Question

Mrs. Johnson is an 80-year-old patient who is having a cataract removal and lens implantation to the right eye at a local outpatient surgery center. The patient has used her anti-inflammatory and antibiotic drops as requested by the surgeon. 1 mg of Xanax will be given IV at the time the patient enters the operating suite.

• Develop a postoperative teaching plan for Mrs. Johnson and provide rationales for all potential interventions.
• Identify five causes of cataracts in the older client and describe how nurses can have a positive impact on the causes documented.
• Identify the procedure for the application of eye drops, especially focusing on infection control patient education.
• Identify the expected outcomes for Mrs. Johnson.

Answer 1

Ans) Postoperative teaching:

The nurse teaches the patient self-care before discharge:

- Activities: Activities to be avoided are instructed by the nurse.
- Protective eye patch: To prevent accidental rubbing or poking of the eye, the patient wears a protective eye patch for 24 hours after surgery, followed by eyeglasses worn during the day and a metal shield worn at night for 1 to 4 weeks.
- Expected side effects: Slight morning discharge, sone redness, and a scratchy feeling may be expected for a few days, and a clean, damp washcloth may be used to remove slight morning eye discharge.
- Notify the physician: Because cataract surgery increases the risk of retinal detachment, the patient must know to notify the surgeon if new floaters in vision, flashing lights, decrease in vision, pain, or increase in redness occurs.

- Causes: Most cataracts develop when aging or injury changes the tissue that makes up your eye's lens. Some inherited genetic disorders that cause other health problems can increase your risk of cataracts. Cataracts can also be caused by other eye conditions, past eye surgery or medical conditions such as diabetes.

- Administer a drop of the medication onto the closed eyelid in the nasal corner. Ask the patient to open the eye and close it gently once the drug has entered it.
Administering drops and ointment:
At the correct time;
In the correct strength;
Via the correct route;
To the right person;
Into the correct eye.

Eye drops: Hold eye-drop container above eye, taking care not to touch the eye, eyelids, or eyelashes. Instill one drop or more, if prescribed, into conjunctival sac.
Eye ointment: Apply about 1.5 cm of ointment along conjunctival sac, moving from inner to outer canthus. Twist tube to break off ribbon of ointment.

Touching the tip of the container to anything can contaminate the medication.

- An initial evaluation is performed to determine if you have a cataract, and whether it can be safely removed. A full eye examn is performed during this visit, which involves dilating the eyes. Furthermore, we determine if cataract surgery will improve the vision.