Lippincott Certification Review Medical-Surgical Nursing

18 Eye, Ear, and Nose Disorders

Chapter

Introduction ●● Disorders of the eye, ear, and nose can be particularly disruptive to activities of daily living (ADLs). ●● Full visual function requires normal brain function, an intact retina, a clear lens, and normal intraocular pressure (IOP). ●● Common vision disorders result from alterations in ocular function or anatomy due to disease, trauma, the aging process, or abnormal IOPs; patients with significantly impaired vision may be frightened, anxious, and require special nursing care. ●● Hearing loss is a common disability that affects millions of people and causes significant alterations in ADLs; sclerotic disorders and vestibular dysfunction can be especially upsetting. It is important that other means of communication such as writing, picture board, or even a sign language interpreter be available if necessary to ensure the accurate transmission of information between the patient and the health care team. ●● Although the nose is the primary organ of smell, nasal disorders can affect taste and the smooth passage of air during respirations. ●● Nursing history ●● The nurse asks the patient about their chief complaint . ●● A patient with an eye disorder may report having diplopia, visual floaters, iridescent vision, vision loss, eye pain, or photophobia. ●● The patient may also report decreased visual acuity or clarity, defects in color vision, and difficulty seeing at night. ●● A patient with an ear disorder may experience hearing loss, tinnitus, pain, discharge, or dizziness. ●● A patient with a nose disorder may experience nasal stuffiness, nasal discharge, or epistaxis. ●● The nurse then questions the patient about their present illness . ●● Ask the patient about their symptom(s), including when it started, associated symptoms, location, radiation, intensity, duration, frequency, and precipitating and alleviating factors. ●● Ask about the use of glasses and contact lenses. ●● Ask about the use of prescription and over-the-counter (OTC) drugs, herbal remedies, and vitamin and nutritional supplements. ●● The nurse asks about the medical history . ●● Question the patient about a history of allergies, hypertension, diabetes, cerebrovascular accident, multiple sclerosis, syphilis, human immunodeficiency virus, or sleep apnea. ●● Ask about corrective eye surgery. ●● Ask the patient about previous ear problems or injuries, frequent colds, allergens, headaches, nose or head trauma, and sinus symptoms. ●● The nurse then assesses the family history . ●● Ask about a family history of eye disorders, such as cataracts, glaucoma, or blindness.

●● Question the patient about a family history of diabetes and hypertension. ●● Question the patient about a family history of eye, ear, and nose problems. ●● The nurse obtains a social history . ●● Ask about work, exercise, diet, use of recreational drugs and alcohol, and hobbies. ●● Also ask about stress, support systems, and coping mechanisms. Copyright © 2025 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited.

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