Alterations in Sensory Perception

A comprehensive set of 60 flashcards testing key concepts, diagnostic tests, clinical judgment, and nursing management of visual and auditory alterations based on ATI sensory perception notes.

What is the definition of sensory perception according to Ignatavicius, Rebar & Heimgartner (2021)?

The ability to perceive and interpret sensory input into 1 or more meaningful responses.

Which 5 senses are involved in sensory perception?

Vision, hearing, touch, smell, and taste.

What external structures comprise the eye?

Eye muscles, upper and lower eyelids, sclera, conjunctiva, and lacrimal structures.

What are the three internal layers of the eye?

Fibrous, vascular, and neural layers.

What are the key internal eye structures identified in the A&P overview?

Iris, choroid, ciliary body, retina, rods and cones, aqueous humor, and optic nerve.

How is Age-Related Macular Degeneration (AMD) defined pathophysiologically?

AMD occurs when there is a buildup of photoreceptor waste products, drusen, that accumulates beneath the retina, causing it to be unable to function.

What is Dry AMD and how common is it?

Dry AMD is the most common form of AMD and involves the breakdown of the outer retina.

What is Wet AMD and how does it affect vision?

Wet AMD involves abnormal growth of blood vessels that leak liquid and blood under the macula, resulting in visual distortion, rapid onset, sudden blurred vision, or blind spots.

What is metamorphopsia?

Visual distortion where straight lines appear wavy or bent; it is a hallmark symptom and early sign of wet AMD.

What condition is the most common cause of irreversible blindness in people greater than $65\text{ years}$ old?

Age-Related Macular Degeneration (AMD).

What epidemiological and etiological risk factors contribute to AMD?

Smoking, HTN, high cholesterol, obesity, family history of AMD, and lighter skin and eye color.

Which comorbidities show a direct association with Age-Related Macular Degeneration (AMD)?

Cardiovascular and renal conditions.

What specialized visual tool can clients use in the home setting to monitor AMD progression?

Amsler grid.

What class of medications is administered to slow abnormal blood vessel formation in Wet AMD?

Antivascular endothelial growth factor (anti-VEGF) medications.

What is the primary management strategy for Dry AMD?

There is no cure for Dry AMD, making lifestyle modifications vital.

What is a cataract?

A cloudy or opaque area of the eye lens where the lens becomes denser and less transparent due to loss of water.

What is the most common etiology and risk factor for cataracts?

Aging.

What dietary lifestyle modification is recommended to help prevent cataracts?

An increased diet in dark green leafy vegetables.

How are lab tests utilized in the clinical management of cataracts?

No blood test identifies cataracts, but blood tests (blood glucose, LFT, KFT, CBC, PT/INR/PTT) are used to rule out causative factors or for presurgical evaluation.

Which diagnostic tool is specifically used to visualize a cataract?

Slit-lamp biomicroscope.

What diagnostic procedure is used to assess blood supply in the rear of the eye?

Fundoscopy.

What is the most effective treatment for cataracts?

Surgical extraction or removal of the cloudy lens and implantation of an intraocular lens (IOL).

What is phacoemulsification?

The most common surgical technique used for cataract removal.

What nursing action is required regarding anticoagulants prior to cataract surgery?

Report the use of anticoagulants to the provider immediately, as they are usually held $1\text{ week}$ prior to surgery.

What postoperative precautions and activity restrictions should be taught to cataract surgery patients?

Avoid getting water or using contacts for $1\text{ week}$, and avoid sneezing, coughing, gagging, and strenuous activities such as lifting or bending.

When does progressive improvement of vision typically occur postoperatively after cataract surgery?

Usually $6\text{-}8\text{ weeks}$ postoperatively.

How is glaucoma characterized pathophysiologically?

Progressive optic neuropathy characterized by retinal ganglion cells and axon degeneration, caused by increased ocular pressure on the optic nerve due to increased production or decreased outflow of aqueous humor.

What clinical manifestations indicate acute angle-closure glaucoma requiring emergent treatment?

Eye pain, headache, nausea, sudden vision loss, and visual disturbances such as halos around lights.

What health promotion guidelines exist for glaucoma eye examinations?

A full eye exam with dilation by age $40$, and an annual glaucoma test for high-risk individuals.

What is the normal range for intraocular pressure (IOP)?

$11\text{-}21\,\text{mmHg}$.

What intraocular pressure (IOP) measurement range is classified as high?

$21\text{-}32\,\text{mmHg}$.

What diagnostic test is used for frequent monitoring of intraocular pressure (IOP)?

Tonometry.

What is the purpose of visual field testing (perimetry) in glaucoma management?

