Transcript The Profession of Medical Assisting

CHAPTER
43
Assisting with Eye
and Ear Care
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-2
Learning Outcomes (cont.)
43.1 Describe the medical assistant’s role in eye
exams and procedures performed in a
medical office.
43.2 Discuss various eye disorders encountered
in a medical office.
43.3 Identify ophthalmic exams performed in the
physician’s office.
43.4 Summarize ophthalmologic procedures and
treatments.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-3
Learning Outcomes (cont.)
43.5 Describe the medical assistant’s role in
otology.
43.6 Describe disorders of the ear encountered in
the medical office.
43.7 Recall various hearing and other diagnostic
ear tests.
43.8 Summarize ear procedures and treatments.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-4
Introduction
• Think how often you use your eyes and
ears
• Good eye and ear care is critical
• Ophthalmology and otology
– Disorders
– Exams and procedures
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-5
Ophthalmology
• Specialty of the anatomy, function and
diseases of the eye
• Ophthalmologists
• Medical assistant
– Visual acuity
– Color vision
– Intraocular pressure
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-6
Eye Diseases and Disorders
• Disorders of external eye structures
– Blepharitis ~ chronic inflammation of the
eyelid’s edges
– Ptosis ~ droopy upper eyelid
– Sty ~ eyelash follicle infection
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-7
Eye Diseases and Disorders (cont.)
• Disorders of structures of the front of the
eye
– Conjunctivitis
• Allergic
• Infectious
– Corneal ulcers and abrasions
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-8
Eye Diseases and Disorders (cont.)
• Disorders involving internal eye structures
– Cataracts ~ cloudy or
opaque lens
– Glaucoma ~ increased fluid
pressure
– Iritis ~ inflammation of the iris
and sometimes the ciliary body
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-9
Eye Diseases and Disorders (cont.)
• Disorders of the Retina
– Retinal detachment ~ retina separate from the
middle, vascular layer of the eye
– Diabetic retinopathy ~ damage to small blood
vessels supplying the retina
– Macular degeneration ~ dark spot in the
center of the field of vision
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-10
Eye Diseases and Disorders (cont.)
• Disorders involving eye movement
– Strabismus
• Deviation of one eye
• Children – misaligned or unbalanced muscles
• Adults – nerves and/or muscles
– Amblyopia ~ “Lazy” eye
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-11
Eye Diseases and Disorders (cont.)
• Refractive disorders
– Myopia
– Hyperopia
– Presbyopia
– Astigmatism
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-12
Apply Your Knowledge
ANSWER:
True or False
T An ophthalmologist specializes in treating eyes and
related tissues. A sty
F Blepharitis is the result of an eyelash follicle infection.
F Viral or bacterial conjunctivitis is not easily spread.
T In glaucoma, fluid pressure builds up in the eye.
F There is a loss of the vision in the center of the eye with
retinal detachment. macular degeneration
T Presbyopia is related to aging.
T Visual defects are the most common eye disorders
treated by ophthalmologists.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-13
Ophthalmic Exams
• Ophthalmoscope
• Tests
– Visual fields
– Convergence of the
eyes
– Glaucoma – tonometer
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-14
Ophthalmology Exams
• Slit lamp
• Refraction exam
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-15
Types of Vision Screening Tests
• Includes tests for
– The ability to see clearly
– The ability to distinguish shades
of grey and colors
• Screening
– Snellen chart
– Jaegar chart
– Ishihara book
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-16
Types of Vision Screening Tests (cont.)
• Near Vision
– Hyperopia
– Presbyopia
• Contrast Sensitivity
– Shades of gray
– Cataracts / retinal
problems
• Color vision
– Color-blindness
– Retina / optic nerve
problems
(Reprinted with permission of Richmond
Products, Inc.)
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-17
Apply Your Knowledge
Match the following:
ANSWER:
A. Refraction exam
B. Otoscope
measures intraocular pressure
C. Distance visual
used to examine the anterior eye
acuity
verifies the need for corrective
D. Color-blindness
lenses
E. Tonometer
Snellen chart
F. Near vision
G. Slit lamp
Jaegar chart
B used to view the inner eye
E
G
A
C
F
D Ishihara book
Correct!
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-18
Ophthalmologic Procedures and
Treatments
• Minor injury or infection – lasting
consequences
• Medical assistant
– Proper technique
– Patient education
• Routine care
• Warning signs
• Use of protective
equipment
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-19
Administering Medications to the Eye
• Purposes
– Assist patients in eye tests
– Reduces pressure in the eye
– Relieves eye pain
– Treats infections
• Medical assistant
– Dispense eye medication
– Patient instructions
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-20
Administering Medications to the
Eye (cont.)
• Eye irrigation
– Remove foreign materials
– Relieve discomfort
• Use sterile solution
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-21
Apply Your Knowledge
When administering eye medications, you should
avoid touching the tip of the dropper or tube to the
eye. Why?
ANSWER: Touching the tip of the dropper or
ointment tube can injure the eye, cause
infection, and contaminate the medication.
Excellent!
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-22
Otology
• Otologist – treats diseases and disorders
of the ears
• Medical assistant
– Auditory screening
– Administer ear medications
– Perform ear irrigations
– Assist with diagnostic tests
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-23
Apply Your Knowledge
What are the functions of a medical assistant
related to otology?
