Question

In: Nursing

susan is admitted to the hospital for eye surgery.she was diagnosed in childhood with diabetes and...

susan is admitted to the hospital for eye surgery.she was diagnosed in childhood with diabetes and is now 50 years old.susan has also been diagnosed with retinopathy,a frequently occuring condition in diabetic patients. Her vision has been deteorating over the last several years.she has recently suffered a vitreous hemorrhage due to neovascularization of the eye,which is common in diabetic patients.

1. what procedure will be performed to resolve the problems?
2. breifly describe theprocedure and explain how susan will benefit?
3. what are the possible approaches that the surgeon may use to enter the eye? which is preferred?
4. what piece of equipment is crucial to a vitrectomy?
5what substance,if any will be used to replace the vitreous humor?




ronald has been having trouble with his stereoscopic vision. his wife says that he appears to have "lazy eyes". the amount of misalignment seems to stay the same,no matter which direction his eyes are looking. ronald has been admitted to the ambulatory care center for surgery.

1. what is the correct term for the condition that ronald has?
2. what is the name of his condition?
3.what surgical procedure will be performed to correct the condition?
4.in what position will ronald b e placed for this procedure?
5.what are the anatomic boundaries for the skin prep?

for case study 1 question 3: what are the possible approaches the surgeon can take to correct Susan's condition and which one will be the preferred choice?

Solutions

Expert Solution

Q1

1+2

Vitrectomy Vitrectomy is a surgical procedure undertaken by a specialist where the vitreous humor gel that fills the eye cavity is removed to provide better access to the retina. This allows for a variety of repairs, including the removal of scar tissue, laser repair of retinal detachments and treatment of macular holes. Once surgery is complete, saline, a gas bubble or silicone oil may be injected into the vitreous gel to help hold the retina in position.

2 When the vitreous cavity becomes cloudy, patients experience hazy vision. If the haziness is caused by benign (mild) or inactive conditions such as asteroid hyalosis, posterior vitreous detachment, vitreous hemorrhage, vitreous condensation, or old inflammation, a complete pars plana vitrectomy may resolve symptoms and permanently improve vision.

rectomy surgery is performed to address abnormal pulling (traction) by the vitreous on the retina. Vitreoretinal traction is a common causative finding associated with aging, nearsightedness, severe diabetes, severely premature infants, head or eye trauma, following YAG laser capsulotomy, and after complex anterior segment surgery.

3 Posterior Pars Plana Vitrectomy: The vitreous or vitreous humor is thought
to serve as a framework or support for the layers of a newborn’s eye during development. In normal eyes, the vitreous is crystal clear throughout adult- hood and fills the eye from the front or anterior (iris-lens) to the back or posterior (optic nerve). This area comprises two-thirds of the volume of the eye and is called vitreous cavity, which along with the retina, the retinal pigment epithelium, choroid, and sclera, make up the posterior segment.
A vitrectomy performed for diseases of the posterior segment is called a posterior or pars plana vitrectomy. This kind of vitrectomy is performed by a retina specialist.

Pars plana: This is a section of the eye just behind the cornea and extending to the anterior insertion of the rectus muscles that move the eye. Incisions can be placed in this portion of the eye without damaging the anterior structures of the eye such as the iris or lens or posterior structures


Anterior Vitrectomy: In rare cases, the vitreous gel comes through the pupil into the anterior (front) chamber of the eye. This can happen:
• Following eye trauma (injury)
• During complex cataract, cornea, or glaucoma surgery
• As a result of lens problems
Because leaking vitreous gel can lead to future problems, an anterior vitrectomy may be performed to minimize risk and to promote visual recovery.

posterior is the preferred approach

4canulas. (Valved and valveless)

