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
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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.
22
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
23
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.
27
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.
29
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.
30
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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