A nurse is performing a focused eye assessment. Select up to 5 unexpected findings.

A) Cataracts: Cataracts are a condition where the lens of the eye becomes cloudy, leading to blurred vision. While cataracts can impact vision, they do not cause fixed, dilated pupils. Cataracts would typically affect the clarity of vision rather than pupil size and response.

B) Miosis: Miosis refers to constricted pupils that are smaller than normal, typically less than 2 mm in size. The finding described in the question (fixed and 7 mm) is the opposite of miosis, which would indicate excessively small pupils.

C) Astigmatism: Astigmatism is a refractive error caused by an irregular shape of the cornea or lens, resulting in blurry vision. It is unrelated to the size or responsiveness of the pupils and does not cause fixed or dilated pupils, making it an inappropriate choice for this finding.

D) Mydriasis: Mydriasis refers to the dilation of the pupils, typically greater than 6 mm in size. When the pupils are fixed and dilated (7 mm, as described), this condition is termed mydriasis. It can occur due to various factors such as certain medications, trauma, or neurological issues. The nurse should document this finding as mydriasis and notify the healthcare provider for further assessment.

A) Oral Candidiasis: Oral candidiasis, also known as a yeast infection or thrush, typically presents as white patches or plaques on the mucosa, especially on the tongue, inner cheeks, and roof of the mouth. These lesions are not usually painful unless they become irritated or infected. They are different from aphthous ulcers, which are small, round, and painful sores that occur on the mucous membranes of the mouth.

B) Thrush: Thrush is another term for oral candidiasis, caused by the overgrowth of Candida albicans. As with oral candidiasis, thrush typically presents as white lesions or patches rather than painful, round, white lesions like those seen in aphthous ulcers. These lesions can often be scraped off, which distinguishes them from the painful lesions associated with aphthous ulcers.

C) Hepatic Disease: Hepatic disease can cause various symptoms such as jaundice (yellowing of the skin and eyes), dark urine, and abdominal discomfort, but it does not specifically lead to small, round, white painful lesions in the mouth. The lesions described in the question are more characteristic of aphthous ulcers rather than a systemic condition like hepatic disease.
D) Aphthous Ulcers: Aphthous ulcers, also known as canker sores, are small, round, painful lesions that commonly appear on the oral mucosa. These sores are typically white or yellow with a red border and are known to be painful, particularly when eating or talking. This condition is the most consistent with the symptoms described in the question, including the size, shape, and pain associated with the lesions.