Assessment and Management of Patients with Eye and Vision Disorders
Case Study, Chapter 63, Assessment and Management of Patients With Eye and Vision Disorders
1. Ellie Lee, a 74-year-old patient, is admitted to the hospital in the same-day surgery unit for nasal surgery. The patient is legally blind. The patient was diagnosed with a genetic disease, recessive retinitis pigmentosa (RP), which results in degeneration of the photoreceptor cells. A patient with RP has a progressive loss of visual acuity, progressive night blindness, and progressive loss of peripheral vision. The patient’s best corrected visual acuity is currently 20/200 with a visual field restriction of 12 degrees. The patient bumps into objects in the room and gets disoriented as to the location of the bathroom or the door to the hallway. (Learning Objectives 3 and 7)
a. What strategies should the nurse provide to help the client with low vision become oriented with the hospital room environment and to maintain as much independence with mobility as possible?
b. What nursing considerations should the nurse make when providing perioperative care?
Online Activity:
A Web site that provides simulations of various vision disorders is Lighthouse International: http://www.lighthouse.org/medical/eye-disorders.
2. Betsy Waters, an 82-year-old patient, had right-eye cataract surgery and implant of an intraocular lens. The nurse provides discharge instructions; special wraparound sunglasses; a padded, metal eye protector for bedtime; and a prescribed antibiotic, corticosteroid, and NSAID eye drops. (Learning Objectives 4 and 6)
a. What discharge instructions should the nurse provide?
Wear eye protector for next 4 hours, and then wear wraparound sunglasses when going into the sunlight.
• Do not sleep on the operated side at night, and wear the padded eye protector over the eye for 1 to 4 weeks.
• Kneel to pick up an object; do not bend over because this increases pressure in the eye that was operated on.
• Do not lift any heavy objects as directed by the physician
1. Ellie Lee, a 74-year-old patient, is admitted to the hospital in the same-day surgery unit for nasal surgery. The patient is legally blind. The patient was diagnosed with a genetic disease, recessive retinitis pigmentosa (RP), which results in degeneration of the photoreceptor cells. A patient with RP has a progressive loss of visual acuity, progressive night blindness, and progressive loss of peripheral vision. The patient’s best corrected visual acuity is currently 20/200 with a visual field restriction of 12 degrees. The patient bumps into objects in the room and gets disoriented as to the location of the bathroom or the door to the hallway. (Learning Objectives 3 and 7)
a. What strategies should the nurse provide to help the client with low vision become oriented with the hospital room environment and to maintain as much independence with mobility as possible?
b. What nursing considerations should the nurse make when providing perioperative care?
Online Activity:
A Web site that provides simulations of various vision disorders is Lighthouse International: http://www.lighthouse.org/medical/eye-disorders.
2. Betsy Waters, an 82-year-old patient, had right-eye cataract surgery and implant of an intraocular lens. The nurse provides discharge instructions; special wraparound sunglasses; a padded, metal eye protector for bedtime; and a prescribed antibiotic, corticosteroid, and NSAID eye drops. (Learning Objectives 4 and 6)
a. What discharge instructions should the nurse provide?
Wear eye protector for next 4 hours, and then wear wraparound sunglasses when going into the sunlight.
• Do not sleep on the operated side at night, and wear the padded eye protector over the eye for 1 to 4 weeks.
• Kneel to pick up an object; do not bend over because this increases pressure in the eye that was operated on.
• Do not lift any heavy objects as directed by the physician