LICEO DE CAGAYAN UNIVERSITYR.N.P. Blvd., Carmen, Cagayan de Oro City

C O L L E G E O F N U R S I N G

A Case Study

Edwin Quilab Fabro Sr.With

Cataract Mature, ODCataract Mature, ODSubmitted to:

Ms. Vivasceni L.C. Magtajas, RN

Clinical Instructor

As Partial Requirement for NCM501202

Submitted by:

Ramyr R. Ociones

Charmaine Marie France G. Samonte

1

January 26, 2008

I. Introduction

a. Overview of the Case

b. Objective of the Study

c. Scope and Limitation of the Study

II. Health History

a. Profile of Patient

b. Family and Personal Health History

c. Chief Complain

III. Developmental Data

IV. Medical Management

a. Medical Orders and Rationale

b. Drug Study

V. Pathophysiology with Anatomy & Physiology

VI. Nursing Assessment (System Review & Nursing. Assessment II)

VII. Nursing Management

a. Ideal Nursing Management (NCP)

b. Actual Nursing Management (SOAPIE)

VIII. Health teachings

IX. Prognosis

X. Evaluation

XI. References

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INTRODUCTION

a. Overview of the Case

A cataract is a lens opacity or cloudiness that develops in the crystalline

lens of the eye or in its envelope. Cataract is painless and unaccompanied by

inflammation. Cataracts rank only behind arthritis and heat disease as a leading

cause of disability in older adults. Early on in the development of age-related

cataract the power of the crystalline lens may be increased, causing near-

sightedness (myopia) and the gradual yellowing and opacification of the lens may

reduce the perception of blue colors. Cataracts typically progress slowly to cause

vision loss and are potentially blinding if untreated. Moreover, with time the

cataract cortex liquefies to form a milky white fluid in a Morgagnian Cataract, and

can cause severe inflammation if the lens capsule ruptures and leaks. Untreated,

the cataract can cause phacomorphic glaucoma. Very advanced cataracts with

weak zonules are liable to dislocation anteriorly or posteriorly. Such spontaneous

posterior dislocations (akin to the historical surgical procedure of couching) in

ancient times were regarded as a blessing from the heavens, because it restored

some perception of light in the bilaterally affected patients.

Cataract derives from the Latin cataracta meaning "waterfall" and the Greek

kataraktes and katarrhaktes, from katarassein meaning "to dash down" (kata-,

"down"; arassein, "to strike, dash"). As rapidly running water turns white, the term

may later have been used metaphorically to describe the similar appearance of

mature ocular opacities. In Latin, cataracta had the alternate meaning,

"portcullis", so it is also possible that the name came about through the sense of

"obstruction".

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b. Objective of the Study

The objective of this study is to find a case relating to our concept surgery.

Rule-out blurred vision and later on diagnosed as positive for cataract mature

was the condition of my patient Edwin Quilab Fabro Sr.. As a nursing student, I

have to do interventions for my patient and to provide care which is relevant to

her condition. Considering that my patient needs systematic care to restore her

normal vision that is lost from her condition. And one goal is that to provide a

good patient outcome and prevent conflicts to restore my patient’s normal state.

In the case of our patient who is suffering from cataract mature the

etiology is to determine, it is said that unlike other eye disorders, cataract is the

most leading cause of blindness especially among the older adults. It is caused

blindness by obstructing passage of light, but the patient can distinguish light

from darkness.

As an NCM501202 students, this care study helps us not just to pass this

said requirement but also to evaluate our efficacy upon rendering our services in

the optimum capacity or the ability to care to a patient suffering this kind of

illness. These studies also provide information on actual handling, caring and an

overview of the patient’s vision status with cataract mature.

