Question

ACTIVE LEARNING TEMPLATE: System DISUI uer STUDENT NAME DISORDER/DISEASE PROCESS Planning care for a patient who has Vision loss REVIEW MODULE CHAPTER Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Procedures PATIENT-CENTERED CARE Complications Nursing Care Medications Client Education Therapeutic Procedures Interprofessional Care

Answer 1

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Alteration in health (Diagnosis ):

Patient with complaint with decrease in vision or vision loss are diagnosed cataract.

Pathophysiology related to clients problem :

Most cataract relate to age (senile cataract ) and other factors including penetrating trauma, congenital factor, exposure to radiation or UV ray.

Health promotion and disease prevention :

1. Mainly there are no proven measures to prevent cataract.
2. Suggest to the patient to wear sunglass.
3. Avoid unnecessary radiation.
4. Maintain appropriate intake of antioxidant vitamins (e.g . vitamin E and C ) and good nutrition.
5. Provide information about vision enhancement techniques.

Risk factors :

1. Increasing age
2. Obesity
3. Smoking
4. Increasing blood pressure
5. Previous eye injury
6. Previous eye surgery

Expected findings :

1. Decrease vision loss
2. Abnormal color perception and glare
3. Decrease opacity of lens

Laboratory tests :

Laboratory tests mainly not done but maximum diagnostic procedure is done.

Diagnostic procedure:

1. Visual acuity measurement
2. Ophthalmoscope
3. Slit lamp microscopy
4. Glare testing

Safety consideration :

1. Change glass perception
2. Take strong reading glasses
3. Increased lighting
4. Lifestyle adjustment
5. Instructions to the patient caregiver about patient self care activities.

Nursing care:

1. Maintain patient acceptable level of physical and emotional comfort.
2. Teach the patient with cataract needs accurate information about the disease process, treatment and cataract surgery.
3. Decreasing room light when administering pupil dilatation medication.
4. After eye surgery teaching about -------

• Maintain proper hygiene and eye care.
• Surgical dressing wound not contaminated during eye care.
• Instil eye medication using aseptic techniques.
• Monitor pain and take medicine regularly.

5.In home care----

• Information about postoperative eye care, activity restrictions, medication, follow up visit schedule.

Medication :

1.Preoperarive

• Mydriatic agent
• Nonsteroidal antiinflammatory drugs
• Topical antibiotics

2.Postoperative

• Topical antibiotics
• Topical corticosteroids
• Mild analgesia

Therapeutic procedures :

• Removal of lens
• Use contact lenses
• Phacoemulsification
• Intraocular lens implantation

Client education :

In a client with cataract surgery teaching about

• Proper hygiene and eye care techniques
• Sign and symptoms of infection is reported to the physician
• Restrictions about positioning, bending and coughing
• Instil eye medication using aseptic techniques

Interprofessional care :

Depending on the type of anaesthesia patient eye covered with eye shield.

Complication :

• Retinopathy
• Increase Intraocular pressure
• Retinal detachment