Sensory Review

Sensory review
1. How to administer eye medications

With the patient sitting or reclining, ask the patient to look up at the ceiling and tilt the head
slightly toward the eye receiving the drop.
• With a tissue beneath the fingers, retract the lower lid downward, exposing the conjunctival
sac.
• Stabilize the eyedrop container above the eye and drop the designated number of drops
directly into the conjunctival sac. Do not place drops on the cornea. Block the entrance to the
lacrimal gland by placing a finger over it.
• Carefully replace the cap on the container without contaminating the dropper tip.
• Ask the patient to close the eyelids gently and move the eyes from side to side under the lids
to distribute the medication
 Eyelid should remain closed for about 2 min w./o blinking
 Apply pressure on the tear duct wearing clean gloves against the bone and the nose
2. How to explain to someone the Snellen chart (20/70)

 Has lines of letters for visual acuity
 E chart is used for people w./ literacy issues
 Normal is 20/20  patient can see at 20 feet
 Mod / low 20/70 -20 /160 (0.5-1.3)  patient must be at 20 feet distance to see object
of what normal people would see 70 feet away
 Legal blindness 20/200 (higher then 1.3)
3. Know what are interventions if you have debris in your eye?
 Do not rub eye
 Tears can wash out the object
 Pull upper eyelid down on eye briefly
 Wipe from inner canthus to the outer canthus
 Irrigate w./ normal solution
 Remove w./ cotton swap if possible
 Topical antibiotic ointment to prevent infection
4. Eye drops for injured eye w./ patch cover
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 Eye patch is applied to keep the eyelid shut & to protect it from further damage
 Rest the eye
5. Patient report difficulty seeing the print on the newspaper? What is the diagnosis ?
 “Presbyopia”
 Hyperopia – farsightedness
6. Macular degenerations
 “ patient is moving about in the apartment w./o problems”
 “Central vision is gone & only peripheral vision remains”
 Slow progressive loss of central and near vision
 Onset is sudden
 Blurred vision
 Distortion of straight lines
 Dark or empty spot in central vision
 Decreased ability to distinguish colors
 Luetin
 Zeaxanthin
 Macular degeneration is another major cause of impaired vision. It is now known that
smoking has a direct link to the incidence of macular degeneration.
7. Know teaching for someone w./ open angle glaucoma
 Lifelong Compliance w./ drug therapy is essential to prevent loss of vision
 Report pain
 Keep walking area clutter free/ do not rearrange furniture
 Should carry medical alert id & medications
 Need regular eye exams
 Rest hand on forehead if hand movement is not steady
8. What test to do for screening for someone that has hearing acuity
 “Whisper voice test”-
 Rinne test- “ patient continues to hear the tuning fork for twice as long when it is lifted
from the mastoid bone”
 Weber test-
9. Infected cerumen of the ear canal for an older adult, what is most likely the cause of it
(something shrinks)
 “Dryness of secretions from shrinking ear canal glands”
 Cerumen is drier
 Secretions decrease
 Ceruminous glands shrink
 Keratin continues to collect
When performing an otoscopic exam ?
“Examine the eardrum”
10. Meniere’s disease intervention /medications
 Diuretics, antihistamines, vasodilators (prophylactic)
 Avoid alcohol, caffeine & tobacco.
 Meclizine (Antivert) for vertigo, tranquilizers, vagal blockers
 Bed rest
 Assess for nutritional deficiencies, dehydration, weight loss, or weight gain.
 Use a calming approach.
 Monitor for signs of anxiety.
 Provide a quiet environment & diversional activity.
 Initiate fall precautions.
 Monitor for headaches or fullness of the ears.

11. Which is the next step for STD finding?
 Report to cdc
12. Herpes simplex infection in the eye keratitis?
 “ wearing sunglasses indoors and outdoors to decrease photophobia effects”
 Inflammation of the cornea
 People who have “dry eyes” have decreased corneal sensation, immunosuppressed,
poor contact Len hygiene
 Place eyepatch over affected eye to help reduce pain
Signs & symptoms
 Pain increases w./ movement
 Blepharospasm
 Decreased vision
 Photophobia
 Tearing
13. Know s&s of sensorineural hearing loss
 Vertigo
 Tinnitus
 “Prolonged exposure to loud music”
 “Instruct client not to turn head quickly”
Medications to question ?
 “Gentamicin, furosemide & indomethacin”
14. Know about effectiveness of teaching pt who has visual impairment (visual impairment that
comes w./ diabetes?)
 “Background retinopathy”
 “Use a lower tone of voice”
 “ the best color discrimination b/w blue, green, & purple”
 Ask the patient what they need (don’t assume they need help w/ everything)
 Explain procedures before beginning them.
15. S&s to report w./ open angle glaucoma

