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nursing care for eye disorders

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الكلية كلية التمريض     القسم قسم التمريض العام     المرحلة 2
أستاذ المادة حسام عباس داود السلطاني       6/25/2011 9:40:41 AM
Eye disorders Second Stage/Adult Nursing Assistant lecturer / Hussam Abbas Eye anatomy:- Eye consist from : 1-eyelids 2-eyelashes 3-conjectiva 4-sclera 5-cornea 6-pupil 7-iris 8-lens 9-retina 10-aqueous fluid 11-optic disc 12-optic nerve Diagnostic tests of Eyes ? 1-Ophthalmoscopy Look into eye-see retina, optic disk, blood vesselsِ-A ? May see changes with eye disorders b- ? C-May see changes with diabetes mellitus ? D-Look into series of refractors-lenses ? E-Client chooses the clearest vision ? 2-Tonometry ? A-Measures eye pressure B-Pneumotonometer uses puff of air C-Normal pressure 12-21 mm Hg ? 3-Visual field ? Peripheral vision Important in some eye diseases ? Snellen eye chart- 4 ? Visual acuity ? Normal is 20/20 ? Example: 20/30—the person sees at 20 feet what a person with normal vision sees at 30 feet Assessment ? Eye lid, conjunctiva, sclera 1- ? 2-Any discharge, signs of inflammation or infection ? 3-Visual acuity ? 4-Current and past medical history eyes ? 5-Dry, red, edema ? Causes of eye problems ? 1-Diabetes mellitus ? 2-Neurological damage ? 3-Hypertension ? 4-Eye injury ? 5-Family history ? 6-Corticosteroid use ? 7-Occupation ? Conjunctivitis ? Inflammation of conjunctiva from bacteria, virus, allergen, irritant ? Symptoms: ? burning, itching eyes, discharge, edema, pain, redness ? Treatment: ? - antibiotic, antiviral ointments; if allergy, treat allergy ? -use infection control measures Some term:- ? 1-Myopia: nearsightedness ? Light focuses on front of retina ? Starts with children ? 2-Hypermyopia: farsightedness. Light focuses behind the retina ? 3-Astigmatism: hard to see small objects. Light rays distorted ? Preoperatively ? 1-Orient to room if bilateral eye patch, very important ? 2-Consent form ? 3-Expectations postoperatively ? 4-Eye drops ? 5-Report any S/S of infections ? Postoperatively ? 1-Safe environment ? 2-Apply the patient up 30-45 degrees ? 3-NO cough, lifting, stooping over, straining, laying on affected side ? 4-If nausea, get antiemetic order ? 5-Avoid constipation ? 6-Eye shield, esp. at night ? 7-Report any eye pain STAT ? 8-Report any bloody drainage ? 9-mild to moderate pain ? Mydriatics: dilate the pupil ? Cycloplegics: paralyze muscles of accommodation ? Both used in diagnostic eye procedures, eye surgery ? Anticholinergics: dilate the pupil; paralyze muscle of accommodation ? Relax ciliary & dilator muscles by blocking ? Cataract disease ? Opacity or clouding of lens ? Causes :Congenital, chemical, traumatic, mechanical, or degenerative ? Assessment: ? subjective cloudy vision, seeing spots or ghost images; floaters ? Gradual loss of vision ? Advanced: can see milky white lens ? Cataract treatment ? Extract lens, implant new one ? Outpatient status, go home 2-3 hrs. post op ? Mild sedative, local anesthesia ? Preop: mydriatic, cycloplegic ? Post op: avoid increasing IOP ? Do not drive car until released to do so ? Wear dark glasses ? Retinal detachment ? Separation of retina from choroid layer ? Collection of fluid between sensory and pigmented layer ? Causes: trauma, degenerative changes; secondary to other surgeries ? Myopic clients at more risk ? Assessment: ? 1-flashes of bright lights or floaters ? 2-Cloudy vision ? 3-No pain ? 4-May have sudden blindness ? Objective data ? Loss of peripheral vision ? Loss of acuity of vision ? ? Treatment ? Prompt medical attention needed ? Laser reattachment: adhesion formed ? Cryosurgery: cold used to adhere layers ? silicon implant used to band retina ? Pneumatic retionopexy: use air or gas to hold retina in place ? Glaucoma ? Abnormal pressure within the eyeball ? Damages cells of optic nerve by decreasing blood flow ? Most common form: primary open angle glaucoma ? Incidence increases over 40 years, family history ? Drainage of eye system blocked-trabecular ? Bilateral condition ? Acute angle-closure glaucoma ? Highest incidence in Asians, women over 40, nearsighted ? Unilateral ? Narrowed angle at the junction where iris meets cornea ? Iris protrudes into anterior chamber, occludes angle ? Loss of peripheral vision cardinal symptom ? Other complaints: ? blurred vision, halos around lights, complaints of “tired eyes” ? Glaucoma painless, untreated = blindness ? Diagnosis: ? 1-tonometry ? 2-Pupils should be dilated first ? Treatment: ? first line—opening aqueous flow ? Use miotics ? Constricts pupil, iris pulls away from drainage canal ? Diamox: decreases production of aqueous ? Timoptic: beta blocker, decreases production ? Steroids if inflammation ? ? Narrow angle glaucoma ? Avoid anticholinergics: Atropine ? Avoid antihistamines ? Eye examination ? Visual acuity ? Ophthalmoscopy ? Fundus photography/angiography ? ? Treatment ? Few specifics at this time ? Lasers for neovascularization ? Vitamin and mineral supplements ? New drugs ? Laser surgery: laser emits an intense concentrated ray of light ? create holes in tissue, seal layers of tissue ? Cryotherapy ? Use of frozen probe: retinal tear or cataract ? Enucleation ? Removal of entire eyeball ? 1
المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .
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