A nurse in an ophthalmology clinic is assessing a client who has suspected primary open-angle glaucoma (PAOG). Which assessment finding would support a diagnosis of this type of glaucoma?

Loss of peripheral vision

Opacity of the lens

Decrease in color perception

Pain and purulent discharge

Answer and Explanation

The Correct Answer is A

A.   Loss of peripheral vision is a hallmark sign of primary open-angle glaucoma. In POAG, increased intraocular pressure causes damage to the optic nerve, leading to a gradual loss of peripheral vision. This vision loss is often subtle and progresses slowly, making it difficult for individuals to notice until the condition is advanced.

B.   Opacity of the lens is characteristic of cataracts, not glaucoma. Cataracts involve the clouding of the eye's natural lens, which leads to blurred vision and difficulties with seeing clearly, particularly in bright light. While cataracts and glaucoma can occur simultaneously, opacity of the lens is not indicative of POAG.
C.   Decrease in color perception can be associated with various eye conditions, including age-related macular degeneration (AMD) and certain types of retinal diseases. While it can occur in glaucoma as the disease progresses, it is not the primary or most characteristic sign of POAG.
D.   Pain and purulent discharge are more associated with acute conditions such as conjunctivitis (pink eye) or an eye infection, rather than primary open-angle glaucoma. POAG typically presents without pain or discharge, as it is a chronic condition with a gradual onset of symptoms.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Methylprednisolone is a corticosteroid used to reduce inflammation and suppress the immune system. While corticosteroids are sometimes used in critical care settings, they are not specifically used to prevent stress ulcers. In fact, corticosteroids can increase the risk of gastrointestinal bleeding and may require additional measures to protect the stomach lining.
B. Enoxaparin is a low molecular weight heparin (LMWH) used primarily for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). It works as an anticoagulant, preventing blood clots. While enoxaparin is important for preventing thromboembolic events in critically ill patients, it does not specifically address the prevention of stress ulcers.
C. Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid production by inhibiting the proton pumps in the stomach lining. PPIs are commonly used to prevent and treat stress ulcers because they help decrease gastric acid secretion, thereby reducing the risk of ulcer formation and bleeding. This makes pantoprazole the appropriate medication to administer to prevent physiologic stress ulcers in a patient with sepsis on a ventilator.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain relief and inflammation. NSAIDs can actually increase the risk of gastrointestinal bleeding and ulceration, especially in critically ill patients.

A. "The medication will help block the neural impulses that are sent to the muscles in the eye." B. "The medication will help dilate the pupil to allow drainage of fluid to occur." C. "The medication causes the pupil to constrict, opening the angle where the iris meets the cornea." D. "The medication pulls excess aqueous humor from the eye, into the bloodstream."

Correct Answer is C

Explanation

A. This statement is not accurate in the context of miotic medications. Miotic drugs do not work by blocking neural impulses to the muscles. Instead, they directly affect the eye's pupil size and fluid dynamics. This response does not correctly describe the action of miotic agents.
B. This response is incorrect because miotic medications actually constrict the pupil, not dilate it. In acute angle-closure glaucoma, dilation of the pupil would worsen the condition by further blocking the drainage angle. Miotics are used to constrict the pupil, which helps open the angle between the iris and the cornea, thereby facilitating fluid drainage.

C. Miotic medications cause the pupil to constrict (miosis), which helps in opening the narrow angle between the iris and the cornea. In acute angle-closure glaucoma, the angle is closed or narrow, preventing proper drainage of aqueous humor. By constricting the pupil, miotic medications can help to relieve this obstruction and allow better drainage of fluid, thereby reducing intraocular pressure.
D. This statement is incorrect regarding the action of miotic medications. Miotic drugs do not pull aqueous humor into the bloodstream. Their primary effect is on the pupil's size and the angle of the eye to improve drainage. Medications that reduce aqueous humor production or increase its outflow, such as carbonic anhydrase inhibitors or prostaglandin analogs, are responsible for these actions

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A nurse in an ophthalmology clinic is assessing a client who has suspected primary open-angle glaucoma (PAOG). Which assessment finding would support a diagnosis of this type of glaucoma?

Nursing Test Bank

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Explanation

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Correct Answer is C

Explanation

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