Search This Blog

Cataract Care Plan - Pre and Post Operative

Tuesday, April 30, 2013 · 0 komentar

Definition

Cataract is a condition in which the normally clear lens of the eye becomes cloudy and clear change.

Cataract is the opacity of the progressive lens or the lens capsule.

Cataract is a cloudiness in the lens of each state, which can occur due to hydration (addition of liquid), lens protein denaturation, or due to both of them, usually occurs in both eyes and progressive.


Etiology
  • Physical
  • Chemical
  • Elderly
  • Disease predisposing
  • Genetic and developmental disorders
  • Virus infection in the future growth of the fetus.


Classification

Cataracts can be classified according to developmental and degenerative processes by:

1. Congenital Cataracts

Congenital cataract is a cloudiness in the lens that occur during the formation of the lens. Turbidity was there at the time the baby is born. Cataract is often found in infants born to mothers who had rubella, diabetes, toxoplasmosis, hipoparatiroidismo, galactosemia. There are also accompanying congenital abnormalities in the eye itself as microphthalmus, aniridia, coloboma, keratoconus, Ectopia lentis, megalocornea, hetero cornea iris.
Turbidity can be found in the form: hyaloidea persistent artery, anterior polar cataract, posterior, Axialis cataract, zonular cataract, stellate cataract, cataract totalis and congenital totalis membranacea.

2. Primary Cataracts

Primary cataracts by age, there are three groups, namely:
a. Juvenile Cataract (age <20 years)
b. Presenile Cataract (ages up to 50 years)
c. Senile Cataract (age> 50 years)

3. Senile Cataracts

Senile cataract is, all contained lens opacities in the elderly, the age group above 50 years.
Senile cataract is known in four stages, namely:
a. Incipient cataract
An early stage of cataract is clouding the lens is shaped patches of irregular opacities. Clients complain visual disturbances such as seeing double at the sight of one eye. At this stage, the process of degeneration absorb the liquid so that the anterior chamber has a normal depth. Iris in a normal position with mild cloudiness in the lens. Impaired visual acuity has not happened yet.

b. Immature cataract
Lens begins to absorb the liquid, so the lens is slightly convex, causing myopia and iris pushed ahead with a shallow anterior chamber. Anterior chamber angle can be closed so that may arise secondary glaucoma.

c. Mature cataract
An advanced lens degeneration process. At this stage, there was opacification of the lens. Fluid pressure within the lens is in equilibrium with the liquid in the eye so that the lens will return to normal size. Visual acuity had decreased and only a positive light projection.

d. Hypermature cataract
At this stage of the process further degeneration and cortical lens can melt lens, so the lens nucleus immersed in the lens cortex. At this stage, it can also happen that the degeneration of the lens capsule and cortical lens material liquid lenses that can be entered into the anterior chamber. Lens material to occlude the anterior chamber fluid, causing phacolytic glaucoma.

Clinical Manifestations

Cataracts develop slowly and do not cause pain accompanied by visual disturbances that appear gradually. Vision problems can be:
  1. Difficulty seeing at night.
  2. See the circle around the light or the light was blinding.
  3. Decrease in visual acuity (even in daylight).
  4. Frequently changing glasses.
  5. Double vision in one eye. Sometimes cataract lens causing swelling and increased pressure within the eye (glaucoma), which can cause pain.
  6. As there are dark spots in front of eyes.
  7. Difficult to see objects that are dazzling.
  8. Color change in the pupil or white.
  9. Difficult to do the daily work.
  10. Reading time illumination require brighter light.
  11. Night vision much less.
  12. 2. For a while obviously look closely.

Examination Support
  1. Examination of visual acuity.
  2. Check is performed to see visual acuity. This examination is conducted by the Snellen card is the card to see the person's visual acuity.
  3. Slit lamp examination. See all makeup eye front with enlargement. With these tools can see the state of the cornea, manic eyes, black lining, and lenses.
  4. Tonometry
  5. Ophtalmoscope
  6. Ocular examination


