Title HANDOUTS - SS (Mr. Aguirre) ✅

COMPREHENSIVE PHASE HANDOUTS SPECIAL SENSES Prepared By: Mr. Ian Rocky Aguirre, RN MAY 2025 Philippine Nurse Licensure Examination Review REFRACTIVE ERRORS ⇨ when ________ entering the eye ________________ on the retina ANATOMY & PHYSIOLOGY ● Refraction: ________________ ● Goal: ____________________ What affects refraction? 1. Cornea 2. Lens 3. Eyeball Myopia Hyperopia Astigmatis m Vision Eyeball Refraction Focal pt. Lens ASSESSMENT Visual Acuity Test ● Position ________ away ● Eye glasses on? ________________________ ● Sequence: ________________ ● Read the smallest line she/he can Interpretation: ________________ Normal: ________ Legal blindness: ________ CATARACT ⇨ cloudiness or opacity of the ________. ANATOMY & PHYSIOLOGY ● Colorless, transparent, biconvex structure ● Located between the ________ and ________ ● Contains ________ which are proteins that affect the opacity of the lens. ● 2 main functions: ○ Refraction ○ Accommodation TYPES ● Congenital cataracts ● Senile cataracts ● Traumatic cataracts ● Secondary cataracts ASSESSMENT Slit Lamp Examination ● used to assess ________________ ● an instrument equipped with a special lighting system and a binocular microscope. RN INTERVENTIONS Priority Goal: ________________ 1) Keep the side rails up 2) Assist the client while ambulating 3) Ensure clear pathway 4) Provide adequate lighting MD MANAGEMENT ● Surgical removal of all parts of the lens: ________________________ ● Surgical removal of all parts of the lens, except posterior capsule: ________________________ ○ Use of ultrasonic devices to liquefy the nucleus and cortex, followed by micro suction: ________________________ ○ Use of pencil-like instrument with a supercooled metal tip (-35° C) to extract lens: ________________________ Lens Replacement: ● 1st choice: ________________________ ● 2nd choice: ○ ________________________ ○ ________________________ Pre-op ● Apply eye drops ○ Analgesics (Flurbiprofen sodium 1%) ○ Mydriatic (Tropicamide) Post-op Priority Goal: ________________ TOP RANK REVIEW ACADEMY, INC. Page 1 | 3
● Position: ________________ ● Keep the eyes ___________ ● Protect the eyes ● Notify HCP if: ○ Signs of bleeding: ________________ ○ Signs of infection: ________________ ○ Signs of increased IOP: ________________ ● Avoid activities that increase IOP GLAUCOMA ⇨ increased ______________ caused by congestion of ________________ resulting in ________________ ANATOMY & PHYSIOLOGY Chambers of the eye ● Anterior ● Posterior ● Vitreous Aqueous humor is a liquid produced by the _________ that nourishes the _________ and maintains the normal IOP. Normal IOP: ___________ mmHg TYPES OPEN-ANGLE CLOSE-ANGLE Pain Progression Pathognomon ic sign ASSESSMENT Tonometry: measures ___ by determining the pressure necessary to indent or flatten small anterior area of the eye. ● Contact ● Noncontact Considerations: ● Document: ________________ ● Instruct: ________________ MD MANAGEMENT ● Prostaglandin analogs (Latanoprost) ● Beta-blockers (Betaxolol/Timolol) ● Carbonic anhydrase inhibitor (Acetazolamide) ● Miotics (Pilocarpine) OPEN-ANGLE CLOSE-ANGLE Laser trabeculoplasty Laser iridotomy Trabeculectomy RN INTERVENTIONS Priority Goal: ________________ 1) Diet: ________________ 2) Avoid bending over 3) Avoid valsalva maneuver 4) Avoid rubbing the eye 5) Avoid lifting objects heavier than 5 lbs 6) Avoid specific drugs: ________________ RETINAL DETACHMENT ⇨ separation of the _______________ of the retina from the ________________. ANATOMY & PHYSIOLOGY Layers of the eye ● Outer ● Middle ● Inner ○ RPE ○ Neurosensory area ■ Rods ■ Cones TYPES RHEGMA-TOGE NOUS NON-RHEGMATOGENOUS TRACTION EXUDATIVE ASSESSMENT Ophthalmoscopy: used to assess ________________ ● The room is darkened. ● The instrument is held with the ________ hand when examining the ________ eye, vice versa. ● Approach the client’s eye from about ______ away and _____ degrees lateral to the client’s line of vision. MD MANAGEMENT ● Use of a scleral buckle or a silicone band to hold the retina and choroid together: ______________ ● A gas bubble, silicone oil, or perfluorocarbon and liquids may be injected into the vitreous cavity to help push the sensory retina up against the RPE: ________________ ● Use of a cooled probe to the sclera causing scarring which helps reattachment: ____________ ● Use of a heated probe to the sclera causing scarring which helps reattachment: ____________ RN INTERVENTIONS Priority Goal: ________________________ 1) Bed rest, position the patient ________________ 2) Protect the eyes 3) Avoid jerky movements 4) Avoid activities that increase IOP 5) Notify HCP if: ○ Signs of bleeding: ________________ ○ Signs of increased IOP: ________________ TOP RANK REVIEW ACADEMY, INC. Page 2 | 3
MACULAR DEGENERATION ANATOMY & PHYSIOLOGY ● Part of the retina that contains the highest concentration of ________________ ● Function: ________________________________ ● Contains the area of sharpest vision called ________________ TYPES DRY WET ASSESSMENT Amsler grid ● Hold chart ____________ away ● Cover one eye ● Focus on the central fixation point. Abnormal: _______________________________ MACULAR DEGENERATION ANATOMY & PHYSIOLOGY TYPES OF HEARING LOSS CONDUCTIVE SENSORINEURAL ASSESSMENT WEBER’S TEST RINNE’S TEST Conduction Position Normal CHL SHL RN INTERVENTIONS Priority Goal: ________________________ 1) Face client when speaking 2) Move closer 3) Speak slowly and clearly 4) Speak in normal volume and lower pitch 5) Repetition and validation CAUSES OF HEARING LOSS CONDUCTIVE • Otitis Externa • Otitis Media • Otosclerosis SENSORINEURAL • Meniere’s Disease • Acoustic Neuroma OTITIS EXTERNA ⇨ inflammation of the ____________ due to ______________________. ASSESSMENT Otoscopy 1) Position: ____________ 2) Pull the pinna: ____________ ____________ Interpretation ● N: ____________ ● Signs of infection: ________________________ RN INTERVENTIONS 1) Position: ____________ 2) Cotton-tipped applicators? 3) Keep the ears _____ and _____ 4) Apply _____ compress locally for __ minutes, __ times a day. 5) Administer antibiotic or antifungal, as ordered. OTITIS MEDIA ⇨ inflammation of the ____________ due to ______________________. ASSESSMENT Otoscopy ● N: ____________ ● Abnormal: ____________ MENIERE’S DISEASE ⇨ abnormal ________ balance caused by ___________ or ____________. ASSESSMENT ● Meniere’s Triad MD MANAGEMENT ● Antiemetics ● Diuretics ● Nicotinic acid ● Antihistamines ● Endolymphatic sac decompression ● Labyrinthectomy RN INTERVENTIONS Priority Goal: ________________________ ● During attack: __________________ ● Avoid triggers: __________________ TOP RANK REVIEW ACADEMY, INC. Page 3 | 3