{"id":3002,"date":"2024-08-13T10:38:44","date_gmt":"2024-08-13T14:38:44","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/?post_type=chapter&#038;p=3002"},"modified":"2024-11-11T10:04:34","modified_gmt":"2024-11-11T15:04:34","slug":"ophthalmoscope-examination","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/ophthalmoscope-examination\/","title":{"raw":"Ophthalmoscope Examination","rendered":"Ophthalmoscope Examination"},"content":{"raw":"<span style=\"color: #000000\">Use an ophthalmoscope examination (see <strong>Figure 24<\/strong>) to assess the presence of any [pb_glossary id=\"3194\"]ocular opacities[\/pb_glossary]. Assess the ocular fundus (back of the eye) structures such as the retina, the macula, optic disc, and the vasculature (artery and vein; see <strong>Figure 25<\/strong>).<\/span>\r\n\r\n<span style=\"color: #000000\">One component of the ophthalmoscope exam involves assessing the [pb_glossary id=\"3196\"]ocular fundus reflex[\/pb_glossary]. This test was originally \u2013 and inaccurately \u2013 called the \u201cred reflex\u201d based on the colour of light reflected from the back of the eye in white babies. The ophthalmoscope has a light that is directed onto the pupil to highlight this reflex.\u00a0<\/span>\r\n\r\n<span style=\"color: #000000\">Conduct this assessment with the client standing or sitting on the edge of the examination table. Again, position yourself so that your eyes are at the same level as the client\u2019s. If relevant, both you and the client should remove eyeglasses as these can obstruct assessment. The ophthalmoscope has different types of lights: the medium circle is usually sufficient for the purposes of a nursing assessment. Brighter lights are more uncomfortable for clients, so always use the least brightness possible.<\/span>\r\n\r\n<span style=\"color: #000000\">Begin by <strong>comparing the ocular fundus reflexes<\/strong> in the left and right eyes as follows:<\/span>\r\n<ol>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Ask the client to look straight ahead at a distant point on the wall behind you (i.e., at the opposite end of the room) to slightly dilate the pupils and keep eye structures still. If possible, reduce the lighting in the room to dilate the pupils.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Hold the ophthalmoscope in your dominant hand.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Look through the viewing aperture as you place the ophthalmoscope against your orbital and cheek bone on your dominant side.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">You may need to adjust the lens selector dial to focus so the image is clear (if it is your first time, try this out first by focusing on a few objects in the room).<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Stand 15 degrees lateral to the eye that will first be assessed and place your opposite hand on the client\u2019s forehead above their eye, with your arm extended about 30 cm away from the client.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Direct the light on the client\u2019s pupil and observe the ocular fundus reflex.<\/span><\/li>\r\n \t<li><span style=\"color: #000000\">Then repeat on the other eye so that you can compare.<\/span><\/li>\r\n<\/ol>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li><span style=\"color: #000000\">Normally, the ocular fundus reflexes are present in both eyes and are symmetrical in terms of colour and intensity (brightness). Colour varies by pigmentation:<\/span>\r\n<ul>\r\n \t<li><span style=\"color: #000000\">Clients who have darker skin colour often have darker reflexes that appear as green or blue.<\/span><\/li>\r\n \t<li><span style=\"color: #000000\">Clients who have medium skin colour often have reflexes that appear as orange to yellow.<\/span><\/li>\r\n \t<li><span style=\"color: #000000\">Clients who have lighter skin colour often have reflexes that appear red to orange. <\/span>(WE C Hope, 2023).<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li><span style=\"color: #000000\">Abnormal ocular fundus reflex findings may include asymmetry in terms of colour and intensity, a dark patch, and\/or one or both eyes having an absent\/black, dull or white reflex. These findings can be associated with eye conditions such as cataracts, infections, tumours, retinal detachment, hemorrhage, and cornea abrasion. Report all abnormal findings to the physician or nurse practitioner.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<span style=\"color: #000000\">8.\u00a0Note the findings:<\/span>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\"><strong>Normal findings<\/strong> might be documented as: \u201cOcular fundus reflex present in both eyes and symmetrical in colour and brightness.\u201d<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\"><strong>Abnormal findings<\/strong> might be documented as: \u201cOcular fundus reflex asymmetrical, left eye shows whitening of reflex.