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cataracts 411 notes
cataracts 411
Question | Answer |
---|---|
Cataract | Opacity within crystalline lens |
Influencing factors | Age Blunt trauma |
Congenital factors | maternal rubella/ |
Influencing factors= | Exposure to UV light exposure Long-term corticosteroid use Ocular inflammation/ |
Senile cataract= | Most common type |
Altered metabolic processes cause | Accumulation of water Altered lens fiber structure r/t fiber & protein changes with aging/ |
Clinical Manifestations | Decrease in vision: close and distant Abnormal color perception visual glare, especially at night/ |
Diagnostic Studies | History and physical examination Visual acuity measurement Ophthalmoscopy Glare testing/ |
Nonsurgical therapy | No nonsurgical “cure” Visual aids (palliative) Reading glasses Magnifiers Increased lighting / |
Preoperative phase | Antibiotic eye drops Dilating eye drops Midfrin, neosynephrine/ |
Other meds for cataract treatment | Mydriatics |
Anticholinergics (cycloplegic) | They block the effects of acetylcholine on the iris sphincter muscle |
Patient teaching: | wear dark glasses to minimize photophobia/ |
Intraoperative phase | Corneoscleral incision Cataract extracted and sutured Cortex irrigated and aspirated |
Corticosteroid ointment applied with | protective shield/ |
Postoperative phase | Outpatient procedure unless complications occur Antibiotic and corticosteroid eye drops 6- to 8-week follow-up/ |
Post op care/teaching | First 24 hours no perception depth until patch is removed Mild analgesic |
Notify MD: | severe pain decreased vision Purulent discharge Redness/ |
Nursing Management | Visual acuity Psychosocial impact of visual disability Level of knowledge of disease Comfort and ability to comply with postop treatment/ |
Preoperative goals | Make informed decisions regarding therapeutic options Experience minimal anxiety/ |
Postoperative goals | Understand and comply with postoperative therapy Maintain level of comfort Free of infection and other complications/ |
tell pt. | Wear sunglasses Avoid unnecessary sun exposure Adequate antioxidant vitamins Good nutrition/ |
Acute intervention= | Educate about disease process and treatment options Administer mydriatics using punctal occlusion Teach signs and symptoms of infection/ |
Ambulatory and home care= | Provide information on long-term eye care Activity restrictions Medications Follow-up visits Signs and symptoms of possible complications/ |
Ambulatory and home care | Educate on postoperative visual acuity Instruct family to modify activities and environment Remove area rugs Prepare frozen meals Provide audio books/ |
Expected outcomes | Improved vision Ability to care for self Minimal to no pain Optimistic expectations/ |