Physiological adaptation - neurological

Eye
• Anything that dilates the pupil obstructs the canal of Schlemm and increases intraocular pressure.
• Color blindness is caused by a deficiency in one or more types of cones and is caused by a sex-linked recessive gene.
• Destruction of either the right or left optic nerve tract results in blindness in the respective side of both eyes
• When mydriatics are instilled, caution clients that vision will be blurred with photophobia for up to two hours since the pupils have been dilated
• After eye surgery teach client to avoid, for six weeks, activities that can increase IOP

  • • Stooping
  • • Bending from the waist
  • • Heavy lifting
  • • Excessive fluid intake
  • • Emotional upsets
  • • Constrictive clothing around neck
  • • Straining with bowel movement (or straining at stool)
  • • Sustained coughing or blowing of the nose

• Teach client proper administration of eyedrops especially to wash hands before installation
• Provide sunglasses for photophobia
• Assist with activities of daily living as required
• When clients wear one eye patch, they lose depth perception. Remember that this loss presents a safety risk.
• Systemic disorders that can change ocular status include diabetes mellitus, atherosclerosis, Graves’ disease (hyperthyroidism), AIDS, leukemia, lupus erythematosus, rheumatoid arthritis sickle cell disease.
Ear
• Changes in barometric pressure will affect persons with ear disorders to cause increased findings or malfunctions
• Hearing loss can

  • • be partial or total
  • • affect one or both ears
  • • occur in low, medium or high frequencies
  • • in elderly be more frequently high frequency so special smoke detectors may be needed

• American Medical Association formula for hearing loss: hearing is impaired 1.5% for every decibel that the pure tone average exceeds 25 decibels (dB)
• A hearing loss of 22.5% usually affects social functionality and requires a hearing aid
• Noise exposure is the major cause of hearing loss in the United States of America
• Ask client how he/she communicates: lip-reading, sign language, body gestures, or writing
• To gain the client’s attention, raise a hand or touch the client’s arm
• When talking with client, speak slowly and face him/her
• Speak toward the client’s good ear
• If the client wears a hearing aid, allow him/her to show how it’s inserted
• Speaking louder to a hearing impaired client does not increase his/her chances of hearing
• Communicate the client’s hearing loss to other staff members
• Ototoxic drugs include:

  • • Aminoglycosides
  • • Antimyobacterials
  • • Thiazides
  • • Loop diuretics
  • • Antineoplastics

• Tell clients taking ototoxic drugs to report any signs of dizziness, loss of balance, tinnitus, or hearing loss


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