M. Tayseer (2008) International Academy for Health SciencesInternational Academy for Health SciencesAl Ahsa·a Male AcademyAl Ahsa·a Male AcademyNursing Care of Patients Nursing Care of Patients with Sensorineural with Sensorineural Disorders Disorders Prepared By: Prepared By: Nursing DepartmentNursing Department
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Nursing Care of Patients With Sensorineural Disorders
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8/6/2019 Nursing Care of Patients With Sensorineural Disorders
Myopia (nearsighted)Myopia (nearsighted) ± ± can see objects closely; distant objectscan see objects closely; distant objectsblurred; image f ocuses in front of retinablurred; image f ocuses in front of retina
Hyperopia (farsighted)Hyperopia (farsighted) ± ±
distant objects cleardistant objects clear ± ±
near onesnear onesblurred; image behind retinablurred; image behind retina
�� PresbyopiaPresbyopia ± ± f orm of hyperopiaf orm of hyperopia ± ± aging aging ± ± lens less elastic; ey elens less elastic; ey ecancan¶¶t accommodate f or neart accommodate f or near
8/6/2019 Nursing Care of Patients With Sensorineural Disorders
Muscles innervated by CN VII facial nerveMuscles innervated by CN VII facial nerve ConjunctivaConjunctiva ± ± transparent mucous membranetransparent mucous membrane ± ± f orms pocketf orms pocket
under ey elidunder ey elid
ScleraSclera ± ± collagencollagen ³³ w hite w hite´́ ey eey e ± ± protectsprotects ± ± y ellow ish w ith age duey ellow ish w ith age dueto lipid deposits or blue due to thinning (also in infant)to lipid deposits or blue due to thinning (also in infant) ± ± dark dark
Lacrimal apparatusLacrimal apparatus ± ± gland and ductsgland and ducts
Pro vides tears to moisten ey e and pro vide OPro vides tears to moisten ey e and pro vide O22to coroneato coronea
Extraocular musclesExtraocular muscles ± ± 3 3 pairs; ey es mo ve inpairs; ey es mo ve insame direction (conjugate mo vement)same direction (conjugate mo vement)
8/6/2019 Nursing Care of Patients With Sensorineural Disorders
OpthalmoscopeOpthalmoscope ± ± bl/vessels and optic discbl/vessels and optic disc ± ± red reflex w illred reflex w illdecrease w ith cataractsdecrease w ith cataracts ± ± look f or nicks/narrow ing look f or nicks/narrow ing
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Auditory canal Auditory canal ± ± S shapedS shaped ± ± 11´́ long long
Lined w ith fine hairs and sebaceous glands plusLined w ith fine hairs and sebaceous glands plusceruminous ( w ax ) glandsceruminous ( w ax ) glands
Fx Fx ± ± keep free of debris/bacteriakeep free of debris/bacteria
Ty mpanic membrane (eardrum) Ty mpanic membrane (eardrum) ± ± receive sound w avesreceive sound w avesfrom the external ear/canal; separates external auditory from the external ear/canal; separates external auditory canal from earcanal from ear
8/6/2019 Nursing Care of Patients With Sensorineural Disorders
Continuous from nasal phary nx via eustachian tube by mucucousContinuous from nasal phary nx via eustachian tube by mucucousmembranesmembranes
Cavity is an aiir space in temporal boneCavity is an aiir space in temporal bone
3 3 tiny bo
nes: maleeus, incus and stap
es ( o
ssicular chain)tiny bo
nes: maleeus, incus and stap
es ( o
ssicular chain) ± ± vibrations from the ty mpanic membr. Cause fluid in inner ear to vibrations from the ty mpanic membr. Cause fluid in inner ear to mo ve and stimulate receptors hearing mo ve and stimulate receptors hearing
Cavity filled w ith arCavity filled w ith ar ± ± atmospheric pressure equalizes during atmospheric pressure equalizes during s w allow ing/y a w ning s w allow ing/y a w ning
CN VII (facial nerve) crosses o ver middle earCN VII (facial nerve) crosses o ver middle ear Can be damaged by trauma, skull f x, infectionsCan be damaged by trauma, skull f x, infections
Air conduction Air conduction ± ± problems in mid ear cause hearing lossproblems in mid ear cause hearing loss
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CochleaCochlea ± ± organ of Corti = pitch soundsorgan of Corti = pitch sounds
Vestibulocochlear nerve (CN VIII) sends sound Vestibulocochlear nerve (CN VIII) sends soundto brain to process/interpretto brain to process/interpret
Nerv ous stimuli by vestibular portio of VIIINerv ous stimuli by vestibular portio of VIII
