The most common site of disease in the hypopharynx is the:
Questions
The mоst cоmmоn site of diseаse in the hypophаrynx is the:
The nurse оbtаins оrders fоr а 72-yeаr-old client who is diagnosed with glaucoma in the urgent care center. Nurses Notes 1000: Client is sitting on examination table with spouse at side. Client is tearful and appears anxious; states, “I can’t see out of my right eye. I’m so scared.” Facial features are symmetric, speech is clear and appropriate, follows all commands and moves all extremities equally. Conjunctival erythema present in right eye. Left pupil round, 2 mm, and reactive to light. Right pupil round, 6 mm, and nonreactive. Central vision present and consistent for both eyes. Left eye peripheral vision is normal. Loss of right eye peripheral vision noted. VS: T 98.2°F (36.7°C); HR 88 beats/min; RR 18 breaths/min; BP 142/68 mm Hg; SpO2 98% on RA. Client reports a frontal headache rated 6/10 on a scale of 0–10.1015: NIH Assessment• Level of consciousness = 0, Alert; keenly responsive• Orientation = 0, Oriented to month and age• Commands = 0, Performs two tasks correctly• Horizontal extraocular movement = 0, Normal• Visual = +1, Partial hemianopia• Facial palsy = 0, Normal symmetry• Upper extremity motor = 0, No drift in left arm or right arm for 10 seconds• Lower extremity motor = 0, No drift in left leg or right leg for 5 seconds• Limb ataxia = 0, No ataxia• Sensation = 0, Normal; no sensory loss• Language = 0, Normal; no aphasia• Dysarthria = 0, Normal• Inattention (neglect) = 0, No abnormalityScore = +1 History and Physical History of Present Illness: Client is a 77-year-old who is married and lives with spouse, who is at the bedside. Client reports sudden loss of vision in right eye, stating, “I haven’t felt comfortable driving at night for the past year because the lights look a bit foggy to me, but I didn’t realize there was an issue with my vision until this morning. I feel like I’m looking through a narrow tunnel.” Ophthalmoscopic examination of right eye reveals shallow anterior chamber, cloudy aqueous humor, and a moderately dilated, nonreactive pupil. Client reports right eye pain and headache, and shares, “I had a headache like this last night. It lasted a little over an hour and was accompanied by blurry vision, but I didn’t think much about it since it resolved quickly.”Past Medical History• Asthma• Environmental allergies• Chronic depression• Peripheral vascular diseaseDrug Allergies• PenicillinCurrent Medications• Albuterol MDI 2 puffs every 6–8 hours PRN for bronchospasm• Amitriptyline 75 mg orally every night before bed Diagnostic Test Results Right Eye Left Eye Intraocular pressure(Normal range: 10–20 mm Hg) 32 mm Hg 14 mm Hg Gonioscopy Iridocorneal angle width narrowed; inflammation present in anterior chamber Within Normal Limits Select the 2 priority actions the nurse would plan to implement.
The nursing is cаring fоr а 72-yeаr-оld client in the urgent care center. Nursing Nоtes 1000: Client is sitting on examination table with spouse at side. Client is tearful and appears anxious; states, “I can’t see out of my right eye. I’m so scared.” Facial features are symmetric, speech is clear and appropriate, follows all commands and moves all extremities equally. Conjunctival erythema present in right eye. Left pupil round, 2 mm, and reactive to light. Right pupil round, 6 mm, and nonreactive. Central vision present and consistent for both eyes. Left eye peripheral vision is normal. Loss of right eye peripheral vision noted. VS: T 98.2°F (36.7°C); HR 88 beats/min; RR 18 breaths/min; BP 142/68 mm Hg; SpO2 98% on RA. Client reports a frontal headache rated 6/10 on a scale of 0–10.1015: NIH Assessment• Level of consciousness = 0, Alert; keenly responsive• Orientation = 0, Oriented to month and age• Commands = 0, Performs two tasks correctly• Horizontal extraocular movement = 0, Normal• Visual = +1, Partial hemianopia• Facial palsy = 0, Normal symmetry• Upper extremity motor = 0, No drift in left arm or right arm for 10 seconds• Lower extremity motor = 0, No drift in left leg or right leg for 5 seconds• Limb ataxia = 0, No ataxia• Sensation = 0, Normal; no sensory loss• Language = 0, Normal; no aphasia• Dysarthria = 0, Normal• Inattention (neglect) = 0, No abnormalityScore = +1 History and Physical History of Present Illness: Client is a 77-year-old who is married and lives with spouse, who is at the bedside. Client reports sudden loss of vision in right eye, stating, “I haven’t felt comfortable driving at night for the past year because the lights look a bit foggy to me, but I didn’t realize there was an issue with my vision until this morning. I feel like I’m looking through a narrow tunnel.” Ophthalmoscopic examination of right eye reveals shallow anterior chamber, cloudy aqueous humor, and a moderately dilated, nonreactive pupil. Client reports right eye pain and headache, and shares, “I had a headache like this last night. It lasted a little over an hour and was accompanied by blurry vision, but I didn’t think much about it since it resolved quickly.”Past Medical History• Asthma• Environmental allergies• Chronic depression• Peripheral vascular diseaseDrug Allergies• PenicillinCurrent Medications• Albuterol MDI 2 puffs every 6–8 hours PRN for bronchospasm• Amitriptyline 75 mg orally every night before bed Diagnostic Results Assessment Test Right Eye Left Eye Intraocular pressure(Normal range: 10–20 mm Hg) 32 mm Hg 14 mm Hg Gonioscopy Iridocorneal angle width narrowed; inflammation present in anterior chamber Within Normal Parameters Complete the following sentences by selecting from the lists of options below.The client is most likely experiencing acute ________________ as evidenced by sudden vision loss, increased ________________, and _______________. The client’s history of _____________ increases risk for this condition. Options for 1 [Select1] Options for 2 [Select2] Options for 3 [Select3] Options for 4 [Select4] Angle-closure glaucoma Anxiety Dilated nonreactive pupil Anticholinergic use Cataract Corneal drainage angle Frontal headache Asthma Cerebral infarction Intraocular pressure Nyctalopia Penicillin allergy Subarachnoid hemorrhage Respiratory rate Myopia Vascular disease