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Sensory perception Class Notes
Lecture notes taken about Cataracts, Glaucoma, Hearing Loss, and Perip...
Course
Health Care Concepts II (NSG 211)
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Students shared 45 documents in this course
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Germanna Community College
Academic year: 2023/2024
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Sensory perception Class Notes
Trabeculoplasty – trabecular mesh in the corner of the eye allows for drainage
- Can lead to glaucoma
- Clutter free
- Glasses and hearing aids within reach
- Safe and effective care
- Never approach a patient confused with an otoscopy
- Washing hands
Health promotion
- Avoid rubbing your eyes
- Polarized sunglasses are recommended
- **UV light puts us at risk for cataracts – protect your eyes
- Googles for sports – protects from injury, trauma -> causes cataracts
o Trauma causes cataracts
o Can cause closed angle glaucoma
- Cleaning out your ears from earwax
o Impacted earwax
Use warm water (98) and a curved syringe to squirt it into the side canal to
flush with 10 mL and then tilt head to get the impacted earwax out
Not cold water, not directly at the ear drum, not when eardrum is perforated,
no Q-tips
Stop if pt becomes nauseated
Psychosocial considerations with eyes/ears
- Isolation is huge
o Hearing is more affected bc they don’t admit it and they sit and won’t enter
conversations and stay out of loud, noisy background areas
Someone who talks louder than they should
Person nods consistently
Person doesn’t answer the question you asked
Cupping their ear to hear you better
Lip reading
Asking you to repeat yourself or speak louder
Cataract vs Glaucoma
- Cataracts –yellowing of vision, not just peripheral loss, not just central vision tunneling
- Glaucoma – pain and a halo
Eye drop administration
- Meds in the form of eye drops (glaucoma and cataracts)
- Designed to decrease production of aqueous humor (anterior chamber) coming in OR open the
network to allow for better drainage
- Need to be able to teach how to administer eye drops
- Drop the drops in the lower conjunctival sac and do punctal occlusion for 1 minute (put finger
on tear duct and occlude it to keep med from becoming systemic) – don’t want to drop BP
o Med is meant to be local, so this keeps in where it needs to be
- Have pt avoid blinking to avoid pushing too much med out of the eye area
Glaucoma
Glaucoma = pressure
- Pressure = normal pressure is 10-21, over 21 indicates glaucoma
- Eye doctor will do eye pressure test every 2 yrs until age 40, age 40-45 every year, over age 65
test is done every 6-12 months
o Very common issue in aging age group
o Decreased draining of aqueous humor causes problems
- Silent blindness
o Signs & symptoms of glaucoma:
Peripheral vision changes/loss or spots when damage has happened
When pressure is high enough that it causes damage to the vessels
Can cause permanent blindness
- *Not curable but it is maintainable
o Take meds to maintain it to prevent progression of disease
o Meds:
Meds in the form of eye drops (glaucoma and cataracts)
Designed to decrease production of aqueous humor (anterior chamber) coming
in OR open the network to allow for better drainage
Need to be able to teach how to administer eye drops
Drop the drops in the lower conjunctival sac and do punctal occlusion
for 1 minute (put finger on tear duct and occlude it to keep med from
becoming systemic) – don’t want to drop BP
o Med is meant to be local, so this keeps in where it needs to be
Have pt avoid blinking to avoid pushing too much med out of the eye
area
Wait 3-5 minutes before administering another meds
Ointment always goes last
o For contact wearers – wait 10 minutes from last med
administration before putting in contacts
o Can darken contact lenses
Encourage fluid intake with these meds unless otherwise contraindicated
o Gluacoma Medication Types
Alpha Adrenergic Agonists
Decreases aqueous humor production and allows for a better outflow
Improves IOP
End in -ine
Pupils can remain dilated with these meds – leads to photosensitivity
Can increase BP, wait 15 minutes before putting in contacts
A little irritation and redness is normal
Beta Blockers
Decreases aqueous humor
o Make sure to check rubella status in pt charts
o Vaccina for rubella if needed while in the hospital
o Congenital cataracts in babies are not hard to see – its kind of whiter against the grey
background
Can check by shining light in the eye and looking for “red eye” flash back
- Sun bathers
- People with down syndrome?
