Question 1

A patient comes to the ambulatory care clinic after getting hay into the eyes while farming.Which action(s)should the nurse implement?

Accepted Answer

If the foreign body is not deeply embedded in the tissues of the eye,it can easily be removed by irrigation.Irrigation with clear,lukewarm water or sterile water or saline is used to remove a foreign body sticking to the cornea.Have the patient tilt the head back.Hold the eyelids open to prevent blinking.Sometimes a speck of foreign matter on the cornea can be removed with a moistened,sterile cotton swab.The goals of treatment will be to remove the foreign objects from the eyes and to prevent further injury to the eye.Rubbing an irritated eye may cause a corneal abrasion.

Question 2

The nurse is caring for a patient following a left corneal transplant.When positioning the patient,the nurse correctly assists the patient into which positions?

Accepted Answer

The patient may lie only on his back and nonoperative side postoperatively.Flat on his back,on his back with his head on a small pillow,and positioned on his nonoperative side are acceptable as all these positions place no undue pressure on the transplant.Allowing the patient to rest on the operative side or in high Fowler position would place excessive pressure on the operative site.

Question 3

A patient presents to a walk-in clinic with a small piece of rock deeply embedded in his right eye.What should the nurse do first?

Accepted Answer

If a foreign body is sticking out of the eye,no attempt to remove it should be made.Both eyes should be patched to prevent further eye movement,and then the patient should be referred to the emergency department or to an ophthalmologist.For foreign bodies not deeply embedded in the tissues of the eye,irrigation can easily remove them.Irrigation with clear,lukewarm water or sterile water or saline is used to remove a foreign body sticking to the cornea.

Question 4

The nurse is caring for a patient who is receiving dipivefrin (Propine).Which abnormal finding is an expected side effect of this medication?

Accepted Answer

Sympathomimetic drugs such as dipivefrin are used to reduce intraocular pressure by increasing aqueous outflow.They can cause tachycardia and hypertension.

Question 5

Which manifestation is the classic early warning symptom of a detached retina?

Accepted Answer

Seeing flashing colored lights is an early warning symptom of retinal detachment.

Question 6

The nurse is caring for a patient who has developed keratitis.When planning care,the nurse should implement which action to improve the patient's comfort?

Accepted Answer

Keratitis is an inflammation of the cornea caused by irritation or infection.Artificial tears will reduce the irritation.Antibiotics can be given in the event of a bacterial infection.Eye shields and compresses are not indicated in the management of this condition.

Question 7

The patient with glaucoma is prescribed an Ocusert miotic.How often should the medication be replaced?

Accepted Answer

Eye medications that are delivered per Ocusert are replaced every week.

Question 8

The nurse is caring for a patient with suspected macular degeneration.During the assessment the patient is asked to focus on an image.Which finding supports the diagnosis?

Accepted Answer

The person with macular degeneration sees a dark spot in his central vision.Peripheral vision is not affected until later in the disease.

Question 9

The nurse is caring for patient who presented to an ambulatory care clinic with a large amount of sand in his eyes following an all-terrain vehicle accident.After the nurse completes eye irrigation,the patient reports that his eyes still hurt and feel irritated.What action is most appropriate?

Accepted Answer

The continued sensation of grittiness or irritation may signal the presence of a corneal abrasion.To prevent further injuries,the nurse should notify the physician.

Question 10

The nurse is reviewing the plan of care for a patient following a tympanoplasty.Which intervention should the nurse implement in the immediate postoperative period?

Accepted Answer

Postoperative care involves keeping the patient quiet and flat in bed for at least 12 hours.Coughing and sneezing should be avoided,or if unavoidable,should be accomplished with the mouth open to decrease pressure in the ear.Position changes should be accomplished slowly.The head is turned so that the affected ear is uppermost.

Question 11

After teaching a patient about a new eye medication,the nurse observes the patient applying eye ointment.Which technique indicates that the nurse's teaching has been successful?

Accepted Answer

A thin line of eye ointment should be applied from the inner canthus to the outer canthus along the lower eyelid inside the conjunctival sac.

Question 12

The nurse is teaching a patient who is scheduled to undergo surgery to manage glaucoma.Which statement indicates that the patient understands the nurse's teaching about the procedure?

Accepted Answer

Glaucoma is a condition that causes increased ocular pressure.Surgical management for the condition seeks to provide an increased outflow of aqueous humor.

Question 13

The patient with a corneal transplant asks how long he must wear the eye shield at night.The nurse instructs the patient that he should wear the shield for at least what period of time?

Accepted Answer

Nightly wearing of the eye shield following a corneal transplant is recommended for 1 month following surgery.

Question 14

The nurse is discussing the postoperative period with a patient with a corneal transplant.Which statement indicates that the patient displays realistic expectations about vision improvement?

Accepted Answer

Increasing visual acuity may take up to 2 weeks before improvement in vision is noted.

Question 15

The nurse is caring for a patient who has come to the ambulatory care clinic after experiencing a chemical burn to the eye.The nurse should irrigate the patient's eye with which solution?

Accepted Answer

The preferred solution for use when irrigating the eye is an intravenous bag of normal saline.In the event that normal saline is not available,the next option would be tap water.

Question 16

The patient who had a corneal transplant is taught that inflammatory changes (redness,swelling,and pain)in the corneal graft are best indicators of which complication?

Accepted Answer

Inflammatory symptoms are indicative of graft rejection.

Question 17

The nurse is caring for a patient with Ménière disease.Which action is most important for the nurse to take?

Accepted Answer

Treatment of Ménière disease focuses on relieving symptoms; there is no cure for this condition,although the disorder does disappear spontaneously in some cases.To control edema and reduce pressure in the inner ear,the patient may be placed on a low-sodium diet.The patient's fluid intake may be restricted,and diuretics may be ordered.The nurse should avoid turning on bright overhead lights,making loud noises,or having the patient reposition unnecessarily.

Question 18

The nurse notices that the patient must hold the newspaper at arm's length and squint to read.The nurse understands that this finding is consistent with which eye problem?

Accepted Answer

The person with hyperopia is farsighted; the patient cannot see things up close and must change the distance from the eyes in order to focus.The person with myopia cannot see things in the distance.Presbyopia refers to the hardening of the ciliary bodies of the eyes.Astigmatism refers to a visual defect resulting from a warped lens or an irregular curvature of the cornea.

Question 19

The nurse is caring for a patient in the postoperative period after enucleation.Which intervention is most important?

Accepted Answer

Postoperatively,the nurse should observe for signs of complications such as excessive bleeding,swelling,increased pain,elevated temperature,or displacement of the implant.Losing an eye is a devastating experience even when there has been a long period of painful blindness preoperatively.Understanding of the emotional impact and support of the patient are prime nursing responsibilities.The permanent prosthesis is placed about 6 weeks after the surgery,and while it is important to teach the patient about prosthetic placement and medications,providing support is most important.

Question 20

The nurse explains that a photorefractive keratectomy (PRK)is a very brief surgery that corrects myopia.Which statement indicates that the nurse's teaching about the procedure has been successful?

Accepted Answer

A PRK uses a laser to remove a thin layer of the cornea.The LASIK procedure uses a laser to reshape the cornea and replace the outer layer.Making tiny cuts in the cornea to flatten it refers to a radial keratotomy.

Quiz 26: Care of Patients with Disorders of the Eyes and Ears

A patient comes to the ambulatory care clinic after getting hay into the eyes while farming.Which action(s) should the nurse implement?