Exam (elaborations)
CEN OCULAR: QUESTIONS / ANSWERS
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CEN OCULAR: QUESTIONS / ANSWERS
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CEN OCULAR: QUESTIONS / ANSWERSWHY should the nurse triage as most emergent A pt with Central retinal
artery occlusion? Correct Ans - Central retinal artery occlusion
produces the sudden onset of unilateral, painless vision loss and is a true
ocular emergency.
Retinal circulation must be restored within 60 to 120 minutes (or less) to
prevent permanent vision loss.
To assess the external eye, the nurse should perform which activity?
A. Have the patient identify letters or objects on a chart or card.
B. Inspect and gently palpate the eyelids, lashes, and surrounding bony
structures.
C. Have the patient follow the nurse's fingers with his or her eyes.
D. Visualize the external structures with a slit lamp. Correct Ans - An
external eye assessment consists of the inspection and gentle palpation of the
eyelids, lashes, and surrounding bony structures.
Visual acuity is assessed by having the patient identify letters or objects on a
chart or card.
Cardinal fields of gaze are assessed by having a patient follow the nurse's
fingers with his or her eyes.
A slit-lamp microscope is used to help visualize the superficial structures and
the anterior chamber.
Retinal detachment requires consultation with an Correct Ans -
Retinal detachment requires consultation with an ophthalmologist to
determine a definitive treatment, such as laser repair or scleral buckling.
Herpes zoster ophthalmicus requires Correct Ans - Herpes zoster
ophthalmicus requires local wound care, administration of analgesics and
antivirals, and possibly topical steroids and antibiotics.
Hyphema requires consultation with an Correct Ans - Hyphema
requires consultation with an ophthalmologist.
,In a patient with a globe rupture, which sign or symptom is expected?
A. Altered depth of the posterior chamber
B. Dilated pupil
C. Teardrop-shaped pupil
D. Decreased pain sensation Correct Ans - Signs and symptoms of a
globe rupture include hyphema, a teardrop-shaped pupil, altered depth of the
anterior chamber, altered light perception, vitreous hemorrhage
(occasionally), and minimal to severe pain.
WHAT disorder results in abnormal extraocular movements? Correct Ans
- Orbital cellulitis
The nurse evaluates extraocular movements by testing the six cardinal fields
of gaze. This assesses cranial nerves III, IV, and VI (the oculomotor, trochlear,
and abducens nerves).
A PT WITH Orbital cellulitis WHEREIN A NURSE NEEDS TO EVALUATE THEIR
EXTRAOCULAR MOVEMENTS IS TEST HOW? Correct Ans - in Orbital
cellulitis, the nurse evaluates extraocular movements by testing the six
cardinal fields of gaze.
six cardinal fields of gaze assesses which cranial nerves: Correct Ans -
this assesses cranial nerves
III, IV, and VI (the oculomotor, trochlear, and abducens nerves).
Impaired extraocular movement may result from Correct Ans - an
entrapped muscle caused by orbital cellulitis, an orbital blowout fracture,
muscular injury, or an underlying central nervous system problem.
the three ocular dx do not affect extraocular movement. Correct Ans -
Corneal ulcer
retinal detachment, and glaucoma do not affect extraocular movement.
For a patient with an alkali burn of the eye, what is the pH that indicates the
endpoint for continuous irrigation?
B Correct Ans - Ocular pH of 7.4
, For a patient with an alkali burn, continue irrigation until the ocular pH
reaches about 7.3 or 7.4.
Normal conjunctival pH is? Correct Ans - Normal conjunctival pH is 7.0
to 7.3.
If litmus paper is not available for pH measurement of the conjunctiva then to
mark the end point of irrigation of eye is Correct Ans - irrigate for at
least 60 minutes with 2 L of fluid.
A severe chemical burn may require 2 to 4 hours of irrigation. Measure the pH
periodically during and after the initial irrigation.
A patient with a corneal infection may develop a Correct Ans -
hypopyon (collection of pus due to white blood cells in the anterior chamber
of the eye).
Which intervention is appropriate for a hypopyon?
A. Apply an eye patch for comfort.
B. Apply cool compresses.
C. Obtain a specimen for culture and sensitivity testing.
D. Irrigate the eye with copious fluids. Correct Ans - Obtain a specimen
of the hypopyon for culture and sensitivity testing to determine the specific
cause of the infection. Other interventions include applying warm compresses
and administering broad-spectrum antibiotics and possibly antifungal eye
drops.
because of the risk of Pseudomonas infection, DO NOT APPLY ? TO A PATIENT
WITH HYPOPYN Correct Ans - Do not patch the eye because of the risk
of Pseudomonas infection, which is a particular concern with contact lens
wearers. Irrigation with copious fluids is an intervention for a chemical burn,
not a hypopyon.
When caring for a multisystem trauma patient, what should you expect to
assess after airway, breathing, circulation and disability: Correct Ans -
Ocular injuries commonly occur with head and facial injuries, so carefully
evaluate patients with these injuries for coexisting ocular injuries after
evaluating and stabilizing airway, breathing, circulation, and disability.
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