Jenna Cohen Exam 3 Study Guide System Visual and Auditory Concept Sensory Perception Eye and Ear Disorders Normal Aging Changes in Sensory Presbycusis Hearing o Cochlear degeneration o Progressive hearing loss o Begins in early adulthood o Higher pitched tones and conversation speech o Hearing aids Prebyopia Seeing o Age related inability to focus on close objects Hearing Tests o Tympanogram o Otoscopy Vision Tests o Ophthalmoscope o Vision acuity tests Snellen and Rosenbaum System Specific Assessment Lab and Diagnostic Procedures determines if its normal aging or acute problem Physiology and Assessment Cataracts fuzzy less clear people complain about blurred vision o Physiology blurred Opacity of lens in eye impairs vision o Assessment people don t notice it until they cant get their eyes clear gets more No pain Progressive Blurred vision Diplopia double vision Photo sensitivity Macular Degeneration affects central vision no depth perception doesn t effect periphery o Physiology Deterioration of macular affects central vision Most common 60 Progressive o Assessment No pain Progressive blind spots occur Blind spots center vision begin to lose depth perception risk for injury Lack of depth perception Open Angle Glaucoma shoot pressure in eyes to check ocular pressure o Physiology Intraocular pressure increased from aqueous humor eventual destroys optic fibers Destroys Optic fibers Progressive tunnel vision Eventual blindness o Assessment No pain Progressive Tunnel vision don t have any peripheral not good for driving if they can get on early you can help slow down disease Increased IOP 21 mmHg Angle Closure Glaucoma o Emergency o Physiology Less common Unilateral one eye o Assessment Intermittent Severe pain others don t have pain Abrupt onset See halos bc of rapid increase in iop Rapid increase in IOP No pupil react Photophobia Analysis of Concepts Sensory System Safety Prevention of Injury Sensory Perception Health Promotion Patient Teaching prevention of falls adequate lighting First Priority Interventions Eye Diseases Cataracts o Comprehensive Risk assessment to prevent injury often have cataract surgery so they don t progress very bad option of correcting all vision not just cataracts o Post op care Wear dark glasses avoid bright lights Report yellow green drainage indicates infections No activity that increases IOP Report n v may indicate increased IOP Limit sports driving operating machinery bending over straining restrictive clothing around neck increase IOP Macular Degeneration o Comprehensive Risk assessment to prevent injury Safe environment at home to prevent injuries talking to them about home occupation do they have to drive at home do they have adequate lighting stairs rugs Regular eye exams important all these o Diet Increased Carotine and Vitamin E and B12 Vitamin A and even supplements so they can help prevent the injury Open Angle Glaucoma o Comprehensive Risk assessment to prevent injury Patient Teaching on Importance of Taking Medications Angle Closure Glaucoma o Emergency o Comprehensive Risk assessment to prevent injury Annual Exam because it comes on suddenly all you can do is eye exams and see if client could be at any risk for this o Atropine used to dilate pre operatively might use when doing exam or if preop First Priority Interventions Medications Cataracts lets them see eyes better and structures Open Angle Glaucoma o Cholinergic Agonists Miotics constrict pupil Pilocarpine Isopto Carpine o Beta Blockers Timolol constricts pupil be sure to look at bp and pulse put pressure against nostril to avoid eye drops being absorbed systemically o Occular Steroids Prednisone acetate to decrease inflammation o May do surgery to improve flow of aqueous humor by opening chamber wait 10 15 minutes between eye drops so you can make sure it doesn t run out of the eye if giving more than one eye drop o Post Op Avoid activities that increase IOP Don t lie on operative side like bending over activities Angle Closure Glaucoma o Emergency o No dilation of the eye o Diuretics Mannitol to get ocular pressure down Hearing Physiology and Assessment Hearing often client complains of dizziness vertigo Inner Ear Meniere s Disease o Physiology Triad of symptoms Vertigo Tinnitus Progressive unilateral hearing loss Cause is unclear Adults between ages of 35 and 60 o Assessment Women and men equally Tinnitus and vertigo Signs of Vertigo Nausea and Vomiting bc some people with vertigo Falls Assess use of ototoxic drugs like gentamycin drugs that are toxic to kidneys also toxic to hearing Inner Ear Labyrinthitis o Physiology o Assessment Infection of labyrinth often secondary to otitis media Sudden onset of tinnitus and vertigo can lead to n v May resolves 3 6 days or longer if infection Analysis of Concepts Sensory System Safety Prevention of Injury Sensory Perception Health Promotion Patient Teaching eye exam recommended yearly First Priority Interventions Inner Ear Meniere s Disease o Analysis Safety Prevention of Injury FALLS Sensory Perception Hearing o Interventions Rise slowly assistive devices if needed Avoid tobacco alcohol caffeine can cause vertigo Comprehensive Risk assessment to Maintain safe environment prevent injury Vertigo reducing activities Inner Ear Labyrinthitis o Analysis Prevention of Injury FALLS Sensory Perception Hearing o Interventions Comprehensive Risk assessment to maintain safe environment to prevent injury Assess where client is an individual needs and current situation Vertigo reducing activities First Priority Interventions Medications if innear ear infections then abx Meclizine Antivert treat vertigo Antimedics for nausea and vomiting Antihistamines and Anticholinergics treat vertigo and nausea Valium treat vertigo SAFETY Treatments for Hearing Loss Hearing Aids o Fits into ear or just outside of ear can fit right in ear cant even see some o Check battery regularly o Turn off hearing aid when not in use o Always have extra battery available Cochlear Implants for Sensorineural Hearing Loss o Electrodes placed into cochlear go in back of scalp attach important that has electrodes and then they attach that so the hearing is heard through options for many people Surgeries depending on cause of hearing loss o Stapedectomy o Labyrinthectomy Trending Potential Complications and Risks Risk for Injury Prevent FALLS Review from Foundations How to administer eye drops and ear drops Fundamental ATI book Aging Changes General Care of clients with hearing or