Assessment of the Visual System-F23

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Apr 29, 2024

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NURS 144 Pre-Class Assignment Assessment of the Visual System 1. Use the following terms to fill in the labels in the illustration below: Terms Anterior Chamber Optic Nerve Choroid Posterior Chamber Ciliary Body Pupil Cornea Retina Iris Sclera Lens Vitreous Humor Optic Disc A. Lens H. Vitreous Humor B. Iris I. Optic Disc C. Cornea J. Optic Nerve D. Anterior Chamber K. Retina E. Pupil L. Choroid F. Posterior Chamber M. Sclera G. Ciliary Body 1
2. What is in the posterior cavity of the eye? a. Zonules c. Aqueous humor b. Cornea d. Vitreous humor 3. What is the function of the sclera? a. Secrete aqueous humor b. Focus light rays on the retina c. Protect outer layer of the eyeball d. Photoreceptor cells stimulated in dim environments 4. What accurately describes the conjunctiva? a. Junction of the upper and lower eyelids b. Point where the optic nerve exits the eyeball c. Transparent mucous membrane lining the eyelids d. Drains tears from the surface of the eye into the lacrimal canals 5. Which tissue nourishes the ciliary body, iris, and part of the retina? a. Pupil c. Choroid b. Cones d. Canal of Schlemm 2
6. Identify the cranial nerves that are responsible for the following eye functions. Eye Function Cranial Nerve Eyelid movement, open and close Cranial Nerve III (Oculomotor) Pupil constriction Cranial Nerve III (Oculomotor) Pupil dilation Cranial Nerve III (Oculomotor) Visual acuity Cranial Nerve II (Optic) 7. Identify the causes of the following assessment findings of the eye that are associated with aging. Assessment Finding Cause Floaters Changes in the vitreous humor Ectropion Weakening of the eyelid muscles and tissues Pinguecula It’s thought to be caused by exposure to sun, wind, and dust Arcus senilis Fat deposits in the cornea Yellowish sclera Jaundice, aging-related changes in the collagen of the sclera Dry, irritated eyes Reduced tear production Decreased pupil size Decreased muscle tone or inflammation in the iris, drugs, harsh chemicals Changes in color perception Aging-related changes in the lens and retina, different conditions such as diabetes, glaucoma, or macular degeneration. 8. Priority Decision: When obtaining a health history from a patient with cataracts, it is most important for the nurse to ask about the patient’s use of which drug? 3
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a. Corticosteroids c. -Adrenergic blocking agents β b. Oral hypoglycemic agents d. Antihistamines and decongestants 9. Identify a specific finding by the nurse during assessment of each of the patient’s functional health patterns that indicates either a risk factor for visual problems or the response of the patient to an eye problem. Functional Health Pattern Risk Factor or Response to Visual Problem Health perception – health management A patient with an alteration in the visual senses does not wear their glasses properly or as prescribed causing more risk for inadequate vision. Nutritional – metabolic The patient has uncontrolled diabetes and does not follow a diabetic diet. Elimination Constipation and straining can increase intraocular pressure. Activity – exercise A patient with hypertension is increasing their risk for ocular hypertension. Sleep – rest A patient who suffers from inadequate sleep patterns is at risk for glaucoma. Cognitive - perceptual A patient with an alteration in a form of sensory perception can have increased confusion. Self-perception – self-concept A patient with an alteration in the senses can lead to decreased independence and therefore decreased dignity. Role – relationship A patient with decreased vision will have the decreased ability to read written instructions and information causing a need for mor verbal communication. On the other hand, a patient with decreased hearing will have a decreased ability to hear verbal instructions and information causing a need for more written or sign language. Sexuality – reproductive A fetus has a risk for genetic risks for alterations in vision. Coping – stress intolerance A patient with a loss or significant of the vision sense can lead to an increase in sensory compensation which can cause stress. Value – belief Values and beliefs can influence the patients response to a vision problem. 4
10. Describe what is meant by the finding that the patient has a visual acuity of OD: 20/40; OS: 20/50. Visual acuity of OD: 20/40; OS: 20/50 means that the patient's right eye (OD) has a visual acuity of 20/40, and the left eye (OS) has a visual acuity of 20/50. This indicates that at a standard testing distance, the patient's right eye can see at 20 feet what a person with normal vision can see at 40 feet, and the left eye can see at 20 feet what a person with normal vision can see at 50 feet. The higher the second number (denominator), the worse the visual acuity. 11. The nurse documents PERRLA following assessment of a patient’s eyes. What is one finding that supports this statement? a. A slightly oval shape of the pupils b. The presence of nystagmus on far lateral gaze c. Dilation of the pupil when a light is shined in the opposite eye d. Constriction of the pupils when an object is brought closer to the eyes 5
12. Identify the assessment techniques used to obtain the following assessment data. Assessment Data Assessment Technique Peripheral vision field Confrontation test Extraocular muscle functions Hirschberg test, Cover-Uncover test Near visual acuity Jaeger eye chart Visual acuity Snellen eye chart Intraocular pressure Tonometer 13. In which individuals should the nurse expect to find a yellow cast to the sclera? a. Infants c. Persons with brown eyes b. Older persons d. Patients with eye infections 14. To determine the presence of corneal abrasions or defects in a patient with an eye injury, what would the nurse provide? a. A tonometer c. Pocket penlight b. Fluorescein dye d. An ophthalmoscope 15. What are possible abnormal assessment findings when assessing the eyelid? Select all that apply. a. Ptosis b. Strabismus c. Blepharitis d. Anisocoria e. Swollen pinna 6
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16. When the patient has a diagnosis of hyperthyroidism, which abnormal assessment of the eye could be found? a. Light intolerance c. Protrusion of eyeball b. Unequal pupil size d. Deviation of eye position 17. When examining the patient’s eye with an ophthalmoscope, the nurse would consider which finding to be of most concern? a. No blood vessels in the macula b. Depression at the center of the optic disc c. A break in the retina at the site of the macula d. Pieces of liquefied vitreous in the vitreous chamber 18. To prepare, a patient for a fluorescein angiography, what should the nurse explain about the test? a. Measures curvature of the cornea b. Involves IV dye injection to evaluate blood flow through retinal blood vessels c. Includes application of eye drops containing a dye that will localize arterial abnormalities in the retina d. Anesthetizes the eye so that probes can be inserted into the anterior chamber to measure intraocular pressure 7

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