Cataracts
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| Focus on Diversity and Culture table. What populations are the most affected by glaucoma and cataracts? Pg.1307 | African Americans are more affected than Caucasians & Hispanics.
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| What are the four types of cataracts that can occur independent of the aging process? Pg.1307 | Secondary cataracts, Traumatic cataracts, Radiation cataracts, & congenital cataracts
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| What can cause Secondary cataracts? Pg.1307 | can form after surgery to treat another eye disorder (glaucoma or effect of medication)
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| What can cause Traumatic cataracts? Pg.1307 | may result from an injury to the eye
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| What can cause Radiation cataracts? Pg.1307 | may result from long term exposure to radiation
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| What can cause Congenital cataracts? Pg.1307 | may appear in a child at birth or in childhood, usually both eyes
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| What is the greatest single risk factor for cataracts? Pg.1307 | Age
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| What are some additional risk factors for cataracts? Pg.1307 | Genetics (link unclear), Environmental, Life-style, Long-term exposure to sun (UVB rays), Cigarette smoking, heavy alcohol usage, diabetes mellitus, eye trauma, exposure to heat, radiation, medications
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| What medications put a client at risk for cataract development? Pg.1307 | systemic or inhaled corticosteroids, lovastatin, phenytoin, chlorpromazine, busulfan
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| Table. Clinical Manifestations and therapies. What is the Etiology of congenital cataracts? Pg.1307 | rare, Usually unknown cause, May occur with other birth defects: Congenital rubella, Trisomy 21(Down syndrome), Pierre Robin Syndrome, Trisomy 13 (Patau syndrome)
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| Table. Clinical Manifestations and therapies. What are the clinical manifestations of congenital cataracts? Pg.1307 | May be different from age-onset cataracts, Grey & white cloudy pupils, May have nystagmus, may not have "red eye" glow in photos
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| Table. Clinical Manifestations and therapies. What are the clinical therapies of congenital cataracts? Pg.1307 | Dx confirmed by Ophthalmologist, Tx depends on severity, If mild without affecting vision condition maybe monitored, mod-severe and affects vision surgical removal is recommended, In most cases Intraocular lens implanted
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| Table. Clinical Manifestations and therapies. What is the Etiology of age-related cataracts? Pg.1307 | Aging causes proteins in the lens to deteriorate & become cloudy, By 75 most people will have cataracts that affects vision, Factors that speed up process: Diabetes, UVA/UVB exposure, smoking, family hx
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| Table. Clinical Manifestations and therapies. What are the clinical manifestations of age-related cataracts? Pg.1307 | Cloudy/opaque lens, May cause cloudy vision, halos, diplopia, or photophobia
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| Table. Clinical Manifestations and therapies. What are the clinical therapies of age-related cataracts? Pg.1307 | Early cataracts or those with minimal effect on vision require no surgical intervention, Encourage UVA/UVB protection, Utilize safety measures, Surgery only if ADL's are impacted
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| How is a cataract diagnosis made? Pg.1307 | Diagnosis made based on history and eye examination
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| What are some No pharmacologic therapies for cataracts? Pg.1309 | Early cataracts can be managed with magnifying glasses, stronger prescription lenses, brighter lighting, or antiglare sunglasses. No medications available for cataracts
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| What are some Complementary and alternative therapies for cataracts? Pg.1309 | Insufficient data exists to support the treatment of cataracts with alternative therapies, Some CAM practitioners believe antioxidants improve cataracts because they reduce the amount of free radicals that can cause damage to the eyes
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| When doing a physical examination on a client suspected of cataracts what type of presence may a nurse visualize on the pupil? Pg.1309 | Presence of red reflex, cloudy gray or white pupil
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| What nursing diagnosis would be most appropriate for a client with cataracts? Pg.1309 | - Risk for injury related to visual impairment
- Decisional conflict: Cataract removal
- Risk for ineffective health maintenance
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| When the nurse is planning for a client with cataracts what are some appropriate outcomes? Pg.1309 | Remain free from injury, Be able to articulate understanding of surgery, Participate in self-care activities to protect eyes from further damage, Follow self-care instructions following surgery to ensure healing
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| When a client is diagnosed with cataracts what should the RN teach about injury prevention? Pg.1309 | Wear sunglasses with UVA/UVB protection when outdoors, Use reading or prescription glasses or contact lenses as necessary, Maximize lighting for reading, cooking, & other indoor activities, Limit or discontinue nighttime driving
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| What things should a client be aware of after cataract surgery? Pg.1309 | May experience mild-mod discomfort, some fluid discharge, symptoms normally subside in 1-2 days but call if they persist, wear eye protection, avoid rubbing eyes, 7-8weeks for full recovery
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| How does a nurse facilitate informed decision making? Pg.1309-1310 | - Explain nonemergent nature of condition
- Help client determine effect on daily life
- Attend to verbalized concerns
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| What are some Limitations post-operatively? Pg.1310 | Limitations-avoid reading, lifting, bending to pick up objects, strenuous activity, & sleeping on operative side
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| How can a nurse encourage wellness for cataract patients? Pg.1310 | Ophthalmologist at least every 2 yrs for clients with diabetes, history of visual problems, or use of corticosteroids,
- Smoking cessation, - Appropriate eye protection with tools/sun
- Eye, vision assessment at each visit for 65yrs+
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| When evaluating a client with cataracts what indicates the nurse that the treatment was successful? Pg.1310 | - Remain free from injury
- Make informed decision regarding cataract surgery
- Verbalize concern about home care and activities
- Demonstrate correct med administration
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