Nokea
A nurse is caring for a client diagnosed with keratitis. What advice should the nurse give this client?
- A. Use warm soaks frequently.
- B. Begin using dark glasses.
- C. Wash the face and hair frequently.
- D. Massage the surrounding area.
Correct Answer: B
Rationale: Dark glasses are recommended for a client with keratitis to relieve photophobia. Treatment for keratitis does not require use of warm soaks and massages or washing of the face and hair.
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A client asks the nurse why miotic eye solutions were prescribed in the treatment of the client's glaucoma. Which is the best nursing rationale for the use of this medication?
- A. Constricts intraocular vessels
- B. Paralyzes ciliary muscles
- C. Constricts pupil
- D. Dilates the pupil
Correct Answer: C
Rationale: A miotic agent works by constricting the pupil and pulling the iris away from the drainage channels so that the aqueous fluid can escape. These medications increase outflow and decrease intraocular pressure. Cycloplegics paralyze the ciliary muscles of the eye. Mydriatics drugs are used to dilate the pupil and are contraindicated in glaucoma.
An older adult client is admitted with the diagnosis of retinal detachment and is scheduled for laser surgery and scleral buckling procedure. The nurse anticipates which symptom(s) to be exhibited in this client? Select all that apply.
- A. Flashing lights
- B. Cobwebs in vision field
- C. Complete loss of vision in both eyes
- D. Loss of central vision
- E. Eye pain
- F. Arcus senilis
Correct Answer: A,B
Rationale: Many clients with detached retina experience a sensation of a curtain or veil lowering over vision field, flashing of lights, floaters, cobwebs, or spots. Complete vision loss can occur in the affected eye. Loss of central vision, eye pain, and arcus senilis are not indicated in this disorder.
An eighth-grade client visits the school nurse and reports having been to an eye doctor who identified an astigmatism and described it as a condition in which the eyeball is not shaped correctly. The client asks the nurse why both eyes look alike in the mirror if this is the case. What is the nurse's best response?
- A. Astigmatism means that the very front part of the eye is shaped differently than the very front part in most eyes.
- B. Astigmatism means that the overall shape of the eye resembles an olive more than most eyes.
- C. Astigmatism means that the inside of the eye is shaped differently than the inside of most eyes.
- D. Astigmatism means that the overall shape of your eye is shorter than most eyes.
Correct Answer: A
Rationale: Astigmatism is visual distortion caused by an irregularly shaped cornea. When the overall shape of the eye is like an olive, or more oblong, it results in myopia, not astigmatism, although both conditions may be present at once. The inside of the eye is not shaped differently in the client with an astigmatism. The overall shape of the eye being shorter results in hyperopia, not astigmatism.
Following an ophthalmologic exam, an anxious client asks the nurse, 'How serious is a refraction error?' Which is the best response from the nurse?
- A. It is nothing serious.
- B. It means corrective lenses are required.
- C. Simple surgery can fix this problem.
- D. This is normal for anyone your age.
Correct Answer: B
Rationale: Refractive errors can be corrected with glasses or contact lenses. Telling a client that 'nothing is serious' does not provide the necessary information to help alleviate fears. The word surgery can increase fears. If the refractive error is associated with aging, this is a normal finding but does not provide information about the condition.
The client with chronic open-angle glaucoma is receiving timolol eye drops. Which evaluation finding would indicate to the nurse the treatment is working?
- A. Intraocular pressure 15 mm Hg
- B. Reduced peripheral vision
- C. Halos around lights
- D. Decrease in nausea and vomiting
Correct Answer: A
Rationale: Timolol is a beta-blocker that is used topically to decrease the flow rate of aqueous humor in the eye. As flow rate decreases, the intraocular pressure decreases. IOP of 12 to 21 mm Hg is within normal range. Reduced peripheral vision, halos around lights, and blurred vision are all symptoms of open-angle glaucoma. Nausea and vomiting are more likely to occur with acute angle-closure glaucoma.