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c. Scope and Limitation of the Study

Our concept is about Surgery. At Tagoloan Polymedic General Hospital,

Misamis Oriental, we have to find a case which is relevant to the concept. At the

Surgical Ward where we are assigned, there are cases of cataracts and one of

them is our patient Edwin Quilab Fabro Sr. For two days, from January 9-10,

2008, our duty time is limited from 8-4pm. On the first day I have assessed my

patient and up to the last day of confinement of my patient and did some

interventions like providing preoperative and postoperative care of the patient

and teaching patient’s self-care to return her normal vision. Questions were being

answered by the patient himself. The actual nursing interventions were all carried

out with the supervision of a clinical instructor and limited to those which were

permitted or allowed by agency protocol. This study was completed altogether by

both research using different references and actual hands-on exposure and

interaction with the patient.

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HEALTH HISTORY

a. Profile of Patient

Patient’s Name: Edwin Quilab Fabro Sr.

Birth Date: August 10, 1956

Birthplace: Butuan City

Age: 51 years old

Sex: Male

Height: 5’7”

Weight: 150 lbs

Status: Married

Religion: Roman Catholic

Nationality: Filipino

Address: Barangcot Dangcagan, Butuan City

Allergy: None

Date of Admission: January 9, 2008

Time of Admission: 10 AM

Chief Complaints: Blurred Vision

Admitting Diagnosis: Cataract Mature, OD

Vital Signs:

Temperature: 36.5 °C

Pulse Rate: 80 bpm

Respiratory Rate: 20 cpm

BP: 150/100 mmHg

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b. Family and personal health history

Mr. Edwin Quilab Fabro Sr., 51 years old, a Carpenter is the wife of Mrs.

Flora Fabro. Presently residing at Barangcot Dangcagan, Butuan City and belong

to a middle class family. Mr. Fabro had a family health history of Hypertension

and Diabetes. Most previous illnesses were fever, cough and flu and uses over

the counter medication such as Paracetamol Biogesic, Neozep, Dimetapp,

Cotrimoxazole, Mefenamic acid. They also used Herbal medicine as there

alternatives when over the counter is not available.

c. History of Illnesses

Our patient was Edwin Quilab Fabro Sr., he was admitted last

January 9, 2008 and his condition started a day prior to admission as

onset of vision & blurring.

d. Chief Complaints

A case of our patient, Edwin Quilab Fabro Sr., was due to blurred vision.

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Developmental Task

ROGER GOULD’S ADULTHOOD THEORY

“Adult continues to change over the period of time considered to adulthood and

developmental phase maybe found during the adult’s span of life”.

Personalities are seen as set. Time is accepted as finite. Individuals

are interested in social activities with friends and spouse.

This is the period of transformation with realization of mortality and

concern for health.

ERIK ERIKSON’S STAGES OF DEVELOPMENT

Integrity vs. Despair

Acceptance of worth and uniqueness

Acceptance of death

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MEDICAL MANAGEMENT

DOCTOR’S ORDER RATIONALE

January 9, 2008

> Pls. admit under Dr. Romero

> Consent to care and for

cataract extension

> Monitor vital signs every 4

hours

> Meds:

Captopril 25 mg 1 tab P.O BID

> Will inform AP

>Refer accordingly

> IVF PNSS 1L @ KVO rate

- To provide appropriate treatment for the

patient.

- To let the patient know what procedure maybe

than for the treatment of his illness. The patient

has the right to refuse the treatment.

- To provide a baseline data for the patient’s

health status.

- To lower down blood pressure.

- To know if the patient is capable to undergo

surgery.

- To check any alterations of the patient’s

health status thus provide appropriate

treatment.

- To provide a route for the drug to be

administered.

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Name of

drug

Date

OrderedClassification

Dosage/

Frequenc

y

Route

Mechanism of

Action

Specific

IndicationContraindications

Side Effects/Toxic

Effects

Nursing

Precaution

Captopril

(Capotin)

January

9, 2008

Ace Inhibitor,

Antihypertensive

25 mg 1

tab P.O

BID

Blocks ACE

from converting

angiotensin I to

angiotensin II, a

powerful

vasoconstrictor,

leading to

decreased BP,

decreased

aldosterone

secretion, a

small increase

in serum

potassium

levels, and

sodium and fluid

Treatment of

hypertension

alone or in

combination

with

thiazide-type

diuretics

- Contraindicated

in patients with

allergy to

captopril, history

of angioedema,

second or third

trimester of

pregnancy.

