Chapter 42: Caring for Clients with Eye Disorders

After surgery for removal of cataract, a client is being discharged, and the nurse has completed discharge instruction. Which client statement indicates that the outcome of the teaching plan has been met?

"I should avoid pulling or pushing any object that weighs more than 15 lbs."

A client has been diagnosed with glaucoma and the nurse is preparing health education regarding the client's medication regimen. The client states that she is eager to "beat this disease" and looks forward to the time that she will no longer require medication. How should the nurse best respond?

"In fact, glaucoma usually requires lifelong treatment with medications."

Which client statement would lead the nurse to suspect that the client is experiencing bacterial conjunctivitis?

"My eyelids were stuck together this morning."

The nurse is teaching the client to instill eye drops. Which statement is correct?

"Wash your hands before and after instilling eye drops and do not touch the tip of the bottle."

A 52-year-old comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, "I'm hoping that I don't have to use these drops for very long." Which response by the nurse would be most appropriate?

"You'll need to use the drops for the rest of your life to control the glaucoma."

The nurse is administering eye drops to a client with glaucoma. After instilling the client's first medication, how long should the nurse wait before instilling the client's second medication into the same eye?

5 minutes

A client is being discharged home from the ambulatory surgical center after cataract surgery. In reviewing the discharge instructions with the client, the nurse instructs the client to immediately call the office if the client experiences what

A new floater in vision

Which type of glaucoma presents an ocular emergency?

Acute angle-closure glaucoma

A client has just arrived to the floor after an enucleation procedure following a workplace accident in which his left eye was irreparably damaged. Which of the following should the nurse prioritize during the client's immediate postoperative recovery?

Assessing and addressing the client's emotional needs

The nurse is providing health education to a client newly diagnosed with glaucoma. The nurse teaches the client that this disease has a familial tendency. The nurse should encourage the client's immediate family members to undergo clinical examinations how often?

At least once every 2 years

The patient with glaucoma is usually started on the lowest dose of medication. Which of the following is the preferred initial topical medication?

Beta-blockers

The nurse is administering an ophthalmic ointment to a patient with conjunctivitis. What disadvantage of the application of an ointment does the nurse explain to the patient?

Blurred vision results after application.

What type of medication would the nurse use in combination with mydriatics to dilate the patient's pupil?

Cycloplegics

A public health nurse is teaching a health promotion workshop that focuses on vision and eye health. What should this nurse cite as the most common causes of blindness and visual impairment among adults over the age of 40? Select all that apply.

Diabetic retinopathy Glaucoma Macular degeneration

What is the correct advice regarding food for a client who underwent a cataract surgery?

Eat soft, easily chewed foods.

A client has been prescribed eye drops for the treatment of glaucoma. At the yearly follow-up appointment, the client tells the nurse that she has stopped using the medication because her vision did not improve. Which action by the nurse is appropriate?

Explain the therapeutic effect and expected outcome of the medication.

A client with chronic open-angle glaucoma is being taught to self-administer pilocarpine. After the client administers the pilocarpine, the client states that her vision is blurred. Which nursing action is most appropriate?

Explaining that this is an expected adverse effect

The nurse is admitting a 55-year-old client diagnosed with a left eye retinal detachment. While assessing this client, what characteristic symptom would the nurse expect to find?

Flashing lights in the visual field

A client has just returned to the surgical floor after undergoing a retinal detachment repair. The postoperative orders specify that the client should be kept in a prone position until otherwise ordered. What should the nurse do?

Follow the order because this position will help keep the retinal repair intact.

A nurse is teaching a client with glaucoma how to administer eye drops to achieve maximum absorption. The nurse should teach the client to perform what action?

Instill the medication in the conjunctival sac.

Several residents of a long-term care facility have developed signs and symptoms of viral conjunctivitis. What is the most appropriate action of the nurse who oversees care in the facility?

Isolate affected residents from residents who have not developed conjunctivitis.

Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella?

Laser-assisted in situ keratomileusis (LASIK)

To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treat inflammatory conditions of the eyes?

NSAIDs

To avoid the side effects of corticosteroids, which medication classification is used as an alternative to treating inflammatory conditions of the eyes?

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A legally blind client is in pre-op area prior to an appendectomy. What steps does the nurse take to effectively communicate with this client ?

Notify the client prior to touching the client.

When administering a client's eye drops, the nurse recognizes the need to prevent absorption by the nasolacrimal duct. How can the nurse best achieve this goal?

Occlude the puncta after applying the medication.

Which of the following surgical procedures involves taking a piece of silicone plastic or sponge and sewing it onto the sclera at the site of a retinal tear?

Scleral buckle

A client with a diagnosis of retinal detachment has undergone a vitreoretinal procedure on an outpatient basis. What subject should the nurse prioritize during discharge education?

Signs and symptoms of increased intraocular pressure

The registered nurse taking shift report learns that an assigned client is blind. How should the nurse best communicate with this client?

State her name and role immediately after entering the client's room.

The nurse is teaching a client to care for her new ocular prosthesis. What should the nurse emphasize during the client's health education?

The need to perform thorough hand hygiene before handling the prosthesis

A young client is being seen by a pediatric ophthalmologist due to a recent skateboarding accident that resulted in trauma to the right cornea, and is now at risk of developing an infection. Which nursing intervention would be contraindicated for a client at risk for infection?

To ensure correct application of antibiotic ointment, gently drag tip of tube along lower lid while squeezing ointment on to lid.

A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should:

demonstrate eyedrop instillation.

A client has noticed recently having clearer vision at a distance than up close. What is the term used to describe this client's visual condition?

hyperopia

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following?

myopia

The nurse realizes that a client understands how to correctly instill ophthalmic medications when the client:

pulls the tissue near the cheek downward to instill medication.

A client is scheduled to undergo surgery to remove a cataract in the left eye using phacoemulsification. When phacoemulsification is used, a:

small portion of the anterior capsule is removed. Ultrasound is emitted through a probe, and suction is used to extract the lens.

A client presents to the ED reporting a chemical burn to both eyes. Which is the priority nursing intervention?

Irrigate both eyes.

A major role for nursing in the management of glaucoma is health education. Which of the following is the most important teaching point that the nurse should advise the patient of?

Adhere to the medication regimen.

A client has become legally blind as a result of macular degeneration. When attempting to meet this client's psychosocial needs, what nursing action is most appropriate?

Assess and promote the client's coping skills during interactions with the client.

Which of the following is the leading cause of blindness in the United States?

Glaucoma

The nurse should monitor for which manifestation in a client who has undergone LASIK?

Halos and glare

A client is exploring treatment options after being diagnosed with age-related cataracts that affect her vision. What treatment is most likely to be used in this client's care?

Surgical intervention

When obtaining the health history from a client with retinal detachment, a nurse expects the client to report:

light flashes and floaters in front of the eye.

After a fall at home, a client hits their head on the corner of a table. Shortly after the accident, the client arrives at the ED, unable to see out of their left eye. The client tells the nurse that symptoms began with seeing spots or moving particles in the field of vision but that there was no pain in the eye. The client is very upset that the vision will not return. What is the most likely cause of this client's symptoms?

retinal detachment