ANSWER: The medical assistant may
 Perform auditory screening
 Administer ear medications
 Perform ear irrigations
 Assist with diagnostic tests
HEAR! HEAR!
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-24
Ear Diseases and Disorders
Common Disorders of the Outer Ear
• Cerumen impaction
– Eardrops to soften
wax
– Irrigation to remove it
• Otitis externa
– Swimmer’s ear
– Medicated drops
• Pruritus
– Less wax with aging
– Mineral oil drops
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-25
Common Disorders of the Middle Ear
• Otitis Media
– Fluid buildup
– Ear infection
• Mastoiditis
• Otosclerosis
– Abnormal bone
tissue growth
– Hearing loss and
tinnitus
• Ruptured ear drum
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-26
Common Disorders of the Inner Ear
• Labyrinthitis
– Infection of labyrinth
– Vertigo
• Ménière’s disease
– Increased fluid in labyrinth
– Vertigo, nausea, and vomiting
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-27
Common Disorders of the Inner Ear
• Presbycusis
– Deterioration of sensory receptors in the
cochlea
– Aging
• Tinnitus
– Ringing in the ears
– Damage to hearing receptors
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-28
Hearing Loss
• Not a normal aging process
• Types
– Conductive hearing loss ~ sound waves do
not reach the inner ear
– Sensorineural hearing loss~ damage to the
inner ear, nerve, or brain
• Noise pollution
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-29
Working with Patients with a
Hearing Impairment
• Speak at a reasonable volume
• Speak clearly, in low-pitched tones
• Stand facing the patient
• Do not over-emphasize lip movements
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-30
Working with Patients with a
Hearing Impairment
• Avoid hand gestures
• Re-state message in short, simple
sentences
• Treat patients with patience and respect
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-31
Apply Your Knowledge
1. Ménière’s Disease
2. Otitis externa
3. Otitis media
4. Ruptured eardrum
5. Tinnitus
6. Mastoiditis
7. Cerumen impaction
Arrange disorders properly:
Inner Ear
Middle Ear
Outer Ear
Ménière’s
Disease
Otitis
media
Otitis
externa
Tinnitus
Ruptured
eardrum
Labyrinthitis
Mastoiditis
8. Otosclerosis
9. Labyrinthitis
10. Pruritus
11. Presbycusis
Presbycusis
Otosclerosis
Cerumen
impaction
Pruritus
Nice Job!
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-32
Hearing and Other Diagnostic Ear Tests
• Medical assistant
– Assist with testing
– Educate patients
• Tuning fork
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-33
Hearing and Other Diagnostic Ear
Tests (cont.)
• Audiometer
– Measures hearing acuity
– Varies frequency and decibels
• Tympanometry
– Measures eardrum’s ability to move
– Gauges pressure in the middle ear
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-34
Ear Treatments and Procedures
• Medical assistant
– Patient education ~ preventive ear care
– Administer ear medications
– Perform ear irrigations
– Assist with earwax removal
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-35
Ear Treatments and Procedures (cont.)
• Administering
medications
– Local effect
• Earwax removal
– Ear curette
– Irrigation
– Warm before
administering
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-36
Ear Treatments and Procedures (cont.)
• Ear irrigation
– Relieve inflammation or
irritation
– Loosen and remove impacted
cerumen
– Remove foreign body
• Microscopic earwax and foreign body
removal
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-37
Hearing Aids
• Parts
– Microphone
– Amplifier
– Speaker
• Obtaining a hearing aid
– Otologist
– Audiologist
• Care and use
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-38
Other Devices and Strategies
• If hearing not helped by hearing aid
– Devices that light up as well as ring
– Amplifiers for phone, TV, and radio
– Closed-captioning
• Cochlear implant
– Does not amplify sound
– Stimulates the auditory nerve
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-39
Apply Your Knowledge
What is the differences in technique for
administering eardrops to a child or an adult?
ANSWER: To administer eardrops you need to
straighten the ear canal by pulling the auricle upward
and outward for adults, down and back for infants and
children.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-40
In Summary
43.1 The medical assistant may perform some of
the procedures that involve measuring
various aspects and functions of the eye,
such as visual acuity, color vision, and
intraocular pressure.
43.2 Disorders of the eye include: those of the
external eye structures, disorders of the
anterior eye structures, and refractive
disorders.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-41
In Summary
43.3 Ophthalmic exams performed in the
physician’s office include: inspecting internal
eye structures; testing visual fields;
glaucoma testing; inspecting external eye
structures; and refraction exams.
43.4 Ophthalmologic procedures and treatments
include administering eye medications like
eyedrops and ointments, and performing eye
irrigation.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-42
In Summary
43.5 Medical assistants in an otology office may
assist with or perform auditory screening,
administer ear medications, perform ear
irrigations, and help with diagnostic tests
such as tympanometry.
43.6 Ear diseases and disorders include: those of
the outer ear, middle ear disorders, and
those of the inner ear.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-43
In Summary
43.7 Hearing and other diagnostic ear tests
include audiometry and tympanometry.
43.8 Ear treatments and procedures include
administration of ear medications, ear
irrigation, microscope-aided earwax or
foreign body removal, hearing aid fitting, and
cochlear implants.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
43-44
End of Chapter 43
There is no such thing as an
empty space or an empty
time.
There is always something to
see, something to hear.
In fact, try as we may to
make a silence, we cannot
- John Cage
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution
in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.