Patholog y sensorineural hearing lossPatholog y sensorineural hearing loss(sensitivity to high(sensitivity to high--pitched tones)pitched tones)
Central hearing loss= difficulty in understanding Central hearing loss= difficulty in understanding the meaning of words heardthe meaning of words heard
8/6/2019 Nursing Care of Patients With Sensorineural Disorders
Infection or inflammation of conjuctivaInfection or inflammation of conjuctiva
CommonCommon
Epidemics common in children due to poor
Epidemics common in children due to poorhy gienehy giene
Most common organismMost common organism ± ± Staph, streptStaph, streptpneumoniae, haemophilus influenzaepneumoniae, haemophilus influenzae
Irritation, tearing, redness, mucopurulentIrritation, tearing, redness, mucopurulentdrainagedrainage ± ± spreads from affected ey e to spreads from affected ey e to unaffected ey eunaffected ey e
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Contraindicated w ith narrow Contraindicated w ith narrow--angle glaucomaangle glaucoma
My dratics cardio vascular effectsMy dratics cardio vascular effects
Use punctual occlusionUse punctual occlusion
Inf orm re lack depth perception ( Inf orm re lack depth perception (2424 hrs)hrs) Notif y MD if pain intenseNotif y MD if pain intense ± ± may signal hemorrhage,may signal hemorrhage,
infection or incr. IOPinfection or incr. IOP
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Separation of sensory retina and undelry ing pigmentSeparation of sensory retina and undelry ing pigmentepitheliumepithelium
Fluid accumulate bet w een theFluid accumulate bet w een the 22 lay erslay ers
Increased w ith aphakiaIncreased w ith aphakia Causes blindness!!Causes blindness!! Caused by retinal break (tears or holes)Caused by retinal break (tears or holes) holes spontaneous; tears w ith aging holes spontaneous; tears w ith aging
Sx of photopsia (light flashes); floaters, and aSx of photopsia (light flashes); floaters, and a
³³cobw ebcobw eb
´́
³³hairnethairnet´́ or ring in visual fieldor ring in visual field Curtain comes across visionCurtain comes across vision Ultrasound to dx if opthalmoscope or slit lamp notUltrasound to dx if opthalmoscope or slit lamp not
definitivedefinitive
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Congenital or primary diseaseCongenital or primary diseaseIOP regulated by f ormation/reabsorption of aqueous humorIOP regulated by f ormation/reabsorption of aqueous humor
Glaucoma R/T balance or imbalanceGlaucoma R/T balance or imbalance
A CU TE A CU TE ± ± Most common problem of middleMost common problem of middle childhood disease assoc w ith colds, allergies, sorechildhood disease assoc w ith colds, allergies, sore
throats, blockage eustachian tubethroats, blockage eustachian tube E
arlier theE
arlier the 11stst
episode, > risk subsequentepisode, > risk subsequentRisk Risk ± ± young, congenital, immune deficiencies, exposureyoung, congenital, immune deficiencies, exposureto cig smoke, family hx, recent URI, males/allerg y to cig smoke, family hx, recent URI, males/allerg y
MedsMeds ± ± amoxicillin f oramoxicillin f or 1010 day s is the drug of choiceday s is the drug of choice ± ±surgery : my ring otomy w ith short or long surgery : my ring otomy w ith short or long --term useterm use ± ±prompt rx prevents perf oration ty mpanic membraneprompt rx prevents perf oration ty mpanic membrane Antihistamines in aduts Antihistamines in aduts
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Untreated or repeated attacks of acuteUntreated or repeated attacks of acute
More common in those w ho have has childrenMore common in those w ho have has children
Middle ear and air cells of mastoidMiddle ear and air cells of mastoid
ChronicChronic ± ± purulent, mucoid or serous discharge w ith hearing purulent, mucoid or serous discharge w ith hearing
loss and ear pain, nausea, dizzinessloss and ear pain, nausea, dizziness Ossicle destruction leads to hearing lossOssicle destruction leads to hearing loss
Also ty mpanic membrane perf or fluids ( pain) Also ty mpanic membrane perf or fluids ( pain)
DX DX ± ± sinus X sinus X --ray s, MRI, CT scan of temporalray s, MRI, CT scan of temporalbonebone««««««««««««can show a cholesteatomacan show a cholesteatoma
Antibiotic ear gtts + acetic acid Antibiotic ear gtts + acetic acid Parenteral antibiotics if a recurrenceParenteral antibiotics if a recurrence