Nursing Care of Client With Cataract Surgery

8/4/2019 Nursing Care of Client With Cataract Surgery

1/11


2/11

Pre-Operative

# Fear and anxiety related to the surgery

Post Operative

# Risk of Fall due to Impaired Vision#Risk of Eye Infection related to Surgery

#Pain related to surgical wound

#Knowledge Deficit related to Eye Care


3/11

Objective: Patient express less fear and anxiety

Nursing Intervention:

1-Introduce self and ward staff. Establish a therauputic relationship.

: So client feel comfortable

2- Orientate patient to ward routine

: To make client at ease and gain client confidence3-Demonstrate a caring and polite attitude

: So client feel comfortable and less fear

4- Assess clients knowledge regarding the operation

: To facilitate health education

5-Reinforce doctors explanation

: Makes client understand better

6-Introduce patient to another patient that had gone the same operation

To gain clients confidence

7-Explain all physical preparation and post operative expectations pre operatively

8- encourage family members to visit

To give a continous moral support


4/11

Objective: Client does not sustain any eye injury

1-Transfer patient with care from trolley to the bed with hand support thehead

Aggrassive movemoent can cause eye bleeding

2-Place patient in unoperated side (recumbent/lateral)

To avoid pressure on the operated eye

3- Ensure patient had eye pad/ Castella shield over the operated eye

To protect from injury

4-Advise patient to rest in bed for 24hours

To prevent from increase in IOP

5-Teach patient to use call bell

To call for assisstance

6-Reorientate patient when fully conscious

Help patient to remember the surrounding

7-Place locker on the side of the good eye

So client easy to grab things and avoid putting pressure on operated eye

8. Assist patient to ambulated when permitted

Prevent from fall


5/11

Objective: Patient are at no risk of eye infection

1-Observe condition of eye 24 hours post-op

To detect any signs of infection eg redness, tearing, discharge

2-Perform eye dressing QID using aspetic technique

To prevent cross infection 3-Instill antibiotics drops- Gutt Chloramphenicol pre and post-op

As a prophylaxis

4-Take vital signs QID especially temperature

To detect fever that indicate sign of infection

5-Take eye swab for culture and sensitivity if there is eye disharge

To detect causative organism and treat appropriately 6-Instill Gutt Dextrosone (Maxidex) as ordered

To reduce inflammation

7- Cover operated eye with castella shield

To protect from dust

8-Instill antibiotic drops every 15minutes as ordered eg Gutt Gentamycin

To treat eye infection


6/11

1- Remind patient to inform nurse immediately for any painover the operated eyes

For rapid intervention can be taken

2- Assess patients level of pain and document in nursingreport

So right intervention depends on level of pain can be

taken 3- Administer analgesics as ordered by the doctor

Eg- Oral Tramal 500mg prn

To reduce level of pain

4-Reassess effect of analgesics after half an hour

To evaluate the effectiveness of the medication 5-Check patient eye pad/ bandage

To detect any bloood stain, discharge

6-Advise patient to rest in bed

To decrease level of pain


7/11

Objective:

Patient is knowlegable about the eye care

1- Teach patient how to:

a- Prevent eye infection Wash hand with soap and water, rinse and dry.

Clean the eye using cool boiled water, cottonswabs and clean container

Instill eye drops as ordered

Not to go over crowded area- Night market,shopping mall


8/11

Wear castella shield day and night for 1 week, at nightfor 2-3 weeks

Avoid pressure, squeezing and wrinkles eyes, carryinginfant

Touch eye unnessarily

Purposely wink on the operated eye Wipe away tears with hand

Bend head agrresively

Lie on operated eye

Do not eat on the operated side

Do not bite hard food

Do not cough or sneeze with mouth closed

Do not shave his beard (men)


9/11

Wear dark sunglasses outdoors to prevent fromUV rays

d. Prevent strain on the eye Do not try to reach for objects that are out of

reach

Straining during defecation

Sneezing/coughing with mouth closed

Avoid driving for 1 month

Do not reading or watching TV for prolonged time

Do not lifting heavy objects >5kg

Do no participating on certain sport-Rugby


10/11

1- Can wash face but ensure soap doesnt getinto the eyes

2-Can shower but face held away from shower

head3- Can reading or watch tv but not for prolongtime. Rest eye in between

4. Muslim can pray but cannot bend head below

waist level5. Ladies can makeup but not for 1-2 weeks

post-operatively


11/11

Take a well balanced diet with more fluids,fruit and fiber

Regular follow up to evaluate progress

Advise patient to seek prompt treatment ifany complications arise eg severe eye pain

Documents

Nursing Care of Client With Cataract Surgery