To determine the amount of vision lost in the peripheral and central vision fields.

What is considered the first-line intervention for glaucoma treatment?

Nonsurgical pharmacological treatment (medications).

What mechanism of action do alpha agonists use to manage glaucoma?

They reduce aqueous humor production and increase the amount of fluid drained from the eye.

How do beta-blockers function in lowering intraocular pressure in glaucoma?

They decrease the volume of aqueous humor created by the eye.

How do carbonic anhydrase inhibitors work to reduce intraocular pressure?

They decrease the volume of aqueous humor created by the eye.

What is the mechanism of action of prostaglandin analogs in glaucoma therapy?

They improve the amount of fluid drainage from the eye.

What is laser trabeculoplasty?

The least invasive surgical method to lower IOP, using lasers to tighten and thicken angle tissue to allow for increased aqueous humor fluid drainage.

What takes place during a trabeculectomy procedure?

Creation of a drainage flap to allow fluid drainage into the vascular system.

What are two specific alpha agonist eyedrop medications used for glaucoma?

Alphagan P (brimonidine) and Lopidine (apraclonidine).

What are two specific beta-blocker eyedrop medications used for glaucoma?

Timoptic (timolol) and Betoptic (betaxolol).

What carbonic anhydrase inhibitor eyedrop medications are listed for glaucoma treatment?

Azopt (brinzolamide) and Trusopt (dorzolamide).

What prostaglandin analog eyedrop medications are listed for glaucoma treatment?

Xalatan (latanoprost), Lumigan (bimatoprost), Travatan Z (travoprost), and Zioptan (tafluprost).

What adverse effects are associated with prostaglandin analog eyedrops?

Alteration of eye color, dark eyelid skin, increased eyelash growth, eyelid drooping, burning or stinging sensation, and eye irritation (redness and itching).

What systemic and ocular adverse effects are associated with beta-blocker eyedrops?

Bradycardia, difficulty breathing, decreased energy, burning or stinging sensation, and eye irritation.

What occurs pathophysiologically during retinal detachment?

The retina detaches from blood vessels, leading to vitreous humor collapse and loss of oxygen and nourishment.

What characteristic sensory visual perception is reported by clients experiencing retinal detachment?

Dark floaters or a feeling of a curtain coming down in line of vision.

What visual manifestations may be present in a client with retinal detachment?

Blurred or distorted vision, photopsia (flashes of light), or floaters.

How is the confrontational visual field test conducted?

The client looks directly at the nurse's finger while the nurse moves the finger randomly in all directions to check if vision is present in all visual fields.

What is a scleral buckle procedure?

The most common surgical treatment for retinal detachment, where a silicone band is sewn on the sclera to create an eye wall indentation that relieves pressure on the retina.

What occurs during Pars Plana Vitrectomy & Pneumatic Retinopexy?

An absorbable gas bubble is inserted into the vitreous chamber to apply gentle pressure, promoting reattachment of the torn retina.

How long may it take for an absorbable gas bubble to be reabsorbed after pneumatic retinopexy?

Up to $8\text{ weeks}$.

What specific postoperative positioning is required after retinal detachment repair and for how long?

The client must lie prone (face down) for $3\text{ days}$ to $2\text{ weeks}$ to facilitate healing and reduce the opportunity for retinal detachment while healing.

What postoperative physical restrictions must be followed after retinal detachment surgery?

Avoid vigorous exercise and lifting $>15\,\text{lbs}$ for $3\text{ months}$, no driving for $2\text{ weeks}$, and no liquids or objects in the eye for $1\text{ week}$.

What structures compose the middle ear and inner ear?

Middle ear: tympanic membrane and ossicles (malleus, incus, and stapes). Inner ear: organs for hearing and balance including the spiral-shaped cochlea and fluid-filled semicircular canals.

What is presbycusis and what causes it?

Age-related hearing loss caused by gradual cochlear hair cell degeneration or decreased blood supply to the inner ear.

Which ototoxic medications are specifically identified as risk factors for hearing loss in the transcript?

Furosemide and cisplatin.

What are the procedure and test interpretation for the finger rub hearing screening test?

Gently rub fingers together $6\,\text{inches}$ from the client's ear $6\text{ times}$. Detecting the rub in at least $4\text{ of }6$ tries is normal; inability to detect in at least $3\text{ of }6$ indicates a hearing deficit.

What diagnostic tests are used for Meniere's disease to monitor eye movements and ear pressure?

Electronystagmography (ENG) monitors uncontrolled eye movements to assess brain vs inner ear causes, and Electrocochleography (ECOG) evaluates pressure in the ears.