Exam 1 for NUR 407 - Adult Health & Illness III ORU

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what is a major risk factor for hearing loss?
____ loss affects nearly every aspect of an individual's life
progressive, age related hearing loss
cochlear implant
auditory prosthetic used for people with profound bilateral sensorineural hearing loss
aural rehabilitation
intervention to improve communication skills of the person who has a hearing impairment
hearing aids
much smaller and more cost effective
hearing guide dogs
For moderate to severe hearing loss assist owners in hearing things in the environment and cues owner
true or false? does repeated exposure to loud noises cause the development of conductive hearing loss?
false: noise exposure causes irreparable sensorineural hearing loss.
conductive hearing loss
hearing impairment caused by interference with sound or vibratory energy in the external canal, middle ear, or ossicles
in order to enhance communication with a pt who has moderate hearing loss the nurse should? a. speak as loudly as possible b. discuss only simply, unambiguous topics c. ensure the pt can see the nurse's mouth d. use writing as the sole means of communication
c. make sure the pt can see the nurses mouth
cerumen impaction:
buildup of ear wax blocking ear canal --> can be removed
how can cerumen be removed
irrigation, suction, or instrumentation
how are foreign bodies removed in the ear?
same way as cerumen
tympanic perforation
tear of hole in the eardrum
what causes tympanic perforation
infection or trauma
what sound does a tympanic perforation make
whistling sounds when you sneeze and blow your nose.
symptoms from tympanic perforation
pain, < hearing, purulent drainage
surgical repair of the eardrum
hearing loss that results from the formation of new, abnormal spongy bone that impairs the functioning of the stapes
options to help otosclerosis
only surgical: stapedectomy or stapedotomy
the sensation of dizziness
Involuntary rapid eye movements
is vertigo an issue with the middle or inner ear?
inner ear
is nystagmus a middle or inner ear issue?
inner ear
menière disease
chronic disease of the inner ear characterized by dizziness, ringing in the ear, and hearing loss
what causes meniere disease
changes in pressure within the inner ear or mixing of inner ear fluids
how can we treat pts with meniere disease
diet and medication
what meds would we prescribe someone with meniere disease?
antihistamines, tranquilizers, antiemetics, or surgery
true or false: a pt with meniere disease should be counseled to avoid high-salt foods and caffeine
TRUE: low sodium diet, NO alcohol or caffeine
is vertigo an issue with the middle or inner ear?
inner ear
ringing in the ears
what is tinnitus caused by
underlying disorder of the ear associated with hearing loss
benign paroxysmal positional vertigo (BPPV)
brief period of incapacitating vertigo that occurs when the position of the patient's head is changed
result of medications that have adverse effects of the cochlea, vestibular apparatus, or cranial nerve VIII
acoustic neuroma
slow growing benign tumor of cranial nerve VIII
a nurse should be aware of potential ototoxicity when administering which of the following medications a. amino glycoside antibiotics b. alpha-adrenergic blockers c. anti fungal meds d. opioid analgesics
amino glycoside antibiotics gentamicin are some of the most ototoxic drugs
nearsightedness - distant vision is blurred
farsightedness - near vision is blurred
irregularity of the curve of the cornea
20/400 to no light perception
true or false: typically an individual who becomes suddenly blind adapts to his or her new circumstances more easily than someone who loses vision gradually
false: pts with progressive eye disorders develop coping and management techniques over time
group of ocular conditions characterized by optic nerve damage related to intraocular pressure (IOP)
open-angle glaucoma
the most common form of glaucoma, where the trabecular meshwork gradually becomes blocked, causing a buildup of pressure
angle-closure glaucoma
Rapid onset of elevated IOP
clouding of the lens
nurse is teaching a group of older adults about cataracts what teaching point should the nurse include in this health education?
