Question

In: Nursing

For a patient with a retinal detachment, the nurse would anticipate the patient will complain of:...

For a patient with a retinal detachment, the nurse would anticipate the patient will complain of:

Group of answer choices

Cloudy vision.

Loss of central vision.

Floaters.

Double vision.

Solutions

Expert Solution

Answer:-

What is a Detached Retina (Retinal Detachment)?

A detached retina occurs when the retina is pulled away from its normal position in the back of the eye. The retina sends visual images to the brain through the optic nerve. When detachment occurs, vision is blurred. A detached retina is a serious problem that can cause blindness unless it is treated.

The retina normally lies smoothly and firmly against the inside back wall of the eyeball and functions much like the film in the back of a camera. Millions of light-sensitive retinal cells receive optical images, instantly "develop" them, and send them on to the brain to be seen. If any part of the retina is lifted or pulled from its normal position, it is considered detached and will cause some vision loss.

Symptoms

Floaters
Flashing lights
Gray curtain or veil moving across your field of vision
The symptoms described above may not necessarily mean that you have a detached retina. However, if you experience one or more of these symptoms, contact your ophthalmologist for a complete exam.

Causes

The vitreous is the clear collagen gel that fills the eye between the retina and the lens. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye. Usually the vitreous separates from the retina without causing a problem. But sometimes the vitreous pulls hard enough to tear the retina in one or more places, causing the retinal detachment. Fluid may pass through the retinal tear and lift the retina off the back of the eye like wallpaper can peel off a wall.

Risk Factors

A detached retina can occur at any age, but it is more common in midlife and later. Conditions that can increase the chance of a retinal detachment include nearsightedness; previous cataract surgery; glaucoma; severe trauma; previous retinal detachment in your other eye; family history of retinal detachment; or weak areas in your retina that can be seen by your ophthalmologist.

Treatment and Drugs

Retinal Tears Retinal holes or tears will usually need to be treated with laser treatment or cryotherapy (freezing), to seal the retina to the back wall of the eye again. These treatments cause little or no discomfort and may be performed in your ophthalmologist's office. This treatment will usually prevent progression to a retinal detachment. Occasionally retinal tears are watched without treatment.
Detached Retina Retinal detachments may require surgery to return the retina to its proper position in the back of the eye. There are several ways to fix a detached retina. The decision of which type of surgery and anesthesia (local or general) to use depends upon the characteristics of the retinal detachment. In each of the following methods, your ophthalmologist will locate any retinal tears and use laser surgery or cryotherapy (freezing) around them to seal the tear.
Surgery for a Detached Retina

Pneumatic retinopexy
Pneumatic retinopexy describes the injection of a gas bubble into the vitreous space inside the eye enabling the gas bubble to push the retinal tear back against the wall of the eye and close the tear. Laser or cryosurgery is used to secure the retina to the eye wall around the retinal tear. Your ophthalmologist will ask you to maintain a certain head position for several days. The gas bubble will gradually disappear. Sometimes this procedure can be done in the ophthalmologist's office.
Scleral buckle
A scleral buckle or flexible band is placed around the equator of the eye to counterbalance any force pulling the retina out of place. Often the ophthalmologist will drain the fluid from under the detached retina, allowing the retina to return back to its normal position against the back wall of the eye. This procedure is performed in the operating room, usually on an outpatient basis.
Vitrectomy
A vitrectomy is a surgical procedure to remove the vitreous gel that pulls on the retina. This may also be necessary if the vitreous is to be replaced with a gas bubble.

After Surgery

You can expect some discomfort after surgery for a detached retina. Your ophthalmologist will prescribe any necessary medications for you and advise you when to resume normal activity. You will need to wear an eye patch for a short time. If a gas bubble was placed in the eye, your ophthalmologist may recommend that you keep your head in special positions for a time. If a gas bubble is used, you will be restricted from air travel, scuba diving, and certain types of anesthesia until after the bubble is gone. A change of glasses may be necessary after the retina has been reattached.

What are the Risk of Surgery ?

Any surgery has risks; however, an untreated retinal detachment will usually result in permanent severe vision loss or blindness. Some of these surgical risks include infection, bleeding, high pressure inside the eye, or cataract. Most retinal detachment surgery is successful, although a second operation is sometimes needed. If the retina cannot be reattached, the eye will continue to lose sight and ultimately become blind.

Will you vision improve ?

Vision may take many months to improve and in some cases may never fully return. Unfortunately, some patients, particularly those with chronic retinal detachment, do not recover any vision. The more severe the detachment, and the longer it has been present, the less vision may be expected to return. For this reason, it is very important to see your ophthalmologist at the first sign of trouble.


Related Solutions

The nurse is working on a postoperative unit. For which patient(s) would the nurse anticipate continuous...
The nurse is working on a postoperative unit. For which patient(s) would the nurse anticipate continuous cardiac monitoring? (Select all that apply.) Group of answer choices All postoperative patients older than age 65. A patient with a prescribed anticoagulant (blood thinner). A patient with a newly implanted defibrillator. A patient who was resuscitated in the operating room. A patient with a history of atrioventricular block.
1. What might the patient with gallbladder compromise complain of? What might the nurse assess? 2....
1. What might the patient with gallbladder compromise complain of? What might the nurse assess? 2. When do patients with cholelithiasis seek medical attention? 3. How is osteoporosis diagnosed?
What should the nurse anticipate regarding dosages when 2 highly protein bound medications are ordered for a patient?
Place the following modes of delivery in order from fastest absorption (1) to slowest absorption rate (4).__Tablet__Enteric-coated pill__Liquid suspension__IntramuscularWhat should the nurse anticipate regarding dosages when 2 highly protein bound medications are ordered for a patient?
Discuss what a nurse would do to assist a patient and family that does not read...
Discuss what a nurse would do to assist a patient and family that does not read or write or is at an 8th grade level of comprehension when discussing pregnancy plan of care?
Discuss what a nurse would do to assist a patient and family that does not read...
Discuss what a nurse would do to assist a patient and family that does not read or write or is at an 8th grade level of comprehension when discussing pregnancy plan of care?
Case A: A 25 year old male patient came to the clinic with chief complain of...
Case A: A 25 year old male patient came to the clinic with chief complain of depression and anger problem. Patient was reported to have mood swings with angry outburst. He has history of irritable temperament, substance abuse and anxiety. Reported occasional agitation, restlessness, poor concentration, passive suicide thoughts, zero sense of guilt with amotivation. He has difficulty delaying gratification, poor frustration tolerance. Clinical Impressions: (Rationale for diagnosis and recommendations for services) DSM-5 Diagnosis with list of diagnostic creterials:                                   ...
nurse Harris is admitting a patient...
nurse Harris is admitting a patient...
when the nurse is checking the lab results for a patient taking spironolactone, which results would...
when the nurse is checking the lab results for a patient taking spironolactone, which results would be potential concern?
Why would the Nurse Practitioner consider switching the patient from an Ace inhibitor to an Angiotension...
Why would the Nurse Practitioner consider switching the patient from an Ace inhibitor to an Angiotension II receptor antagonist when treating a patient for hypertension? What type of lab work should be checked when patients take the above medications and why? How often should lab work be checked?
Why would the Nurse Practitioner consider switching the patient from an ACE inhibitor to an Angiotension...
Why would the Nurse Practitioner consider switching the patient from an ACE inhibitor to an Angiotension II receptor antagonist when treating a patient for hypertension ? What type of lab work should be checked when patients take the above medications and why? How often should lab work be checked?
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT