits; Wet (neovascular) — less common (~10%), faster, associated with abnormal blood vessels, hemorrhage and ischemia.
11
Question
List risk factors for macular degeneration (modifiable and nonmodifiable).
Page 17
Answer
Modifiable: Hypertension, obesity, hyperlipidemia, smoking, poor diet (low vitamin E/carotene). Nonmodifiable: Age (older), family history, more common in Caucasians and women.
12
Question
What are classic symptoms of macular degeneration?
Page 19
Answer
- Blurred central vision - Dark or fuzzy spots (central scotomas) - Metamorphopsia (distorted or wavy vision) - Decreased contrast sensitivity and difficulty reading or seeing in dim light - Loss of ability to read/drive; trouble seeing faces
13
Question
What treatments are used for wet macular degeneration?
Page 22
Answer
Treatments: Anti-vascular endothelial growth factor (anti-VEGF) injections (e.g., ranibizumab, bevacizumab) to inhibit new vessel growth; photodynamic therapy (PDT); laser therapy in select cases. Nursing: education about injections, monitoring for infection, and follow-up schedules.
14
Question
Define retinal detachment and list common causes/risk factors.
Page 25
Answer
Definition: Separation of the retina from the underlying supportive tissue (choroid), causing impairment of vision due to retinal ischemia. Causes/Risk factors: Trauma, history of retinal tears, high myopia, previous eye surgery (cataract), increasing age, conditions like diabetic retinopathy and posterior vitreous detachment.
15
Question
What are classic clinical manifestations of retinal detachment?
Page 27
Answer
- Sudden onset of floaters - Flashes of light (photopsia) - A “curtain” or shadow coming across field of vision - Sudden loss of a portion of visual field - Often painless
16
Question
Describe initial acute management and nursing priorities for retinal detachment.
Page 26
Answer
Initial management: Emergent ophthalmology consult; keep patient supine with head turned towards detached area as directed; prepare for surgery (pneumatic retinopexy, scleral buckle, or vitrectomy). Nursing priorities: Protect the eye, keep patient NPO if surgery likely, provide emotional support, instruct on avoiding activities that increase intraocular pressure, monitor vision and pain, maintain positioning orders.
17
Question
What is Meniere’s disease and what are its primary symptoms?
Page 31
Answer
Definition: A disorder of the inner ear (endolymphatic sac) leading to excess fluid (endolymph) with unclear cause. Primary symptoms: Recurrent episodes of severe vertigo, tinnitus, fluctuating unilateral hearing loss, ear fullness, nausea/vomiting, and nystagmus. Attacks can last minutes to hours; may lead to progressive hearing loss.
18
Question
What medical treatments are used for acute Meniere’s attacks and for long-term management?
Page 36
Answer
Acute: Antiemetics and vestibular suppressants (meclizine), benzodiazepines for severe vertigo, antihistamines, diuretics (to reduce endolymphatic fluid) and low-salt diet as supportive measures. Long-term: Diuretics, low-sodium diet, avoidance of triggers; in refractory cases: intratympanic steroid injections, endolymphatic sac decompression, vestibular nerve section, or labyrinthectomy. Nursing: safety during vertigo, fall precautions, educate on trigger avoidance (salt, caffeine, alcohol), and medication adherence.
19
Question
Define tinnitus and list common causes.
Page 41
Answer
Definition: Perception of sound (ringing, buzzing, hissing) without an external source. Common causes: Age-related hearing loss, noise exposure, ear infections, ototoxic medications, Meniere’s disease, impacted cerumen, and sensorineural hearing loss.
20
Question
What is the recommended nursing communication and safety advice for patients with hearing loss?
Answer
- Use clear, calm communication; face the patient and speak slowly and clearly. - Ensure good lighting so lip-reading is possible; reduce background noise and distractions. - Do not shout; rephrase rather than repeat louder. - Confirm understanding, involve family/significant others with permission. - Teach hearing aid care if applicable and encourage early detection and treatment of ear disease. - Provide resources (hearing-impaired agencies) and recommend medical follow-up.
21
Question
Define epilepsy and seizures; what are generalized seizure types?
Page 11
Answer
Epilepsy: Chronic disorder with two or more unprovoked seizures due to disturbed electrical brain activity. Generalized seizure types include: Absence (petit mal), myoclonic, atonic (drop attacks), and generalized tonic-clonic (grand mal). Generalized seizures involve both cerebral hemispheres from onset and often produce loss of consciousness.
22
Question
What are priority nursing interventions during a generalized (tonic-clonic) seizure?
