Which of the following clients are at risk for developing and acute episode of angle-closure glaucoma? Select all that apply
A) A 60-year-old female emotionally devastated after divorcing her husband of 35 years
B) A soldier ordered to stay in a pitch-black cave to observe enemy militants for an extended period of time
C) A person with low dietary intake of lutein, omega-3 fatty acids, and zinc
D) A person with a high grade of myopia
E) A surgical client who has received many doses of IV atropine to keep heart rate above 50
Ans: A, B, E
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Manifestations of acute angle-closure glaucoma are related to sudden, intermittent increases in intraocular pressure. These occur after prolonged periods in the dark, emotional upset, and other conditions that cause extensive and prolonged dilation of the pupil. Administration of pharmacologic agents, such as atropine, that cause pupillary dilation (mydriasis) also can precipitate an acute episode. Age-related macular degeneration (AMD) is the most common cause of reduced vision in the elderly. In addition to older age, identifiable risk factors include cigarette smoking, obesity, and low dietary intake of lutein, omega 3 fatty acids, zinc, and vitamins A, C, and E. Persons with high grades of myopia or nearsightedness may have abnormalities in the peripheral retina that predispose to sudden detachment.
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