Download Airgas template

Chapter 50
Nursing Care of a Family When
a Child Has a Vision or Hearing
Disorder
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Vision or Hearing
Disorder
• Assessment
• Nursing diagnosis
• Outcome identification, planning
• Implementation
• Outcome evaluation
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Vision or Hearing
Disorder (cont’d)
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Vision
• Stereopsis
• Accommodation
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Vision Disorders
• Refractive errors
– Light refraction
– Hyperopia
– Myopia
– Laser in situ keratomileusis
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Vision Disorders (cont’d)
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Vision Disorders (cont’d)
• Astigmatism
• Nystagmus
• Amblyopia
– Assessment
– Therapeutic management
• Color vision deficit
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Structural Problems of the Eye
• Coloboma-pic 1473 “key-hole appearance”
• Hypertelorism-”wide-spaced” eyes
• Ptosis-”drooping upper eyelid”
• Strabismus-”unequal alignment” pic 1474
– Assessment
– Therapeutic management
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Structural Problems of the Eye (cont’d)
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
INFECTION OR INFLAMMATION OF THE
EYE
• TABLE 50.2 * Infectious and Inflammatory
Eye Disorders 1475-1476
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Traumatic Injury to the Eye
• Assessment
• Foreign bodies
• Contusion injuries
• Eyelid injuries
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Inner Eye Conditions
• Congenital glaucoma
– Assessment
– Therapeutic management
– Discharge planning, follow-up
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Inner Eye Conditions (cont’d)
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Inner Eye Conditions (cont’d)
• Cataract
– Assessment
– Therapeutic management
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• The best way to approach a child who is
blind would be to
A. call his name and then identify yourself.
B. call his name and then touch him.
C. touch him and then identify yourself.
D. touch him and then say his name.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
• A. Call his name and then identify yourself.
• Rationale: Touching a child before he or she
realizes you are there can be frightening.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Structure and Function of the Ears
• Physiology of hearing loss
• Hearing impairment
– Hearing aids
– Speech therapy
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Structure and Function of the Ears
(cont’d)
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ear Disorders
• External otitis
– Assessment
– Therapeutic management
• Impacted cerumen
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ear Disorders (cont’d)
• Acute otitis media
– Assessment
– Therapeutic management
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ear Disorders (cont’d)
• Otitis media with effusion
– Assessment
– Therapeutic management
• Tubal myringotomy
• Cholesteatoma
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• A school-aged child with external otitis
media wonders how she got the illness. What
information would the nurse discuss with her
as a common cause?
A. Swimming
B. Use of ear plugs
C. Wearing sunglasses that are too tight
D. Excessive use of cotton swabs
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
• A. Swimming
• Rationale: Swimming or the presence of a
foreign body are leading causes of
“swimmer’s ear.” Secondary infections may
also occur.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ear Disorders (cont’d)
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• Which statement by a parent would best indicate
that she understands the precautions required for
her son after the insertion of myringotomy tubes?
A. “I will keep him away from all children to prevent
infections.”
B. “I will be certain he takes showers, not tub baths.”
C. “I will be certain he does not swim with the tubes
in place.”
D. “I will not shampoo his hair until the tubes come
out.”
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
• C. “I will be certain he does not swim with
the tubes in place.”
• Rationale: Myringotomy tubes would allow
water to enter the middle ear and lead to
infection.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins