Assessing the Eyes & Ears

By: Faridokht YazdaniFaculty of Nursing-IAUN

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Assessing The Eyes

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vision movement

sensory data from cornea eyelids

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DevelopmentalVariations

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Snellen E chart:

3yr old 20/40

4yr old vision 20/30,

5-6yr old normal

tests: color blindness, regular Snellen

All around deterioration

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Cultural Variations

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HTNDM

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Vision loss

Double vision

Eye tearing

Eye drainage

Eye pain

Blurred Vision

Dry Eyes

Eye Appearance Changes

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HTN, DM

Lasix, Captopril, and Glucatrol

+ Family history of CV disease, DM, MS

Last eye exam 5 years ago

Widow: son and friends as supports

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Nursing Diagnosis

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Nsg Dx?

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Physical Assessment

: visual fields

(superior, inferior, nasal, temporal)

inspection, palpation, ophthalmoscopy

sitting

visual acuity charts (Snellen), penlight, ophthalmoscope, cotton ball, cotton swab, printed material

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Visual Acuity

Snellen eye chart

read newsprint 13 to 15eyes

identify color bars on Snellen or use color plates

come in from the periphery in all fields and note field cuts 23

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Palpation of External Structures

consistency and tenderness

: tenderness and excessive tearing

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Ophthalmoscopy

Red reflex: presence, opacities

Optic disc and physiologic cup: color, size, shape, borders, cup-disc ratio

Retinal vessels: size ratio of arteries and veins2:3, color, arteriole light reflex,

Retina: color, texture, exudates, lesions, hemorrhages, and aneurysms

Macula and fovea: color, size, location, lesions

fovea

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Eye Pain

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Red Eye

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Pupil size

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Arcus Senile Cornea

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hirschberg test

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(LP)

(HM)

(CF)

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Assessing the Ears

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Objectives

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Anatomy Review Structures

: auricle and external ear canal

tympanic membrane and auditory ossicles, eustachian tube

labyrinth, cochlea, organ of Corti, and CN VIII

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FunctionsWhat are the functions of:

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Functions,

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Relationships of the Ears to Other Systems

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CN VIII,

1st Level:

2nd Level:

3rd Level:

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DevelopmentalVariations

Children Eustacian tubes are shorter, wider, more horizontal

therefore more prone to migrating bacteria from nasopharnyx

Young Adults Exposure to NOISE is most common cause of hearing

loss

Older Adults Hearing loss from aging, cerumen accumulation

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What symptoms would signal a problems with the ears?

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conductive and sensorineural hearing loss

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Physical Assessment

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Inspection/Palpation of the External Ear

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Otoscopic Exam

: patency , color, drainage, lesions, and foreign objects

: color, intactness , landmarks , and mobility

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Eardrum

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Ear Infection Acute Suppurative Otitis

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Binaural Tympanic-Membrane Perforation

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Tests for Function

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Whispering test

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Weber's Test

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Rinne test

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Case Study

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Pertinent History Findings with Mr. Nejati

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