Nursing diagnosis and management

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Plz i need help concerning the nursing and medical management of a patient with cataract who has undergone a surgery. I also need help concerning the nursing diagnosis. can anyone help out plz?

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Anxiety r/t threat of permanent vision loss, surgical procedure

Risk for Injury r/t increased intraocular pressure, accommodation to new visual field

Disturbed Sensory Perception: vision r/t edema from surgery

Ineffective Health Maintenance r/t deficient knowledge regarding postoperative restrictions

(you will probably have to teach the person how to instill eye medications, unless the patient has had this procedure done before, and make up a daily schedule with times, and remind to wash hands before instilling eye meds)

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Specializes in Hospital Education Coordinator.

always consider Maslow's hierarchy. Is safety a problem with decreased vision (even after surgery they generally wear a patch for at least 24 hours)? Are they afraid? The ABC's and Maslow's are popular NCLEX-RN question topics.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

emybabybaby. . .i would love to help you, but you haven't provided enough information. you will find lots of information on writing care plans and the nursing process on these two threads:

please tell me if this is a real patient or a non-existent patient that you are doing a case study on. if this is a real patient, you need to list the abnormal data you gathered in your assessment. that abnormal data is extremely important in determining the nursing diagnoses that you will eventually use in this patient's care plan. provide me with that information and i will show you how to determine the nursing diagnoses.

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The real case study of a 69 year old man with a Cataract.

History :- Had cataract operation in left eye in 2001 and was about to be operated upon on August 19th, 2006.

* Can't see with left eye

*Ocular pain in left eye

*Can't see clearly with right eye

There is no family history of Cataract. patient is allergic to Quinine

Past Medical History:- Patient is a known hypertensive

ON EXAMINATION

EYELIDS---- opens well

CORNEA---clear

ANTERIOR CHAMBER---deep

PUPIL------irregular

LENS---Aphakia

BLOOD PRESSURE --150/100mmhg

VISUAL ACUITY ---- OD/ 6/60

OS-----

INTRA OCULAR PRESSURE 17.3mmhg

For CHECKUP, he had redness, cloudy vision and sandy sensation in the eye

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Specializes in med/surg, telemetry, IV therapy, mgmt.

it seems to me that this patient is showing early symptoms of glaucoma (elevated intraocular pressure, eye pain and some of the changes in his vision)

http://www.fpnotebook.com/eye41.htm - glaucoma

http://www.medicinenet.com/glaucoma/article.htm - glaucoma

http://www.emedicine.com/oph/topic576.htm - unilateral glaucoma

http://www.emedicine.com/oph/topic139.htm - primary open angle glaucoma

this is a list of his symptoms:

  • can't see out of left eye
  • can't see clearly out of right eye with visual acuity of 6/60
  • states vision is cloudy
  • states has sandy sensation in eye
  • aphakia
  • intraocular pressure 17.3mmhg (elevated)
  • pain in left eye
  • irregular pupils
  • b/p 150/100 (elevated)
  • allergic to quinine

these are my ideas for possible nursing diagnoses you could use:

  1. disturbed sensory perception: vision r/t altered sensory input http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=46 http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/careplan_062.php
  2. acute pain r/t pressure in anterior chamber of eye aeb eye pain http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=40 http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/careplan_052.php
  3. self-care deficits (need to state specific ones) r/t inability to see to perform adls and impaired vision http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=43 http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/careplan_059.php http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/careplan_060.php

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