Pre Operative Cataract Care
  1. Retinal function should be good, which is checked by the test beam projection.
  2. There should be no infection in the eye or surrounding tissue.
  3. There should be no glaucoma. In the state of glaucoma, retinal blood vessels have been adapted to high IOP. If surgery is performed, at the time the cornea is cut, IOP decreased, blood vessels rupture and cause severe bleeding. Also can cause bulbus oculi prolap of content, such as iris, glass body and lens.
  4. Check the vision.
  5. General state must either: no hypertension, no diabetes mellitus (blood glucose <150 mg / dl), no chronic cough and heart disease, such as cardiac decompensation.
  6. Instruct the patient to bathe and wash before surgery, to reduce the risk of infection.
  7. Give premedication drugs, and shaving eyelashes, appropriate advice doctor.
Cataract surgery is commonly performed and generally safe. After surgery are rare infections or bleeding in the eye that can lead to serious vision problems. To prevent infection, reduce inflammation and accelerate healing, for several weeks after surgery was given eye drops or ointment. To protect the eyes from injury, patients should wear glasses or protective goggles made of metal until the surgical wound is completely healed.

Post Operative Cataract Care
  1. Limit the patient to perform an action that can increase IOP, including: coughing, bending, straining, sneezing, lifting objects weighing&gt; 7.5 kg, was lying beside the surgery.
  2. Instruct the patient to wear glasses during the day and wear eye protection at night.
  3. Give eye drops / eye ointment suitable doctor advice.
  4. Observation of increased IOP is characterized by: severe pain, nausea, vomiting.
  5. Observe for signs of infection, and advise the patient not to rub the eyes to prevent infection.
  6. Instruct the patient to wash their hands before administering an ointment / eye drops.
  7. Observe for signs of bleeding anterior eye chamber is characterized by changes in vision.
  8. Observation for signs of retinal detachment, which is marked with a black dot seems, an increasing number of floaters or light and loss of part / whole field of view.

Healing Pain in Acute Appendicitis

Monday, April 29, 2013 · 0 komentar

Nursing Care Plan for Acute AppendicitisAcute appendicitis is defined as the acute inflammation of the appendix. It is considered to be the most common cause of abdominal pain and distress in children and teenagers worldwide (ages 4-15). The appendix is a channel in its interior that communicates with the large intestine where feces semifluidas.

The appendix is a small pouch attached to your large intestine. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix or to stool that enters the appendix from the cecum. When the appendix is blocked by calculus and feces or it is squeezed by the lymph nodes (due to bacterial infection, the lymph nodes usually become swollen and press against the appendix), it swells and usually doesn't receive enough blood. Bacteria grow inside the appendix, eventually causing its death. In acute appendicitis, the inflammation of the appendix is serious and can lead to complications (perforation, gangrene, sepsis).

Acute appendicitis is caused in most cases, usually by a fossilized feces (fecalito) that obstructs the appendiceal channel. Acute appendicitis is the most common cause of acute abdominal pain and its treatment is surgical and emergency.

The most common symptoms of acute appendicitis are intense, continuous abdominal pain (at first it occurs in the umbilical region and later locates in the right lower region of the abdomen) that usually amplifies during movement, poor appetite, nausea, vomiting, constipation or diarrhea and fever. Vomiting and anorexia can occur after the feeling of pain. Besides, an elevated body temperature is a sign of an ongoing inflammation in the body. In atypical forms of acute appendicitis, the patients may have only one symptom or they may not have any symptoms at all! This complicates the process of correctly diagnosing acute appendicitis and the only effective means of discovering the illness are abdominal computerized tomography, blood analysis and detailed physical examination.

The most frequent complication is that the wall of the appendix is necrosa (gangrenous appendicitis), causing a perforation, with consequent generalized peritonitis, or in some cases the adjacent bowel loops are affected in such a way that causes perforation of the small intestine.

Another complication is the possibility that the omentum can join restricting peritonitis in the right iliac fossa. Fibrosis and inflammation produce a persistent right iliac fossa mass (mass apendicial). This can be solved through healing by formation of an abscess to drain to the surface or by drilling with generalized peritonitis.

The surgical intervention performed in acute appendicitis is called appendectomy. If acute appendicitis is treated in time, the patients recover quickly and effortless. Most patients are fully recovered within 4 weeks from surgery. However, in the case of complicated acute appendicitis, the patients require special monitoring before and long after the surgical treatment. Complicated acute appendicitis is life-threatening and the rate of mortality in patients with this form of illness is considerably high. Acute appendicitis requires immediate treatment.