- Use cautiously

in patients with

impaired renal

function; CHF;

salt or volume

depletion,

lactation.

CV: tachycardia,

angina pectoris,

MI, CHF,

hypotension in

salt or volume-

depleted patients.

Dermatologic:

rash, scalded

mouth sensation,

pemphigoid-like

reaction,

exfoliative

dermatitis,

alopecia.

GI: gastric

- Take drug

1 hour

before

meals; do

not take with

food. Do not

stop taking

drug without

consulting

your health

provider.

- Be careful

of drop in

blood

pressure

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loss; increased

prostaglandin

synthesis also

may be involved

in the

antihypertensive

action.

irritation, aphthous

ulcers, peptic

ulcers, dysgeusia

anorexia,

constipation.

GU: proteinuria,

renal insufficiency,

renal failure,

polyuria, oliguria,

urinary frequency.

Hematologic:

Neutropenia,

agranulocytosis,

thrombocytopenia,

hemolytic anemia,

pancytopenia.

Other: cough,

malaise, dry

mouth,

(occurs most

often with

diarrhea,

sweating,

vomiting, or

dehydration)

; if light-

headedness

or dizziness

occurs,

consult your

health care

provider.

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lymphadenopathy.

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PATHOPHYSIOLOGY WITH ANATOMY & PHYSIOLOGY

Structure of the Eye

The amount of light entering the eye (right) is controlled by the pupil, which

dilates and contracts accordingly. The cornea and lens, whose shape is adjusted

by the ciliary body, focus the light on the retina, where receptors convert it into

nerve signals that pass to the brain. A mesh of blood vessels, the choroid,

supplies the retina with oxygen and sugar. Lacrimal glands (left) secrete tears

that wash foreign bodies out of the eye and keep the cornea from drying out.

Blinking compresses and releases the lacrimal sac, creating a suction that pulls

excess moisture from the eye’s surface.

.

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Eye Movement

Eye movement is controlled by six muscles that are directly attached to the

eyeball. The four rectus muscles form a relatively straight line from their points of

origin, while the two oblique muscles approach the surface of the eye at an

angle. All the muscles combine to keep the eyeball in nearly constant motion in

order to maximize human vision, which is capable of focusing on about 100,000

distinct points in the visual field. These muscles also enable both eyes to focus

on the same point simultaneously, thereby creating effective depth perception.

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Anatomy & Physiology

The entire eye, often called the eyeball, is a spherical structure approximately 2.5

cm (about 1 in) in diameter with a pronounced bulge on its forward surface. The

outer part of the eye is composed of three layers of tissue. The outside layer is

the sclera, a protective coating. It covers about five-sixths of the surface of the

eye. At the front of the eyeball, it is continuous with the bulging, transparent

cornea. The middle layer of the coating of the eye is the choroid, a vascular layer

lining the posterior three-fifths of the eyeball. The choroid is continuous with the

ciliary body and with the iris, which lies at the front of the eye. The innermost

layer is the light-sensitive retina.

The cornea is a tough, five-layered membrane through which light is admitted to

the interior of the eye. Behind the cornea is a chamber filled with clear, watery

fluid, the aqueous humor, which separates the cornea from the crystalline lens.

The lens itself is a flattened sphere constructed of a large number of transparent

fibers arranged in layers. It is connected by ligaments to a ringlike muscle, called

the ciliary muscle, which surrounds it. The ciliary muscle and its surrounding

tissues form the ciliary body. This muscle, by flattening the lens or making it more

nearly spherical, changes its focal length.

The pigmented iris hangs behind the cornea in front of the lens, and has a

circular opening in its center. The size of its opening, the pupil, is controlled by a

muscle around its edge. This muscle contracts or relaxes, making the pupil larger

or smaller, to control the amount of light admitted to the eye.

Behind the lens the main body of the eye is filled with a transparent, jellylike

substance, the vitreous humor, enclosed in a thin sac, the hyaloid membrane.

