Download Cataracts Outline- A Medrano-T Polly- A Alvarado

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Ashley Medrano – Mrs. Horton
Theresa Polly - Mrs. Horton
Ashley Alvarado - Mrs. Horton
Ruben Olmsted – Mrs. Osborn
RNSG 1430-002
October 7, 2015
Cataracts Outline
What are Cataracts?

Cataracts are cloudy areas in the lens of the eye that can cause changes in vision.
The 3 Most Common Type of Cataracts

Nuclear – tends to have a substantial genetic component that causes a central opacity in
the lends. It is associated with myopia (i.e. nearsightedness), which worsens when the
cataract progresses.

Cortical – involves the anterior, posterior, or equatorial cortex of the lens. Cortical
cataracts progress at a high variable rate. Vision is worse in very bright light.

Posterior Subcapsular – occurs in front of the posterior capsule. Near vision id
diminished, and the eye is increasingly sensitive to glare from bright lights.
Diagnosis of Cataracts – How are Cataracts Diagnosed?
Visual Acuity Test:

A visual acuity test uses an eye chart to measure how well you can read a series of letters
(e.g. Snellen Chart.) Your eyes are tested one at a time, while the other eye is covered.
Retinal Examination:

The eye doctor puts dilating drops in your eyes to open your pupils wide. Making it
easier to examine the back of your eyes (retina).
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Slit-lamp Examination:

A slit lamp allows your eye doctor to see the structures at the front of your eye under
magnification. The microscope is called a slit lamp because it uses an intense line of
light, a slit, to illuminate your cornea, iris, lens, and the space between your iris and
cornea. The slit allows your doctor to view these structures in small sections, which
makes it easier to detect any signs of cataracts or tiny abnormalities.
Ophthalmoscopy:

A test that allows a health professional to see inside the fundus of the eye and other
structures
Who is at Risk?

Increasing age

Diabetes

Drinking excessive amounts of alcohol

Excessive exposure to sunlight

Exposure to ionizing radiation, such as that used in X-rays and cancer radiation therapy

Family history of cataracts

High blood pressure

Obesity

Previous eye injury or inflammation

Previous eye surgery

Prolonged use of corticosteroid medications

Smoking
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Clinical Signs & Symptoms

Clouded, blurred or dim vision.

Increasing difficulty with vision at night.

Sensitivity to light and glare.

Seeing "halos" around lights.

Frequent changes in eyeglass or contact lens prescription.

Fading or yellowing of colors.

Double vision in a single eye.
Nonsurgical Treatments

Eye protection – wearing sunglasses outdoors to protect eyes.

New Research: researchers from the University of California, San Diego have discovered
eye drops containing lanosterol can improve vision by dissolving the clumped proteins
that form cataracts.
Surgical Treatments
Phacoemulsification:

a portion of the anterior capsule is removed,allowing extraction of the lens nucleus and
cortex while the posterior capsule and zonular support are left intact. An ultrasonic device
is used to liquefy the nucleus and cortex, which are then suctioned through a tube.
Lens Replacement:
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
After removal of the crystalline lens. The lens which focuses light on the retina must be
replaced for the patient to see clearly. These are the 3 types of lens replacement options:
aphakic eyeglasses, contact lenses, and IOL implants.
Postoperative Care

Educate patient regarding eye protection, recognition of complications, activities to
avoid, and obtaining emergency care.

Educate the patient administration of medications. Such as mild analgesic agents,
acetaminophen, antibiotic, anti-inflammatory, and corticosteroid eye drops or ointments
prescribed.

Inform that there should be minimal discomfort after surgery.
Postoperative Care Continued..

Eye is unpatched, discharge usually occurs within 1 hour

Dark glasses required

Mild itching normal

Pain indicates complications

Reduce IOP

Prevent infection

Assess for bleeding
Prognosis
The likely course of the disease how its identified as cataracts
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Clinical Signs & Symptoms of the Potential Post Op Complications
Potential Early Postoperative Complications: chart
Clinical Signs & Symptoms of the Potential Post Op Complications
Potential Late Postoperative Complications: chart
Actual Nursing Diagnosis
Actual:

Disturbed sensory perception r/t lens protein denaturation
AMB clouded, blurred or dim vision secondary to cataracts.
Goal:

Improving visual acuity within the limits of individual situations, recognize sensory
disturbances and compensate for changes.
Interventions:

Determine visual acuity, note whether one or two eyes involved.

Orient clients to the environment

Observation signs of disorientation.

Approach from the side that was operated on, talk to touch.

Remind clients use of cataract glasses whose purpose enlarge approximately 25 percent,
loss of peripheral vision and blind spot may exist.

Put the items required / position call bell within reach.
Risk Nursing Diagnosis
Risk:
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
Risk for injury related to blurred vision
Goal:

Prevention of injury.
Interventions:

Help the patient when able to do until postoperative ambulation and achieve stable vision
and adequate coping skills, using techniques of vision guidance.

Do not put pressure on the affected eye trauma.

Use proper procedures when providing eye drugs.

Discuss the need for the use of metal shields or goggles when instructed
Cultural Overtones

Different races that are susceptible to cataracts

Percentage of different races who have cataracts
References
Cohen, Paula. "Eye Drops Hold Promise for Reversing Cataracts." CBSNews. CBS Interactive,
28 July 2015. Web. 09 Oct. 2015.
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Cataracts." - Mayo Clinic. N.p., 5 June 2012. Web. 06 Oct. 2015.
Cataracts-Medications." WebMD. WebMD, 9 Sept. 2014. Web. 6 Oct. 2015.
Cataracts." Treatments and Drugs. N.p., 30 July 2013. Web. 09 Oct. 2015.
Nursing Care Plan." : 4 Cataract Nursing Diagnosis and Interventions. N.p., 14 Mar. 2012. Web.
09 Oct. 2015.
NANDA Nursing." : Nursing Care Plan for Cataract. N.p., 23 Dec. 2014. Web. 09 Oct. 2015.
NCP for Cataracts - Disturbed Sensory Perception : Visual." Nursing Care Plan. N.p., 15 Oct.
2014. Web. 07 Oct. 2015.