Galen Med surg Exam 2 Questions
with 100% Correct Answers
Rehabilitative Nursing Care: Mobility - Answer- Hemiplegia
Pressure ulcer prevention
ADLs
Avoid hot and cold
Positioning
DVT prophylaxis
Rehabilitative Nursing Care: Sensory - Answer- Injury risk to flaccid extremity
Homonymous hemianopsia
Encourage the client to scan the room. Place objects near the client.
Diplopia - eye patch
Rehabilitative Nursing Care: Dysphagia - Answer- Aspiration precautions
NPO until Swallow screening
Thickened, as prescribed
Nutritional alteration
Rehabilitative Nursing Care: Speech - Answer- Aphasia
Receptive - loss of comprehension
Expressive - loss of production of language
Global - total inability to communicate
Perseveration, dysarthia
Be clear and concise
Use cues and gestures
Avoid yes or no questions
Alternative forms of communication.
Rehabilitative Nursing Care: Bowel and Bladder - Answer- Constipation
Stool softeners, as prescribed
Fiber Fitness Fluids
UTI surveillance
Rehabilitative Nursing Care: Ineffective Coping - Answer- Emotional labiality
Psych consult
Care giver support
Be patient with those recovering
Cataracts - Answer- Medical condition characterized by opacity of the crystalline lens.
Most commonly seen in older adults. Causes a gradual, painless, progressive loss of
vision.
Cataracts Pathophysiology - Answer- Lens is mostly protein and water. With aging, lens
loses water, dries up and becomes thicker. As it thickens it loses transparency.
Cataract Symptoms - Answer- Visual impairment is the chief complaint. Pt may c/o
blurry, cloudy, hazy, foggy, or yellowing of vision. Also diplopia that doesn't go away
when one eye is covered. Halos—particularly when looking at light or with night-time
driving
PE: Diagnosed with a slit-lamp exam
Cataracts: Treatment - Answer- Treatment is surgical removal of the cataract material
Prognosis: 95% of adults will have increased visual acuity following surgery
Cataracts: Aftercare - Answer- Post-operative care:
Antibiotic and steroid ointments are instilled
Instruct patients to wear dark glasses or in brightly lit environments until the pupil
responds to light
Teach patient and family members how to instill the prescribed eye drops (chart 46-2,
page 962; chart 47-1 page 970)
Mild eye itching, bloodshot eye is normal
Contact surgeon immediately if any pain, reduction in vision, or s/s infection in the eye
that had the cataract removed
Avoid activities that increase IOP (table 47-2
Glaucoma: Primary Open Angle - Answer- Most common form
Develops slowly, gradual loss of visual fields
Usually affects both eyes
No S/S in early stages
Foggy Vision
Mild eye aching or headaches
Late S/S:
Halos around lights
Loss of peripheral vision
Glaucoma: Drug Therapy - Answer- Timolol: Reduces production of aqueous humor by
the ciliary body
Pilocarpine: Opens the trabecular meshwork, allowing aqueous humor to flow out
Mannitol: Osmotic diuretic; removes water from aqueous humor; decreases volume of
AH leading to decrease in IOP
Glaucoma: Nursing Role - Answer- Priority nursing intervention for pt with glaucoma is
teaching
Drug (eye gtt) adherence
If more than one drug is prescribed, wait 5-10 minutes between instillations to prevent
one drug from diluting another drug
Good Handwashing
Avoid touching the tip to any part of eye
Punctal occlusion to prevent systemic absorption of the drug (BB's)
Macular Degeneration - Answer- Macula: Part of the retina responsible for central vision
Unknown etiology, there are some risk factors.
Chronic condition affecting the eyes causing progressive central vision loss
Macular Degeneration: Dry - Answer- Most Common-90% of cases
A/W Development of characteristic yellow drusen (yellow cellular debris)
Drusen accumulates in the retina causing loss of central vision
Macular Degeneration - Answer- 10% of cases
More severe faster progressing
A/W neovascularization of the choroid leading to hemorrhage and ischemia
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