The pressure of the vitreous humor keeps the eyeball distended.

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The retina is a complex layer, composed largely of nerve cells. The light-sensitive

receptor cells lie on the outer surface of the retina in front of a pigmented tissue

layer. These cells take the form of rods or cones packed closely together like

matches in a box. Directly behind the pupil is a small yellow-pigmented spot, the

macula lutea, in the center of which is the fovea centralis, the area of greatest

visual acuity of the eye. At the center of the fovea, the sensory layer is composed

entirely of cone-shaped cells. Around the fovea both rod-shaped and cone-

shaped cells are present, with the cone-shaped cells becoming fewer toward the

periphery of the sensitive area. At the outer edges are only rod-shaped cells.

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Pathophysiology

Toxin/Chemical

Direct destruction

Edema

Herniation

Metabolic derangement

Ischemia

Compression

Failure of inhibitory component of spatial

orientation

Disorder in “move”

component

Decreased visual search and scanning

Failure to orient

Distractibility

Orient when should not

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NURSING SYSTEMS REVIEW CHART

Name: Edwin Quilab Fabro Sr. Date: 01-09-08

Vital Signs:

Pulse: 80 bpm Bp: 150/100 mmHg RR: 20 cpm Temp: 36.5 °CHeight: 5’7” Weight: 150 lbs.

EENT[x] impaired vision [x] blind[ ] pain redden [ ] drainage impaired vision & [ ] gums [ ] hard of hearing [ ] deaf pain at the surgical site[ ] burning [ ] edema [ ] lesion [ ] teeth[ ] assess eyes ears nose [ ] throat for abnormality [ ] no problem RESP: [ ] asymmetric [ ] tachypnea [ ] barrel chest[ ] apnea [ ] rales [ ] cough [ ] bradypnea [ ] shallow [ ] rhonchi[ ] sputum [ ] diminished [ ] dyspnea[ ] orthopnea [ ] labored [ ] wheezing[ ] pain [ ] cyanoticAssess resp. rate, rhythm, pulse bloodbreath sounds, comfort [x] no problemCARDIOVASCULAR:[ ] arrhythmia [ ] tachycardia [ ] numbness [ ] diminished pulses [ ] edema [ ] fatigue[ ] irregular [ ] bradycardia [ ] murmur[ ] tingling [ ] absent pulses [ ] painAssess heart sounds, rate rhythm, pulse, bloodpressure, circ., fluid retention, comfort [x] No problemGASTROINTESTINAL TRACT:[ ] obese [ ] distention [ ] mass[ ] dysphagia [ ] rigidity [ ] painassess abdomen, bowel habits, swallowing,bowel sounds, comfort [x] no problemGENITO – URINARY AND GYNE[ ] pain [ ] urine [ ] color [ ] vaginal bleeding[ ] hematuria [ ] discharge [ ] nucturiaAssess urine frequency, control, color, odor, [ ] gyne bleeding [ ] discharge [x] no problemNEURO: [ ] paralysis [ ] stuporus [ ] unsteady [ ] seizure[ ] lethargic [ ] comatose [ ] vertigo [ ] tremors[ ] confused [ ] vision [ ] gripAssess motor, function, sensation, LOC, grip, gait, coordination, speech [x] no problemMUSCULOSKELETAL and SKIN:[ ] appliance [ ] stiffness [ ] itching [ ] petechiae[ ] rashes [ ] drainage [ ] prosthesis [ ] swelling[ ] lesion [ ] poor turgor [ ] cool [ ] flushed[ ] atrophy [ ] pain [ ] ecchymosis [ ] diaphoretic Assess mobility, motion gait, alignment, skin color, texture, turgor, integrity [x] no problem

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NURSING MANAGEMENT

a. Ideal Nursing Management (NCP)

ACTIONS/INTERVENTIONS

Sleep Enhancement (NIC)

Independent

Provide comfortable bedding and

some of own possessions; e.g., pillow,

afghan.

