Ch 47 - Elsevier Case Study CH 47 PDF

Preview

Summary

Elsevier Case Study CH 47...

Description

Ignatavicius: Medical-Surgical Nursing, 9th Edition Chapter 47: Care of Patients with Eye and Vision Problems Case Study

The Patient with Retinal Detachment A 49-year-old man comes to the ophthalmology office because he has been seeing floating dark spots on the right side in the last few days. Examination of the eye reveals right and left pupils 4/2 and 4/2. Pupils are equal and round, and react to light and accommodation. Conjunctiva is clear bilaterally, sclera is white, and the cornea and iris are intact. The left eye retina background has even color with no hemorrhages or exudates. The right eye has a retinal detachment. He has gastrointestinal reflux disease and takes an over-the-counter antacid. He has smoked for 15 years, one pack per day. 1. Document a nursing note for the patient using a body systems format. A 49 year old male presents with seeing floating dark spots on the right side in the last few days. Up on eye exam, the right and left pupils are 4/2 bilaterally. Pupils are equal and round, and react to light and accommodation. The conjunctiva is clear bilaterally, the sclera is white and cornea and iris are intact. The left retina has even color with no signs of hemorrhage or exudates. The right eye exhibits retinal detachment

2. Describe the typical signs and symptoms of a retinal detachment. Typical signs and symptoms or RD include sudden painless sensation. The pt may see bright flashes of light or have floating dark spots. The pt may feel like something in covering their eye and the visual acuity is lost in the affected eye.

3. It is determined that the patient needs surgery. Which surgical procedure will this patient undergo? The patient may need scleral buckling. This will correct a retinal detachment and restore the vision.

Copyright © 2018 Elsevier Inc. All rights reserved.

Case Study

47-2

4. What will be the patient’s preoperative activity orders? The pt needs to restrict activity and head movement prior to surgery to prevent the retina form detaching further. An eye patch will need to be put over the affected eye to reduce movement prior to surgery and after.

5. What is included in the postoperative teaching for this patient? The patient needs to avoid any activities that may cause increase intralocular pressure such as Valsalva maneuver and any kind of bending or lifting. The pt should also avoid driving and take medications as prescribed. The patient should also avoid reading and writing and rapid eye movement. Report any sudden increase in pain and teach signs and symptoms or infection and detachment. Notify the HCP of infection or detachment occurs.

Copyright © 2018 Elsevier Inc. All rights reserved....