 Develops bilaterally
 Onset is gradual & painless
 Mild aching in the eyes
 “Headache & Halos around lights”
 Frequent visual changes that are not correct w./ glasses
16. after ear & eye surgery (post op teaching)
Post op Eye Surgery
 How to administer eye medications
 Seek medical care for sudden or worsening pain, watery or bloody discharge, or sudden
loss of vision.
Post op Ear Surgery
 “impulses for hearing come from the middle and inner ear”
 Pt w/ ear tubes to avoid getting in water in the ear, use shower cap or ear plugs.
 Seek medical care if excessive bleeding or drainage occurs.
 Change cotton plug daily & as needed.
 Sneeze w/ mouth open
 Avoid blowing nose.
 No flying or heavy lifting.
 Make follow up appt.
 “obtain swab for drainage”
17. What is pneumatic retinopexy surgery?
 “Injects air or gas into the eye ball”
 “Reclining for about 16 hours before the procedure is required to allow the retina to fall
back toward the choroid”
procedure to repair a detached retina & restore vision. Recovery takes up to 1 week with

strict face down positioning for 4-6 hours followed by gradual elevation of the head until
it is upright.
 Expected findings
 “Flashing lights”
 “Loss of peripheral vision”
 “Loss of acuity in the affected eye”
18. Know about Carbuncle
 “Several hair follicles have formed an abscess”
 Erupt and drain spontaneously
19. If you have something penetrating the eye, what should you do? Why do you cover them?
 “Covering the uninjured eye stops ocular movement in the injured one”
20. Who is most at risk otitis media?
 HIV
 swimmers
21. What nonpharmaceutical measures can be done for otitis media?
 Offer a massage
 Apply heat to the area
 Offer liquid or soft diet
22. Patho for the retina, how does it work?
 “ the foeva centralis is located directly behind the center of the lens & contains cones”
 Contains photoreceptors (rods & cones) light rays focus to retina  transmission of
the subsequent nerve impulses to visual areas of the cerebral cortex
23. everything about Cataract surgery

one eye is treated at a time
laser or no stitch to remove “cloudy lens “
“place the index finger on the corner of the eye & apply pressure against the nose bone”
24. Why do you do a otoscopic examination?
 “To examine eardrum”
 To identify specific disorders or infections, remove wax, or remove foreign bodies
25. Know about glaucoma (what the pressure means)

 The pressure in the eye increases when the drainage system (trabecular meshwork & canal of
Schlemm) blocks the flow of the aqueous humor of the eye.
 What would you use to measure intra ocular pressure ?
 “Tonometer”
26. What should you not do with a guard dog?

 They should not be touched, touched, or fed w./o owners permission
 Ask petting preference
 Ask permission
27. Which client needs correcting when teaching about eye patch?
 Pt should not watch tv or read.
 Avoid patching just one eye (avoid ocular motion)
o Suggest quiet activities (listening to music or audiobook, or sleeping
28. What PPE to wear for irrigation Infection control
 Eye goggles or face shield
29. What is a positive Romberg test?
Patient stands w/ feet together, first w/ eyes open then closed. Positive test indicates patient has
difficulty maintaining balance or loses balance. (Inner ear problem)
30. for interventions for visual impairment ( SATA)
 Use large print labels or audiotaped instructions.
 Use large multicolored dot stickers on medication bottles & corresponding instruction cards.
 Lay out coordinated clothing for pt.
 Use a clock as reference for location of food on a plate.
 Use contrasting color for furniture & carpet/floor.
 Use bright tape or paint on the stairs.
 Well-lit areas
 Nonglare surfaces
 Large print signs
 Use of assistive devices
31. Know dos and don’t about atropine

 “Contact the physician “
 DO NOT give anticholinergics (atropine), antihistamines (Benadryl), or hydroxyzine
(Vistaril). CAUSE BLINDNESS
 Is a contraindication for patients w./ acute glaucoma, can cause blindness
32. Know about Meniere disease (at least 5 questions)
 “salt restricted diet & prescribed antihistamines & vasodilators”

 A balance disorder.
 Develops between ages 40-60
 May take several weeks to resolve.
 May result in permanent hearing loss.
S&S
 Vertigo
 Hearing loss
 Tinnitus
 Nausea & vomiting
 May have warning signs of headache or fullness in ears.
 Dizziness & unsteadiness
 Irritability
33. the nurse has reinforced teaching with a patient about the diagnostic tests that evaluate eye
muscle balance. which tests identified by the patient indicate teaching has been effective?
SATA
 cover test
 corneal light reflex

34. during a physical exam of a patient pupillary reflexes are checked. a light is shone
into the right eye while it is observed. pupillary reaction and size are noted. then a
light is shone into the left eye as the right eye is still observed. which response
occurs during the second step of this test?
 consensual response
35. while checking a patient's pupils, the nurse notes that the left pupil constructs when a light is
shone into the right eye. which info does the finding suggest to the nurse?
 consensual response present
36. the national eye institute has performed research regarding the impact of nutrition
on eye diseases. which factor does the nurse recognize as an incorrect
conclusion from this research?
 with intensive glycemic control, patients with DM do not experience retinopathy
37. the nurse determines that a patient is experiencing common age related changes
in vision and hearing. which finding does the nurse identify in the patient? SATA
 . presbycusis
yellowing of the lens
distorted depth perception
decreased lacrimal secretions
38. during a health history, the nurse suspects that a patient is at risk for a vision problem. which
info within the family history does the nurse use to make a decision? SATA
 DM
 cataracts
 blindness
 glaucoma
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Sensory review

1. How to administer eye medications

2. How to explain to someone the Snellen chart (20/70)

15. S&s to report w./ open angle glaucoma

Post op Ear Surgery

17. What is pneumatic retinopexy surgery?

23. everything about Cataract surgery

25. Know about glaucoma (what the pressure means)

26. What should you not do with a guard dog?

31. Know dos and don’t about atropine

32. Know about Meniere disease (at least 5 questions)

 “salt restricted diet & prescribed antihistamines & vasodilators”

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