Exam 18: Ophthalmic Surgery

When preparing for pars plana vitrectomy in the posterior segment,the perioperative nurse must be aware that a combined scleral buckling procedure may be necessary.Other important information the perioperative nurse should know before preparing the OR for the procedure includes the location of the ocular problem,the surgeon's plan to address the problem,and the instrumentation and biomedical equipment and devices to be used.Technologic advances in ophthalmic surgery require that perioperative nurses be familiar with complex biomedical equipment.A best practice,stated below,relevant to the safe use of complex equipment would be to:

The extraocular muscles work in yoked pairs,with ocular movements generated by an increase in the tone of one set of muscles and a decrease in the tone of the antagonistic muscles.Of the two muscle types,how many are represented in each eye?

A cataract is defined as any opacification of the lens.Cataracts may be congenital,posttraumatic,or induced by medications but are most commonly the result of age-related changes.Which of the following statements about cataracts best describes its presentation or etiology (cause)?

A wide range of equipment is used in ophthalmic surgery.The perioperative team's knowledge of proper operation should be confirmed through inservice education and training specific to new equipment,plus demonstrated competency.To ensure patient safety and appropriate function and application of surgical devices,which statement best reflects recommended practice when using complex biomedical equipment?

A 59-year-old woman with a significant retinal tear close to the macula emerges from anesthesia in the postanesthesia care unit (PACU)after a 4-hour pneumatic retinopexy with scleral buckling,posterior vitrectomy,and injection of a gas bubble to close and support the retinal tear.She will have to maintain a face-down head position for 7 to 10 days,followed by laser surgery or cryotherapy to seal the tear.As the patient prepares for discharge from the PACU,she informs the perioperative nurse that she has reserved a flight to Denver,Colorado in 3 weeks to visit friends and celebrate the end of her ophthalmic surgeries and survival of sustained face-down positioning during recovery.The nurse firmly informs her that she should cancel and delay her trip until the surgeon approves that type of travel.Which statement below justifies the nurse's response to the patient's vacation plans?

Select the true statement about dacryocystorhinostomy (DCR).

Patients presenting for ophthalmic surgery may have endured chronic progressive impairment or recent decrease in visual acuity.Most patients are admitted as outpatients.Select the appropriate nursing actions when admitting the ophthalmic surgery patient.

Select the true statement about antimetabolite drugs and their indications for use.

Select the appropriate procedure performed for a patient with Fuchs' dystrophy,edema after cataract surgery,or keratoconus (abnormal steepening)of the cornea.

The perioperative nurse prepares a separate treatment setup for the surgeon to use before the DCR operative procedure is started.Select the statement that describes the justification for this separate treatment setup.

Review the list below,and select the option that describes an action that occurs during vitrectomy.

To accommodate near and distant focus,the lens changes shape and focus by relaxation and tightening of the zonular fibers.What physiologic change of the normal aging process is typically corrected with bifocals?

The nurse must ensure that the microscope used in ophthalmic surgery is specifically intended for safe use in eye surgery.The perioperative nurse must also be familiar with adjusting the pupillary distance (distance between pupils of the user's eyes)and diopter settings on the oculars (eyepieces)for operator vision correction to work without eyeglasses.How should the oculars be set for a user with astigmatism?

Most medications prescribed for the eye are administered in the form of eye drops.What techniques should the perioperative nurse use to minimize systemic absorption of eye drops?

The procedure for cataract extraction with implantation of an intraocular lens (IOL)exposes the patient to risks of infection of the anterior chamber and corruption of the implanted device.Appropriate measures for the circulating nurse and scrub person include managing patient safety needs.Efforts are directed at preventing foreign substances from being introduced intraocularly.Select the nursing actions that may ensure this outcome.

The refractive apparatus of the eye directs (refracts)the light rays to strike the:

Cycloplegic drugs produce a similar effect on the pupil as mydriatic drugs,with one difference.From the options below,select the most appropriate statement about the effects of cycloplegics.

Miotics and mydriatics produce opposite effects on the pupil of the eye.Select the most appropriate statement about miotic and/or mydriatic drugs.

Sutures used in ophthalmic surgery are very fine and range in size from 4-0 to 10-0.Handling and arming these sutures can be a challenge for the scrub person with uncorrected presbyopia.Eye sutures should be handled as little as possible to avoid:

Review the list below and select the statement that accurately describes toxic anterior segment syndrome (TASS).