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Nursing Skills Final Exam study guide
Module 7
Glaucoma: Increased ocular pressure: Cupping and atrophy of optic disc. Symptoms
• Headache or brow pain
• Nausea and vomiting
, • Colored halos around lights
• Sudden blurred vision with decreased light perception
Cataract: Clouding and blurring of lens, Opacity makes it difficult to see retina. Requires
transplantation of the cornea to improve quality of life
Macular degeneration (AMD): Deterioration of the macula-central vision
• Central vision declines, and patients describe mild blurring and distortion at first
• Highest risk for development of age-related Smokers, hypertension, female, short,
family history, long-term diet poor in carotene and vit E.
Nursing Focus on the Older Adult: Promote Independent Living in Patients With Impaired Vision
• Drugs
• • Having a neighbor, relative, friend, or visiting nurse visit once a week to measure the proper
drugs for each day may be helpful.
• • If the patient is to take drugs more than once each day, it is helpful to use a container of a
different shape (with a lid) each time. For example, if the patient is to take drugs at 9 AM, 1 PM,
and 9 PM, the 9 AM drugs would be placed in a round container, the 1 PM drugs in a square
container, and the 9 PM drugs in a triangular container.
• • It is helpful to place each day's drug containers in a separate box with raised letters on the side
of the box spelling out the day.
• • “Talking clocks” are available for the patient with low vision.
• • Some drug boxes have alarms that can be set for different times.
• Communication
• • Telephones with large, raised block numbers may be helpful. The best models are those with
black numbers on a white phone or white numbers on a black phone.
• • Telephones that have a programmable automatic dialing feature (“speed dial”) are very
helpful. Programmed numbers should include those for the fire department, police, relatives,
friends, neighbors, and 911.
• Safety
• • It is best to leave furniture the way the patient wants it and not move it.
• • Throw rugs are best eliminated.
• • Appliance cords should be short and kept out of walkways.
• • Lounge-style chairs with built-in footrests are preferable to footstools.
• • Nonbreakable dishes, cups, and glasses are preferable to breakable ones.
• • Cleansers and other toxic agents should be labeled with large, raised letters.
• • Hook-and-loop (Velcro) strips at hand level may help mark the locations of switches and
electrical outlets.
• Food Preparation
• • Meals on Wheels is a service that many older adults find helpful. This service brings meals at
mealtime, cooked and ready to eat. The cost of this service varies, depending on the patient's
ability to pay.
• • Many grocery stores offer a “shop by telephone” service. The patient can either complete a
computer booklet indicating types, amounts, and brands of items desired; or the store will
complete this booklet over the telephone by asking the patient specific information. The store
then delivers groceries to the patient's door (many stores also offer a “put-away” service) and
charges the patient's bank card.
, • • A microwave oven is a safer means of cooking than a standard stove, although many older
patients are afraid of microwave ovens. If the patient has and will use a microwave oven, others
can prepare meals ahead of time, label them, and freeze them for later use. Also, many
microwavable complete frozen dinners that comply with a variety of dietary restrictions are
available.
• • Friends or relatives may be able to help with food preparation. Often relatives do not know
what to give an older person for birthdays or other gift-giving occasions. One suggestion is a
homemade prepackaged frozen dinner that the patient enjoys.
• Personal Care
• • Handgrips should be installed in bathrooms.
• • The tub floor should have a nonskid surface.
• • Male patients should use an electric shaver rather than a razor.
• • Choosing a hairstyle that is becoming but easy to care for (avoiding parts) helps in
independent living.
• • Home hair-care services may be available.
• Diversional Activity
• • Some patients can read large-print books, newspapers, and magazines (available through local
libraries and vision services).
• • Books, magazines, and some newspapers are available on audiotapes or discs.
• • Patients experienced in knitting or crocheting may be able to create items fashioned from
straight pieces such as afghans.
• • Card games, dominoes, and some board games that are available in large, high-contrast print
may be helpful for patients with low vision.
Hearing Loss
Position directly in front of the patient
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