Establish new sleep routine

incorporating old pattern and new

environment. Match with roommate

who has similar sleep patterns and

RATIONALE

Increases comfort for sleep and

physiologic/psychologic support.

When new routine contains as

many aspects of old habits as

possible, stress and related anxiety

may be reduced, enhancing sleep.

NURSING DIAGNOSIS: Sleep Pattern Disturbances

Risk factors may include

Internal factors: illness, psychologic stress, inactivity

External factors: environmental changes, facility routines

Changes in activity pattern

Possibly evidenced by

Reports of difficulty in falling asleep/not feeling well-rested

Interrupted sleep, awakening earlier than desired

Change in behavior/performance, increasing irritability

DESIRED OUTCOMES/EVALUATION CRITERIA— CLIENT WILL:

Sleep (NOC)

Report improvement in sleep/rest pattern.

Verbalize increased sense of well-being and feeling rested.

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nocturnal needs.

Encourage some light physical

activity during the day. Make

sure client stops activity several

hours before bedtime as

individually appropriate.

Promote bedtime comfort regimens;

e.g., warm bath and massage, a glass

of warm milk, wine/brandy at bedtime.

Instruct in relaxation measures.

Reduce noise and light.

Encourage position of comfort, assist

in turning.

Lower bed and position one side

against wall when possible.

Collaborative

Administer sedatives, hypnotics

with caution as indicated.

Decreases likelihood that “night owl”

roommate may delay client’s falling

asleep or create interruptions that

cause awakening.

Daytime activity can help client

expend energy and be ready for

nighttime sleep; however,

continuation of activity close to

bedtime may act as stimulant,

delaying sleep.

Promotes a relaxing, soothing

effect.

Helps induce sleep.

Provides atmosphere conductive to

sleep.

Repositioning alters areas of

pressure and promotes rest.

May heave fear of falling because of

change in size and height of bed.

May be given to help client

sleep/rest during transition period

from home to new sitting.

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ACTIONS/INTERVENTIONS

Sleep Enhancement (NIC)

Independent

Review pathology of individual

condition.

RATIONALE

Awareness of type/area of

involvement aids in assessing

for/anticipating specific deficits and

planning care.

NURSING DIAGNOSIS: Visual Sensory Perception, disturbed

May be related to

Altered sensory reception, transmission, integration (neurologic trauma)

Psychologic stress (narrowed perceptual fields caused by anxiety)

Possibly evidenced by

Disorientation to time, place, person

Change in behavior pattern/usual response to stimuli; exaggerated

emotional responses

Poor concentration, altered thought processes/bizarre thinking

Reported/measured change in sensory acuity: hypoparesthesia; altered

sense of taste/smell

Inability to tell position of body parts (proprioception)

Inability to recognize/attach meaning to objects (visual agnosia)

Altered communication patterns

Motor incoordination

DESIRED OUTCOMES/EVALUATION CRITERIA—CLIENT WILL:

Cognition (NOC)

Regain/maintain usual level of consciousness and perceptual functioning.

Acknowledge changes in ability and presence of residual involvement.

Demonstrate behaviors to compensate for/overcome deficits.

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Observe behavioral responses, e.g.,

hostility, crying, inappropriate affect,

agitation, hallucination

Eliminate extraneous noise/stimuli as

necessary.

Speak in calm, quiet voice, using short

sentences. Maintain eye contact.

Ascertain/validate client’s perceptions.

Reorient client frequently to

environment, staff, and procedures.

Evaluate for visual deficits. Note loss

of visual field, changes in depth

perception (horizontal/vertical planes),

and presence of diplopia (double

vision).

Approach client from visually intact

side. Leave light on; position objects

Individual responses are variable,

but commonalities such as

emotional lability, lowered

frustrations threshold, apathy, and

impulsiveness may complicate care.

Reduces anxiety and exaggerated

emotional responses/confusion

associated with sensory overload.

Client may have limited attention

span or problems with

comprehension. These measures

can help client attend to

communication.

Assists client to identify

inconsistencies in perception and

integration of stimuli and may

reduce perceptual distortion or

reality.