\u201d<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<span style=\"color: #000000\">The second step in this examination is assessment of the <strong>ocular fundus<\/strong>. This assessment is usually done by a physician, but nurses may also complete it. Follow steps 1\u20136 above and then continue to hold the ophthalmoscope against your orbital and cheek bone while slowly moving in and maintaining focus on the ocular fundus reflex until you can view the ocular fundus. This part of the examination involves assessing the optic disc. Normally, it will be round\/oval in shape with demarcated boundaries (no blurring) and yellow-orange-pink in colour (no paleness or dark spots). You should also assess the other areas of the fundus, including the retina, retinal vasculature, and macula.<\/span>\r\n\r\n<img src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ophthalmoscope-viewed-on-the-left-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" class=\"size-medium wp-image-3200 aligncenter\" \/>\r\n\r\n<span style=\"color: #000000\"><strong>Figure 24<\/strong>: Ophthalmoscope - viewed on the left.<\/span>\r\n\r\n<span style=\"color: #000000\">(By James Heilman, MD - Own work, Public Domain,<\/span> <a href=\"https:\/\/commons.wikimedia.org\/w\/index.php?curid=4398920\" target=\"_blank\" rel=\"noopener\">https:\/\/commons.wikimedia.org\/w\/index.php?curid=4398920<\/a><span style=\"color: #000000\">)<\/span>\r\n\r\n<img src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ocular-fundus.jpg\" alt=\"\" width=\"300\" height=\"300\" class=\"size-full wp-image-3202 aligncenter\" \/>\r\n\r\n<span style=\"color: #000000\"><strong>Figure 25<\/strong>: Ocular fundus<\/span>\r\n\r\n<span style=\"color: #000000\">(By: H\u00e4ggstr\u00f6m, Mikael (2014).<\/span> \"<a href=\"https:\/\/en.wikiversity.org\/wiki\/WikiJournal_of_Medicine\/Medical_gallery_of_Mikael_H%C3%A4ggstr%C3%B6m_2014\" target=\"_blank\" rel=\"noopener\">Medical gallery of Mikael H\u00e4ggstr\u00f6m 2014<\/a><span style=\"color: #000000\">\". WikiJournal of Medicine 1 (2).<\/span> <a href=\"https:\/\/en.wikipedia.org\/wiki\/Digital_object_identifier\" target=\"_blank\" rel=\"noopener\">DOI<\/a>:<a href=\"https:\/\/doi.org\/10.15347\/wjm\/2014.008\" target=\"_blank\" rel=\"noopener\">10.15347\/wjm\/2014.008<\/a>. <a href=\"https:\/\/en.wikipedia.org\/wiki\/ISSN\" target=\"_blank\" rel=\"noopener\">ISSN<\/a> <a href=\"https:\/\/www.worldcat.org\/issn\/2002-4436\" target=\"_blank\" rel=\"noopener\">2002-4436<\/a>. <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en\" target=\"_blank\" rel=\"noopener\">Public Domain<\/a><span style=\"color: #000000\">. or By Mikael H\u00e4ggstr\u00f6m, used with permission. - Own work)<\/span>\r\n<div class=\"textbox shaded\">\r\n<h2 style=\"text-align: center\"><span style=\"color: #000000\"><strong>Contextualizing Inclusivity<\/strong><\/span><\/h2>\r\n<span style=\"color: #000000\">The continued use of \u201cred reflex\u201d terminology reflects unconscious bias and a tendency to use the white body as the norm in nursing and medicine. It is important to challenge this racist discourse and use the term \u201cocular fundus reflex\u201d in order to shift this language and advocate for more inclusive approaches to ophthalmological examinations.<\/span>\r\n\r\n<\/div>\r\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<h2 class=\"textbox__title\" style=\"text-align: center\"><strong>Prioritizing Care<\/strong><\/h2>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\n<span style=\"color: #000000\">Any abnormal findings related to the ocular fundus reflex or the ocular fundus require specialist examination. Always report abnormal findings to the physician or nurse practitioner.<\/span>\r\n\r\n<\/div>\r\n<\/div>\r\n<h2>Activity: Check Your Understanding<\/h2>\r\n<span style=\"color: #000000\">[h5p id=\"258\"]<\/span>\r\n<h3><strong><span style=\"color: #000000\">References<\/span><\/strong><\/h3>\r\n<span style=\"color: #000000\">WE C Hope (2023). Fundal (red eye) reflex and red-eye reduction.<\/span> <a href=\"https:\/\/wechope.org\/retinoblastoma\/white-eye-reflex\/what-causes-red-eye\/\" target=\"_blank\" rel=\"noopener\">https:\/\/wechope.org\/retinoblastoma\/white-eye-reflex\/what-causes-red-eye\/<\/a>","rendered":"<p><span style=\"color: #000000\">Use an ophthalmoscope examination (see <strong>Figure 24<\/strong>) to assess the presence of any <button class=\"glossary-term\" aria-describedby=\"3002-3194\">ocular opacities<\/button>. Assess the ocular fundus (back of the eye) structures such as the retina, the macula, optic disc, and the vasculature (artery and vein; see <strong>Figure 25<\/strong>).<\/span><\/p>\n<p><span style=\"color: #000000\">One component of the ophthalmoscope exam involves assessing the <button class=\"glossary-term\" aria-describedby=\"3002-3196\">ocular fundus reflex<\/button>. This test was originally \u2013 and inaccurately \u2013 called the \u201cred reflex\u201d based on the colour of light reflected from the back of the eye in white babies. The ophthalmoscope has a light that is directed onto the pupil to highlight this reflex.