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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