Presence of visual disorders can

negatively affect client’s ability to

perceive environment and relearn

motor skills and increase risk of

accident/injury.

Provides for recognition of the

presence of persons/objects; may

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to take advantage of intact visual

fields. Patch affected eye or

encourage wearing of prism glasses if

indicated.

help with depth perception

problems; prevents client from

being startled. Patching may

decrease the sensory confusion of

double vision, and prism glasses

may enhance vision across midline,

decreasing neglect of affected side.

ACTIONS/INTERVENTIONS

Sleep Enhancement (NIC)

Independent

Assess degree of impairment in

ability/competence presence of

impulsive behavior.

RATIONALE

Identifies potential risks in the

environment and heightens

awareness of risks so caregivers more

NURSING DIAGNOSIS: Risk for Injury/Trauma

Risk factors may include

Inability to recognize/identify danger in environment, impaired judgment

Disorientation, confusion, agitation, irritability, excitability

Weakness, muscular incoordination, balancing difficulties, disturbed

perception

Seizure activity

Possibly evidenced by

[Not applicable; presence of signs and symptoms establishes an actual

diagnosis]

DESIRED OUTCOMES/EVALUATION CRITERIA— CLIENT WILL:

Physical Injury Severity (NOC)

Be free of injury

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Assist SO to identify any

risks/potential hazards and visual-

perceptual deficits that may be

present.

Eliminate/minimize identified hazards

in the environment.

alert to dangers. Clients

demonstrating impulsive behavior are

at increased risk of injury because

they are less able to control their own

behavior/actions.

Visual-perceptual deficits increase

the risk of falls.

A person with cognitive impairment

and perceptual disturbances is

prone to accidental injury because

of the inability to take responsibility

for basic safety needs or to evaluate

the unforeseen consequences.

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b. Actual Nursing Management (SOAPIE)

S “Sakit akong isa ka mata tungod sa pag opera” as verbalized by the patient.

O

Facial grimace

Guarding

Restlessness

A Risk for injury related to impaired vision

P

Long term: At the end of 1 week, the patient will be able to verbalize

understanding of individual factors that contribute to possibility of injury and

take steps to correct situation.

Short term: At the end of 24 hours, the patient will be able to verbalize

understanding of individual factors that contribute to possibility of injury and

take steps to correct situation.

I

Provide information regarding disease/condition that may result in

increased risk of injury.

o To prevent/avoid injury and take preventive actions.

Identify interventions/safety devices.

o To promote safe physical environment and individual safety.

Demonstrate/encourage use of techniques to reduce/ manage stress

and emotions, such as anger, hostility.

o These factors can lead to higher risk for injury.

Discuss importance of self-monitoring of conditions/emotions that can

contribute to occurrence of injury.

o To assist client to reduce or correct individual risk factors.

E

After rendering nursing intervention, the patient was able to understand

individual factors that contributed to possibility of injury and took steps to

correct situation.

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S“Sagabal kau akong isa ka mata, dili kau ko ka tarong og tan-aw” as

verbalized by the patient.

O

Facial grimace

Guarding

Restlessness

A Impaired physical mobility r/t sensory-perceptual impairment

P

Long term: At the end of 1 week, the patient will be able to verbalize

understanding of situation or risk factors and individual treatment regimen

and safety measures.

Short term: At the end of 24 hours, the patient will be able to verbalize

understanding of situation or risk factors and individual treatment regimen

and safety measures.

I

Provide for safety measures as indicated by individual situation,

environmental segment, and full prevention.

o To reduce risk for injury.

Encourage adequate intake of fluids/nutritious foods.

o Promotes well being and maximizes energy production.

Instruct patient/significant others to provide a safer environment. (e.g.,

rearrange furniture, removal of sharp objects).

o To produce a safer environment.

Encourage patient to verbalize feelings/emotions regarding the

problem.

o Feeling of frustrations and anxiety may impede attainment of goals.

E

After rendering nursing intervention, the patient was able to understand the

risk factors and individual treatment regimen and safety measures as

evidenced by nodding as a sign of understanding and clarifications.

