nursing. 2 pages. 2-23 THE PATIENT WITH CATARACT SURGERY 179 2-23 THE PATIENT WI
ID: 139704 • Letter: N
Question
nursing.
2 pages.
2-23 THE PATIENT WITH CATARACT SURGERY 179 2-23 THE PATIENT WITH CATARACT SURGERY S Mrs. G, 72 years old, has senile cataracts and has been instilling mydriatic eye drops. Her vision has progressively worsened and she is scheduled today for a right cataract extraction at the ourpatient clinic. The MD orders the following preop preparation: NPO; instill mydriatic and cycloplegic eye drops 1 hour before surgery; diazepam 5 mg po 1 hour before surgery. Mrs. G arrives at the outpatient clinic at 0800, and she is scheduled for surgery at 1000. Mrs. G's daughter will stay with her at home on the day of surgery B Mrs. G is a widow and lives alone. She is an active senior citizen and participates in several volunteer organizations. She has diabetes mellitus type 2 for 30 years and takes glipizide 5 mg po daily Prioritize the following five recommended nursing interventions as you would do them to take care of Mrs. G. Write a number in the box to identify the order ofyour interventions (#1 first intervention #2-second intervention, etc.), and state a rationale for each intervention. INTERVENTIONS PRIORITY # RATIONALE . Provide information regarding preop preparation . Begin to instill ordered eye drops . Have patient void . Take VS . Ensure that the surgical consent is signed before initiating preop preparation KEY POINTS TO CONSIDERExplanation / Answer
The following shows the priority, interventions and rationale respectively.
1. Provide information regarding preop preparation. Rationale: There priority step in any procedure or care is to provide information regarding the procedure, the outcomes and prognosis. The patient has the right to know about the care given to them. By giving information the patient gains knowledge and has the knowledge to take decision if they want or don't want the procedure.
2. Ensure that the surgical consent is signed before initiating preop preparation. Rationale: After information is given, a consent form is signed by the patient and the family members. This is a legal procedure which safeguards both the patient and the healthcare provider. Consent forms should be checked before starting the preparations and before performing the procedure.
3. Have patient to void. Rationale: In the preop preparation the patient will be prescribed with a mydriatic eye drops. This causes the lens of the eyes to dilate, which will cause visual disturbances. Thus the patient is asked to void first.
4. Take VS. Rationale: After settling the patient vital signs are checked. This will indicate that the patient is fit for surgery.
5. Begin to instil ordered eye drops. Rationale: The last step is to carry out the preop preparation like instilling the ordered eye drops for the ordered time duration.
The following is the priority nursing diagnosis, rationale and nursing interventions:
Nursing diagnosis: Anxiety.
Rationale: This is the priority because of poor vision and also because the eye is patched.
Nursing intervention:
• Assess the degree and duration of visual impairment.
• Encourage conversation to find out the concerns and feelings of the patient.
• Orient the patient to the environment.
• Explain the postoperative routine care.
• Assist the patient whole doing activities of daily living.
• Encourage family members of the patient while providing care.
• Encourage patient to get involved in social activities and diversional activities like listening to songs.
The response that the patient requires further follow-up is statement number 4. I am taking it easy. The only problem I have is some constipation.
Rationale for the questions are:
1. This question is asked to check if the patient is taking the medication regularly and if she is able to instil on her own.
2. This question indicates the intensity of pain for the patient and of the patient is still feeling pain.
3. This question will rule out of there is any eye infection.
4. This question emphasis that the patient should not strain over doing heavy works like lifting and bending.
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