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CMN 568 Unit 1: Questions & Complete Solutions
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CMN 568 Unit 1: Questions & Complete Solutions
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CMN 568 Unit 1: Questions & Complete SolutionsPatients with _____ must undergo at least an annual examination for
retinopathy, even if they have no vision problems. Right Ans - diabetes
Visual Acuity:
- able to BRIEFLY visually track mother's face or brightly colored object within
an hour after birth (fixation reflex not developed for several weeks, so fixation
is brief) Right Ans - Newborn
Visual Acuity:
Don't talk to baby when assessing vision - he may look toward sound rather
than visual stimulus.
Look for __________ Right Ans - fix and follow of object.
- With any eye condition (infection, injury, etc.), check visual acuity to best
extent possible based on age
- foreign body or chemical injury is exception - IRRIGATE eye profusely first
and worry about acuity later
-When there is decreased acuity -->____________ Right Ans - refer
immediately
Vision is only about ________ in the newborn Right Ans - 20/200 to 20/400
Typical visual acuity in developmentally appropriate child reaches level of
20/20 by _____ years of age Right Ans - 5 years of age
Vision should be checked every ______ Right Ans - 1-2 yrs
Acuity changes occur quickly with _______________ Right Ans - growth spurts
Boys may develop _________ later than girls due to differences in growth
patterns.
Typical onset - elementary school. Right Ans - myopia(near sighted)
,Refer ________: If acuity if less than 20/40 in either eye, or if there is a
difference of 2 lines in acuity between eyes Right Ans - 3-5 YEAR OLD
Refer _________: If acuity if less than 20/30 in either eye, or if there is a
difference of 2 lines in acuity between eyes Right Ans - 6 and older
Most common intraocular malignancy of childhood, usually presenting before
age 3 Right Ans - Retinoblastoma
Most common presenting sign is Leukocoria (white reflex inpupil).
May present with strabismus, red eye, or glaucoma Right Ans -
Retinoblastoma
Always check red reflex (Bruckner test) in young children with an
ophthalmoscope Right Ans - Retinoblastoma
Positive Bruckner test: difference in the quality of the red reflex between eyes
REFER!! Right Ans - Retinoblastoma
Assessing for malalignment (strabismus) of eyes:
Perform the _________: Check the corneal light reflex --> It should be in the same
position in each eye.
Perform the _______: watch for movement of the eye after cover removed
Right Ans - Hirschberg test
Cover Test
Brief periods of malalignment are normal in NB.
Unless strabismus is very obvious and persistent, generally wait until child is
______ and then REFER all cases of strabismus to an ophthalmologist.
Patching or surgery is used Right Ans - 4 months old
eye or eyes turn in (cross-eyed if bilateral) Right Ans - Esotropia
,eye or eyes turn outward Right Ans - Exotropia
eye is depressed (downward) Right Ans - Hypotropia
eye is elevated Right Ans - Hypertropia
All kids age ______ must have vision checked at least once Right Ans - 3 - 5
Poor vision in one eye.
Brain doesn't recognize sight from 1 eye and relies more on the stronger eye
while vision in weaker eye gets worse. Right Ans - Amblyopia (lazy eye)
This is caused by the brain trying to suppress the off-center image.
It can result in permanent blindness in the "unused" eye unless corrected
early in life. Right Ans - Amblyopia (lazy eye)
In well baby check, look for _______ of cornea and red reflex Right Ans -
clarity
Presence of ______ does not mean NB baby can see, only that the eye itself is
intact.
Abnormal _________ - refer to ophthalmologist Right Ans - red reflex
Conjunctivitis in first month of life.
(Gonococcal, Staph, Chlamydia, pneumococcal, Herpes simplex) Right Ans -
Opthalmia neonatorum
Look for drainage, redness, swelling of lids/conjunctiva. Right Ans -
Opthalmia neonatorum
Prophylactic ________ (rarely used anymore, given just afterbirth) can cause
chemical conjunctivitis with excessive drainage.
Also is not effective against chlamydia Right Ans - silver nitrate
, _________ ointment is most often used as prophylaxis after birthto prevent
opthalmia neonatorum Right Ans - Erythromycin
Another common condition that causes drainage of eye in the newborn
- there is continuous tearing and a yellowish discharge and swelling. Right
Ans - nasolacrimal duct obstruction
Have mother massage lacrimal sac 6 times a day. Right Ans - nasolacrimal
duct obstruction
Nasolacrimal duct obstruction may lead to acute or chronic ___________, a
bacterial infection of the nasolacrimal sac. Right Ans - dacryocystitis
Presents as purulent discharge, swelling, & tenderness over lacrimal sac.
Right Ans - dacryocystitis
Oral antibiotics used to treat mild infection (Augmentin)
Topical antibiotics are sometimes used as an adjunct Right Ans -
dacryocystitis
If condition persists beyond age 8 mos or there is inflammation of lacrimal
sac, REFER immediately (with chronic, inform Mom what to watch for)
Right Ans - dacryocystitis
IV antibiotics used to treat severe infection or if there is evidence of orbital
cellulitis (see picture below)
May need surgical probing to relieve chronic obstruction Right Ans -
dacryocystitis
When there is inflammation & infection, it's called acute dacryocystitis -->
___________ Right Ans - REFER
Type of conjunctivitis commonly known as "pink eye"
can occur in one or both eyes; appears as red, itchy, watery eyes
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