Nursing Management of Clients with Sensory Function客户感觉功能的护理管理.pptVIP

Nursing Management of Clients with Stressors of Sensory Function NUR133 Lecture # 14 K. Burger, MSEd, MSN, RN, CNE Eye DisordersNursing Assessment History: Acuity changes, blurring, diplopia, photophobia, pain, use of gtts or other eye meds, hx of trauma, familial eye disease, occupational risks Risk Factors for Eye Disorders: Aging process, DM, HTN, HIV, +++others, Medications, Gender, Nutritional deficiencies Eye DisordersNursing Assessment Visual testing: distance, near, peripheral, color External examination: lids, conjunctivae, sclerae, pupils, extraocular muscles Internal examination: opthalmoscopy to observe- lens clarity, red reflex, fundus Sample Eye Assessment Note Near vision 20/40 each eye uncorrected, corrected to 20/20 with glasses. Distant vision 20/20 by Snellen. Color vision intact. Visual fields full by confrontation. Extraocular movements intact and full, no nystagmus. Corneal light reflex equal. Lids and globes symmetric. No ptosis, edema, or lesions Conjuntivae pink, sclerae white. No discharge evident. Cornea clear, corneal reflex intact. Irides brown; PERRLA Opthalmoscopic exam reveals red reflex. Discs cream colored, borders well-defined. Maculae yellow OU No venous pulsations, hemorrhages, exudates, Drusen bodies. Eye DisordersDiagnostic Assessments Tonometry – IOP testing (normal = 10-21mmHg ) Slit lamp – close examination of specific area of eye Corneal staining – detects corneal defects Angiography – detects circulatory defects Electroretinography – retinal light response GlaucomaEtiology/ Incidence / Prevalence Increased ocular pressure resulting from: inadequate drainage of aqueous humor overproduction of aqueous humor Pressure leads to damage of retina and optic nerve Primary – Secondary – Associated Increased incidence in African-Americans Increased incidence with aging GlaucomaTypes Open Angle Most common Bilateral Slow onset Usually painless Blurred vision Closed Angle Sudden onset E