nursing interventions for visually impaired patients

Shining a light obliquely on the eyeball can help visualize a contact lens. Outcomes (NOC) Knowledge: Treatment Regimen Emphasize thorough cleaning practices of the skin and scalp. • Slit lamp microscopy Table 22-1 outlines emergency management of the patient with an eye injury. • Wearing eye protection during potentially hazardous work, hobby, and sport activities reduces the risk of eye injuries. Collaborative Therapy Approximately 40,000 corneal transplants are performed in the United States each year. D In addition, establishing eye contact ensures that you can observe the patient’s facial expressions and reactions. CSF, Cerebrospinal fluid; UV, ultraviolet. Question the patient about the level of difficulty involved in doing certain tasks. 9. Herpes simplex keratitis Often blepharitis is caused by both staphylococcal and seborrheal microorganisms, and the treatment must be more vigorous to avoid hordeolum, keratitis (inflammation of the cornea), and other eye infections. Jill Rushing is a nursing instructor at the University of Southern Mississippi in Hattiesburg. Manifestations of both trachoma and AIC are mucopurulent ocular discharge, irritation, redness, and lid swelling. Take drugs to reduce dizziness if prescribed. 7. With decreased tear secretion, the patient may use artificial tears or ointments. Almost 22 million Americans ages 40 years and older have cataracts, and by age 80 more than 50% have cataracts. Artificial tears can be effective in diluting the allergen and washing it from the eye. That simply means their vision does not meet their specific needs. The cornea can become infected by a variety of bacteria. It ensures that you are speaking while facing the patient so the patient has no difficulty hearing. • Evaluate the patient’s ability to self-administer medications to identify further teaching needs. Intacs inserts are two clear plastic lenses surgically inserted on the cornea perimeter to reduce astigmatism and myopia. Many people are uncomfortable around a blind or partially sighted individual because they are not sure what behaviors are appropriate. • Administer antibiotic therapy as appropriate. Surgical management for refractive errors includes laser surgery and IOL implantation. Change positions slowly. • Instruct the patient on the proper application of each medication to promote adequate self-care. An untreated corneal ulcer can result in corneal scarring and perforation (hole in the cornea). Serve as the sighted guide, walking slightly ahead of the patient with the patient holding the back of your arm. If the patient’s visual acuity is decreased, modify the patient’s environment or activities for safety. • Avoid clutter on floor surface to prevent tripping. Diagnosis is based on decreased visual acuity or other complaints of visual dysfunction. Report fever, pain, an increase in hearing loss, or drainage from the ear. Deficient knowledge related to lack of information and experience regarding eye surgery as evidenced by questions regarding postoperative care and expectations Summarize the action and uses of drug therapy for treating problems of the eyes and ears. Herpes zoster ophthalmicus, keratitis (bacterial and viral), endophthalmitis (bacterial and fungal), cotton-wool spots and microvasculopathy of the retina, Kaposi sarcoma of eyelids or conjunctiva Discussion of assistive devices for visual and hearing impairment is also included. Conjunctivitis may occur simultaneously. Risk factors include mechanical or chemical corneal epithelial damage, contact lens wear, nutritional deficiencies, immunosuppressed states, and contaminated products (e.g., lens care solutions and cases, topical medications, cosmetics). Nursing Interventions Improving Mobility and Preventing Deformities. 0 Yes, but now they are retired. Please try again soon. astigmatism, p. 387 This nursing care plan Risk for Injury includes a diagnosis and care plan for nurses with nursing interventions and outcomes for the following conditions: Diplopia also known as Double Vision. Infections This condition generally appears at about age 40. // If there's another sharing window open, close it. The patient who needs frequent eyedrop administration may experience sleep deprivation. Rehabilitation after partial or total loss of vision can foster independence, self-esteem, and productivity. The patient with viral conjunctivitis may complain of tearing, foreign body sensation, redness, and mild photophobia. 2 = Rarely demonstrated Describe the etiology and collaborative care of extraocular disorders. Tissue loss caused by infection of the cornea produces a corneal ulcer (infectious keratitis) (Fig. Societal devaluation of the elderly may compound the self-esteem or isolation issues associated with the older patient’s visual impairment. Nursing Diagnosis patient’s reach and let the patient know where they are. • White blood cell count elevation __ Acute Intervention. The patient may require eyedrops as frequently as every hour. Peter Drucker New accommodating IOLs correct both myopia and presbyopia. Health Impact of Responsible Eye Care Problems commonly associated with immobility include weakened muscles, joint contracture, and deformity. Trachoma is a chronic conjunctivitis caused by Chlamydia trachomatis (serotypes A through C). If warm, moist compresses are ineffective in promoting spontaneous drainage, the ophthalmologist may surgically remove the lesion (this is normally an office procedure) or inject the lesion with corticosteroids. 