Risk for Injury - Post Operative Cataract Care Plan


Cataract is a clouding of the eye's lens.
Cataracts are the most common cause of vision loss in people over age 40 and is the principal cause of blindness in the world. In fact, there are more cases of cataracts worldwide than there are of glaucoma, macular degeneration and diabetic retinopathy combined, according to Prevent Blindness America (PBA).

Types of cataracts include:
  • A cortical cataract is characterized by white, wedge-like opacities that start in the periphery of the lens and work their way to the center in a spoke-like fashion. This type of cataract occurs in the lens cortex, which is the part of the lens that surrounds the central nucleus.
  • A subcapsular cataract occurs at the back of the lens. People with diabetes or those taking high doses of steroid medications have a greater risk of developing a subcapsular cataract.
  • A nuclear cataract forms deep in the central zone (nucleus) of the lens. Nuclear cataracts usually are associated with aging.

Besides advancing age, cataract risk factors include:
  • Diabetes
  • Eye inflammation
  • Eye injury
  • Radiation exposure
  • Family history of cataracts
  • Long-term use of corticosteroids (taken by mouth) or certain other medications
  • Smoking
  • Surgery for another eye problem
  • Too much exposure to ultraviolet light (sunlight)

The best prevention involves controlling diseases that increase the risk of a cataract, and avoiding exposure to factors known to promote cataract formation.

Wearing sunglasses when you are outside during the day can reduce the amount of ultraviolet (UV) light your eyes are exposed to. Some sunglasses do not filter out the harmful UV. An optician should be able to tell you which sunglasses filter out the most UV. For patients who smoke cigarettes, quitting will decrease the risk of cataracts.

Cataract surgery is the removal of the natural lens of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract. Metabolic changes of the crystalline lens fibers over time lead to the development of the cataract and loss of transparency, causing impairment or loss of vision. Many patients' first symptoms are strong glare from lights and small light sources at night, along with reduced acuity at low light levels. During cataract surgery, a patient's cloudy natural lens is removed and replaced with a synthetic lens to restore the lens's transparency.


Nursing Care Plan for Cataract

Nursing Diagnosis : Risk for Injury related to intraocular hemorrhage, vitreous loss.

Goal : injuries can be prevented.

Expected outcomes: environmental change as an indication for increased security.

Interventions and Rational
1. Discuss what happened to the post-surgery, on pain, activity restrictions, appearance, eye bandage.
Rationale: helps reduce fear and increase cooperation within the necessary restrictions.

2. Give the patient leaning position, head height, or tilted position to no pain, as desired.
Rational: break just a few minutes to a few hours at an outpatient surgery or an overnight stay in case of complications. Lowering the pressure on the sore eye, minimizing the risk of bleeding or stress on the seams open.

3. Limit activities such as moving the head suddenly, scratched eyes, bowed.
Rational: reduce stress on the area of operation.

4. Ambulatory with assistance; give special bathroom when recovering from anesthesia.
Rational: take a little strain rather than use the potty.

5. Encourage deep breath, cough to lung clearance.
Rational: cough increased intra-ocular pressure.

6. Encourage use of stress management techniques instance, guidance imagination, visualization, deep breathing and relaxation exercises.
Rational: increase relaxation and coping.

7. Maintain eye protection as indicated.
Rational: used to protect from accidental injury and reduce eye movements.

8. Ask the patient to tell the difference between discomfort and pain sudden sharp eye. Investigate restlessness, disorientation, impaired bandage. Observation of bleeding in the eye with a flashlight as indicated.
Rational: discomfort may be due to the surgical procedure; acute pain showed bleeding, occurs because strain or unknown causes (tissue vascularization cured many, and is unbelievably fragile capillaries).

9. Observation crusting sores, pear-shaped pupil.
Rational: iris prolapse or rupture showed injuries caused by damage to seams or eye pressure.

10. Collaboration: give the drug as indicated.
Rationale: nausea / vomiting can increase the risk of ocular injury, requiring immediate action to prevent ocular injury.

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