\u00a0<\/span><\/p>\n<p><span style=\"color: #000000\">Conduct this assessment with the client standing or sitting on the edge of the examination table. Again, position yourself so that your eyes are at the same level as the client\u2019s. If relevant, both you and the client should remove eyeglasses as these can obstruct assessment. The ophthalmoscope has different types of lights: the medium circle is usually sufficient for the purposes of a nursing assessment. Brighter lights are more uncomfortable for clients, so always use the least brightness possible.<\/span><\/p>\n<p><span style=\"color: #000000\">Begin by <strong>comparing the ocular fundus reflexes<\/strong> in the left and right eyes as follows:<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Ask the client to look straight ahead at a distant point on the wall behind you (i.e., at the opposite end of the room) to slightly dilate the pupils and keep eye structures still. If possible, reduce the lighting in the room to dilate the pupils.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Hold the ophthalmoscope in your dominant hand.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Look through the viewing aperture as you place the ophthalmoscope against your orbital and cheek bone on your dominant side.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">You may need to adjust the lens selector dial to focus so the image is clear (if it is your first time, try this out first by focusing on a few objects in the room).<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Stand 15 degrees lateral to the eye that will first be assessed and place your opposite hand on the client\u2019s forehead above their eye, with your arm extended about 30 cm away from the client.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Direct the light on the client\u2019s pupil and observe the ocular fundus reflex.<\/span><\/li>\n<li><span style=\"color: #000000\">Then repeat on the other eye so that you can compare.<\/span><\/li>\n<\/ol>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><span style=\"color: #000000\">Normally, the ocular fundus reflexes are present in both eyes and are symmetrical in terms of colour and intensity (brightness). Colour varies by pigmentation:<\/span>\n<ul>\n<li><span style=\"color: #000000\">Clients who have darker skin colour often have darker reflexes that appear as green or blue.<\/span><\/li>\n<li><span style=\"color: #000000\">Clients who have medium skin colour often have reflexes that appear as orange to yellow.<\/span><\/li>\n<li><span style=\"color: #000000\">Clients who have lighter skin colour often have reflexes that appear red to orange. <\/span>(WE C Hope, 2023).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li><span style=\"color: #000000\">Abnormal ocular fundus reflex findings may include asymmetry in terms of colour and intensity, a dark patch, and\/or one or both eyes having an absent\/black, dull or white reflex. These findings can be associated with eye conditions such as cataracts, infections, tumours, retinal detachment, hemorrhage, and cornea abrasion. Report all abnormal findings to the physician or nurse practitioner.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span style=\"color: #000000\">8.\u00a0Note the findings:<\/span><\/p>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\"><strong>Normal findings<\/strong> might be documented as: \u201cOcular fundus reflex present in both eyes and symmetrical in colour and brightness.\u201d<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\"><strong>Abnormal findings<\/strong> might be documented as: \u201cOcular fundus reflex asymmetrical, left eye shows whitening of reflex.\u201d<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span style=\"color: #000000\">The second step in this examination is assessment of the <strong>ocular fundus<\/strong>. This assessment is usually done by a physician, but nurses may also complete it. Follow steps 1\u20136 above and then continue to hold the ophthalmoscope against your orbital and cheek bone while slowly moving in and maintaining focus on the ocular fundus reflex until you can view the ocular fundus. This part of the examination involves assessing the optic disc. Normally, it will be round\/oval in shape with demarcated boundaries (no blurring) and yellow-orange-pink in colour (no paleness or dark spots). You should also assess the other areas of the fundus, including the retina, retinal vasculature, and macula.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ophthalmoscope-viewed-on-the-left-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" class=\"size-medium wp-image-3200 aligncenter\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ophthalmoscope-viewed-on-the-left-225x300.jpg 225w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ophthalmoscope-viewed-on-the-left-65x87.jpg 65w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ophthalmoscope-viewed-on-the-left-350x467.jpg 350w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ophthalmoscope-viewed-on-the-left.jpg 384w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/p>\n<p><span style=\"color: #000000\"><strong>Figure 24<\/strong>: Ophthalmoscope &#8211; viewed on the left.