Question

A 74-year-old woman comes to clinic with 77-year-old husband who has macular degeneration & progressive vision loss. She states, “Now, I’ve noticed he’s also having difficulty hearing me. I’m worried because he doesn’t want to leave the house & we hardly see any of our friends anymore. We used to go out to the movies or dinner at least once a week. Lately, if we get out once a month, that’s a lot.”

1. What is the NANDA nursing diagnosis?
2. What teaching points would you provide to both the wife and husband?

Answer 1

Macular degeneration is an age-related progressive disease that affects light-sensing cells in the retina, it stops working eventually which results in loss of central vision. when the disease progress person will have difficulty to do any other activities. most of the people experience anxiety and depression.
NANDA diagnosis:
-Risk for injury due to complete vision loss.
-Ineffective coping due to less knowledge about disease progress
-social isolation due to disease progress cause anxiety
-Low self-esteem due to loss of vision that makes the loss of sense on self.
Teaching point:
-advice patient wife disease as an age-related illness
-Teach wife about patient disease progression and how that affects patients both functional and psychological well-being.
-Teach wife about problem-solving activities like maintaining calmness to approach patients, provide comfort measures, establish a trusting relationship, support patient defenses, avoid forcing the patient to have choices and decrease environmental stimuli. like loud noises, bright light, etc..
-Advice wife to consult an eye care specialist to address the psychological problem.
-Advice patient to participate in simple relaxation techniques.
-advise patients to involve in low vision rehabilitation, specific behavioral and self-management programs to improve mental health and prevent and treat depression.