Diagnosis of Acute Appendicitis

This disorder is mainly based on clinical diagnosis, the doctor makes the patient's physical examination (signs of Mc Burney Blumberg or positive), other relevant data that help us to diagnose the taking of a blood BiometrĂ­a showing (leukocytosis of 10,000 to 15,000 leuc/mm3 and normal urinary tract examination (to rule out a possible infection and the differential diagnosis).

Prevention and Treatment of Acute Appendicitis

1. Antibiotics almost always useful in Appendicitis.
2. Appendectomy surgery removal of the appendix.
3. Intravenous (IV) fluids decrease the risk for wound infections after surgery.
4. Appendicitis is less common in people who eat foods high in fiber so eat very low.

Healing Pain in Acute Appendicitis

1. Assess the level of pain, location and characteristics of pain.
Rationale: To determine the extent of pain and is an indicator of early to be able to give further action.

2. Encourage deep breathing.
Rationale: deep breathing, can breathe oxygen adequately, so that the muscles into relaxation so as to reduce pain.

3. Perform gate control.
Rationale: The gate control large diameter nerve stimulating small-diameter nerve so that pain stimuli are not forwarded to the hypothalamus.

4. Give analgesics.
Rationale: As a prophylactic in order to relieve pain (if already know the symptoms for sure).

Privacy Policy

Sunday, April 28, 2013 · 0 komentar

If you require any more information or have any questions about our privacy policy, please feel free to contact us by email at sdridiahnurhayati@gmail.com.

At http://nanda-2013.blogspot.com/, the privacy of our visitors is of extreme importance to us. This privacy policy document outlines the types of personal information is received and collected by http://nanda-2013.blogspot.com/ and how it is used.

Log Files
Like many other Web sites, http://nanda-2013.blogspot.com/ makes use of log files. The information inside the log files includes internet protocol ( IP ) addresses, type of browser, Internet Service Provider ( ISP ), date/time stamp, referring/exit pages, and number of clicks to analyze trends, administer the site, track user’s movement around the site, and gather demographic information. IP addresses, and other such information are not linked to any information that is personally identifiable.

Cookies and Web Beacons
http://nanda-2013.blogspot.com/ does use cookies to store information about visitors preferences, record user-specific information on which pages the user access or visit, customize Web page content based on visitors browser type or other information that the visitor sends via their browser.

DoubleClick DART Cookie
.:: Google, as a third party vendor, uses cookies to serve ads on http://nanda-2013.blogspot.com/.
.:: Google's use of the DART cookie enables it to serve ads to users based on their visit to http://nanda-2013.blogspot.com/ and other sites on the Internet.
.:: Users may opt out of the use of the DART cookie by visiting the Google ad and content network privacy policy at the following URL - http://www.google.com/privacy_ads.html

Some of our advertising partners may use cookies and web beacons on our site. Our advertising partners include ....
Google Adsense


These third-party ad servers or ad networks use technology to the advertisements and links that appear on http://nanda-2013.blogspot.com/ send directly to your browsers. They automatically receive your IP address when this occurs. Other technologies ( such as cookies, JavaScript, or Web Beacons ) may also be used by the third-party ad networks to measure the effectiveness of their advertisements and / or to personalize the advertising content that you see.

http://nanda-2013.blogspot.com/ has no access to or control over these cookies that are used by third-party advertisers.

You should consult the respective privacy policies of these third-party ad servers for more detailed information on their practices as well as for instructions about how to opt-out of certain practices. http://nanda-2013.blogspot.com/'s privacy policy does not apply to, and we cannot control the activities of, such other advertisers or web sites.

If you wish to disable cookies, you may do so through your individual browser options. More detailed information about cookie management with specific web browsers can be found at the browsers' respective websites.

About

· 0 komentar

nanda-2013.blogspot.com is an online nursing resources to nursing students and current nurses. With this blog I want to be able to share and discuss my thoughts on healthcare, nursing, and nursing education issues with nurses from all over the world.

To search this website, please use the listings in the column on the upper left corner of this screen. You can also use the navigation bar that is in the top portion of this screen. Please be aware that if you click on the ‘labels’ that you will see at the right side of this screen.

I hope you enjoy my blog and I hope to hear from you. Please email me any questions you have about anything you see on my blog or about any aspect of nursing. I also look forward to reading your comments and suggestions.

Popular Posts

Site Sponsors