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HEALTH TEACHINGS

MEDICATIONS > Patient was advised to take Captopril

when his blood pressure increases.

> Do not give patient more than 5 doses of

antihypertensive drugs in 24 hours unless

prescribed by physician.

EXERCISE > Take some rest to prevent stress and

other complications.

> Patient was advised to keep activity light

(e.g walking, reading, watching television).

Resume the following activities only as

directed by the physician: driving, sexual

activity, unusually strenuous activity.

TREATMENT > Patient was advised to continue for

compliance of medication regimen as

prescribed by his physician.

> Patient instructed to wear sunglasses

during the day because the eye is sensitive

to light.

OUT-PATIENT

(Check-up)

> Patient instructed to have a return check-

up with her attending physician.

> Patient instructed to call her physician

immediately if he experiences any

unusualities.

DIET > Encourage the patient to eat rich in high

protein such as meat, fish, and eggs for

early wound healing

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REFERRALS & FOLLOW-UP

To allow continuous monitoring of the patient’s healing progress, patient

was encouraged to consult her doctor 2 weeks after discharge for follow-up

check up of her general condition. This will ensure thorough follow up of her

condition and prevention of potential complications. Apart from this, patient

was advised to wear eyeglasses during the day and a metal shield worn at

night for 1 to 4 weeks, thus, this is to prevent accidental rubbing or poking of

the eye, and make sure that proper hand washing is always priorities before

touching or cleaning the postoperative eye.

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PROGNOSIS

Patients with cataract usually progress especially when it is not yet to its

mere complication. The rate of progression depends on the underlying diagnosis,

on the successful implementation of secondary preventative measures, and on

the individual patient. If the patient is untreated the prognosis becomes worst and

poor.

In the case of our patient, as he undergone tough Petrobulbar Blocked

method of surgery at Polymedic General Hospital, his prognosis is considered

as good. As evidenced by tolerating slowly vision gradually improves as the

eye heals.

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EVALUATION

At the end of my hospital duty, we as a student nurse were able to render

care to my patient to help him resolve his problem regarding health. Through

observing the patient’s status, we were able to identify some problems during our

assessment. Because of a couple of interventions or health teachings applied

and imparted to the patient, we were able to render his needs on his problem;

alleviated pains felt by the patient due to the effects of the eye surgery and even

have improved his sleeping/resting pattern.

Patient was willing to pursue his medical therapy just to promote health

and wellness for the betterment of his condition. During the treatment, the patient

was able to developed or enhanced health awareness on his disease and with

this knowledge instilled to his mind, he was then aware on how the disease was

occur and what are the proper ways or interventions done just to minimize or

prevent this disease from getting worst.

We have also made the patient realized the importance of completing the

course of therapy by taking the medicines prescribed or ordered to him by his

physician. In addition, eating healthy or nutritious foods that were prescribed to

him by the health providers was further been explained to him especially the

benefits he will gain in eating these nutritious foods.

In general, the patient was very cooperative to what health measures

administered to him by the health providers.

Moreover, these several interventions given to the patient made his body

functions different than as before.

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BIBLIOGRAPHY

Black, Joyce M. 1993. Medical-Surgical Nursing. - A Psychologic

Approach. 4th Edition. W.B Saunders Company: Philadelphia,

Pennsylvania,USA.

Smeltzer, Suzanne C.et al.2004. Medical Surgical Nursing. - 10th

Edition. Lippincott Williams and Wilkins: Philadelphia

Price, Sylvia A. 1997. Pathophysiology: Clinical Concepts of

Disease Processes. 5th Edition. Mosby Year Book, Inc: United

States of America

Carpenito, Lynda Juall.2000. Nursing Diagnosis: Application to

Clinical Practice. 8th Edition. Lyndal Juall Carpenito: United States

of America.

Doenges, Marilynn E. 2006. Nurse’s Pocket Guide. F. A Davis

Company: Philadelphia.

http:/www.askreeves.com/cataract/definition/com.

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