Chapter 52

1. Chapter 52 Nursing Care of Patients with Sensory Disorders— Vision and Hearing

2. Eye Infections and Inflammation • Conjunctivitis: Inflammation of the Conjunctiva • Blepharitis: Inflammation of the Eyelid Margins • Hordeolum: Staphylococcal Abscess in Sebaceous Gland

3. Eye Infections and Inflammation (cont’d) • Chalazion: Abscess in Meibomian Glands • Keratitis: Inflammation of the Cornea

4. Nursing Diagnoses • Acute Pain • Disturbed Sensory Perception • Risk for Injury • Risk for Infection • Deficient Knowledge

5. Refractive Errors • Emmetropia: Normal Vision • Hyperopia: Farsightedness • Myopia: Nearsightedness • Astigmatism: Unequal Curvatures in Cornea • Presbyopia: Loss of Lens Elasticity

6. Refractive Errors (cont’d)

7. Blindness • Obstacle to Rays of Light • Disease of Optic Nerve or Tract of Brain Connected with Vision

8. Visual Field Abnormalities

9. Nursing Diagnoses • Disturbed Sensory Perception • Self-Care Deficit • Risk for Injury • Risk for Impaired Home Maintenance • Interrupted Family Processes • Ineffective Role Performance

10. Nursing Diagnoses (cont’d) • Deficient Knowledge • Deficient Diversional Activity • Fear

11. Diabetic Retinopathy • Vascular Changes in Retinal Blood Vessels • Microaneurysms • Preproliferative Retinopathy • Therapeutic Interventions • Laser Photocoagulation • Vitrectomy

12. Diabetic Retinopathy (cont’d) • Nursing Diagnoses • Impaired Home Maintenance • Ineffective Therapeutic Regimen Management • Disturbed Sensory Perception

13. Retinal Detachment Separation of Retina from Choroid Layer of Eye

14. Retinal Detachment (cont’d) • Signs and Symptoms • Sudden Change in Vision • Flashing Lights, Floaters • Looking Through a Veil • Curtain Being Lowered Over Vision • No Pain

15. Retinal Detachment (cont’d) • Therapeutic Interventions • Laser Reattachment • Cryosurgery • Scleral Buckling

16. Glaucoma • Abnormal Pressure Within Eyeball • Damage is Silent, Progressive, Irreversible • Lifelong • Diagnosis with Tonometry

17. Glaucoma (cont’d) • Acute Angle-closure • Narrowed Angle Blocks Aqueous Fluid • Medical Emergency

18. Glaucoma (cont’d) • Acute Angle-closure • Severe Eye Pain • Blurred Vision • Rainbows Around Lights • Eye Redness, Steamy Cornea • Photophobia, Tearing

19. Glaucoma (cont’d) • Primary Open-angle • Degenerate of Drainage System Blocks Aqueous Fluid • Gradual and Painless

20. Glaucoma (cont’d) • Primary Open-angle • Mild Eye Aching • Headache • Halos Around Lights • Frequent Visual Changes

21. Glaucoma (cont’d) • Medications • Miotics • Agents to Decrease Production of Aqueous Fluid • Mannitol

22. Glaucoma (cont’d) • Contraindicated in Acute Angle-closure • Mydriatics • Can Cause Blindness!

23. Glaucoma (cont’d) • Surgery • Laser Peripheral Iridotomy • Surgical Iridectomy • Laser Trabeculoplasty • Trabeculectomy • Cyclocryotherapy

24. Flow of Aqueous Humor After Trabeculoplasty

25. Glaucoma (cont’d) • Nursing Diagnoses • Pain • Disturbed Sensory Perception • Self-Care Deficit • Anxiety

26. Glaucoma (cont’d) • Nursing Diagnoses (cont’d) • Risk for Injury • Impaired Home Maintenance • Deficient Knowledge

27. Cataracts • Opacity in Eye Lens Causing Loss of Visual Acuity • Halos Around Lights, Difficulty Reading, Sensitivity to Glare, Double Vision, Decreased Color Vision

28. Cataracts (cont’d) • Surgical Removal of Lens

29. Nursing Diagnoses:Eye Surgery • Disturbed Sensory Perception • Deficient Knowledge • Risk for Infection • Risk for Injury • Anxiety

30. Macular Degeneration

31. Macular Degeneration (cont’d) • Deterioration in Macula • Wet • Dry • Slow, Progressive Loss of Central/Near Vision • Amsler Grid Detects

32. Amsler Grid

33. Macular Degeneration (cont’d) • Therapeutic Interventions • Wet • Laser Treatment • Dry • None

34. Nursing Diagnoses: Macular Degeneration • Disturbed Sensory Perception • Self-Care Deficit • Risk for Injury • Risk for Impaired Home Maintenance • Interrupted Family Processes • Ineffective Role Performance

35. Eye Trauma • Emergency • Foreign Bodies • Burns • Abrasions • Lacerations • Penetrating Wounds

36. Eye Trauma (cont’d) • Therapeutic Interventions • Foreign Object • Irrigate • Normal Saline • Chemicals • 15- to 20-Minute Irrigation

37. Eye Trauma (cont’d) • Therapeutic Interventions • Penetrating Object • Do Not Remove • Antibiotic Ointment • Surgery

38. Eye Trauma (cont’d) • Enucleation • Entire Eyeball Removal

39. Nursing Diagnoses: Eye Trauma • AcutePain • Risk forInfection • Anxiety • DeficientKnowledge

40. Hearing Loss • Conductive Hearing Loss • Interference with Sound Conduction to External Auditory Canal, Eardrum, Middle Ear

41. Hearing Loss (cont’d) • Sensorineural Hearing Loss • Involves Hair Cells and Nerve Endings

42. Hearing Loss (cont’d) • Presbycusis • Aging Process • Degeneration of Organ of Corti • Inability to Decipher High-Frequency Sounds

43. Hearing Loss (cont’d) • Therapeutic Interventions • Hearing Aid • Cochlear Implants

44. Hearing Aids

45. Nursing Diagnoses: Hearing Loss • Disturbed Sensory Perception • Impaired Verbal Communication • Impaired Social Interaction • Disturbed Body Image • Ineffective Coping • Deficient Knowledge

46. External Ear • Infections • External Otitis • Ear Canal Furuncle • Ostomycosis • Perichondritis

47. External Ear (cont’d) • Impacted Cerumen • Normally Ear Self-cleaning • Older Adult at Risk • Hearing Loss • Feeling of Fullness

48. External Ear (cont’d) • Masses • Trauma

49. Therapeutic Interventions • Topical Antibiotics • Irrigations • Analgesics • Incision and Drainage

50. Nursing Diagnoses: External Ear • Acute Pain • Disturbed Sensory Perception • Risk for Injury • Deficient Knowledge