<\/span><\/p>\n<p><span style=\"color: #000000\">(By James Heilman, MD &#8211; Own work, Public Domain,<\/span> <a href=\"https:\/\/commons.wikimedia.org\/w\/index.php?curid=4398920\" target=\"_blank\" rel=\"noopener\">https:\/\/commons.wikimedia.org\/w\/index.php?curid=4398920<\/a><span style=\"color: #000000\">)<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ocular-fundus.jpg\" alt=\"\" width=\"300\" height=\"300\" class=\"size-full wp-image-3202 aligncenter\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ocular-fundus.jpg 300w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ocular-fundus-150x150.jpg 150w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ocular-fundus-65x65.jpg 65w, https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-content\/uploads\/sites\/421\/2024\/08\/Ocular-fundus-225x225.jpg 225w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p><span style=\"color: #000000\"><strong>Figure 25<\/strong>: Ocular fundus<\/span><\/p>\n<p><span style=\"color: #000000\">(By: H\u00e4ggstr\u00f6m, Mikael (2014).<\/span> &#8220;<a href=\"https:\/\/en.wikiversity.org\/wiki\/WikiJournal_of_Medicine\/Medical_gallery_of_Mikael_H%C3%A4ggstr%C3%B6m_2014\" target=\"_blank\" rel=\"noopener\">Medical gallery of Mikael H\u00e4ggstr\u00f6m 2014<\/a><span style=\"color: #000000\">&#8220;. WikiJournal of Medicine 1 (2).<\/span> <a href=\"https:\/\/en.wikipedia.org\/wiki\/Digital_object_identifier\" target=\"_blank\" rel=\"noopener\">DOI<\/a>:<a href=\"https:\/\/doi.org\/10.15347\/wjm\/2014.008\" target=\"_blank\" rel=\"noopener\">10.15347\/wjm\/2014.008<\/a>. <a href=\"https:\/\/en.wikipedia.org\/wiki\/ISSN\" target=\"_blank\" rel=\"noopener\">ISSN<\/a> <a href=\"https:\/\/www.worldcat.org\/issn\/2002-4436\" target=\"_blank\" rel=\"noopener\">2002-4436<\/a>. <a href=\"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/deed.en\" target=\"_blank\" rel=\"noopener\">Public Domain<\/a><span style=\"color: #000000\">. or By Mikael H\u00e4ggstr\u00f6m, used with permission. &#8211; Own work)<\/span><\/p>\n<div class=\"textbox shaded\">\n<h2 style=\"text-align: center\"><span style=\"color: #000000\"><strong>Contextualizing Inclusivity<\/strong><\/span><\/h2>\n<p><span style=\"color: #000000\">The continued use of \u201cred reflex\u201d terminology reflects unconscious bias and a tendency to use the white body as the norm in nursing and medicine. It is important to challenge this racist discourse and use the term \u201cocular fundus reflex\u201d in order to shift this language and advocate for more inclusive approaches to ophthalmological examinations.<\/span><\/p>\n<\/div>\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h2 class=\"textbox__title\" style=\"text-align: center\"><strong>Prioritizing Care<\/strong><\/h2>\n<\/header>\n<div class=\"textbox__content\">\n<p><span style=\"color: #000000\">Any abnormal findings related to the ocular fundus reflex or the ocular fundus require specialist examination. Always report abnormal findings to the physician or nurse practitioner.<\/span><\/p>\n<\/div>\n<\/div>\n<h2>Activity: Check Your Understanding<\/h2>\n<p><span style=\"color: #000000\"><\/p>\n<div id=\"h5p-258\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-258\" class=\"h5p-iframe\" data-content-id=\"258\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Ocular Fundus Reflex Multiple Choice\"><\/iframe><\/div>\n<\/div>\n<p><\/span><\/p>\n<h3><strong><span style=\"color: #000000\">References<\/span><\/strong><\/h3>\n<p><span style=\"color: #000000\">WE C Hope (2023). Fundal (red eye) reflex and red-eye reduction.<\/span> <a href=\"https:\/\/wechope.org\/retinoblastoma\/white-eye-reflex\/what-causes-red-eye\/\" target=\"_blank\" rel=\"noopener\">https:\/\/wechope.org\/retinoblastoma\/white-eye-reflex\/what-causes-red-eye\/<\/a><\/p>\n<div class=\"glossary\"><div class=\"glossary__tooltip\" id=\"3002-3194\" hidden><p>refers to the loss of transparency when the cornea becomes opaque (cloudy) due to damage or scarring.<\/p>\n<\/div><div class=\"glossary__tooltip\" id=\"3002-3196\" hidden><p>is the reflection of the ophthalmoscope light from the back of the eye.<\/p>\n<\/div><\/div>","protected":false},"author":34,"menu_order":10,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-3002","chapter","type-chapter","status-publish","hentry"],"part":1653,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/3002","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/users\/34"}],"version-history":[{"count":19,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/3002\/revisions"}],"predecessor-version":[{"id":3478,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/3002\/revisions\/3478"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/parts\/1653"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/3002\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/media?parent=3002"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapter-type?post=3002"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/contributor?post=3002"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/license?post=3002"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}