- Trauma
- Smoking and alcohol
Treatment
- Cataract extraction - Lens replacement of the cloudy lens (cloudy area is sucked out)
- Typically one eye done and then the other due to safety reasons
- Medication is typically in the form of eye drops
- Risks after surgery:
o Post-op - Increase in pressure with N/V
Hearing Loss
Types of hearing loss
- Sensory neural
- Conductive
- Mixed
Types of hearing tests
- Whisper test
- Webber test
o Tap tuning fork and touch it to the pt’s head against the bone
Ask if they can hear the sounds equally on both sides
- Rhine Test
o Tap tuning fork, hold it to mastoid process and when they stop hearing it ____
History
- Personal history
o Music trauma
o History of ear infections – leads to hearing loss
o Decibel hearing levels
Normal conversation is a level of 60
Decibels above 75 puts your hearing at risk for damage
Sound can cause problems, even death (at 185 decibels) – causes an air
embolism
Strategies
- Know preferred communication method
- Face the resident directly
- Avoid noisy backgrounds
- Spotlight your face
o Make sure you have some light on your face in case the person is a lip reader and not
just back lighting
- Give clues when changing subjects
- Keep it simple
- Gain resident’s attention first
- No gum or anything in your mouth
- Use longer phrases
- Communicate
o 2-3 feet away is a good distance
- Don’t shout
Bone is the inner ear that cause hearing loss
- Removal of the stapes bone - stapedectomies or placement of implant
- Post ear surgery, at risk for falls due to feeling off balance
- Post surgery – affected ear is faced up when lying down on side
- Tympanic surgery – keep ear and surgical site dry
- Be mindful that with hearing surgeries, you may not have great hearing for 1-3 weeks post-op
o Can be disappointing
Head/Intracranial Pressure
- Don’t want to do activities to increase head pressure
o Sneezing with mouth open
o Semi fowler
o No bending over
o No tight colors
o Intercourse could increase pressure
o No straining
Peripheral neuropathy
- Nerve damage in the periphery
- Can damage our GI and GU systems
o Most common cause – diabetes
o Other causes – MS, autoimmune diseases, lupus, chemotherapy
o Can be permanent or short term with chemotherapy
o Certain infections – Lyme and hepatitis
o Certain tumors
o Alcohol use – 1 glass for female and 2 glasses for males
- Presentation
o Tingling, pain, numbness, loss of sensation
- Testing
o Monofilament testing – with eyes closed, prick someone with a sharp object and the
patient will indicate where they feel it
Similar to teaching of diabetic foot care teaching
- Patient education about foot care
o Shoes should be ½ “ longer than their longest toe
Foot size may change thru out the day and pt may need a shoe a size larger to
account for swell
o Can cause falls
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Sensory perception Class Notes
Course: Health Care Concepts II (NSG 211)
45 Documents
Students shared 45 documents in this course
University: Germanna Community College
Was this document helpful?
Sensory perception Class Notes
Trabeculoplasty – trabecular mesh in the corner of the eye allows for drainage
- Can lead to glaucoma
- Clutter free
- Glasses and hearing aids within reach
- Safe and effective care
- Never approach a patient confused with an otoscopy
- Washing hands
Health promotion
- Avoid rubbing your eyes
- Polarized sunglasses are recommended
- **UV light puts us at risk for cataracts – protect your eyes
- Googles for sports – protects from injury, trauma -> causes cataracts
oTrauma causes cataracts
oCan cause closed angle glaucoma
- Cleaning out your ears from earwax
oImpacted earwax
Use warm water (98.6) and a curved syringe to squirt it into the side canal to
flush with 10 mL and then tilt head to get the impacted earwax out
Not cold water, not directly at the ear drum, not when eardrum is perforated,
no Q-tips
Stop if pt becomes nauseated
Psychosocial considerations with eyes/ears
- Isolation is huge
oHearing is more affected bc they don’t admit it and they sit and won’t enter
conversations and stay out of loud, noisy background areas
Someone who talks louder than they should
Person nods consistently
Person doesn’t answer the question you asked
Cupping their ear to hear you better
Lip reading
Asking you to repeat yourself or speak louder
Cataract vs Glaucoma
- Cataracts –yellowing of vision, not just peripheral loss, not just central vision tunneling
- Glaucoma – pain and a halo
Eye drop administration
- Meds in the form of eye drops (glaucoma and cataracts)
- Designed to decrease production of aqueous humor (anterior chamber) coming in OR open the
network to allow for better drainage
- Need to be able to teach how to administer eye drops