6. 3. keratitis, p. 391 Other questions can help determine the personal meaning that the patient attaches to the visual impairment. The most common visual problem is refractive error. If the patient is severely symptomatic, topical corticosteroids can provide temporary relief but have no effect on the final outcome. Although the eyes are well protected by the bony orbit and fat pads, everyday activities can result in ocular trauma. Contrast enhancement techniques include watching television in black and white, using a black felt-tip marker, and using contrasting colors (e.g., a red stripe at the edge of steps or curbs). otosclerosis, p. 405 • Apply eye shield to prevent injury and possible contamination of eye. Provide emotional support and direct care to the patient with recent visual impairment. • Activity restrictions ___ Trauma is often a preventable cause of visual impairment. acoustic neuroma, p. 406 • Hispanic Americans have an increased incidence of diabetic retinopathy. The chalazion usually appears on the upper lid as a swollen, tender, reddened area that may be painful. Thermal Burn Chemical Burn The lens accounts for approximately 30% of ocular refractive power. Orienting the Patient to the Room. • Other tests (e.g., visual field perimetry) to determine cause of visual loss • Instruct patient on appropriate hand-washing techniques to prevent bacterial contamination of the eye. • Build on patient’s remaining vision to maximize visual acuity. 4. This condition generally appears at about age 40. Conjunctivitis may occur simultaneously. One eye may deviate in (esotropia), out (exotropia), up (hypertropia), or down (hypotropia) (see eFig. • Nonsteroidal antiinflammatory drugs Being sensitive to the patient’s feelings without being overly worried or smothering the patient’s independence is vital in creating a therapeutic nursing presence. This fact sheet is intended to assist all who provide direct inpatient care to blind or visually impaired Service members or Veterans. Verbalizes minimal anxiety and increased ability to compensate for impaired vision. Patients with dry eyes complain of irritation or “sand in my eye” and that the sensation typically worsens through the day. Clinical Manifestations and Diagnostic Studies These are usually most appropriate for the patient with no functional vision. // If there's another sharing window open, close it. Blurred vision, ptosis, diplopia, fixed and dilated pupil Photorefractive keratectomy (PRK) is indicated for low to moderate amounts of myopia or hyperopia, with or without astigmatism and is a good option for a patient with insufficient corneal thickness for a LASIK flap. Inform the patient who wears contact lenses and develops infections to discard all opened or used lens care products and cosmetics to decrease the risk of reinfection from contaminated products (a common problem and a probable source of infection for many patients). Risk factors include mechanical or chemical corneal epithelial damage, contact lens wear, nutritional deficiencies, immunosuppressed states, and contaminated products (e.g., lens care solutions and cases, topical medications, cosmetics). • Prescribed medication regimen ___ • Determine the patient’s knowledge of medication and understanding of method of administration to plan teaching. Wearing eye protection during potentially hazardous work, hobby, and sport activities reduces the risk of eye injuries. This type of refractive error occurs when the cornea or lens does not have adequate focusing power or when the eyeball is too short. If the patient’s vision is compromised, suggest alternative ways to accomplish necessary daily activities and self-care. Cataract development is mediated by a number of factors. 5. Teach the patient and the family about avoiding sources of ocular irritation or infection and responding appropriately if an ocular problem occurs. // If there's another sharing window open, close it. • Assess visual acuity. Tissue loss caused by infection of the cornea produces a corneal ulcer (infectious keratitis) (Fig. [email protected]. The varicella-zoster virus (VZV) causes both chickenpox and herpes zoster ophthalmicus (HZO). • Absent eye movements In addition, establishing eye contact ensures that you can observe the patient’s facial expressions and reactions. Foreign Bodies Trachoma is a chronic conjunctivitis caused by Chlamydia trachomatis (serotypes A through C). Ability to be independent with self-care, especially in the management of medications, may require ongoing supervision and/or institutionalization. • Do not attempt to treat the injury (except as noted above for chemical exposure). A list of agencies that serve the partially sighted or blind patient is available from the American Foundation for the Blind (www.afb.org). Contact lenses are made from various plastic and silicone substances that are highly permeable to oxygen and have a high water content. Know what services and devices are available for the partially sighted or blind patient, and make appropriate referrals. These infections may be caused by bacteria or viruses. • Instruct patient to wear prescription glasses when out of bed to enhance vision. Report fever, pain, an increase in hearing loss, or drainage from the ear. /*

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