WORKSHEET IN NCM 109: LECTURE
NURSING CARE OF A FAMILY WHEN A CHILD HAS A VISION OR HEARING DISORDER
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1. Anatomy & Physiology of the Eyes.
OUTER LAYER
Name of Structure Function
MIDDLE LAYER
Name of Structure Function
INNER LAYER
Name of Function
Structure
Pupil The pupil appears as a black dot
in the middle of the eye. This
black area is actually a hole that
takes in light so the eye can focus
on the objects in front of it.
Iris The iris is the area of the eye that
contains the pigment which gives
the eye its color. This area
surrounds the pupil, and uses the
dilator pupillae muscles to widen
or close the pupil. This allows the
eye to take in more or less light
depending on how bright it is
around you. If it is too bright, the
iris will shrink the pupil so that
they eye can focus more
effectively.
Lens The lens sits directly behind the
pupil. This is a clear layer that
focuses the light the pupil takes
in. It is held in place by the ciliary
muscles, which allow the lens to
change shape depending on the
amount of light that hits it so it
can be properly focused.
Retina The light focused by the lens will
be transmitted onto the retina.
This is made of rods and cones
arranged in layers, which will
transmit light into chemicals and
electrical pulses. The retina is
located in the back of the eye, and
is connected to the optic nerves
that will transmit the images the
eye sees to the brain so they can
be interpreted. The back of the
retina, known as the macula, will
help interpret the details of the
object the eye is working to
interpret. The center of the
macula, known as the fova will
increase the detail of these images
to a perceivable point.
Fovea The fovea is located in the centre
of the macula region of the retina.
This tiny area is responsible for
sharp central vision essential for
reading, driving, and any activity
where visual detail is important.
Macula The macula is the centre of the
retina. It is a very small area but
has a high concentration of light
 sensitive cells (photoreceptors)
that allow us to read and see in
fine detail. The detailed vision is
known as our central vision. The
remaining larger area of the retina
is responsible for our peripheral,
or side, vision.

Optic The optic nerve is a thick bundle

Nerve of nerve fibers that connect the
back of the eye (retina) to the
brain. It transfers all the visual
information to the brain which
then interprets them as images.

2. Disorders that interfere with Vision.

Disorder Description Assessment findings Treatment & Nursing

Management
1. Myopia
2. Amblyopia
3. Strabismus
4. Congenital
Glaucoma
5. Cataract

3. Please list at least three Nursing Diagnosis for each patient

Chief Complaint
1. A 12-year old diagnosed with Astigmatism
2. 6-year old with Stye
3. 10-year old with Keratitis
4. 8-year old with a piece of barbeque stick inside the eyeball
5. 11-year old with a black eye after a quarrel with playmate

4. Prepare your discharge instructions for a 6-year old child who has undergone surgery removing a Chazalion from
her eyelid.

5. Anatomy & Physiology of the Ears

OUTER EAR MIDDLE INNER EAR

Name of Structure Function
Name of Structure Function
Structure
Cochlea
Name of Function
The cochlea resembles a
snail shell or a wound-up
hose and is filled with a
fluid called perilymph and
contains two closely
positioned membranes.
These membranes form a
type of partition wall in the
cochlea. However, in order
for the fluid to move freely
in the cochlea from one side
of the partition wall to the
other, the wall has a little
hole in it (the helicotrema).
This hole is necessary, in
ensuring that the vibrations
from the oval window are
transmitted to all the fluid
in the cochlea.

Vestibular  The vestibular is another

important part of the inner
ear. The vestibular is the
organ of equilibrium. The
vestibular’s function is to
register the body's
 movements, thus ensuring
that we can keep our
balance.

The vestibular consists of

three ring-shaped passages,
oriented in three different
planes. All three passages
are filled with fluid that
moves in accordance with
the body's movements. In
addition to the fluid, these
passages also contain
thousands of hair fibres
which react to the
movement of the fluid
sending little impulses to
the brain. The brain then
decodes these impulses
which are used to help the
body keep its balance.

Auditory Nerve The auditory nerve is a

bundle of nerve fibres that
carry information between
the cochlea in the inner ear
and the brain. The function
of the auditory nerve is to
transmit signals from the
internal ear to the brain.

The hair fibres in the

cochlea are all connected to
the auditory nerve and,
depending on the nature of
the movements in the
cochlear fluid, different hair
fibres are put into motion.
When the hair fibres move
they send electrical signals
to the auditory nerve which
is connected to the auditory
centre of the brain. In the
brain the electrical impulses
are translated into sounds
which we recognise and
understand. As a
consequence, these hair
fibres are essential to our
hearing ability. Should
these hair fibres become
damaged, then our hearing
ability will deteriorate.

6. Illustrate how a hearing aid and cochlear implant works.

7. Enumerate the key points of your discharge instructions to the family with a child who is hearing challenged.

8. Disorders of the Ear

Disorder Description Etiology Assessment findings Treatment & Nursing

Management
1. External Otitis
2. Acute Otitis Media
3. Otitis Media with
Effusion

References:
https://www.lei.org.au/services/eye-health-information/eye-diagram/
https://robertsonopt.com/parts-of-the-eye-their-function/
https://www.hear-it.org/The-inner-ear-1