Elsevier NCLEX Exam Review
Question: The nurse is caring for a client who has exophthalmos associated with her thyroid disease. What is the cause of exophthalmos?
1. Fluid and edema in the retro-orbital tissues, which increases pressure behind the eyes
2. Impaired vision, which causes the client to squint in order to focus
3. Increased intraocular pressure from an increase in circulating thyroid
4. Decrease in extraocular eye movements, which results in the "thyroid stare"
Rationale: Impaired venous drainage from the orbit of the eye causes fluid and fat accumulation in the areas behind the eyeballs, which forces the eyes forward and out of their sockets. It is the increased pressure in the area that causes the eyeballs to be forced outward and protrude.
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