Disturbed Sensory Perception and Anxiety - NCP for Cataract

Nursing Care Plan for Cataract (Preoperative)

A cataract is a cloudiness in the lens without pain gradually, eventually blurred vision can not receive light. (Barbara)

  • Aging, senile cataract usually encountered.
  • Trauma occurs as blunt / sharp exposure to X-rays or radioactive objects.
  • Eye diseases such as uveitis.
  • Systemic diseases such as diabetes.
  • Congenital defect.

Decreased visual acuity depends on:
  • There was no sign of inflammation (hyperemia none)
  • Oblique illumination looks turbidity grayish or white with a black shadow.
  • Examination with the ophthalmoscope appear black on orange base is called the fundus reflex.
  • At a more advanced cataract, thus increasing turbidity shadow iris and fundus reflexes disappear into a black (negative).

Pre Operative Assessment of Cataract

Subjective : vision complaints
  • Blurred in total.
  • Just look good in dim places.
  • Can only see the light stimulus alone.
  • Double / compound in one eye.
Verbal and non -verbal indicators of anxiety .
An understanding of cataract surgery include :
  • The nature of the procedure.
  • Risks and benefits.
  • Anesthetic drugs.
  • Option for visual rehabilitation after surgery, such as intraocular lens implants, contact lenses and cataract glasses.
The amount of information sought clients .

Objective :
  • There were no signs of inflammation except in complicated cataract that intra ocular disease is still active .
  • On irradiation examination lens opacities appear gray or white.
  • In ophthalmoscope examination , at a certain distance obtained turbidity is black with a red background .
  • On examination of refraction increases . In patients who had been suffering from presbyopia, cataracts later , at an early stage can be read without the use of reading glasses .
  • Observation of the signs of glaucoma as a complication of cataract , glaucoma is the most common such as the presence of pain because of increased IOP , visual field abnormalities .

Nursing Diagnosis for Cataract

1. Disturbed Sensory Perception (visual) related to a decrease in visual acuity, double vision.
Goal: sensory perception disorder is resolved.
  • With limited vision the client is able to see the environment as much as possible.
  • Know the changes are positive and negative stimuli.
  • Identify environmental habits.

  • Orient the patient's activities on the environment.
  • Distinguish between the ability of the visual field of both eyes.
  • Observation of signs of disorientation to remain at the patient's side.
  • Encourage the client to perform simple activities such as watching TV, radio, etc.
  • Instruct the patient to use sunglasses cataracts, prevent peripheral visual field and note the occurrence of blind spots.
  • Position open the doors must be closed, minimize obstacles.

  • Introducing the patient about the environment and activities so as to leave the visual stimulus.
  • Determining the ability of the visual field of each eye.
  • Reducing patient fear and increase stimulus.
  • Increasing sensory input, and maintain a sense of normalcy, without increasing stress.
  • Lowering of peripheral vision and movement.

Nursing Diagnosis for Cataract

2. Anxiety related to surgery that will be undertaken and the possibility of failure to obtain a sight again.

Goal: overcome anxiety

  • Expressed concern and fears about the surgery that will be undertaken.
  • Expressed understanding of routine actions and treatment perioperatively.
  • Create an environment that is calm and relaxed, give encouragement to verbalize and listened attentively.
  • Reassure clients that anxiety has a normal response and is estimated to occur in cataract surgery to be undertaken.
  • Show misconceptions expressed clients, provide accurate information.
  • Present the information using methods and instructional media.
  • Explain to the client the required premedication activity.
  • Discuss nursing actions preoperative expected.
  • Provide information about the activities of the sights and sounds associated with the intra-operative period.
  • Help identify the source of anxiety.
  • Enhance client confidence.
  • Improving learning process and have a source of information written referral after discharge.
  • Increased knowledge will add cooperative clients and reduce anxiety.
  • Explaining the choice of allowing the client to make decisions correctly.
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