5 gas bubble or silicone oil


Related Solutions

A patient was admitted into the hospital and was diagnosed with with Type I diabetes mellitus....
A patient was admitted into the hospital and was diagnosed with with Type I diabetes mellitus. As he was ready for discharge, you review his discharge plan with him. Noticing that his urinalysis shows that he has ketones in his urine, how would you explain this to him? A patient was admitted into the hospital and was diagnosed with with Type I diabetes mellitus. As he was ready for discharge, you review his discharge plan with him. Noticing that his...
A patient diagnosed with multiple sclerosis is admitted to the hospital for an acute exacerbation. The...
A patient diagnosed with multiple sclerosis is admitted to the hospital for an acute exacerbation. The patient’s baclofen dose has been increased to 60mg daily by mouth divided into three doses. The order is entered on the medication administration record as 60mg three times a day. On the third day, the patient is noted to confused and complaining of paresthesia. No follow up action is documented by the nurse.   On the fourth day at 8 AM, the nurse finds the...
A 35 year old woman with type 1 diabetes was admitted to the hospital with severe...
A 35 year old woman with type 1 diabetes was admitted to the hospital with severe anemia, vomiting and fever. She had not been feeling well for the past several months. She lost more than 25 pounds without dieting. Physical examination revealed a pale female with a distended abdomen. A CBC, glucose, pregnancy test and urinalysis were ordered. Patient result Reference range WBC 22.1 x10^9/L RBC 4.06 x 10 ^12/L Hemoglobin 11.4 g/dl HCT 35.5 % MCV 87 fl MCH...
Hilda is being admitted to the hospital for open heart surgery. She reports being diagnosed with...
Hilda is being admitted to the hospital for open heart surgery. She reports being diagnosed with hypertension and Type 2 Diabetes, and taking medication for both disorders. Hilda is 65 years old. She reports her usual weight is 320 pounds. Hilda is able to provide a typical day of food intakes prior to admission that you enter into diet analysis software. During your assessment, you obtain a current weight of 290 pounds and height of 5 feet 6 inches. You...
A wealthy individual is admitted to your hospital. He was diagnosed 48 hours ago with kidney...
A wealthy individual is admitted to your hospital. He was diagnosed 48 hours ago with kidney failure and needs a transplant. He is placed on the transplant list, but is advised it will probably take months or years to obtain a kidney. Suddenly, today an individual arrives with a foreign appearing man, who doesn't speak English and appears unkempt. He states he is the patient's "cousin" and wishes to "gift" a kidney to your patient. What rules apply to organ...
A 35-year-old woman with type I diabetes was admitted to the hospital with severe anemia, vomiting,...
A 35-year-old woman with type I diabetes was admitted to the hospital with severe anemia, vomiting, and fever. She had not felt well for the past several months. She had lost more than 25 lb without dieting.Physical examination revealed a pale and slightly obese female with a distended abdomen. She was the mother of two young children, ages 3 and 5. Her menstrual periods were regular. A CBC, blood glucose, urinalysis, and pregnancy test were ordered. ■ Laboratory Data Hemoglobin...
A 35-year-old woman with type I diabetes was admitted to the hospital with severe anemia, vomiting,...
A 35-year-old woman with type I diabetes was admitted to the hospital with severe anemia, vomiting, and fever. She had not felt well for the past several months. She had lost more than 25 lb without dieting.Physical examination revealed a pale and slightly obese female with a distended abdomen. She was the mother of two young children, ages 3 and 5. Her menstrual periods were regular. A CBC, blood glucose, urinalysis, and pregnancy test were ordered. ■ Laboratory Data Hemoglobin...
A 70-year-old man with type 2 diabetes is admitted to the hospital with altered mental status...
A 70-year-old man with type 2 diabetes is admitted to the hospital with altered mental status and hypoglycemia. He had experienced recurring episodes of mild hypoglycemia over the previous week, which were managed with food. His past medical history includes chronic lymphocytic leukemia, gout, hypertension, and atrial fibrillation. Approximately 6 weeks ago, his serum creatinine increased from 1.6 mg/dL to 2.4 mg/dL following a bout of pneumonia. He had been taking glimepiride 4 mg twice daily. He admitted that he...
Jason is 11 years old and has Type 1 Diabetes. He was diagnosed with Diabetes when...
Jason is 11 years old and has Type 1 Diabetes. He was diagnosed with Diabetes when he was 5 years old. He is comfortable taking his "blood sugar" readings during the day. He likes to participate in sports and is on the soccer team, which practices three times a week after school. His mother always packs his lunch for school so he does not have to worry about eating the food in the cafeteria. For this written assignment plan a...
Jason is 11 years old and has Type 1 Diabetes. He was diagnosed with Diabetes when...
Jason is 11 years old and has Type 1 Diabetes. He was diagnosed with Diabetes when he was 5 years old. He is comfortable taking his "blood sugar" readings during the day. He likes to participate in sports and is on the soccer team, which practices three times a week after school. His mother always packs his lunch for school so he does not have to worry about eating the food in the cafeteria. For this written assignment plan a...
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT