Question

The client with Grave's disease is experiencing exopthalmos. Which action taken by the nurse indicates that the nurse is aware of the problems associated with sicca? A. The nurse applies artificial tears to the client's lower conjuntiva. B. The nurse offers a saliva substitute. C. The nurse provides frequent mouth care. D. The nurse instructs the client to avoid eating uncooked foods.

Short answer

Answer: A. The nurse applies artificial tears to the client's lower conjunctiva.

Step-by-step solution

Define and explain Grave's disease, exophthalmos, and sicca

Grave's disease is an autoimmune disorder that leads to the overproduction of thyroid hormones. Exophthalmos or protrusion of the eyeballs is commonly associated with thyroid conditions like Grave's disease. Sicca is a general term referring to dryness; in the context of this exercise, sicca refers to dryness in the eyes, mouth, and other mucous membranes.

Explain the importance of eye care for clients with sicca

Clients with Grave's disease and exophthalmos often experience dry eyes due to the inability to properly close their eyes. Artificial tears, lubricating drops, and ointments provide moisture and relief from dryness and irritation. Maintaining good eye care is important for clients with sicca to avoid complications such as eye infections and potential vision loss.

Evaluate each option

A. The nurse applies artificial tears to the client's lower conjunctiva. (This option directly addresses the issue of dry eyes related to sicca and exophthalmos) B. The nurse offers a saliva substitute. (Clients with sicca might experience dry mouth, but it is not directly related to exophthalmos in Grave's disease) C. The nurse provides frequent mouth care. (While important for overall oral health, this option does not directly address the dry eyes associated with exophthalmos and Grave's disease) D. The nurse instructs the client to avoid eating uncooked foods. (This option is irrelevant to the issue of dry eyes and exophthalmos in Grave's disease)

Choose the correct answer

Based on the analysis of the steps above, the correct answer is: A. The nurse applies artificial tears to the client's lower conjunctiva.

Key concepts

Exophthalmos

Exophthalmos is a condition where the eyeballs protrude or bulge forward from their normal position in the eye socket. This protrusion often occurs due to an overactive thyroid gland, a hallmark of Grave's disease. With Exophthalmos, patients might experience more than just a noticeable change in appearance. It entails a series of symptoms that critically affect a person's comfort and eye health.
Sufferers of exophthalmos may find it difficult or even impossible to close their eyes completely. This inability can lead to dryness and irritation of the eye surface. Patients often feel grit or discomfort in their eyes, and might also experience excessive tearing, sensitivity to light, and blurred vision. It's important to address these symptoms promptly to prevent further complications, such as corneal ulcers or even vision loss.
The dryness caused by incomplete eyelid closure increases the risk of eye infections. Therefore, vigilant eye care is crucial for individuals with exophthalmos.

Sicca Syndrome

Sicca syndrome, often referred to simply as "sicca," describes a group of symptoms primarily characterized by dryness of the eyes and mouth. In the context of Grave's disease, sicca presents a significant concern because it can exacerbate the discomfort and irritations caused by exophthalmos.
Patients with sicca syndrome often feel constant dryness, burning sensation, and redness in the eyes. Besides the ocular manifestations, the syndrome can cause dry mouth, which might make it hard to chew, swallow, or speak clearly.
Addressing these drought-like conditions involves several measures that focus on symptom relief. It underscores the importance of regular check-ups and preventive care to avoid severe consequences like corneal damage and long-term oral complications.

Artificial Tears

Artificial tears are a common and effective solution for alleviating the dry eye symptoms associated with exophthalmos and sicca syndrome. These products simulate natural tears and help lubricate the eye surface. By applying artificial tears, patients can find relief from the discomfort of dryness, reducing irritation and the risk of infection.
Different types of artificial tears exist, varying in viscosity and purpose. Some provide a thin layer of moisture, while others are thick enough to coat the eye and offer longer-lasting protection. For individuals with severe dryness, the usage of gels or ointments at night may be recommended to ensure the eyes remain moist overnight.
Regular application of artificial tears can also serve a protective function, minimizing damage to the cornea and preserving overall eye health. In the case of Grave’s disease patients, using these tears can significantly improve their quality of life by managing chronic symptoms effectively.