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Sensory EENT Disorders(2) Edited

Sensory EENT Disorders(2) Edited

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Published by: snpjavier on Sep 08, 2010
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03/02/2013

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9/8/20101
Care of Clients withCare of Clients withSensory ProblemsSensory Problems
Pocholo Santos
Chinese General Hospital College of NursingNCM 104
D
iagnostic Assessment
D
iagnostic Assessment
D
iagnostic Assessment
D
iagnostic Assessment
1.Eyea.Snellen¶s Chart
T
o check visual acuityb.
T
onometry
T
o measure intra-ocular pressure
N=12-20 mmHgc.Perimetrya.
T
o check peripheral visiond.Bjerrum¶s tangent screen
For central visione.Ishihara plate
Color vision
D
iagnostic Assessment
D
iagnostic Assessment
D
iagnostic Assessment
D
iagnostic Assessment
2.Eaa.AudiometryDecibels
U
nit of measurement in hearing
70 decibels do not damage the ear 
Conductive Hearing Loss
Problems with tympanic membrane, middle ear or mastoid
Sensorineural Hearing Loss
Problems of the Cochlea (sensory) and acousticnerve (neural)
Mixture Hearing Loss
Combinatation of conductive and sensorineuralaffectation
D
iagnostic Assessment
D
iagnostic Assessment
D
iagnostic Assessment
D
iagnostic Assessment
V
estibular functionDiagnostic test for balance andequilibriumOculovestibular reflex or calorie test
T
est 8
th
cranial nerveCold or hot water into externalauditory canal produces nystagmus
D
iagnostic Assessment
D
iagnostic Assessment
D
iagnostic Assessment
D
iagnostic Assessment
T
uning fork
W
eber test
On patient¶s forehead or teeth
Rinnes test
Shifted between mastoid bone and 2inches from the ear canal opening
 
9/8/20102
Eyes DisordersEyes Disorders
 Anatomy & Physiology Anatomy & Physiology[EYES][EYES] Anatomy & Physiology Anatomy & Physiology[EYES][EYES]
Outer Protective Layer 
Sclera-the white visible portion of the eyeball.
T
he muscles that move theeyeball are attached to the sclera.
Cornea-the clear, dome-shaped surface that covers the front of the eye.Middle
V
ascular Layer 
Choroid-the thin, blood-rich membrane that lies between the retina and thesclera; responsible for supplying blood to the retina.
Ciliary body-the part of the eye that produces aqueous humor.
Iris-the colored part of the eye.
T
he iris is partly responsible for regulating theamount of light permitted to enter the eye.Inner Neural Layer 
Pupil-the opening in the middle of the iris through which light passes to theback of the eye.
Retina-the light-sensitive nerve layer that lines the back of the eye.
T
heretina senses light and creates impulses that are sent through the optic nerveto the brain.
 Anatomy of the Eye  Anatomy of the Eye 
 Anatomy & Physiology Anatomy & Physiology[EYES][EYES] Anatomy & Physiology Anatomy & Physiology[EYES][EYES]
Refractive Media
Cornea -transparent layer that forms the external coat of theanterior portion of the eye
 Aqueous humor-the clear, watery fluid in the front of theeyeball.
Lens (Also called crystalline lens.)-the transparent structureinside the eye that focuses light rays onto the retina.
V
itreous body-a clear, jelly-like substance that fills the backpart of the eye.
G
laucoma
G
laucoma
G
laucoma
G
laucoma
increased intraocular pressure which can damageoptic nerve that eventually lead to blindnessCauses:
Congenital, inherited, trauma
 
9/8/20103
2
TYPES of 
GL
 AUCOMA
2
TYPES of 
GL
 AUCOMA
( Narrow Angle or Close Angle)
Imbalance in the productionand excretion of aqueoushumor that leads tointraocular tension anddisplacement of iris againstthe angle of anterior chamber 
( Simple,
W
ide or Open Angle)
 Actual obstructionin theexcretion of the aqeuoushumor 
Slow, gradual development
 Asymptomatic at first
GLAUCOMA (ACUTE AND CHRONIC)
Risk factors:
1.
Unknown
2.
Emotional disturbances
3.
Hereditary factors4
.
 Allergies
GLAUCOMA (ACUTE AND CHRONIC)
Subjective Data
1.
 Acute (Close-angle)a
. P
ain, severe in and around eyesb
.
Headachec
. *
Rainbow halos around lightsd
. B
lurring of visione
.
Nausea, vomiting
2.
Chronic (Open-angle)a
.
Eyes tire easilyb
. *
Loss of peripheral vision
GLAUCOMA (ACUTE AND CHRONIC)
Objective Data
1.
Corneal edema
2. *
Decreased peripheral vision
3.
Increased cupping of optic disc4
.
Tonometry pressures
"
22
mm
.
Hg5
. P
upils dilated6
.
Redness of eye
GLAUCOMA (ACUTE AND CHRONIC)
 Analysis
/
Nursing Diagnosis
1. V
isual sensory
/
perceptual alterations
2. P
ain
3.
Risk for injury
GLAUCOMA (ACUTE AND CHRONIC)
Nursing Care
P
lan
/
Implementation
1.
Goal: reduce intraocular pressurea
. B
ed restb
.
Semi Fowler¶sc
.
Medications:i
.
Miotics (pilocarpine, carbachol)ii
.
Carbonic anhydrase inhibitors(acetazolamide [Diamox])iii
.
 Anticholinesterase(demecarium bromide [Humorsol])iv
.
Ophthalmic (timolol)

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