The patient assessment reveals absence of the fovea centralis. ...

[j.rubin]

The patient assessment reveals absence of the fovea centralis. The next examination that may be anticipated by the nurse would be:
 
  1. inspection of the red reflex.
  2. inspection of the retina.
  3. inspection of the macula.
  4. inspection of the optic disc.

Question 2

A patient who is using atropine eyedrops is found to have a poor consensual light response. The nurse recognizes that this finding is considered:
 
  1. abnormal and should be reported to the physician.
  2. normal because of the eyedrops.
  3. evidence of retinal degeneration.
  4. evidence of optic nerve damage.

[qytan]

Answer to Question 1

Correct Answer: 3
During the inspection of the macula, the macula should be visible on the temporal side of the optic disc. Absence of the fovea centralis is common in older patients; however, it may indicate macular degeneration, which is a common cause of loss of central vision. The red reflex should be visible when using the ophthalmoscope if it is properly positioned. It is not related to the absence of the fovea centralis. Inspection of the retina and optic disc would not provide any further information concerning the absent fovea centralis.

Answer to Question 2

Correct Answer: 2
Some eye medications may cause unequal dilation, constriction, or inequality of pupil size. Morphine and narcotic drugs may cause small, unresponsive pupils, and anticholinergic drugs such as atropine may cause dilated, unresponsive pupils. This is a normal response and does not need to be reported to the physician. Retinal degeneration is evidenced by an inability of the pupils to respond appropriately to light. Damage to the optic nerve would likely produce visual disturbances.

[j.rubin]

Excellent

[diana chang]

Thanks for the timely response, appreciate it