Glaucoma is an abnormal condition of elevated pressure within the eye .This is because of obstruction of the outflow of the aqueous humor.
Glaucoma can be acute or chronic. This is increase in intraocular pressure, which affect 2% of population over 40years old.
Acute ( Close angle)Implementation of passage of aqueous humor into the circular canal of Schilemm discharge closure of angle between cornea and irish.Surgery is required.
Chronic ( Open)
Local obstruction of aqueous humor between the anterior chamber and the canal.Medication is required for treatment.
Signs and Symptoms if untreated.
Increased aqueous humor pressure. This is due to imbalance between secretion and absorption.
Decreased peripheral vision> Cornea edema >halos and blurring of vision >blindness.
Subjective Data.
Acute ( Closed angle)
Pain is severe in and around the eyes.
Headache.
Halos around light.
Blurring of vision.
Nausea and Vomiting.
Chronic (Open- Angle)This type of glaucoma is difficult to identify because patients frequently have no symptoms at the time. Defection of disease is difficult to identify until it is too late.And patient develops irreversible form of treatment. Quality of life diminished. Patient has to depend on other.
INTERVENTION:
ACUTE GLAUCOMA.
Surgical intervention such as iridectomy is use to produce a filtration pathway for aqueous humor.
But before surgery eyedrops are used unless it is contraindicated. Some of the eye drops treatment are listed below. Acute glaucoma is treated with eye drops in order to constrict the pupil and draw the iris away from the cornea. Osmotic agents such as urea,mannitol or glycerin, if given systemically can help to lower intraocular pressure.
Acetazol helps to reduce fluid formation.
CHRONIC GLAUCOMA
OBJECTIVE DATA
Cornea edema,pupil dilated.
Decrease peripheral vision.
Redness of eye.
Tonometry pressure over 22mmHg.
MEDICATIONS :mitotic eyedrops such as Pilocarpine,Carbachol.Also the other treatment used are as follows Timolol, a beta blocker agent, Carbon anhydrous inhibitors(Diamox),anticholinesterase
(Humorsol)and epinephrine eye drops are use to facilitate outflow of aqueous humor. Treatment has to be consistent.
(1)A 62years old female with glaucoma asks the nurse what causes the disease. The nurse’s response should be based on the knowledge that glaucoma is usually caused by?.
(A) Environmental factors such as dust.
(B) Living in desert areas.
(C) Obstruction to the flow of aqueous humor.
(D) All of the above.
Correct answer C.
Rationale:
Glaucoma increases in intraocular pressure, optic nerve atrophy, loss of vision.
Tonometer is the instrument used to measure intraocular pressure. Normal is 10 to 21mmHg.
Procedure :Sit upright, eye anesthetized, flattened cone brought into contact with anesthetized cornea,measures the amount of pressure needed to flatten cornea.
A Patient is brought is brought in to the hospital by her daughter. And she brought out all the medications that she takes at home for the nurse. The patient ask the nurse what does mitotic do for her eyes?.The nurse should explain to the nurse that mitotic should?.
A Decrease inflammation of the eyes.
(B) Enchance aqueous fluid.
(C) Vasoconstriction of blood vessels in the eyes.
(D)Increase the production of vitreous humor.
Correct answer: B.
The nurse is teaching a patient with open angle Glaucoma. Which of the following statement if made by the patient indicates that more teaching is needed?.
(A) I must press on the inside of my eye to prevent washout.
(B) I will wait for 10 to 15minutes between different eyedrops medications.
(C) I don’t think that this eye drops will cure my glaucoma.
(D) All of the above.
Incorrect answer A.
Rationale : Pressing on the inside of the eye after instillation of eye medication prevents systemic absorption of the drug. To avoid washout the patient should wait for 10 to 15minutes between eyedrops medication.Skipping medication will not worsen the patient condition .Medication will not cure glaucoma but it will control the progression of the disease.
Before the nurse instill Travoprost(Travatan) into the patient eyes.The nurse should assess for?.
(A) Assessment of patient blood pressure.
( B) Check the cornea for abrasions or open areas.
(C) Assess for patient heart rate and rhythm.
(D)Measurement of the intraocular pressure.
Correct answer B.
Rationale: The drug of this category should not be applied unless cornea is completely intact.Travoprost reduces pressure in the eye by increasing the amount of fluid that drains from the eye.It is used to treat glaucoma and ocular hypertension. Travatan is a prostaglandin agonist. Measure of intraocular pressure, blood pressure and heart rates are not needed.
In performing preoperative teaching by the nurse to a 68years old man, who will be having cataract surgery. Which instructions should the nurse include in her preoperative teaching?.
(A )You will be fine.I remember that you had eye surgery before.
(B )So many eyedrops are requested after surgery and it will be taken several times a day for 4weeks.
(C) It is very important to bring sunglasses with you on the day of procedure.
(D)You will experience lot of swelling around the eyes and some bruises.
(E) You will be receiving medications to help you relax.Then you will receive some different eyedrops to dilate your pupils and paralyze the lens.
Correct answer B,C,E.
The nurse is to perform teaching regarding self administration of patient own eye drops.
(A) Be sure to place the eye drops in the conjunctiva sac of the lower eyelid.
(B) Blink your eyelid closely tight after placing the eyedrops.
(C) All of the above.
(D) None of the above.
Correct answer A.
Rationale: The cornea is very sensitive. So it is very important to place the eye drops in the conjunctiva sac of the lower eyelid.
Nurses You Move Me 