Page 13
Answer
- Protect patient from injury (loosen restrictive clothing; move nearby objects away). - Place patient in side-lying position once convulsions stop to maintain airway and allow secretions to drain; suction if necessary. - Do NOT force objects into mouth or use tongue blade; do NOT restrain movements. - Record time seizure started and ended, document type of movements, and vital signs; monitor airway/breathing and give O2 if ordered. - If prolonged (>5 minutes) or repeated seizures (status epilepticus), follow protocol for urgent IV benzodiazepines (lorazepam, diazepam) and call for emergency/rapid response. - Provide postictal care: reorientation, injury assessment, and safety precautions.
23
Question
List key diagnostic tests used in seizure disorders and their purposes.
Page 11
Answer
- Electroencephalogram (EEG): Detects abnormal electrical brain activity and helps classify seizure types. - CT or MRI: Identifies structural brain lesions (tumor, hemorrhage, stroke) that may cause seizures. - PET/SPECT: Functional imaging in complex cases; may help localize seizure focus pre-surgically. - Labs: Drug levels (antiepileptic monitoring), electrolytes, glucose, CBC as indicated. - Continuous EEG video monitoring for presurgical evaluation or unclear events.
24
Question
What are first-line emergency medications for status epilepticus and common maintenance antiepileptic approaches?
Page 14
Answer
Emergency (to stop acute seizures/status): IV benzodiazepines (lorazepam, diazepam) — benzodiazepines rapidly terminate seizures. Next-line/maintenance: IV phenytoin (Dilantin) or fosphenytoin (Cerebyx) loading doses for ongoing control; long-term antiepileptic drugs vary (e.g., levetiracetam, valproate, carbamazepine) and require monitoring of levels and side effects. Vagal nerve stimulation or resective surgery may be options for refractory epilepsy.
25
Question
Define multiple sclerosis (MS) and its pathophysiology.
Page 18
Answer
Definition: A chronic, progressive, inflammatory autoimmune disease causing demyelination of nerve fibers in the brain, optic nerves, and spinal cord. Pathophysiology: Immune-mediated destruction of myelin sheaths (and sometimes axons), creating plaque-like demyelinated areas; results in slowed/abnormal nerve conduction and varied sensory, motor, and cognitive deficits.
26
Question
What are common signs and symptoms of MS to assess for?
Page 19
Answer
Sensory: Tinnitus, blurred vision, diplopia, decreased visual acuity, partial loss of vision (blind spot), hyperalgesia, vertigo. Motor: Weakness, fatigue, stiffness of extremities, tremors, nystagmus, dysarthria. Other: Decreased bowel/bladder function, unsteady gait, cognitive impairment, paresthesia, facial pain, decreased temperature sensation.
27
Question
What diagnostic tests help confirm MS?
Page 21
Answer
- MRI: Shows demyelinating lesions (plaques) in the white matter. - Cerebrospinal fluid (CSF) analysis: Oligoclonal bands indicating CNS inflammation. - Evoked potentials: Delay in nerve conduction supporting demyelination. - Clinical history and neurological exam showing dissemination in time and space.
28
Question
Outline general nursing care and teaching for patients with MS.
Page 25
Answer
- Encourage rest, stress reduction, and balanced diet (consider fatigue management and high-calorie if needed). - Medication compliance: disease-modifying therapies (interferons, IVIG, immunomodulators) and symptomatic meds (antispasmodics, antidepressants). - Provide referrals: physical therapy, occupational therapy, speech therapy, social services, neurologist. - Teach mobility and safety measures, fall prevention, bowel/bladder management, and energy conservation. - Support psychosocial needs and connect to community resources and vocational rehab if indicated.
29
Question
What is Parkinson’s disease (PD) and what are its cardinal motor signs?
Page 35
Answer
Definition: A progressive neurodegenerative disease caused by loss of dopaminergic neurons in the substantia nigra, leading to dopamine deficiency and relative excess of acetylcholine. Cardinal signs (classic): Bradykinesia (slowness of movement), resting tremor (pill-rolling), rigidity, and postural instability. Other features include masked facies, reduced smell, sleep disturbances, and autonomic dysfunction.
30
Question
Describe the mainstay pharmacologic therapy for Parkinson’s disease and nursing considerations.
Page 39
Answer
Mainstay: Levodopa-carbidopa (replaces dopamine centrally) — most effective for motor symptoms. Dopamine agonists and other agents (MAO-B inhibitors, anticholinergics) are adjuncts. Nursing considerations: Educate about medication timing/consistency, monitor for side effects (orthostatic hypotension, dyskinesias, hallucinations), encourage physical therapy, assess swallowing and risk for aspiration, and support nutrition (high-calorie/protein concerns around levodopa timing).