eye surgery is the most effective treatment for cataracts
retinal detachment
separation of the retinal pigment epithelium from the sensory layer
macular degeneration
tiny, yellowish spots called druse beneath the retina
two types of age-related macular degeneration
dry and wet
orbital trauma is used associated with
head injury
inflammation of the conjunctiva
major causes of conjunctivitis
infection, allergy, and irritating toxic stimuli
true or false: preventing the spread of conjunctivitis can often be accomplished by promoting hand washing
removal of entire eye and part of the optic nerve
surgical removal of the intraocular contents
The removal of the eyelids, the eye, and various amounts of orbital contents
common meds with eyes are
topic anesthetics, mydriatics, and cycloplegia agents
when administering a topical ocular medication to a pt the nurse should
position the pt's head in a supine position
non-specific response of the body to any demand for change
acute stress
results from daily life encounters: flight or fight response
chronic stress
sustained response or repeated event that eventually impedes coping
process of applying thoughts and actions to deal with stressful events
problem-focused coping
deals directly with the challenge
emotion-focused coping
directed at dealing with emotions
stimulus initiating the stress response
sociocultural stressors
family, financial, career concerns
altered coping patterns
smoking, drinking, physical illness, addictive behaviors
separation anxiety
fear/anxiety when separated from someone person is emotionally attached to
panic disorder
recurrent panic attacks
irrational fear of a specific object or situation
generalized anxiety disorder
uncontrollable excessive worry > 3 months
unrealistic obsessions
trauma and stress related disorders
- acute stress disorder - PTSD - adjustment disorder
Risk Factors for anxiety:
•Women •Trauma •Genetics •Other mental illness •Worse with substance Abuse 30-44 years old
mild anxiety symptoms
Restlessness, increased motivation, irritability
moderate anxiety symptoms
agitation, muscle tightness
severe anxiety symptoms
inability to function, ritualistic behavior, unresponsive
panic attacks
15-30 minutes palpitations SOB choking chest pain Nausea
social phobia
fear of embarrassment, dread of social situations, feels judged
avoids being outside
specific phobias
fear of objects or specific situations or events
collecting and putting things away in a guarded manner
sensory perception
ability to receive sensory input and translate it into meaningful info
the process by which our sensory receptors and nervous system receive and represent stimulus energies from our environment
the process of organizing and interpreting sensory information, enabling us to recognize meaningful objects and events
age related hearing loss
Toxicity to the ears, often drug induced and manifesting as varying degrees of hearing loss that is likely to be permanent.
abnormal sensation
5 senses
Sight, hearing, touch, smell, taste
what is the largest population at risk for impaired sensory perception
elderly population
what is a test we do for balance
what is Romberg test
Tests the client's equilibrium, client stands with feet together and arms at sides eyes open and then closed. Client should be able to maintain the position for 20 secs with minimal or no swaying
monofilament testing
Testing for lower extremity sensation Diabetic neuropathy screen LEAP program
what do we use for newborn's eyes to prevent infection
what age do vision and hearing screenings occur
around 2-2.5 years old
how often do you check someone's vision or hearing
3-5 years
what medications can we use to treat vision
beta-adrenergic, prostaglandin analogs, adrenergic agonists, carbonic anhydrase inhibitors, antimicrobial, steroidal, analgesics
is cochlear implants a surgery or adaptive method
the transparent outer covering of the eye
the transparent structure behind the pupil that changes shape to help focus images on the retina
Colored part of the eye - controls light levels
ciliary body
mass of muscles
vitreous humor
jellylike substance found behind the lens in the posterior cavity of the eye that maintains its shape
Light sensitive layer of the eye; contains rods and cones
retinal receptors that detect black, white, and gray; necessary for peripheral and twilight vision, when cones don't respond
color vision
which statement about age-related changes that affect vision is true
age-related changes affect all the structures involved in visual function
visual impairment
loss that cannot be corrected with glasses or contacts; ranges from mild to blindness
mild impairment
caused by normal age-related changes, exacerbated by environmental conditions such as glare and poor lighting
loss of accomodation
presbyopia - diminished ability to focus clearly on objects at various distances
diminished acuity
diminished ability to detect details and discern objects
delayed dark and light adaptation
slower adaptive response to changes in lighting
altered color vision:
perception so objects look darker and whites appear more yellowed
diminished critical flicker fusion
ability to perceive flashing lights
what is presbyopia
loss of accommodation
opacification and yellowing of the lens cause an altered perception of which colors
blue and green
AMD (age-related macular degeneration)
leading cause of severe vision loss
glaucoma explained
causes loss of peripheral vision leading to blindness if untreated
diabetic retinopathy
occurs when diabetes damages the tiny blood vessels in the retina, causing blood to leak into the posterior segment of the eyeball
which population is at highest risk for diabetic retinopathy
what is the leading cause of visual impairment in older adults
what is the leading cause of SEVERE vision loss in older adults
macular degeneration
what is the second leading cause of blindness in the U.S.
a client complains of a loss of peripheral vision. which condition should the client be evaluated for
which is not a consequence of a visual impairment while driving?
increased illumination with tinted windows --> it is actually decreased
outer ear
auditory canal
the area that sound waves pass through to reach the eardrum
tympanic membrane
separates outer and middle ear
what is the primary function of the tympanic membrane
transmit sound energy and protect middle and inner ear
What are the 3 auditory ossicles?
malleus, incus, stapes
what meds can affect or cause/contribute to hearing loss
ahminoglycosides, aspirin, loop diuretics, quinine
inflammation of the meninges of the brain and spinal cord
which is the most prevalent risk factor for impaired hearing
exposure to noise
sensorineural hearing loss
abnormalities of sensory and neural structures of inner ear, usually age related or noise induced
mixed hearing loss
combo of conductive and sensorineural impairments
which statement about tinnitus is true
-People with tinnitus should be evaluated pathologic conditions
which letters of the alphabet become distorted as hearing loss progresses
b, d, k, p, t
what do studies of the psychosocial consequences of hearing impairment demonstrate
hearing loss is less likely to have detrimental effects for people who have few social relationships
which is not a contraindication for clearing the impacted ear canal of cerumen
chronic disease of the respiratory system