Exam 17: Ophthalmic Surgery

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.

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)?

MATCHING Match the three descriptive statements with their appropriate globe and orbital surgical procedures. a.Removal of the eye contents with sclera and muscles left intact b.Removal of the entire orbital contents,including the periosteum c.Removal of the entire globe,severing muscular attachments and optic nerve -Exenteration

Anna Lindeman,a 59-year-old woman with a significant retinal tear close to the macula,emerges from anesthesia in the 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 she 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 Anna that she should cancel and delay her trip until the surgeon approves that type of travel.What statement below justifies the nurse's response to Anna's vacation plans?

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

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:

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

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?

Select the true statement about dacryocystorhinostomy (DCR).

MATCHING Match the three descriptive statements with their appropriate globe and orbital surgical procedures. a.Removal of the eye contents with sclera and muscles left intact b.Removal of the entire orbital contents,including the periosteum c.Removal of the entire globe,severing muscular attachments and optic nerve -Enucleation

Vitrectomy is narrowly defined as removal of all or part of the vitreous gel (body).Vitrectomy can also vacuum any pooled blood to enhance visual clarity.Select all indications and complications that apply to vitrectomy.

Toxic anterior segment syndrome (TASS),also known as sterile endophthalmitis,is a sterile noninfectious form of acute inflammation that occurs after eye surgery (typically cataract surgery).It frequently begins within 24 hours after surgery and is characterized by decreased vision,significant corneal edema,and moderate to severe inflammation in the anterior chamber of the eye.Select all of the possible causes and risk reduction strategy statements.

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

MATCHING Match the three descriptive statements with their appropriate globe and orbital surgical procedures. a.Removal of the eye contents with sclera and muscles left intact b.Removal of the entire orbital contents,including the periosteum c.Removal of the entire globe,severing muscular attachments and optic nerve -Evisceration

Local anesthesia,or monitored anesthesia care (MAC),is used for most ophthalmic surgery.The local anesthetic regimen,administered by the operative surgeon,is typically a combination of anesthesia delivery methods,or routes.Select the anesthetic plan that is administered by the surgeon before the start of surgery.

Oculocardiac reflex (OCR)is an intraoperative emergency that can occur during eye surgery.It is characterized by bradycardia that can lead to asystole,hypotension,and a wide range of other dysrhythmias attributable to negative inotropic and conduction effects.Select the definition of the response and contributing factor(s).

Patients scheduled for enucleation,evisceration,or exenteration may present with other injuries or conditions that will impact their care and recovery.During nursing assessment,the perioperative nurse should review the patient's record for the presence of conditions or injuries related to the surgical diagnosis that may impact a successful surgical outcome and recovery.Select the patient statement from the list below that is an example of a related secondary condition that may impact the patient's care.

How does the lacrimal gland differ from the lacrimal sac?

Anesthetic management impacts the success of ophthalmic surgery.Safe ambulatory surgery,especially in certain populations,depends on patient selection,preoperative evaluation,preparation,monitoring,and local anesthesia techniques.Select the patient below that would be an appropriate candidate for general anesthesia,instead of local anesthesia alone.