Nokea
A patient has been seen at a clinic for repeated hordeolum of the eyes during the last 6 months. Which of the following actions should the nurse recommend to the patient to help prevent further infection?
- A. Apply cold compresses at the first sign of recurrence.
- B. Discard all open or used cosmetics used near the eyes.
- C. Wash the scalp and eyebrows with an anti-seborrheic shampoo.
- D. Seek evaluation for the presence of sexually transmitted infections (STIs).
Correct Answer: B
Rationale: Hordeolum (stye) is commonly caused by Staphylococcus aureus, which may be present in cosmetics that the patient is using. Warm compresses are recommended to treat hordeolum. Anti-seborrheic shampoos are recommended for seborrheic blepharitis. Patients with adult inclusion conjunctivitis, which is caused by Chlamydia trachomatis, should be referred for STD testing.
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The nurse is caring for a patient in the eye clinic who has 20/200 vision with the use of corrective lenses. Which of the following information should the nurse include when providing patient teaching?
- A. How to use a cane safely
- B. How to access audio books
- C. Where Braille instruction is available
- D. Where to obtain specialized magnifiers
Correct Answer: D
Rationale: Various types of magnifiers can enhance the remaining vision enough to allow the performance of many tasks and activities of daily living (ADLs). Audio books, Braille instruction, and canes usually are reserved for patients with no functional vision.
The nurse is admitting a patient for surgery who has functional blindness for several years and is cared for by the patient's spouse. Which of the following actions is most important to implement during the initial assessment?
- A. Obtain more information about the cause of the patient's vision loss.
- B. Obtain information from the spouse about the patient's special needs.
- C. Make eye contact with the patient and ask about any need for assistance.
- D. Perform an evaluation of the patient's visual acuity using a Snellen chart.
Correct Answer: C
Rationale: Making eye contact with a partially sighted patient allows the patient to hear the nurse more easily and allows the nurse to assess the patient's facial expressions. The patient (rather than the spouse) should be asked about any need for assistance. The information about the cause of the vision loss and assessment of the patient's visual acuity are not priorities during the initial assessment.
The nurse is admitting a patient to the outpatient surgery unit who is scheduled for cataract extraction and implantation of an intraocular lens. Which of the following information has the most immediate implications for the patient's care?
- A. The patient has not eaten anything for 8 hours.
- B. The patient takes three antihypertensive medications.
- C. The patient gets nauseated with general anaesthesia.
- D. The patient has had blurred vision for several years.
Correct Answer: B
Rationale: Mydriatic medications used for pupil dilation are sympathetic nervous system stimulants and may increase heart rate and blood pressure. Using punctal occlusion when administering the mydriatic to minimize systemic effects and monitoring of blood pressure are indicated for this patient. Patients are expected to be NPO for 6-8 hours before the surgical procedure. Blurred vision is an expected finding with cataracts. Cataract extraction and intraocular lens implantation are done using local anaesthesia.
An older-adult patient with presbycusis is fitted with binaural hearing aids. Which of the following information should the nurse include when teaching the patient how to use the hearing aids?
- A. Experiment with volume and hearing ability in a quiet environment initially.
- B. Keep the volume low on the hearing aids for the first week while adjusting to them.
- C. Add the second hearing aid after making the initial adjustment to the first hearing aid.
- D. Wear the hearing aids for about an hour a day at first, gradually increasing the time of use.
Correct Answer: A
Rationale: Initially the patient should use the hearing aids in a quiet environment like the home, experimenting with increasing and decreasing the volume as needed. There is no need to gradually increase the time of wear. The patient should experiment with the level of volume to find what works well in various situations. Both hearing aids should be used.
Which of the following assessment findings in a patient who was struck in the right eye with a baseball is a priority for the nurse to communicate to the health care provider in the emergency department?
- A. The patient complains of a right-sided headache.
- B. The sclerae on the right eye have broken blood vessels.
- C. The area around the right eye is bruised and tender to the touch.
- D. The patient complains of 'a curtain' blocking part of the visual field.
Correct Answer: D
Rationale: The patient's sensation that a curtain is coming across the field of vision suggests retinal detachment and the need for rapid action to prevent blindness. The other findings would be expected with the patient's history of being hit in the eye with a ball.