Question

The nurse determines that a client's pupils constricts as they change focus from a far object. What documentation should the nurse enter about this finding?

Answer 1

The nurse should document that the client's pupils constrict as part of the accommodation-convergence reflex when focusing on a closer object, which is mediated by the optic nerve and the oculomotor nerve.

Step-by-step explanation:

When a client's pupils constrict while changing focus from a far object to a closer one, the nurse is observing the accommodation-convergence reflex. This reflex consists of two main components: the convergence of the eyes and the accommodation of the lens. The pupillary constriction is a third component that often accompanies the other two. Specifically, the documentation by the nurse should describe the constriction of the pupils in response to the accommodation reflex.

The neural pathway for this reflex involves several structures: the afferent pathways are initiated by the sensory input through the optic nerve, and the efferent response is mediated by the oculomotor nerve, which stimulates the ciliary ganglion and, ultimately, the circular fibers of the iris to cause pupil constriction. This reflex helps maintain a clear visual image as the object comes closer to the eyes.