Case Study

[aka_selina]

Mr. Lee is a 77 year old retired artist. He lives alone with his wife, they have eight grown children. After doing a routine eye exam the doctor determines he has cataracts.

Mr. Lee is sent home following an uneventful cataract removal and lens implant of the right eye. His wife brings him to the ER two days postop, and Mr.Lee states his eyesight has changed and he feels like he is "looking through a veil, seeing flashing lights and floaters in his right eye". He denies any eye pain. In examining his peripheral vision, you find no peripheral vision present in his right eye. His left eye is normal.

Questions

What do you expect is happening to Mr. Lee and why? Are these normal findings following cataract surgery?

What do yoou expct will be the intervention for Mr. Lee?

[Daytonite, BSN, RN]

you must first know and understand what the normal anatomy and physiology of the eye are. the patient is presenting with a complaint of "looking through a veil, seeing flashing lights and floaters in his right eye"? is this normal or abnormal? do you have a physical assessment or pathophysiology book to refer to? the medical terminology for two of the patient's symptoms are entopsia (the floaters in his eye) and photopsia (the flashes of light).

here are some weblinks for you to check out. after reading them, you will have the answers to your questions.

http://www.fpnotebook.com/eye91.htm

http://www.emedicine.com/oph/topic408.htm

[aka_selina]

Mr. Lee has Retinal detachment which is a very serious condition that occurs when the retina pulls away from its supporting tissues. Since the retina can't work properly under these conditions, permanent vision loss may occur if a detachment is not repaired within 24 to 72 hours.

But I am still very confused as to what is the expected intervention for Mr. Lee??

[aka_selina]

How does this sound? Is it apprioriate?

The nursing intervention is to refer Mr. Alvarez to an ophthalmologist for immediate evaluation. Retinal detachment requires immediate care. Without treatment, vision loss from retinal detachment can progress from minor to severe or total within a few hours or days. Help Mr. Alvarez understand nature and limitations of his condition. Speak to him and his wife about how to plan strategies for assisting him with his daily activities. Reinforce the physician's explanation of medical management and surgical procedures. Teach him general eye care such as maintaining sterility of all eye droppers, tubes of medications. Do not rub eyes. This reduces the risk of eye infection. Demonstrate the proper administration of eye drops or ointments; allow for return demonstration by Mr. Alvarez or his wife.

[Daytonite, BSN, RN]

This sounds very good for a case study. As you progress to actual writing of care plans you will break that into more defined steps. Good job! I see you read the information in the weblinks provided for you. You made the connection between his symptoms and the medical problem. You also took his symptoms and made the connection to nursing problems as well in order to provide nursing interventions. Congratulations on your first successful venture into critical thinking! :yelclap:

Please don't hesitate to ask for more help if you need it.