1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 50 Nursing Care of a Family When a Child Has a Vision or Hearing Disorder

2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Vision or Hearing Disorder Assessment Nursing diagnosis Outcome identification, planning Implementation Outcome evaluation

3. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Vision or Hearing Disorder (cont’d)

4. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Vision Stereopsis Accommodation

5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Vision Disorders Refractive errors –Light refraction –Hyperopia –Myopia –Laser in situ keratomileusis

6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Vision Disorders (cont’d)

7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Vision Disorders (cont’d) Astigmatism Nystagmus Amblyopia –Assessment –Therapeutic management Color vision deficit

8. 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

9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Structural Problems of the Eye (cont’d)

10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins INFECTION OR INFLAMMATION OF THE EYE TABLE 50.2 * Infectious and Inflammatory Eye Disorders 1475-1476

11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Traumatic Injury to the Eye Assessment Foreign bodies Contusion injuries Eyelid injuries

12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Inner Eye Conditions Congenital glaucoma –Assessment –Therapeutic management –Discharge planning, follow-up

13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Inner Eye Conditions (cont’d)

14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Inner Eye Conditions (cont’d) Cataract –Assessment –Therapeutic management

15. 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.

16. 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.

17. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Structure and Function of the Ears Physiology of hearing loss Hearing impairment –Hearing aids –Speech therapy

18. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Structure and Function of the Ears (cont’d)

19. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Ear Disorders External otitis –Assessment –Therapeutic management Impacted cerumen

20. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Ear Disorders (cont’d) Acute otitis media –Assessment –Therapeutic management

21. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Ear Disorders (cont’d) Otitis media with effusion –Assessment –Therapeutic management Tubal myringotomy Cholesteatoma

22. 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

23. 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.

24. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Ear Disorders (cont’d)

25. 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.”

26. 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.